Bridging the Gap

Going to the doctor’s office for a non-emergency related cause is fairly stress free for me. Sure, I might be bothered by whatever cold or ailment I think I’ve caught, but I am able to easily drive there. Filling out forms and billing information is easy when I know that I’ll have coverage. When I meet the doctor, we easily communicate because we both speak the same language. I am able to understand what they are saying and ask questions when I need to. These are all things that seem simple and I often take for granted. I was reminded how this is not the case for a lot of people in America after hearing a local executive speak. In our Management class we recently heard from the CEO of a Federally Qualified Health Center. This CEO discussed how his facilities serve very diverse populations. Over 60% of his patients at one facility do not speak English as a first language. This makes it critical to have interpreters and care that focuses on being culturally competent. His facilities also provide care no matter if the person can pay or not. You could clearly see this CEO was truly passionate about the work he does serving the communities that need it most. After listening to this CEO speak I was interested in looking into the benefits of culturally competent care and what role it plays within an organization. The Commonwealth Fund did research into the importance of culturally competent care and found that not only does it decrease disparities in care, but that it can also improve quality of care across an organization. The article quotes an Administrator for the U.S. Department of Health and Human services who said, “What we’re talking about in terms of cultural competency...is providing quality care to individuals who in the past have not received it...and when I think of quality care, that’s what we're looking for for all Americans”’ Cultural competence is a key part to improving the quality of care in an organization. Although it may not be as easy to measure as reimbursement rates or patient encounters, it is invaluable when it comes to providing patient-first care. I hope to continue learning more about cultural competency and how to implement best practices into an organization.

Link to The Commonwealth Fund’s Report:

http://www.commonwealthfund.org/usr_doc/betancourt_culturalcompetence_576.pdf

A Live Worth Living

After watching two elderly family members suffer from a serious heart attack and a stroke, I realized the frailty of life and the realities of aging. Fortunately, they were both okay but it was a reminder to me about how aging is inevitable. Although they both are able to live in their own homes currently, it made it clear that eventually they will require some form of assisted living. After discussing different forms of long-term care in class, I see how varied in quality their experience could be. In our class on Health Policy, we are reading a book by Atul Gawande called Being Mortal. In this book, Gawande explores the past, present and future of long-term care in America. Many of the problems in long-term care facilities stem from viewing aging as solely a medical problem to fix with medical interventions. Gawande stresses how important it is to give those who are aging reason to live and help them retain their dignity. Although I am not sure if I will work in any sort of long-term care facility or not, reading this book has been an eye-opening experience. If I am a leader in a place like a nursing home or assisted living facility, I hope to bring the lessons I have learned about how to make the experience of aging better. Gawande mentions how successful organizations have used techniques like bringing in animals, plants, and children. Giving the residents as much freedom as possible is another way that quality of life can be improved. The opportunity to retain as much autonomy as possible is another vital component to helping people age with higher quality of life.

    Today in our Management class we discussed how the burden is on society to help take care of aging and other needy populations. Gawande’s book touches on this also and how the culture of that society is often reflected in their long-term care. Often times, Americans view the elderly population as a burden. They either have to be taken care of by younger family members or put into a long-term care facility. What happens after the drop off isn’t always considered. Once an elderly person moves into one of these facilities, their life does not have to be over. If we focus on giving our elderly population as much of their former life as possible, maybe aging won’t be viewed so negatively. As a society, and as healthcare professionals, we have a responsibility to continue to move our long-term care industry towards a culture that does not view aging as a problem to be treated solely with medical intervention. I hope that we continue moving towards a culture of compassion that focuses on letting our elderly population retain as much autonomy as possible!

Gawande's book: https://www.amazon.com/Being-Mortal-Illness-Medicine-Matters/dp/1250081246

Being A Team Player

One of the courses the UNH HMP Juniors are all taking is Healthcare Financial Management with Professor Bonica. After a recent exam, he told the class that there was the typical spread of good and not so great grades. It was what he said after that really stuck with me. He told the class that as a cohort, it was the responsibility of those who did well to help our classmates do better on the next exam. Emphasizing how healthcare is a team effort, that mindset should start now for us in the classroom. Today I had the pleasure of attending the Northern New England Association of Healthcare Executives conference, Shaping the Future: Leadership and Public Policy in Health Care. The theme of teamwork and building relationships that Professor Bonica mentioned was echoed by other executives throughout both panels. This was particularly eye-opening for me to see how important building relationships is in the healthcare field. Panelists from both the discussion on succession planning and the policy talk highlighted different ways that building relationships is critical. One of the big highlights was building mentor/mentee relationships which are beneficial to both parties. Another thing I found particularly interesting was how the executives all agreed that you should always be training your replacement, even if that means training them out of the organization. On the policy side, many of the panelists explained how building relationships is one of the most critical ways to solving problems. One panelist highlighted how important it is to build community relationships before times of crisis because it is imperative to handling emergencies well. Overall, this conference was a great opportunity to bring the classroom to life! Many of the points professors have made in the classroom, were reiterated with real-life examples from panelists. I am thankful for everyone who helped to organize the event and it was a great success!

Drawing Conclusions

Back in high school, I was able to take a course in film production. This class took us through the basics of making a film from start to beginning. It was very hands on. Throughout the semester, we worked in groups to produce short films of our own creation. One of the most tedious parts of making a film was storyboarding. This was the process of physically drawing out every shot and transition from start to end. It was tedious, but I quickly realized the value when it came time to actually shoot our film because we knew exactly what to do and when. If our storyboard was lacking in detail, we quickly realized how much more time it would take to make decisions when the camera was rolling. The better our storyboard plan was, the easier it was to efficiently shoot a film. I recently watched a TED talk that made me think of this notion. Tom Wujec talks about the value of visual planning as a group in his talk, “Got a wicked problem? First, tell me how you make toast?” Wujec outlines how planning things out visually as a group allows you to synthesize several points of view, much like making a storyboard helps plan out camera shots. This technique can be applied to numerous levels of business from decision making to aspirations for the company’s future vision. He uses the example of making toast as a starting point but explains how his technique can work for much larger business issues. Drawing out possible paths of action, made of nodes and links, can align executive teams. Nodes are the tangible steps and links connect them together. I have never heard of this as a business strategy prior to watching the TED talk, but I would be curious to see how this would work in the healthcare field.  I could imagine the resistance that would come from a board of administrators if asked to draw out their plan, but I think it could provide really valuable when trying to figure out a solution that everyone can agree on. Because everyone starts by separately drawing their path and then working to bring the ideas into one best practice, the process naturally breeds compromise and discussion. Although it may not be a realistic practice for every medical facility, those in need of an extreme overhaul or faced with a particularly tricky problem may find this useful. Although this may not be realistic for many organizations, I could see potential value for different healthcare groups at certain points in their time!

Link to Wujec’s TED talk: https://www.ted.com/talks/tom_wujec_got_a_wicked_problem_first_tell_me_how_you_make_toast