Archive for: August 2013

Scaling Equals Cultural Transformation

Aug 31, 2013, 9:51 PM, Posted by Jane Isaacs Lowe

Greenhouse_16

On RWJF’s Vulnerable Populations team, we look for ideas that we believe are going to transform a field; that will create the impetus for significant social change. When we find those ideas, our goal is to take them to scale.

Contrary to popular belief, scaling does not mean hiring more people or growing a bigger organization. When we talk about scaling, it’s about supporting an idea to allow for radical transformation. It is our contribution to creating a culture of health.

One of the ideas that we’re currently working to take to scale is the Green House Project, which aims to transform the culture of long-term care. We’ve tested the model repeatedly in a number of locations and now we’re trying to get it greater national visibility so that it can have the significant impact on the field of long-term care that we believe it can—and should.

View Full Post

Rx for Delivery System Transformation: Satisfied Doctors Who Find More Joy in Practice

Aug 20, 2013, 4:32 PM, Posted by Susan Dentzer

Susan Dentzer

In my last post, I wrote about what would best motivate physicians to transform health care: carrots, sticks or something else. The case for “something else” was made in a series of innovation sessions presented at a recent American Board of Internal Medicine (ABIM) Foundation forum. They focused on evolving health care delivery models aimed at increasing quality, decreasing cost and enhancing patient-centered care.

Readers of Daniel Pink’s book Drive will be familiar with his thesis about “Type I” human behavior: the kind that is less concerned with “the external rewards to which an activity leads and more with the inherent satisfaction of the activity itself.” Many innovations presented at the forum echoed that theme—augmenting the satisfaction that doctors get from focusing most of their attention on helping patients.

Engaging doctors: At the forum, Craig Sammit, the CEO of Wisconsin-based Dean Health noted that “extrinsic” motivators, such as showing doctors how their relative performance data stacked up against their peers, had substantial impact in spurring improvement. But he observed that the measures that were most effective in transforming the way care is delivered  at Dean were those that helped make the organization “the best place for a physician to work.”

View Full Post

Move Over, Richard Kiley. Here’s Why We Want to Combine Public Health Data with Health Care Data

Aug 19, 2013, 9:00 AM, Posted by Paul Tarini

Calit2

We’re announcing today a new $100,000 prize as part of the Knight Foundation’s latest News Challenge, which seeks innovative ideas to harness information and data for the health of communities. The RWJF award is for those entrants who combine public health data with data from health care to improve the health of communities. The Knight Foundation itself has committed $2 million to the contest, as well.

The reason we want to combine public health data with health care data is because of the potential the combined data has to drive real improvements and innovation. When we were discussing this, one of my colleagues broke out with “To dream the impossible dream.” While he couldn’t match Kiley’s sonorous baritone, he did capture the ambition in the song.

View Full Post

Diversity Is a Window: It Lets Light In and Out

Aug 15, 2013, 5:17 PM, Posted by Culture of Health Blog Team

DSC_3031_HIRES

When patients carry racist attitudes into the health care setting along with their illnesses and injuries, how should nurses and other providers of color respond?

While some patient attitudes can be insulting, to say the very least, Angela Amar, PhD, RN, FAAN, says such a patient encounter can also provide a learning opportunity.

In a post on RWJF's Human Capital blog, Amar recalls a particularly challenging incident when she was a new nurse. "I had just entered a patient’s room when he called out from the bathroom to ask his wife who was there," Amar writes. "She replied, 'it’s a lil’ colored girl to see you.'”

View Full Post

Carrots, Sticks, or Something Else? Motivating Doctors to Transform Health Care

Aug 14, 2013, 2:14 PM, Posted by Susan Dentzer

craigsammitforumedited Craig Sammit, MD, president and CEO of Dean Health System, and Holly Humphrey, MD, dean for Medical Education at the University of Chicago Pritzker School of Medicine

An old joke has it that the doctor’s pen is the costliest technology in medicine, since money typically flows where physicians’ prescriptions and other orders decide that it should go. As a result, influencing these decisions is key to achieving the Triple Aim of better health and health care at lower cost.

But what’s more likely to influence doctors: external factors, such as bonuses for improving the quality of care, or internal factors, such as appealing to their sense of altruism or satisfaction with their work?  In other words, carrots, sticks, or something altogether different—what Daniel H. Pink, author of Drive, calls “our innate human need to direct our own lives, to learn and create new things, and to do better by ourselves and our world”?

