This is something that a community could support and afford that may not be adopted by many small practices. If the usual adoption delay in health care, 10+ years applies, maybe it is on the horizon.

I have been watching and wanting this for about 7 years.

2:44:18 PM     comment []   Google It!  

Robert Wood Johnson Foundation's CONNECT PROJECT guided meetings in Washington DC this week.  Six of the seven US pursuing perfection sites met with their congressional members.  The Whatcom county team consisted of Rebecca Bryson (patient), Marc Pierson (me, project executive), and John Hayward (CEO of PeaceHealth). We met with Senators  Patty Murray and Maria Cantwell and with Representatives Rick Larsen and Jim McDermott. The meetings were informational and well received. Each member agreed to work with us to learn more about what we are doing and to lend their support to comprehensive clinical quality improvement efforts.

There was also a meeting with the National Health Policy Forum. The subject was "Pursuing Perfection in Health Care Delivery: Insights from Innovators". There was good attendance by congressional staffers and health agency leaders. Donald Berwick, MD, led off and presented context for the briefing. Honor Page, the mother a patient with cyclic fibrosis spoke next. She gave the patient's or consumer perspective on the current status of health care as well as on her interactions with Pursuing Perfection project at Cincinnati Children's Hospital. Next was Dr. Brian Rank from HealthPartners, Bloomington, Minnesota, explaining the frustration and challenges from the perspective of a physician leader pursuing perfect care in today's environment. Finally John Hayward spoke about the need for change and his rationale for the work going on in Whatcom County, WA, as well as explaining his personal commitment to transformational change in his organization.

Rebecca, John, and I all felt like the relationship building with our congressional members is off to a good start. As you all know, for the improvement that we have started to be sustainable, both Medicare and Medicaid will need to become more flexible in matching payment to innovations in care. Our short and long term goals will be some small appropriation to help cover the short fall on our start up of this transformation, then a demonstration project that will provide the needed flexibility to this county. Ultimately the payment structure of Medicare and Medicare will need to be modified based upon the successes of the demonstration projects.

Click on this link if you would like to study most current recommendations by the Institute of Medicine to CMS (medicare/medicaid) for demonstration projects aimed an transforming health care and aligning payment. Four out of five proposed types of demonstration projects are highly aligned with what we have already begun with Pursuing Perfection and Robert Wood Johnson Foundation.

12:56:12 PM     comment []   Google It!  

We are now providing some new users of the Pursuing Perfection web site with a different tool than Radio. It is called Manila. In most aspects it looks the same on the web.

What you gain with Manila instead of Radio:

No new  software installed on your computer.
Less to learn--no need to learn how to use the above functions: subscriptions, categories, and shared outlines.
Ability to have someone else help you edit your work or add things on your behalf to your site.

What you miss with Manila instead of Radio as your weblog tool:

Active render, collapsing outlines on your web page.
Integrated RSS news reader--ability to subscribe to others weblog updates.
Categories, the ability to send your posts to an assorted group of web pages by topic, eg. Access, Diabetes, Evidence-based medicine.
Ability to see how many people are looking at your posts.
No ability to use Shared Outlines for collaborative work across organizations.

We think it is a good starting place for some people, especially those in communities other than Whatcom County, WA. IF YOU ARE ASSOCIATED WITH THE ROBERT WOOD JOHNSON FOUNDATION PURSUING PERFECTION GRANT IN ANY WAY feel free to contact me to ask for a weblog of your own. mailto:mpierson@peacehealth.org Availability will depend upon our available resources and your organizations agreement for your participation.

10:35:12 AM     comment []   Google It!