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Author Archives: Susan Mende

We Went to Oxford and Got Schooled in Primary Care

Apr 23, 2015, 9:00 AM, Posted by Maryjoan Ladden, Susan Mende

As other countries continue to spend far less on health care but perform better on measurable health outcomes, there's opportunity to learn what works abroad and apply those lessons stateside.

Oxford University

It’s a hard notion for many Americans to accept—although we spend more money on health care than any other country in the world, we are far from having the best health outcomes. When you look at measures that include life expectancy, infant mortality rates and preventable illness, other countries that spend far less than the U.S. perform better. But in many of these countries people of all ages and socio-economic status are able to easily access primary care that is comprehensive, patient-centered and rooted in local communities.

One of our goals as program officers at RWJF is to look beyond our borders to identify promising practices that might be incorporated into America’s health care system. Last fall we traveled to Oxford, England, to learn first-hand about promising primary care practices in Chile, England, the Netherlands and Canada—all high and middle income countries that spend less on health care yet have better outcomes than the U.S. We attended a conference organized by the Training and Research Support Centre (TARSC), an organization supported by Charities Aid Foundation of America through a grant from the RWJF Donor-Advised Fund. TARSC provides support and training to government and civic health organizations, and the conference was the next step after its report, “Strengthening primary care in the USA to improve health: Learning from high and middle income countries.” We came away with a lot of insights from both, but were struck by several themes that were constant throughout.

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Field Notes: What Cuba Can Teach Us about Building a Culture of Health

Jan 29, 2015, 9:54 AM, Posted by Maryjoan Ladden, Susan Mende

MaryJoan Ladden and Susan Mende Trip to Cuba

Ever since President Obama announced the restoration of diplomatic ties between the United States and Cuba, there’s been growing excitement over the potential for new opportunities for tourism, as well as technology and business exchanges. Most people assume that the flow will be one-sided, with the United States providing expertise and investment to help Cuba’s struggling economy and decaying infrastructure.

That assumption would be wrong. America can—and already has—learned a lot from Cuba. At RWJF, we support MEDICC, an organization that strives to use lessons gleaned from Cuba’s health care system to improve outcomes in four medically underserved communities in the United States—South Los Angeles; Oakland, Calif.; Albuquerque, N.M.; and the Bronx, N.Y. Even with very limited resources, Cuba has universal medical and dental care and provides preventive strategies and primary care at the neighborhood level, resulting in enviable health outcomes. Cuba has a low infant mortality rate and the lowest HIV rate in the Americas, for example—with a fraction of the budget spent in the United States.

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A New Nurse's Naivety

Jun 11, 2013, 10:25 AM, Posted by Susan Mende

 A nurse updates information on a white board in a hospital patient's room.

After getting my nursing degree in 1980, I got my first nursing  job at Presbyterian Medical Center in San Francisco. At the time, many of the experienced nurses had been hospital trained and  lacked bachelors degrees. So where did they put me? In charge, of course! I worked the night shift. It was notoriously understaffed, and ripe for crises. I can remember the terror I felt when I realized that I did not have the experience or judgment to lead the team. I had this overwhelming feeling that I was way in over my head. I didn’t sleep for a month.

In a new book, True Stories of Becoming a Nurse, a series of essays about new nurses, one author recounts the transformation of the nursing workforce from “the old guard, the hospital-trained, diploma-prepared nurses” to nurses like me who had a bachelor’s in nursing (BSN). I had my degree, but I still had so much to learn.

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