View Full Post

Childhood Obesity Is Everybody's Problem

Aug 9, 2013, 9:59 AM, Posted by Risa Lavizzo-Mourey

Risa Lavizzo-Mourey

Why? Because, aside from the deleterious impact on the health of kids individually, childhood obesity can have an adverse effect on “our economy, our health care system, and our future,” writes RWJF President and CEO Risa Lavizzo-Mourey, MD, in a new blog post on the professional social networking site, LinkedIn.

So what can you do? Quite a bit, Lavizzo-Mourey concludes.

The rate of childhood obesity has been soaring for more than three decades. That has been cause for deep distress, and still is. All the same, she writes, there is new reason for hope, and it is to be found in the findings of an August 6 report by the Centers for Disease Prevention and Control (CDC).

The report suggests that, for the first time, obesity rates dropped in 18 states and one U.S. territory in recent years for low-income children ages 2 to 4.

The report, while not cause for complacency, suggests that—although childhood obesity is still a major health concern—there are steps we can take to arrest and reverse the epidemic.

“The diverse group of states and communities with declines have instituted a wide range of programs to help families make healthy choices where they live, learn, play, and work—programs that can be adapted and scaled up by other regions,” Lavizzo-Mourey asserts. “All of these communities have one important thing in common—they have made childhood obesity prevention a priority.”

In 2007, the Foundation pledged $500 million to meet a goal of reversing the epidemic by 2015. “We know we can do it,” Lavizzo-Mourey writes, “but we can’t do it alone.”

Another Sign of Progress on Childhood Obesity

Aug 6, 2013, 2:00 PM, Posted by Jim Marks

 A young girl eating an apple.

Today, the Centers for Disease Control and Prevention reported that obesity rates among young children from low-income families are falling in 18 states and one U.S. territory—and rising in only three states. 

What an important sign of progress for all of us working to reverse the childhood obesity epidemic! It’s especially terrific because it builds on recent positive news coming from all across the nation.

Childhood obesity rates are falling in states like West Virginia, Mississippi, New Mexico and California. They’re dropping in big cities like New York and rural areas like Vance and Granville Counties, North Carolina.

Today’s news is of falling obesity rates among children participating in federal health and nutrition programs, such as the Special Supplemental Nutrition Program for Women, Infants, and Children program, better known as WIC. These are young children in low-income families. Children who have been at the highest risk for obesity and whose families have had the most limited chances to make healthy choices. So this is huge.

View Full Post

Building a Better EMR

Aug 5, 2013, 9:43 AM, Posted by Kyna Fong

Moyer_100826_00325_RET

As co-founder of ElationEMR, Kyna Fong and her brother Conan hope to revolutionize the way physicians use electronic medical records (EMRs). In this blog post, Fong, a former Robert Wood Johnson Foundation (RWJF) Scholar in Health Policy Research (2008-2010) and assistant professor of economics at Stanford University, explains how her new product helps physicians and nurses embrace the future of medicine. You can read more about how technology is being used in health care settings here.

Caring for patients is becoming increasingly complex. A whopping 68 percent of Medicare beneficiaries have multiple chronic conditions and, of those, 54 percent have four or more.

There is no doubt that innovations in information technology are essential to meeting this challenge and improving the quality and effectiveness of health care. New data streams are creating increasingly rich stories of our individual health—chronicling how we eat, sleep, exercise, and even what our genes predict.

New modes of delivering care are arising as new technologies offer more precise, more accessible vehicles to manage our health, including telemedicine, remote monitoring, connected messaging, and smart devices. What’s blatantly missing in these tools of the future, however, is a full understanding of how to connect with the key individuals who deliver care: physicians and nurses.

View Full Post

Don't Believe Everything You Read

Aug 2, 2013, 12:22 PM, Posted by Pam S. Dickson

Close up of a mans hand in surgery

Does anybody commute to work anymore without passing by a huge billboard promoting world-class health care at a nearby hospital or surgicenter?  I know I see enough of them to have become pretty calloused to their messages.  But then, I don’t need health care right now.

What if I did?  Could I count on these extravagant advertisements to give me good guidance about where to seek care?

Unfortunately, the answer is probably not.

View Full Post