The November issue of Health Affairs focuses on the “health effects of economic security policies,” including many related to the Coronavirus Aid, Relief, and Economic Security Act. The CARES Act was passed in March 2020 to aid Americans grappling with the early effects of the pandemic. Many of the articles describe programs designed to help […]
Communication and resolution programs can help organizations meet the informational and emotional needs of patients and families, as well as clinicians and staff members, after an adverse or unexpected event in medical care. Advocates of the CARe — or Communication, Apology and Resolution — model held an annual forum earlier this month to highlight the […]
In a conversation with Danny van Leeuwen, Peter Elias, M.D., describes what I would call a “slippery slope” experience that took him from traditional to highly engaged practice 20+ years ago. Inspired by a question from a patient’s wife and a suggestion from a colleague, Elias developed a process for immediately sharing clinical notes with […]
Lisa Rosenbaum’s recent three-part series in the New England Journal of Medicine, “The Quality Movement,”is a detailed, nuanced and deeply reported analysis of efforts to use quantifiable measures to drive quality improvement. My over-simplified take on her bottom line is that the effort has largely failed. The component parts of high-quality care are hard to […]
Being able to contribute patient-generated health data to one’s own personal health history has been the holy grail for many engaged patients. Knowing that ongoing data can support healthy habits and treatment of many conditions inspires many patients and family caregivers to keep records manually or, increasingly, with the aid of user-friendly devices. It may […]
A 25-member panel of experts in long-term care has written a report in which they propose “paving the path to a better future of assisted living.” The report, The Imperative to Reimagine Assisted Living, was published in the Journal of the American Medical Directors Association in February and is available through open access. Having been […]
When Paul Farmer, M.D., died unexpectedly last month, Michael Murphy initially stood out among the people memorializing him because Murphy is an architect, not a physician. But Murphy was an important collaborator in Farmer’s Partners in Health, a non-profit organization that provides health care services to people in Rwanda, Haiti, Peru and many other communities […]
In a JAMA viewpoint essay (open access), Drs. Christine Cassel and Terry Fulmer describe circumstances clinicians should consider when working with older patients, especially when diagnosing new conditions. Many of their recommendations involve specialized knowledge, such as expressions of disease that change in individuals over 65. But overall they urge clinicians to tune in, pay […]
Doula support, which seeks to help individuals and families during pregnancy and childbirth, is gaining new traction in Massachusetts as one way to help address racial inequities in pregnancy care and birth outcomes, invest in community-based care and meet the cost control and value improvement goals of accountable care organizations (ACO). The state’s Medicaid program, […]
The news reports are telling us lately that people are calling 911 when its not an emergency and tying up the emergency response teams who are needed for “real” emergencies. But what is an emergency? Don’t assume people know this. It is part of the disconnect between patient care and patient safety. In 2010 I […]