Supporting Safer Healthcare

On Tuesday, January 31 the American Telemedicine Association will host an important Capitol Hill briefing entitled, “Physician Licensure Barriers to 21st Century Healthcare.”  This public briefing is designed to inform Congressional offices, national organizations and other key stakeholders about how the current U.S. state-based systems to license and regulate physicians unduly restrict quality modern healthcare. Speakers will share constructive ideas for medical licensure reform.

The briefing will be held in the Russell Senate Office Building Caucus Room (SR-325) on Tuesday, January 31, 10:00 a.m. – 11:30 a.m.

This event is free and open to the public. To attend, please RSVP at http://www.americantelemed.org/briefing.

The briefing is part of ATA’s larger effort to promote the deployment of interstate telemedicine, by reforming the U.S. medical licensure system.  For more information about ATA’s activities in this area, please visit http://www.fixlicensure.org.

ATA Policy on State Medical Licensure

Aging physicians on your medical staff are a cause for concern.  Not just concerns regarding their ability to continue to safely care for patients, but concerns for them as valued friends and colleagues, for their dignity and self-esteem.

Medical staff leaders struggle with what, if anything, to do when faced with this dilemma.  Should the clinical privileges of older staff members be limited?  Should they be forced to retire?  Many leaders choose to look the other way, especially when the practitioner is well-loved in the community and no patients have come forward to complain.  That philosophy, however, comes at a price; a high one if a patient ends up being harmed and an older, well-respected, physician’s mistake is the cause. 

Although there are no “one-size-fits-all” answers, Dr. Kenneth Cohn brings the discussion to the fore with a post on Hospital Impact. 

“The CEO and I brainstormed together when I asked him, “How does this physician want to be remembered?” Legacy becomes increasingly important when the marginal value of seeing one more patient diminishes.”

“Then his eyes brightened when I asked, “Does he have a special healthcare cause that he wants to support? Maybe, he could solicit contributions from grateful patients and their families.”

Seeing “one more patient” may not be in the best interest of anyone in this scenario, but older physicians have much to offer.  Their wealth of experience and tenure are valuable assets to the hospital and community.  They are often in an excellent position to act as advisers, or even take the lead, on medical staff projects and committees, especially those dealing with today’s complex issues.

The skill sets of older physicians may be changing, but they remain valuable.  It may simply be a matter of finding the right match of skill and need.

St. John’s Hospital in Joplin was destroyed by a tornado in May 2011.  The damage was so severe that the remaining structure is about to be demolished.

There is good news for Joplin and St. John’s however, ground will be broken at the end of this month on a new hospital.

Best wishes Joplin, for a speedy recovery.

NBC’s Today Show looks back at the past year.

Visit msnbc.com for breaking news, world news, and news about the economy

Is your boss happy with your work?  If you think he or she must be because “no news is good news” you may be so wrong.  As Alison Green reveals in 10 Things Your Boss Isn’t Telling You, bosses are human and some of them avoid conflict, even when having a difficult conversation is called for. 

If you manage employees, you know that it is a challenging task. Even if your team is great, keeping them educated, motivated and focused requires energy and effort. If you have one or more problem employees, the effort required increases exponentially.

Dr. Frank Benest reminds employees that they must work to understand their supervisor’s communication style in Communicating With Your Boss. 

“To enhance communications, you need to figure out how your boss prefers to communicate. Is your manager informal or formal? Does your boss like for staff to simply pop into her office with a new idea or make an appointment? Does your manager like to talk about an idea first, or does she prefer to get a memo or email first, read it, and then talk about the issue? …”

Good communication is a key component of all successful relationships, both personal and professional.

Whether living in interesting times is a blessing or curse, the health care market in Western Pennsylvania is certainly stirring up interest these days. 

The Pittsburgh area boasts two large, well-established health systems, one considerably larger and more financially stable than the other.  In the interest of full disclosure, I work for the smaller of the two systems.  

As those of you who follow health care finance already know, the West Penn Allegheny Health System is in the process of being acquired by Highmark Blue Cross Blue Shield.  The courtship and impending marriage of this unlikely duo has been closely watched by both regulators and the public. Many are hopeful that the couple will be able to live happily (and prosperously) ever after, perhaps even giving birth to a clever new delivery model.

The drama is heightened by the oh-so-public squabble between Highmark and West Penn Allegheny’s powerful neighbor, UPMC.  Highmark and UPMC were inseperable until Highmark started making eyes at West Penn.  The rift has the locals worried.  UPMC, like all providers, offers an in-network discount for patients covered by contracted insurance.  Now that Highmark is engaged to another, UPMC has flatly refused Highmark’s interest in discussing a contract.

Many people in Western Pennsylvania hold Highmark insurance, and many of those same people have long-standing relationships with UPMC physicians.  Change insurance?  Change physicians?  Pay more to keep both?

Interesting times indeed.

Additional Reading:

• Highmark Deal Would Make it a Health Care Pioneer – Pittsburgh Post Gazette
• Highmark Shares Details of West Penn Acquisition Plans – Modern Healthcare
• Highmark West Penn Map Out Plan – Pittsburgh Tribune Review

This week’s edition of Grand Rounds – The Myth Busters edition, is up at GetBetterHealth.com.

http://getbetterhealth.com/grand-rounds-vol-8-no-7-myth-buster-edition/2011.11.08

When you have overnight guests in your home, chances are you do all you can to make their stay as comfortable as possible.  In a sense, patients are guests in our “house,” but often they find their overnight accommodations anything but comfortable and restful.

