Apr 13, 2017, 10:00 AM, Posted by
From a dementia village to the next AirBnB for seniors, global entrepreneurs are searching for ways to improve the lives of a rapidly aging population. Their lessons can inform efforts right here in the United States where the elderly population is expected to more than double by 2060.
Through the plate glass window of the café where I sipped my coffee, I watched an older gentleman bend to pick something off the ground. He did this repeatedly: down and up, down and up. I learned that he did this every day for hours, picking up fallen leaves.
The man had dementia and lived in Hogewey, a community outside Amsterdam where older people with advanced dementia lead largely autonomous lives in familiar, welcoming surroundings. This particular gentleman liked to pick up leaves—and why not? It did him no harm; in fact, it gave him a little exercise, and he probably found the activity relaxing.
Hogewey is unique—a gated, village-like community where those with dementia live in small-group homes that look and feel like real homes, with people of similar backgrounds and experiences. Caregiving and other staff support them in everyday activities and blend into the environment, serving as grocery store clerks, hairdressers, bartenders, and neighbors.
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Jan 3, 2017, 3:00 PM, Posted by
Susan Mende, Tara Oakman
In Europe, rich and poor kids alike are enrolling in early care and preschool programs in large numbers. These accomplishments offer us insights for our collective efforts to strengthen early education in the U.S.
For the past 18 years, every 4-year-old in Oklahoma has been guaranteed a spot in preschool, for free. These kids are learning their letters, numbers, colors and shapes. They’re also developing arguably more important social and emotional tools--how to make friends, feel empathy, solve problems, manage conflict. These are the kind of building blocks children need to become thriving adults.
Nearly 75 percent of 4-year-olds are enrolled in Oklahoma’s pre-K program. That's one of the highest participation rates in the country. But if we look across the United States, we see that just 61 percent of kids between the ages of 3 and 6 are enrolled in pre-K, daycare or other formal early childhood education program.
Why? Of course, many parents stay home or have a friend, neighbor or relative take care of their kid. But a recent Harvard poll of parents with children under the age of five highlights the struggles families face in finding quality, affordable child care. Many parents reported having limited options and said that the cost of child care had caused financial problems. Low-income families were especially likely to report difficulty accessing care.
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Oct 5, 2016, 9:35 AM, Posted by
Laura Leviton, Susan Mende
Disease registries designed to support clinical research can be reimagined to create a new and more effective kind of patient-centered care. Just take a look at Sweden.
Large-scale collection of patient data into disease-specific databases, or registries, is vital to research. These registries house standardized information on patients’ diagnoses, care, and outcomes, supporting large-scale comparison and analysis which can lead to better population health management and interventions. But can disease registries also help to move us closer to patient-centered care?
We’re learning from examples overseas that, with the help of new interactive technologies, they can.
Sweden created a disease registry for rheumatology that is much more than a data storage house. The Swedish Rheumatology Quality Registry (SRQ) is an interactive tool that helps patients and doctors prepare for and make better use of their office visits. It helps them to work like a team—to “co-produce” care together.
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Feb 2, 2016, 10:49 AM, Posted by
What happens when patients gain access to the notes their doctors and nurses take during a visit? A culture shift with empowered and motivated patients at the center.
In December I was proud to announce an exciting partnership with three other foundations—the Cambia Health Foundation, Gordon and Betty Moore Foundation, and the Peterson Center on Healthcare—to take a bold step to expand access to clinical notes written by doctors, nurses, and other clinicians to 50 million patients nationwide. The $10 million in new funding to OpenNotes will allow the initiative to dramatically step up its efforts to create a new standard of care and set a new bar for patient-centeredness.
We know that physicians can help their patients become more engaged in their own care, and that this kind of patient activation can lead to improved outcomes and lower health care costs. Of course, that is easier said than done—especially when clinicians are already under pressure to adopt new technologies, implement new models for delivering health care, and make data on the quality of their care publicly available.
Health care innovators are unrelenting in their search for simple, scalable solutions to help both clinicians and consumers—and philanthropists can help put these bright ideas to the test to determine what works. OpenNotes is one such solution.
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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.
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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Jun 11, 2013, 10:25 AM, Posted by
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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