Navigating Healthcare – Patient Safety and Personal Healthcare Management

News Round Up May 8 at 2:30 on #voiceofthedoctor

Posted in Uncategorized by drnic on May 19, 2012
The Weight of the Nation – The Obesity Epidemic

Top of my list this week is the films “The Weight of the Nation” from HBO over the last few nights. You can watch the films (without a subscription) and really should make a point of doing so. There are 4 episodes, 1 hour each and offer insights into the various challenges for people in dealing wiht obesity, what’s worked, what hasn’t. If there was one takeaway I got it was

“Take small steps you can be successful at”

So for example – instead of I want to loose 10 pounds, I want to loose 2.

Healthcare Challenges

The Health Care Innovation Awards that CMS is awarding to organizations for projects that:
  • deliver better health,
  • improved care and
  • lower costs
Focused mainly on patients that have the highest health care needs: HHS announces first 26 Health Care Innovation awards

It is a similar concept to the X-Prize that was so successful in Space and Exploration has now expanded to include Health and the Tri-Corder Prize

Projects include:

• Emory University’s collaboration with area health systems to train health professionals and use tele-health technologies to link critical care units in rural Georgia to critical care doctors in Atlanta hospitals.  This project aims to save money and improve the quality of care by reducing the need to transfer patients from rural hospitals to critical care units in Atlanta;
• Courage Center, which is a program in Minneapolis-St. Paul serving adults with disabilities and complex medical conditions. The grant will enable Courage Center to save money and improve the quality of care by creating a patient-centered medical home focused on highest-cost Medicaid patients;
• A University Hospitals of Cleveland initiative to increase access and care coordination for children beyond the walls of the doctor’s office. This initiative aims to save money and improve the quality of care by extending the expertise of an elite children’s hospital to local pediatric practices treating children with complex chronic conditions and behavioral health problems with physician extension teams and tele-health.

The HHS Challenge Site includes everything from sharing of imaging data to patient engagement techniques adn tools
  • Ocular Imaging Challenge
  • A multidisciplinary call to create an application that improves interoperability among office-based ophthalmic imaging devices, measurement devices, and EHRs.
  • Reporting Patient Safety Events
    • ONC is challenging multi-disciplinary teams to develop an application that facilitates the reporting of patient safety events.
  • ONC Beat Down Blood Pressure Video Challenge
    • Share how you use technology to help “know your numbers” and achieve blood pressure control.
    Government requesting input – Request for Infomration (RFI) on the Governance of the Nationwide Health Information Network

    A common set of “rules of the road” for privacy, security, business and technical requirements will help lay the necessary foundation to enable our nation’s electronic health information exchange capacity to grow.


    The Movie #OnNursingExcellence from #Voiceofthedoctor

    Posted in Uncategorized by drnic on May 15, 2012

    Last week on VoiceofTheDoctor Radio Show on Friday May 11, 2012  I had the pleasure of talking with

     Karen Kirby, RN, MSN, NEA-BC, FACHE Karen Kirby, RN, MSN, NEA-BC, FACHE President and CEO of Kirby Bates Associates and

    Kathy Douglas Kathy Douglas, RN, MHA the Chief Nursing Officer for API Healthcare. You can listen to the podcast here or download it from here. We talked about the expanding role of nurses that is essential to fill the void in healthcare in the coming years as we see an aging population and stretched resources. As Kathy put it

    Nurses are involved from bedside to boardroom and everything in between

    So true and so important especially as they pointed out that there is an increasing shortage of nurses to meet our existing needs let alone our future requirements.

    As part of their ongoing comitment to the nursing profession to help fill the recruitment void they are both working on the production of the movie “NURSES, If Florence could see us NOW” which is part of On Nursing Excellence (ONE) that explores the complex, exciting and challenging world of being a nurse in today’s society

    The film will show what it means to be a nurse, the many different roles that nurse’s play, from the front line to the Board Room and the realities of nursing – its joys and sorrows and the many ways that nurses impact the lives of others.

