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Saturday, May 18, 2002
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Remote e-mail to your weblog (Radio site). I figured out how to send updates to my weblog from e-mail anywhere. That will come in handy. The only trick is that you need another dedicated e-mail account.
1:19:04 PM 
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Stories or Weblogs. If our logs are to be navigable we either need to find a way to only present the top couple of lines and then link or expand OR use "stories" feature and link to those form a weblog.
12:19:02 PM
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Interactions the antidote for isolation. I am beginning to like this. The reason is that for a babble brain like myself it is an outlet in an otherwise isolated environment. I can see that the exchanges/interactions could become very rewarding in a purely selfish way. But, whatever rings your bell could result in music. [Bill Mahoney's Radio Weblog]
12:19:02 PM
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Medication Hand-offs from Hospital to Community.
From Mary Minniti, Project Manger of Pursuing Perfection and Carol Boston, Director of Clinical Quality for PeaceHealth:
Hi All:
As we move into implementation of our Pursuing Perfection Phase II effort, a number of work teams are being formed. We are blessed with a wonderful opportunity to focus some attention on the issue of medication safety and hand-offs now to get us started. Carol Boston will be leading a team to focus on improving the medication hand-offs between hospital and the community. The aim is to decrease medication list inaccuracy between venues for CHF patients. This project has been scoped and team members are being identified. Either Carol or myself will be contacting those potential members to confirm their ability to participate. As is the case with RWJ efforts, this team will launch quickly. Tentative first meeting is slated for May 9th from 7- 10 am and a follow-up the week of May 20th.
You are receiving this email as an FYI. We would appreciate your support in this effort and we will keep you informed of progress. Clearly, there are many things to do and unlike the work of the core team- to write a grant, transforming healthcare will take a much larger and expanded group. So core team members will not all be able to participate in all activities. However, by keeping communication lines open, we can ensure thoughts and ideas are shared. Stay tuned for details.
Feel free to share this with others as appropriate. Carol Boston is the lead and questions can be directed to her.
Thank You!
Mary Minniti, CPHQ, Project Manager
8:19:06 AM
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Patient ACTIVATION, the key to care planning and resource deployment.. From: Bill Mahoney [mailto:bilmah@telebyte.com]
Sent: Monday, May 06, 2002 9:49 AM
To: Minniti, Mary
Subject: Activated Patient
Hi Mary
As you know I have been working with Judy Hibbard's RWJ data trying to build a measure of how activated is a patient. I have a measure that makes good theoretical sense, is consistent with the research in this area and works quite well.
I just wanted to let you know what is available and what next steps I would suggest to complete this.
I will leave it at that and let you respond, but a few things:
- All of this stuff (activated patient, patient-centered care, team development, culture of patient-centeredness, leadership, outcomes) is integrated around the central concept of patient-centeredness. And all of this is integrated with readiness to change, how change occurs and selg-perception theory (I can give you the model if interested).
- The measurement of how much activation is the up front piece for every patient since this is what optimally serves as the information on which the care plan is built and the care team resources are allocated. Using this in this manner will result in the most effective use of resources and the most targeted care.
- Perhaps it would be useful to meet with the teams (CHF, Diabetes, ?) and discuss this and other needs they think they have. I suspect there are reasonable and unknown needs.
Just some thoughts. Let me know your needs.
Bill
8:19:05 AM
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Acute Care Hospital, measures related to quality.
Common Measures
1. Adverse Drug Events (ADEs) per 1000 doses (Safety)
2. Mortality rates (Effectiveness)
3. Readmissions (Effectiveness)
4. Time to treatment on presentation (Timeliness)
5. Functional status, Quality of Life (Patient centered)
6. Average cost per case (Efficiency)
7. Average length of stay (Efficiency)
8. Hours of diversion per month (Efficiency)
9. Patient satisfaction (Patient centered)
8:19:04 AM
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Access to Care, Measurements of. Common Measures
1. 3rd next available appointment (effectiveness)
2. Total time for a visit (efficiency)
3. # of patients on a wait list to be assigned a primary care physician (effectiveness)
4. Percent of patients “highly satisfied” with appointment scheduling (patient centered)
5. Percent “no show” (efficiency)
8:19:04 AM
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Boston U. Sch. of Health Poligy to evaluate Pursuing Perfections Sites..
