Category Archives: Health Services

Tool to Invite Patient Engagement May Be Helpful for Retirement Communities

The BMJ (formerly British Medical Journal) has just published, An Invitation to Patient and Family Engaged Care for Consumers: What it is, Why it Matters and How Patients and Families Can Engage.  I think we may find it very helpful here at Collington and in other retirement communities as a way to think about patient engagement and partnership.

This short document, of which I am listed as a co-author, explains the concept of patient engaged care, describes and briefly summarizes the Planetree – National Academy of Medicine framework synthesis of the research into the impact of this approach, and perhaps most importantly, then specifically welcomes and invites patients to become engaged and partnering team members. (Note that my blog, attempting to summarize the very rich and detailed original Planetree-NAM paper, into which I had some input, is here.)

The BMJ response includes our offered model “Dear Patients & Families” letter, which could be used generally by medical institutions to explain, welcome and support full engaged participation.

For example, it references and summarizes the research as follows:

The good news is that research shows that patient and family engaged care leads to better relationships between you and your healthcare providers. It helps keeps patients safe. It reduces healthcare costs and keeps people from being unnecessarily readmitted to the hospital. Patient and family engaged care makes healthcare staff feel more connected to the work they do, which makes for a better experience for everyone.

Some of its specific invitations and suggestions to patients are as follows:

  • On your next visit to your healthcare provider, ask them if they have seen the framework for patient and family engaged care. If not, direct them here: https://nam.edu/pfec.
  • Ask your healthcare provider if there is a way for you to be involved in improving care. For example, ask if they have a patient-family advisory council.
  • Ask to be part of the organization’s leadership or government team. Ask if patients are included as board members, for example.
  • Ask to be with your loved one at all times, if they want that. Question why there are restrictions to visiting patients. If having visitors is not beneficial to your healing process, enlist the support of your care team to set parameters for guests.
  • Ask that a Care Partner or family member be present and engaged for all conversations about your health.
  • State your feelings. They matter just as much as your physical condition.
  • Get involved in research. Ask about how your condition is being studied and how you can help.
  • Let your care team know how you like to receive information.
  • Ask to see and contribute to your medical record. If you don’t understand what you read in your medical record, ask questions until you do.
  • Tell your care provider what your health goals are – in your own terms (for instance, being able to walk up a flight of stairs, being able to play with your grandchildren without getting winded, etc.)
  • Come to doctor’s appointments prepared. Bring a notepad with questions, your medication list and any other pertinent personal healthcare information.
  • Create a medical biography about yourself. What conditions and medications have you had in the past? What are you currently experiencing? What are your goals for the future?
  • Act like you belong. Be a teammate, not a subject.

I think the last one, “Act like you belong. Be a teammate, not a subject,” sums the whole approach up perfectly.

I very much hope that medical institutions will want to include this letter in their intake, on-boarding process for new patients, and to encourage staff to use its suggestions as a framework for discussions with patients about a team approach and its specifics. It, together with the underlying NAM framework, could also be an excellent too for staff training at all levels on how not just to have an engagement discussion, but to make all discussions team discussions.

If this approach because a standard in most institutions, then we will truly be on the way way to a greatly improved system.  And the same is true of Collington!

P.S. This post is an edited version of one I did in my Patient Partnering blog.

Hearing Loss, Speaking Capacity, Communication and Community

On April 20, we will hear in the Auditorium from Janice Trent of Hearing Healthcare Services, a local audiologist.

The presentation is being billed as a help to those who want to communicate with those with hearing loss.

clearhear

As a general matter, I think this is a very important first step for Collington.

I have  come to realize that hearing loss and inability to have reciprocal communications not only hurts the people directly involved in the attempted conversation, but also the community as a whole.  One way of looking at it is that the community is deprived of your full contributions, engagement, ideas and energy.  (I know that whenever I see a video of my speaking I am embarrassed by how much I swallow words.)

My suggestion is that we should think about communication, including both articulation and hearing, as a strong community value, and should be thinking of myriad ways in which we can articulate that value.

One such would be to offer free hearing exams to all who are coming to Collington.  No obligation to get a hearing aid, but one to know how you are doing in the hearing department.  Similarly those who have clarity expression difficulties would greatly benefit from information, demonstrations and training.

This the kind of thing that follows logically from the values of community and communication espoused in our strategic plan.

Posting Federal Training Explaining Medicare

The Social Services Dept here at Collington thought it would be useful to post this 2017 training Powerpoint from HHS Center for Medicare and Medicaid Services.  It does a good job of explaining all the basic components and choices.  This is obviously becoming more and more important as these programs come under attack.

It may also help us move thinking about strategic thinking forward, as we look at the “gaps,” and at how we might leverage the more flexible funding programs under Medicare.

The document is available on the left Menu under Health Services, or through this link.

Other materials can be found here.

 

 

Expanded List of Medical Specialists and Resources Added

Thanks to the work of Joe Howard and Julia Freeman, and the Health ervices Committee, there is now a new list of medical specialists and resources in our area.  For obvious reasons, listing here is only informational and does not constitute any recommendation or endorsement.

Use in health, and in getting there!

 

Thoughts on Improving Access to Personal Health Information

I just posted on my patient partnering blog a new post sharing an idea I heard recently on how to improve family access to health records, to the extent desired.  The full blog, very slightly modified, appears below.  If you think it is a good idea, please do share with your friends.  Lets make Collington even more of a center for spreading good ideas and innovations.

It is pretty much a common understanding that the well-intentioned HIPPAA privacy rules have sown much confusion.  In particular, as discussed here, they are as often used throughout the whole health care system as a shield against people and their families understanding what is going on — critical of course to true partnering —  rather than sword to ensure access to information.  Of course, read carefully the regs, even as currently drafted, actually provide a lot of flexibility to the holders of private health care information.

During a recent fascinating and creative HHS phone call to discuss ways to create useful and accessible online prescription records (of which more in a later blog), someone had a superb idea — to issue a model HIPPAA consent form that includes with the usual insurance company and provider list, language like “any and all family members,”  with, of course the option to check or not check it.

Of course, not everyone will want to check the whole family, and might want rather to list individuals who are to be given access, and that should be made possible with a space for such a list or appropriate general description.

Someone else then suggested that the use of such a form should be mandated by HHS.

What I now personally and routinely do is write that language in myself on the current form, drawing explicit attention to it to the professional staff, and suggesting that it will make their lives simpler, and encouraging them to put it in their standard form.  So far, one test only, a very positive response to the idea.

So here is an example of a thing we can do to change the culture by popular will, and of an improvement can ultimately be normalized by the system and government.

I would only add that any provider unhappy with such an approach would certainly face questions from me about their value system and philosophy.

P.S. I do encourage you to take a look at the new blog, link here.  While I will occasionally cross post, most of my posts on other personal blogs will not be copied to this Collington one.  Remember there is always a “subscribe” or “follow” box near the top of the right or left column of the blog. Enter your email, and you will get an email whenever something is posted to that blog.  Thanks to all for your encouragement.