Quality colloquium 2012 final
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  • Concurrent competing sessions:Best practices in hospital patient safetyTechnology to improve health care safety, quality and efficiencyOurs:Millenson’s model; Duane Smith; Joslin remote
  • Atul Gawande told this story in his much-publicized 2010 Stanford commencement address, which he repeated at the National Quality Colloquium at Harvard in August.This slide is followed by what happened next: 2 years later, Smith was on vacation in Mexico when strep swept through him. He survived but lost all his fingers and toes.
  • Atul Gawande told this story in his much-publicized 2010 Stanford commencement address, which he repeated at the National Quality Colloquium at Harvard in August.This slide is followed by what happened next: 2 years later, Smith was on vacation in Mexico when strep swept through him. He survived but lost all his fingers and toes.
  • Atul Gawande told this story in his much-publicized 2010 Stanford commencement address, which he repeated at the National Quality Colloquium at Harvard in August.This slide is followed by what happened next: 2 years later, Smith was on vacation in Mexico when strep swept through him. He survived but lost all his fingers and toes.
  • Remembering allergyBedside shift changeDuane’s vaccinesMissed dosesAbington’s shared care plan====Aneja: one definition of “engagement” is the patient accessing an available service. So good new tech is a way of engaging pts in quality.
  • Remembering allergyBedside shift changeDuane’s vaccinesMissed dosesAbington’s shared care plan====Aneja: one definition of “engagement” is the patient accessing an available service. So good new tech is a way of engaging pts in quality.
  • Remembering allergyBedside shift changeDuane’s vaccinesMissed dosesAbington’s shared care plan====Aneja: one definition of “engagement” is the patient accessing an available service. So good new tech is a way of engaging pts in quality.
  • Remembering allergyBedside shift changeDuane’s vaccinesMissed dosesAbington’s shared care plan====Aneja: one definition of “engagement” is the patient accessing an available service. So good new tech is a way of engaging pts in quality.
  • This is not quite the right slide – find the one that is
  • Find Elaine / Seinfeld slide
  • Add duplicate for The Caregiver Crisis
  • Add duplicate for The Caregiver Crisis
  • Add duplicate for The Caregiver Crisis

Transcript

  • 1. Engaging And Empowering Patients For Quality & Safety
  • 2. “e-Patient Dave” deBronkart• High tech marketing• Data geek; tech trends; automation• 2007: Cancer kicker • 2008: E-Patient blogger • 2009: Participatory Medicine, Public Speaker • 2010: full time
  • 3. Michael Millenson • Health Quality Advisors • Demanding Medical Excellence, Health Affairs, many more • Board of American Medical Group Foundation, AHIMA Foundation, Soc’y for Participatory Medicine Amer Jour of Medical
  • 4. Rajni Aneja, MD, MBA, CPE • EVP, Joslin Diabetes Center • CPE / family practice • Care Continuum Alliance • ACPE • Past: – CMO for WebMD – OptumHealth nat’l medical director for disease mgmt,
  • 5. Tom Peters, MBA, PhD • In Search of Excellence and 16 other books • Extraordinarily diverse industry experiences • Track record of successfully working with leaders to create change
  • 6. What if Duane Smithhad a shared care plan? “e-Patient Dave” deBronkart Twitter: @ePatientDave facebook.com/ePatientDave LinkedIn.com/in/ePatientDave dave@epatientdave.com
  • 7. Proposed taxonomy of fixes from Helen’s keynote• Putting more power in patient hands: – Information – Tools
  • 8. Proposed taxonomy of fixes from Helen’s keynote• Putting more power in patient hands: – Information – Tools• Listening to what patients report from the front line
  • 9. Proposed taxonomy of fixes from Helen’s keynote• Putting more power in patient hands: – Information – Tools• Listening to what patients report from the front line• Not leveraging available contributions – A squandered opportunity – Economic inefficiency
  • 10. “It has taken a full century for the patient’s perspective to go from being routinely ignored to being hailed as a pillar of an ideal health care system.”
