Feb 13, 2015, 5:06 PM, Posted by
Sometimes it feels like we take one step forward, two steps back when it comes to making sure that we are getting the best quality health care for the tremendous amount our society invests in it. Maybe sometimes it’s one step forward, three steps back.
But then I think about Aligning Forces for Quality—RWJF’s signature initiative to lift the quality and equality of care in 16 regions around the country—and my hope returns. While progress is slow, it is still progress.
More than 10 years ago, RWJF’s leadership suggested to me that we change course in our health care quality improvement strategy. Instead of testing single interventions in widely scattered sites, they asked, why not focus on a limited number of target communities where we could go deep with multiple approaches? We knew health care is essentially local, though shaped by state and federal policy.
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Jan 27, 2015, 4:38 PM, Posted by
“If you’ve been waiting more than 15 minutes, please see the receptionist.”
That’s the sign that was posted on a bulletin board in the radiology clinic where I was waiting for an MRI earlier this month. The funny thing? It was so lost amid the other postings around it screaming for attention that I only saw it on my way out, as I waited for a copy of the disk with my MRI on it. It struck me as odd, and a little concerning; did that mean I should be worried the clinic staff might have forgotten about me if I’d been waiting more than 15 minutes?
Don’t get me wrong: I understand that unpreventable delays happen. For me, the most frustrating aspect of signs like this is that they take the power away from the patient.
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Dec 22, 2014, 2:58 PM, Posted by
Pooja Mehta, MD, is a generalist obstetrician/gynecologist and a second-year Robert Wood Johnson Foundation (RWJF) Clinical Scholar at the University of Pennsylvania, with support from the Department of Veterans Affairs. Rebekah Gee, MD, MHS, is Medicaid Medical Director for the state of Louisiana, an assistant professor of health policy and management, and obstetrics and gynecology at Louisiana State University and an alumna of the RWJF Clinical Scholars program.*
The theory of disruptive innovation seeks to explain how complicated, expensive systems may eventually be replaced by simpler, more affordable solutions, driven by new entrants into a market who “disrupt” an older, less efficient, and less accessible order.
In the new issue of Current Opinion in Obstetrics and Gynecology, we track the history of the RWJF Clinical Scholars program (CSP) in the field of obstetrics and gynecology, and offer a curated selection of pieces that suggest that our discipline—now peppered with experts in health services research and health policy trained through the CSP—could be teetering at the precipice of an era of such disruptive innovation.
Highlighting the work of nine current and past scholars, among more than 40 Clinical Scholars working in the field of obstetrics and gynecology, this journal issue covers a range of cutting-edge concepts currently being developed and employed to transform our field from the inside out.
Nathaniel DeNicola, MD, (‘11) discusses the potential uses of social media to disseminate and advance new findings and recommendations to broader audiences. Laurie Zephyrin, MD, MBA, (’03) illuminates how efforts to integrate systems, create interdisciplinary initiatives, and how research-clinical partnerships have allowed for rapid organizational and cultural change and have advanced reproductive health care in the Veterans Affairs system.
Elizabeth Krans, MD, (‘09) writes about ways in which new public funding is allowing for disruptive innovation in the delivery of prenatal care—for example, through dissemination of the highly decentralized, patient-driven Centering Pregnancy model. Working from within a city health department, Erin Saleeby, MD, (‘10) writes about how participatory approaches to public health governance can engage community and clinician leaders in the process of redesigning reproductive care and transforming outcomes.
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Dec 12, 2014, 1:34 PM, Posted by
More and more health care costs are shifted to consumers. So why, asks RWJF President and CEO Risa Lavizzo-Mourey, can’t we easily discover and compare health care costs and quality?
Here’s how the subject came up. Recently, Lavizzo-Mourey underwent cataract surgery at an outpatient center in Philadelphia. No matter whom she talked to—and she was shunted from one person to the next—she could not learn the all-in cost of the procedure.
Lavizzo-Mourey finally did manage to find out the cost of her surgery: $2,000, including co-pays and deductible. But the whole episode, she says, is illustrative of a larger problem.
Writing in a recent blog post on the professional social networking site LinkedIn, Lavizzo-Mourey asks: “Could there be a clearer example of the lack of transparency in the U.S. health care system?”
To get the information we need, the Robert Wood Johnson Foundation is funding a set of studies to help us better understand how greater price transparency influences consumer and provider decisions. “And in March,” Lavizzo-Mourey adds, “we will host a summit on transparency that will attempt to come up with more answers."
Along those lines, RWJF last year issued a challenge to developers to devise consumer-friendly tools to parse the abundant hospital price data released by Medicare. The winner? Consumer Reports, for the Consumer Reports Hospital Adviser: Hip & Knee, a personalized app for health care consumers seeking the best hospital for hip or knee replacement surgery.
You can help us move the cost and quality needle forward. Do you know of any other price/quality apps or tools? Let us know.
Dec 4, 2014, 9:00 AM, Posted by
Ed Wagner, MD, MPH, is director emeritus of the MacColl Center for Health Care Innovation. A general internist and epidemiologist, Wagner was founding director of Group Health Research Institute.
Better care. Healthier patients. Happier staff. A new online resource provides practical, hands-on tools to build better primary care teams that can put those outcomes within reach.
Nationwide, primary care practices are finding that creating more effective practice teams is the key to becoming a patient-centered medical home, improving patients’ health, and increasing productivity. The Improving Primary Care Team Guide (Team Guide) is a free online resource for primary care practices working to do just that. It:
- Provides hands-on tools and resources that are actionable and measureable
- Is appropriate for practices at any stage of development
- Includes modules that enable practices to easily pinpoint relevant topics and areas of interest
The new Team Guide presents practical advice, case studies, and tools from 31 exemplary primary care practices across the country that have markedly improved care, efficiency, and job satisfaction by transforming to a team-based approach. For the last three years, with funding from the Robert Wood Johnson Foundation (RWJF), the LEAP team has identified, studied, and engaged these practices to develop the lessons contained in the Team Guide.
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