    Here’s a preview of the movie as it stands

    The project is well underway but needs your help and support

    You can follow the progress on facebook:

    Please consider donating – you can sign up to donate to the project to help this film get made and be part of the movie perhaps in the name of a relative who was or is in the nursing profession here

    The movie will premier at the ANCC National Magnet Conference Oct 10 – 12 in the Los Angeles Conference Center

    Join me each week on Voice of the Doctor 2:30 ET every Friday. You can listen in in several ways:

    • Stream the show live – click the Listen Live Now to launch our Internet radio player.
    • You can also call in. A few minutes before our show starts, call in the following number:  Call: 1-559-546-1880; Enter participant code: 840521#
    • is now on iTunes Radio!  Stream the show live – you’ll find this station listed under News/Talk

    #VoiceoftheDoctor, #VoiceoftheDr, #OnNursingExcellence, #HealthcareRadioNow



    #NursingWeek: Have physician-nurse relationships improved? Apparently not much

    Posted in Uncategorized by drnic on May 10, 2012

    Have physician-nurse relationships improved?

    April 11th, 2012

    by Jonathan H. Burroughs

    My daughter Serena will graduate from Oregon Health & Science University School of Nursing in September and I wonder if things will be different for her than for the nurses I worked with more than thirty years ago when I entered the healthcare industry.

    When I was a new emergency department medical director at Valley Regional Hospital in Claremont, N.H., I was running a code and asked for epinephrine and atropine (we used atropine in those days!) and the new nurse told me she didn’t know what those were or where they were kept. In my most caustic and superior tone I told her so that everyone could hear, “If you don’t know what epinephrine and atropine are, you should not be here; please send me a nurse who knows what s/he is doing.” She left the unit in tears and we completed the code without her.


    The next day, the chief nursing officer (CNO) came to see me and asked to speak with me privately. Being a wise manager she began by saying, “Jon, I’d like to apologize to you for sending you a nurse who was not properly prepared to assist you in the code. It won’t happen again.”

    I was feeling pretty vindicated at that point and puffed out my chest, smiled and returned, “I appreciate that.”

    And then she went on, “I am concerned that she was so humiliated by the experience that she and the other nurses in the hospital are worried that they will not be able to work with you due to a lack of professional respect and we all hope that you will be able to help us to rectify the situation.” She then quietly turned and left the room.

    I didn’t get much sleep that night and realized with much sobering reflection that part of my training at some of the nation’s most prestigious academic institutions was wrong. Treating people with disrespect and shame will not improve human performance nor will it help patients to have better outcomes.

    The next day I went to the CNO and said, “I thought a lot about our meeting yesterday and would like to do two things: train all nurses who are interested in advanced cardiac life support (this was a radical idea at the time, as only physicians were trained in the technical aspects of resuscitation), apologize to the nurse whom I disparaged in front of her colleagues and let them all know that it will never happen again.”

    The CNO smiled and said, “I appreciate that Jon; it will go a long way towards helping the nursing staff to heal.” As a thank you, the next week she brought me in a “bird of paradise” which I kept for a long time to remind me of human fallibility and how we all are vulnerable to misinformation as a part of our professional indoctrination.

    And so I wonder, will my daughter have to go through a similar traumatic episode on the firing line? Are those days truly over or is there a residue of the perfect physician overseeing an imperfect world and having to defend himself or herself in dysfunctional ways? Can we move towards a world of physicians and nurses working together as functional teams or is that still patient safety rhetoric? Has our professional world evolved sufficiently over the past 30 years or is it still the same?

    What do you think?

    Jonathan H. Burroughs, MD, MBA, FACPE is a certified physician executive and a fellow of the American College of Physician Executives. He is president and CEO of The Burroughs Healthcare Consulting Network and works with some of the nation’s top healthcare consulting organizations to provide “best practice” solutions and training to healthcare organizations throughout the country

    Please enable JavaScript to view the comments powered by Disqus.