  • 11. “Rethinking the relationship between the patient and professional caregivers is a cornerstone of successful health system redesign”
  • 12. “Consumer engagement, whether in the exam room or in a health care organization’s boardroom, is a central element.”
  • 13. “Consumer engagement, whether in the exam room or in a health care organization’s boardroom, is a central element.”I add: same forengagement atthe bedside, too.
  • 14. Whathappened here??
  • 15. Gawande:• A medical miracle – a great save
  • 16. Gawande:• A medical miracle – a great save• In stark contrast, an “epic fail” with great human cost
  • 17. Gawande:• A medical miracle – a great save• In stark contrast, an “epic fail” with great human cost• By the same people in the same system
  • 18. What if Duane’s family had googled “splenectomy”?
  • 19. What happened here?• Squandered potential value
  • 20. What happened here?• Squandered potential value• An asset in the system (knowledge) that was not brought to the point of care at the time when it was needed
  • 21. Who can solve this?
  • 22. Who can solve this? Do we pound on clinicians more?
  • 23. “I want to note especially the importance of the resource that is most often under-utilized in our information systems – our patients” Charles Safran MD, Beth Israel Deaconess quoting his colleague, Warner Slack MD Testimony to the House Ways & Means subcommittee on health, 2004
  • 24. What if the care teamhad shared the care planwith the patient & family?
  • 25. Abington Memorial created one. (It’s just an EMR report)
  • 26. Doc Tom said, e-Patients.net founder“e-Patients are quipped E Tom Ferguson MD 1944-2006 Engaged Empowered Enabled”
  • 27. Web 2.0: “When the web began to harnessthe intelligence of its users” – Tim O’Reilly
  • 28. If the microscope’s happy but the patient’s not,has care been achieved? Has optimal care??Was the money well spent for customer value?
  • 29. This is the only industry where the definition of quality doesn’t startby asking customers what they want more of
  • 30. A patient’s definition of quality: Achieving everything we possibly can in the family member’s care.
  • 31. Compliance
  • 32. Compliance
  • 33. Compliance(Whose goal is it, anyway?)
  • 34. Compliance(Whose goal is it, anyway?) Quality???
  • 35. EMRs and Quality (NEJM)• Patients who achieved 4 out of 5 outcomes With EMR Paper based 44% 16%• Patients whose care met four quality standards With EMR Paper based 51% 7%
  • 36. Peter Margolis, Cincinnati Children’s .5 x .5 = .25
  • 37. A patient’s definition of safety: Avoiding avoidable harm and mistakes.
  • 38. A patient’s definition of safety: Avoiding avoidable harm and mistakes. Also known as accidents.
  • 39. What could possibly stop usfrom speaking up to help?
  • 40. Answer:We’re afraid of you.
  • 41. “I want to note especially the importance of the resource that is most often under-utilized in our information systems – our patients” Charles Safran MD, Beth Israel Deaconess quoting his colleague, Warner Slack MD Testimony to the House Ways & Means subcommittee on health, 2004
  • 42. “What is the Role of the Patient?”
  • 43. “What is the Role of the Patient?”
  • 44. “What is the Role of the Patient?”
  • 45. Gawande at CMMI Summit“There is a bell curve for quality – a wide gap between the best care and the worst.
  • 46. Gawande at CMMI Summit“There is a bell curve for quality – a wide gap between the best care and the worst.“There is another bell curve for costs – again, a wide gap.
  • 47. Gawande at CMMI Summit“There is a bell curve for quality – a wide gap between the best care and the worst.“There is another bell curve for costs – again, a wide gap.“Surprisingly, the two curves do not match.
  • 48. Gawande at CMMI Summit“There is a bell curve for quality – a wide gap between the best care and the worst.“There is another bell curve for costs – again, a wide gap.“Surprisingly, the two curves do not match.“And that means there is hope.”
  • 49. “It has taken a full century for the patient’s perspective to go from being routinely ignored to being hailed as a pillar of an ideal health care system.”
  • 50. Let Patients HelpHeal Healthcare. “e-Patient Dave” deBronkart Twitter: @ePatientDave facebook.com/ePatientDave LinkedIn.com/in/ePatientDave dave@epatientdave.com