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An “accountable care community,” empathy in sepsis, and perspectives on assisted dying: RightCare Weekly

November 6, 2014

In order to bring you more of the news you want to read, RightCare Weekly summarizes and interprets three important articles and provides headlines linking to the many other articles and editorials you’ll find interesting. As always, RightCare Weekly presents articles related to moving our healthcare system toward the right care for all patients.

Join the conversation: Post your comments in our new section at the bottom of this page.

 

Features:

  • In Forbes, Rob Waters interviews Janine Janosky of the Austen Bioinnovation Institute in Akron, Ohio about the institute’s new “accountable care community.” The project is built on the idea that healthcare ought to “…be accountable, but let’s not just be accountable for patients that walk through the doors of hospitals. Let’s be accountable to everyone who lives in our community.” The result is a city-wide collaborative that includes competing hospitals, as well as non-healthcare businesses and governmental agencies. It’s a stellar example of bringing an entire community together to improve health, and we hope it’ll be emulated by others.

 

  • Dr. Rana Awdish, a pulmonary and critical care physician, shares her experience as a patient in a lecture at Henry Ford Hospital in Detroit. Her story is built around a vivid depiction of the inhumane care she received when critically ill, including a number of shocking comments she overhears while hospitalized from fellow physicians. Her doctors didn’t mean any harm, but they failed to recognize how language that’s common among medical professionals can come across as callous and uncaring to a patient. The lecture also highlights the communication training Dr. Awdish conducts for critical care residents, and links to the Caring Conversations app, which provides resources and examples of effective patient communication strategies for physicians, nurses, and medical trainees.

 

  • In an NPR interview, Katherine Morris, MD, a surgical oncologist at the University of New Mexico Hospital, speaks of assisting two patients in Oregon with ending their lives, but that she had mixed emotions about doing so. It was only after much soul-searching and counsel from family members that she became the prescribing physician, noting the importance of honoring patient choice and obligations to support it. “No matter how a patient chooses to approach death and dying, it’s always unique for the patient. And it’s always incredibly impactful for the physician. I cannot imagine this becoming routine,” she said about assisted suicide. “It’s never routine.”

As a strong opponent of widespread legalization of physician-assisted suicide, Lachlan Forrow, MD, of Beth Israel Deaconess Medical Center, in an opinion piece posted on Boston.com, discusses the recent physician-assisted suicide of 29-year-old terminally ill patient Brittany Maynard in Oregon. Forrow argues that physician-assisted suicide should be the option of last resort, considered only after superb palliative care and hospice prove inadequate. But he notes the failures of our healthcare system and hesitancy for families to have conversations about end of life lead needlessly to unbearable suffering for many patients at the end.

 

Announcements:

  • The CIR/SEIU conference, “What’s your QI IQ?” takes place on Nov. 8: Register now. A second QI IQ event will take place in New York in the spring, focusing on health disparities.

 

  • We’re looking forward to hearing America Bracho, executive director of Latino Health Access, keynote on day three of our Road to RightCare conference! Check out her inspiring TEDMED talk below. And don’t forget, early bird registration closes December 1!


Headlines:

Population health

  1. New Buildings for Older People – Louise Aronson, New York Times
  2. Efforts to enable Americans to age in place are expanding, survey shows – Fredrick Kunkle, Washington Post
  3. Guns and Public Health – Joe Nocera, New York Times op-ed
  4. California Voters Have Approved The First Soda Tax In The Nation – Sam P. K. Collins, ThinkProgress

 

End-of-life care

  1. Atul Gawande explains why the health care system should stop trying to help everyone live longer – Harold Pollack, Washington Post’s Wonkblog
  2. Toward ‘A Beautiful Death’ – Jenny Gold, Kaiser Health News
  3. Medicare weighs paying for end-of-life counselingAssociated Press
  4. Reminders May Trigger Advance Care Conversations Earlier – Larry Hand, Medscape
  5. The Right—and Right Time—to Die: How Doctors Should Help – Sandeep Jauhar, TIME Ideas

 

Decisionmaking

  1. Invisible Risks, Emotional Choices — Mammography and Medical Decision Making – Lisa Rosenbaum, MD, New England Journal of Medicine
  2. Candor, Compassion and Communication: Solving Over- and Under-Treatment – Geri Lynn Baumblatt, Engaging the Patient blog
  3. Doctors and Decision Fatigue – Nicholas Bakalar, New York Times Well blog

 

Ebola

  1. Panic, Paranoia, and Public Health — The AIDS Epidemic’s Lessons for Ebola – Gregg Gonsalves and Peter Staley, New England Journal of Medicine
  2. Hospitals Wrestle With Extent of Ebola Treatment – Stephanie Armour, Wall Street Journal

 

Media

  1. Media Messages about Screenings and their Role in Overdiagnosis and Overtreatment – Gary Schwitzer, Engaging the Patient blog

 

Healthcare spending

  1. Malpractice Reform Won’t Do Much to Reduce Health Spending – Aaron Carroll, The Upshot
  2. Changes in Health Care Spending and Quality 4 Years into Global Payment – Zirui Song, PhD, et al., New England Journal of Medicine

 

Practice models

  1. Physicians, NPs, and PAs: Where’s This All Going? – Leigh Page, Medscape
  2. Doctor tries to upend U.S. health system to cut costs – Dierdre Shesgreen, USA Today
  3. A New Effort to Ease the Doctor Shortage – Chris Kardish, Governing
  4. Hospitals Take Cues From The Hospitality Industry – Roni Caryn Rabin, Kaiser Health News

 

Patient safety

  1. Living With Cancer: Not Talking About Medical Mistakes – Susan Gubar, New York Times Well blog
  2. Adventures in Choosing Wisely – Amy Berman, Hartford Foundation blog

 

Access to care

  1. Under Obamacare, Mental Health Lacking – Kimberly Leonard, US News

 

RightCare Weekly is made possible through the generous support of the Robert Wood Johnson Foundation

 

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