    Like Dr Burroughs I can recall many instances of unprofessional behavior on the part of my clinical colleagues. But it was one of early bosses that set the tone and provided me with guidance on the relationship between doctors and nurses (and in fact everyone else in the hospital).

    There was never a time when you would not see JK holding a door open for any staff member approaching a ward and I recall vividly him opening the door for the ward domestic on his way in for an early morning ward round.

    Not only did he demonstrate the professional values and respect to everyone he was also at pains to highlight the importance of the nurses and all the other ancillary members of the team on every ward round. We never had a ward round without the nursing staff and if at all possible the ward sister or charge nurse if they were available. He went to great lengths to explain to me as a junior inexperienced doctor that the nursing staff were my best friend to help navigate the challenging world of medical care – as he put it

    “Most times the nurses know more than you do so heed their advice or better yet ask their advice”

    Sage advice to a young 22 year old House Office (PGY1 equivalent) who may have passed his medical finals but knew little about the management and care of patients on a busy ward. In fact I made such good friends with the nurses I married one (she is a nurse, midwife and health visitor).

    The general consensus of comments is that things have been improving albeit slowly but the road is long and still littered with fall out from some who perpetuate old school notions of inequality. This review on Fierce health focused no the comments and as they rightly pointed out:

    …as recent research found that hospital training programs aimed at increasing physician-nurse communication and teamwork helped reduce surgery-related complications, including blood clots and infections. Moreover, hospitals that used teamwork training saw a 15 percent decrease in patient deaths, compared to a 10 percent drop at hospitals that didn’t use the program, according to a December 2011 study in the Archives of Surgery.


    I’m looking forward to my discussion with Karen Kirby, RN, MSN, NEA-BC, and Kathy Douglas, RN, MHA on #VoiceoftheDoctor on HealthcareRadioNow this Friday at 2:30 ET

    Hope you can join us then

    Month of May on #VoiceoftheDr with National Nurses Week and #SIIM12

    Posted in Uncategorized by drnic on May 9, 2012
    May 11
    May 6 – 12 is National Nurses week
    In honor of this I will be talking with Karen Kirby, RN, MSN, NEA-BC, FACHE who has over 25 years of experience in healthcare administration and has held top-level nursing and hospital administration positions, and serves as an Associate at the Institute for Nursing Healthcare Leadership within Boston’s Harvard healthcare community.

    We will be joined by Kathy Douglas, RN, MHA, who is the President & CEO of the Sedona group and has just completed a Documentary Feature Film “Wise Women of Sedona“. We will be talking about nurses and their impact in the healthcare system, the rise of the Chief Nursing Information Officer (CNIO) and the current project they are both working on Nurses the Movie:
    An in-depth exploration of the complexity, challenges, sorrows and joys of being a nurse, seen through the voices and lives of nurses today.

    You can see more on this Facebook page – ON Nursing Excellence

    May 18 
    News Round up of latest news and events with a discussion on Designing a Better Healthcare System that included some great suggestions including
    • Getting all the stakeholders in the room
    • Design for failure because it is going to happen
    • Riding the Motivation Wave
    • Data + Design + Innovation = Better Health, and
    • The patient of the Future won’t want today’s Healthcare

    May 25
    Preview of the upcoming Society of Imaging Informatics in Medicine SIIM (#SIIM12) meeting scheduled for Jun 7 – 10 in Orlando
    Bob Fleming, Director for Radiology Systems as Nuance Communications will be joinging me to discuss the latest innovations, technologies, and science in the imaging informatics community being presented at SIIM. The theme this year “Strategic Innovation through Enterprise Image Management”

    There are three ways to tune in:

    • Stream the show live – click the Listen Live Now to launch our Internet radio player.
    • You can also call in. A few minutes before our show starts, call in the following number:  Call: 1-559-546-1880; Enter participant code: 840521#
    • is now on iTunes Radio!  Stream the show live – you’ll find this station listed under News/Talk.