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Linking ACLS with end-of-life conversations, EMRs that enhance relationships, and can hospitals address social needs?

March 26th, 2015 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:

Aaron Stupple, MD, offers a provocative idea in The BMJ: Alongside training all providers in the essentials of treating patients with heart attacks through the ACLS (Advanced Cardiac Life Support) certification, hospitals ought to train their physicians to have conversations with patients about their treatment choices at the end of life. End-of-life communication training now is highly variable and often not prioritized. By coupling training with ACLS, hospitals could provide more complete, standardized training, and underscore that end-of-life conversations are a normal and important part of providing quality care. In addition, the analogy with ACLS illustrates that end-of-life conversations, like emergency cardiac care, can’t be left exclusively to palliative care physicians and other specialists. When end-of-life conversations need to happen, all providers should have a basic understanding of how to communicate with patients and comply with their wishes.

 

In the New York Times, Robert Wachter, MD, writes of the ongoing struggle to develop electronic medical records that improve patient care and make life easier for physicians. Many physicians feel like EMRs and other increasingly common forms of IT actually get in the way of being present with patients, and that the systems have failed to live up to promises of improving patient safety. However, even in the face of that record, Wachter argues “We will never make fundamental improvements in our system without the thoughtful use of technology.” Getting from meaningful use to “thoughtful use” will require adopting the tools of human-centered design in the development of healthcare tech – and just as important – “training students and physicians to focus on the patient despite the demands of the computers.”

 

Earlier this month at our annual meeting in San Diego, keynote speaker Mitch Katz, MD, director of Los Angeles County Health Services, expressed the need to use Medicaid funds to provide housing to the homeless—because it’s a much needed medical service. This week in the New York Times, Sabrina Tavernise explains that healthcare systems around the nation are now examining whether social services like housing for the homeless and tackling other consequences of poverty are better ways to keep people at risk from medical crises that land them in hospitals. Some pilot programs are working. Said one official who helps runs such a pilot in Minneapolis, “We’d pay to amputate a diabetic’s foot, but not for a warm pair of winter boots.” This new way of sensible thinking – addressing social determinants—to prevent the need for medical care is proving beneficial to patients and will help keep overall costs down.

 

More media coverage for 2015 Lown Conference

 

Announcement:

Save the Date! Thursday, April 16, 1–2 pm ET. Join us for a webinar on the Do No Harm Project, a special session for clinicians and trainees to learn how to implement this program in your institution. Presenters are the program founders, Brandon Combs, MD, FACP, University of Colorado School of Medicine and Tanner Caverly, MD, MPH, University of Michigan. The Do No Harm Project inspired the Teachable Moments series in JAMA Internal Medicine. Register now.

We’re hiring – the Lown Institute Healthcare Delivery System Fellowship: We’re seeking an energetic, creative, analytical Fellow for a one-year position focused on understanding the healthcare system through the lens of overuse and underuse. By working on  organizing and advocacy outside medicine, and projects that promote culture change within it, fellows will gain an unparalleled perspective on the coming transformation in the healthcare system. Please share the listing with friends, colleagues, and students who might be interested! The job description and qualifications are here.

Headlines:

Quality and productivity

 

Social determinants of health

 

Patient communication

 

Overmedication

 

Health reporting

 

End-of-life care

 

The Affordable Care Act

 

Overdiagnosis

 

Primary care

 

Anti-vaccine movement

 

Patient safety

 

Hospital payments

 

Evidence

 

Money in medicine

 

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

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