From: Fiorillo, John (Robert Wood Johnson Foundation)
Sent: Wednesday, May 15, 2002 3:13 PM
To: Bitting, Nancy J.
Subject: Pursuing Perfection Evaluation
To Pursuing Perfection Phase II CEOs
During prior meetings of the Pursuing Perfection grantees we've briefed you on the Foundation's plans to evaluate this program. We're happy to tell you that, after an excellent competitive process, we've selected a team composed of several national experts in health services research from the Boston University schools of management and public health to conduct the evaluation of Pursuing Perfection.
The team will be led by Dr. Martin Charns who, in addition to his role in the School of Public Health, is Director of the Management Decision and Research Center at the Veteran's Administration. Another key member of the team is Dr. Alan Cohen, Professor of Health Policy and Management at the School of Management. Dr. Cohen is a former Vice President for Research and Evaluation of RWJF. It is important that this team begin working with each of you as early in your implementation efforts as possible, so we have asked that they conduct initial site visits during June. A member of the evaluation team will be contacting you shortly to arrange a visit during which they would like to conduct initial interviews with key staff members. We realize that scheduling for June may require some accommodations in scheduling, but it's important that the team have an understanding of what you're trying to accomplish right from the beginning.
The Boston University team will be present at the May 29th meeting to introduce themselves and answer your questions about the evaluation.
We know you understand how important this evaluation is to building an understanding of how others may follow your example in pursuing perfection in health care. We also believe this team brings expertise to the overall effort that will enhance your ability to achieve your ambitious goals.
Sincerely,
John Fiorillo Linda Bilheimer
Senior Consultant Senior Research and Evaluation Officer , RWJF RWJF
8:19:03 AM
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6 Aims and 10 Simple Rules for more perfect heathcare, Institute of Medicine. The key ideas behind this entire Institute of Medicine approach includes six goals:
1. Safe, 2. Effective (evidence based), 3. Patient-centered, 4. Timely, 5. Efficient, and 6. Equitable; and ten simple rules:
1. Continuous healing relationships
2. Customization
3. Patient control
4. Shared information
5. Evidence-based decision-making
6. Safety as a system property
7. Transparency
8. Anticipation of needs
9. Continuous decrease in waste
10. Cooperation among clinicians
8:19:03 AM
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Patient Centered care, the relationship between measruement and care team behavior.. Bill Mahoney begins the open dialogue on Patient Centered care when he posts:
Activated patientness is not a trait but a state. The state is created by the care team (in whatever form) providing patient-centered care. The only importance of patient traits is that they (e,g, locus of control, self-esteem, soci-economic status, location in the social structure) specify the probability of x level/type of patient-centered care activity resulting in y level of activation. The biggest barrier (if the focus groups done 2 years ago tell us anything) is not the patient, but the provider. Building patient-centered care (CCM's productive interactions) is identical to building team development (it is team development.....patient as full partner in the care team). The absolutely essential foundation of patient-centered care is the creation of team cohesiveness (see team measure) and this will require that providers redefine their role, the patient's role and the nature of the patient-provider relationship. My hypothesis is that few will be willing to go there and we may easily revert to blaming it on those noncompliant patients...an animal that does not exist. [Bill Mahoney's Radio Weblog]
8:19:03 AM
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Cooperation and communication are related.
If we are to begin to cooperate/communicate with web logs we probably need some instruction in "reporting". I am thinking about getting a news paper reporter and some professor types from the university to help us learn to communicate in this style. I wonder if someone from the Weblogging community might not have some good ideas too.
8:19:01 AM
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© Copyright 2002 Marcus Pierson, MD.
Last update: 5/25/2002; 8:26:14 PM.
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