Hospitalized patients often complain “How am I supposed to sleep when…”

My room is close to the nurse’s station and it sounds like a party all night

Keeping in mind that caregivers are human, and humans sometimes talk or laugh loudly, the built-in conflict is obvious.  The patient may be sleepy, but those who work the night shift are trying hard not to be. 

I got a new roommate at 2:00 a.m.

Just try sleeping through furniture rearranging, conversation, and of course the obligatory stamping of multiple documents, causing the addressograph machine to be enthusiastically wacked down 25 times out at the nurse’s station.

Carts and equipment squeak up and down the hallway at all hours

My roommate:  (The list is daunting… )

• Snores
• Coughs / cries / moans / wanders all night
• Watches television all night
• Talks on the phone all night
• Entertains visitors all night
• Et., etc.

And who can blame the poor patient?  Everyone agrees that a sojourn to the hospital is anything but restful.  Since our goal is to help patients heal and improve patient satisfaction, what can be done?

Noise Reduction Strategies

• Install glass around the nurse’s station so the noise reaching patient rooms is minimized
• Mount sound monitors on the wall that display alerts when noise levels rise  
• Limit overhead and room to room paging
• Set cell phones and pagers to vibrate
• Turn down ringers on unit phones
• Consider piping in white noise during the evening to help mask other sounds
• Ask maintenance to ensure that all those wheely things going up and down the hallways move quietly, and that doors in patient areas do not bang shut.
• Give patients headphones for their television sets
• Offer ear plugs
• Keep the addressograph machine in an enclosed area – or better yet, use labels on documents for new admissions during the night.
• While most hospitals are establishing more liberal visitor policies, those policies need to allow enforcement of an expectation of consideration, especially in semi-private rooms and common areas
• Appoint unit champions to come up with additional noise reduction strategies for their area
• Place signs on patient floors reminding staff and visitors to use their “inside” voices  – reminders do  help since many people simply don’t realize they are being loud

Sleep deprived people are crabby people; let’s do our best to make everyone’s life a little better by offering any consideration we can to help our patients get the rest they need.

David Williams of Health Business Blog is our host for this week’s edition of Grand Rounds, the weekly compiliation of the best of medical blogosphere.  This week we’re learning about meaningful use and accountable care – two of the hottest topics in healthcare. 

David included a post from Supporting Safer Healthcare and tagged it “the stone age of medical blogging.”  He’s right;  there were few blogging platforms available in 2004 and 2005 when he and I joined this brave new world of social media.  Medical bloggers often wrote insightful, witty and educational posts in squinty Times New Roman font with no paragraph breaks. 

I forsee a wonderful opportunity to bore the younger generation with woeful tales of how tough it was “back in the day”  to produce a meaningful, accountable, blog while avoiding the horrors of broken html.  

Stop over at the Health Business Blog for a taste of both old and new.

Fierce Health IT recently published 11 Faces to Follow in Healthcare Social Media. 

Most healthcare organizations now use social media as part of their marketing strategy; some more effectively than others.  Many, if not all of the individuals on the Fierce Health IT list were early social media adapters.  I know that because I have connections through this blog to four of them. 

Supporting Safer Healthcare (originally called MSSPNexus) was established in 2004.  Medical blogging in the early days was a heady experience.  The number of medical bloggers was small, and we often found ourselves connecting through shared interests and through Grand Rounds, a weekly collection of medical posts started that same year by Nick Genes, MD, of Blogborygmi.com. 

 In 2005 a few of us had the pleasure of being interviewed by an early podcaster, and #3 on the Fierce Health List Kent Bottles.  Kent asked leading questions and made the experience of a 20 minute telephone interview fairly easy. 

Number 5 on the list is Ves Dimov.  Dr. Dimov and I worked at the Cleveland Clinic at the same time.  He is the founder of one of the most popular clinical blogs on the web, CasesBlog.  Ves pushed us all to use technology in new ways through his innovative use of the latest gadgets and software.

Kevin Pho of KevinMD  fame comes in at #8. Dr. Pho started his blog in 2005.  From the beginning he was a prolific poster; we all wondered how he managed to fit in his “day job” of practicing medicine.  Kevin has always had a unique wisdom about how to manage and market his blog, and today his is one of the most well-read and often-quoted blogs online. 

I would say that #9, Mike Sevilla is a fellow Ohioan, but since I recently moved to Pennsylvania we no longer share a state.  Dr. Sevilla authors Family Medicine Rocks, which is primarily a video blog.  He was among the first to make extensive use of video casting on his site, even when he wrote as Dr. Anonymous.  It didn’t take long for the medical credentialers (me) and others to figure out Dr. Anonymous’ true identity from the clues he scattered through his posts.  Dr. Anonymous did a bit of soul searching and then began writing and posting videos under his own name. 

Blogs were “cutting edge” social media back in 2004.  Since then Facebook, Twitter, Linkedin and others have captured our imaginations and increasingly short attention spans.  I don’t post here as often as I used to, but I just can’t bring myself to give up my little corner of the web.  On those occasions when an important story needs to be told, or I just find myself yearning to put thoughts to pixel, I like knowing there’s a place I can call home.

Congratulations to each of you on the Fierce Health IT list – through you and others like you, humans will continue to find new ways to communicate through technology.