Health and Medical News and Resources

General interest items edited by Janice Flahiff

Explore how changing nursing home culture affects care

From the 28 January 2014 article at Covering Health

 

Any journalist who covers nursing homes should check out this month’s special supplement in The Gerontologist, the Gerontological Society of America’s journal. It focuses on the two-decade long effort to change nursing home culture and many of the articles and studies raise important questions about whether enough progress has been shown.

English: Nursing Home in Goldthorn Hill. This ...

English: Nursing Home in Goldthorn Hill. This area of Wolverhampton has a cluster of nursing homes. (Photo credit: Wikipedia)

For example, this study finds that nursing homes that are considered culture change adopters show a nearly 15 percent decrease in health-related survey deficiency citations relative to comparable nonadopting homes. This study looks at what is meant by nursing home culture change – the nature and scope of interventions, measurement, adherence and outcomes.  Harvard health policy expert David Grabowski and colleagues take a closer look at some of the key innovators in nursing home care and what it might mean for health policy – particularly in light of the Affordable Care Act’s directive to provide more home and community-based care. Other articles look at the THRIVE study, mouth care, workplace practices, Medicaid reimbursement, and more policy implications.

Any of these studies — or several taken together — can serve as a jumping off point for local coverage. Are there nursing homes in your community that are doing things differently? Have any instituted policies or processes that show improvements in care coordination, outcomes, quality, or other key measures? Are there homes that are resisting change? Why? Which one(s) best exemplify person-centered care? How do these changes affect the workforce?

Nursing Home Compare from CMS provides the data behind complaints, violations, quality, and cost, among other metrics. This article in The Philadelphia Inquirer is a great example of interweaving research with personal narrative. Another approach might be to look at trends in the city, state, or region. How are nursing homes marketing themselves to consumers? To referral sources? Have their business models changed?

Experts on all sides have been talking about culture change for more than a decade. And in 2008, a Commonwealth Fund report explored culture change in nursing homes. Has the time finally come, for real?

 

Read the entire article here

 

Unfortunately, the articles referred to are subscription based only.
For information on how to get them for free or low cost, click here.

 

Articles referred to above

 

  • Transforming Nursing Home Culture: Evidence for Practice and Policy

     

  • What Does the Evidence Really Say About Culture Change in Nursing Homes?
  • A “Recipe” for Culture Change? Findings From the THRIVE Survey of Culture Change Adopters
  • High-Performance Workplace Practices in Nursing Homes: An Economic Perspective
  • Medicaid Capital Reimbursement Policy and Environmental Artifacts of Nursing Home Culture Change
  • Building a State Coalition for Nursing Home Excellence
  • Implications for Policy: The Nursing Home as Least Restrictive Setting

     

 

 

 

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March 14, 2014 Posted by | health care | , , , , | Leave a comment

NYTimes: Rethinking Our ‘Rights’ to Dangerous Behaviors

Originally posted on NobodyisFlyingthePlane:

“What we need,” Freudenberg said to me, “is to return to the public sector the right to set health policy and to limit corporations’ freedom to profit at the expense of public health.”

Bittman contributes to the ongoing discussion here at NobodyisFlyingthePlane about how certain industries deflect public discourse from what is best for our citizens to what makes the most profit, no matter the consequences.

The author he quotes poses a series of questions which get at the heart of the matter.

“Shouldn’t science and technology be used to improve human well-being, not to advance business goals that harm health?”

Similarly, we need to be asking not “Do junk food companies have the right to market to children?” but “Do children have the right to a healthy diet?”

Essentially its a PR game. Do we let whole industries spin how the conversation is framed or do we let the…

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March 13, 2014 Posted by | Consumer Health, Consumer Safety, Public Health | , , , , , | Leave a comment

Resources from the Association of Health Care Journalists

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From the Resource page

The Association of Health Care Journalists offers a wide range of resources – many of which are available exclusively to members.

AHCJ publications include our newsletter, HealthBeat, as well as several guides to covering specific aspects of health and health care.

Members share ideas and ask questions of fellow members on the AHCJ electronic mailing list. Tip sheets are prepared for our conferences and workshops, often offering sources and information about covering specific stories.

Contest entries are from the Awards for Excellence in Health Care Journalism, recognizing the best health reporting in print, broadcast and online media. We have links to past winners and information culled from questionnaires submitted with the entries about how each story was researched and written.

We include links to some recent reports and studies of interest to our membership, as well as links to Web sites relevant to health care.

Members and other journalists write articles specifically for AHCJ about how they have reported a story, issues that our members are likely to cover and other important topics.

 

 

 

 

December 8, 2013 Posted by | Educational Resources (High School/Early College(, Health Education (General Public), Health Statistics, Librarian Resources, Medical and Health Research News, Tutorials/Finding aids | , , , , | Leave a comment

The U.S. Health Disadvantage – Part 2: Possible Causes and Solutions

Originally posted on :

by Kirsten Hartil 

“Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care.”

Image

Reference: Mokdad AH, Marks JS, Stroup DF, Gerberding JL (March 2004). “Actual causes of death in the United States, 2000″. JAMA 291 (10): 1238–45. DOI:10.1001/jama.291.10.1238. PMID 15010446.

At least according to Article 25 of The United Nations Universal Declaration of Human Rights, so why does the United States, one of the wealthiest countries in the world, have some of the poorest health outcomes compared to other high income countries?

My previous blog, adapted from the Institute of Medicine (IOM) report U.S. Health in International Perspective: Shorter Lives, Poorer Health, described how the U.S. compares in causes of mortality and years of life lost with other high income and OECD countries. Here, as outlined in the report, I…

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July 14, 2013 Posted by | Consumer Health, Consumer Safety, Health Statistics, Public Health, statistics | , , , , , , , , , , , , | Leave a comment

The Guide to Community Preventive Services: What Works to Promote Health

The Guide to Community Preventive Services  is a great resource for what methods and interventions work well to improve public health. It is geared towards public health officials, researchers, and policy makers. However, it is also a good aid for anyone looking for the best way(s) to address issues touching family members and friends. The information can be used to promote or advocate for changes in policies and laws at local or national levels. They can be used to positively influence changes for the better in schools, workplaces, public health departments, and more.

A good way to start is through the Topics link at the top of the page. It includes links to issues as asthma, cancer, diabetes, nutrition, obesity, vaccines, and violence. Each topic includes links to more information on the topic and related topics.
Many topics have summaries of recommendations and findings. For example the topic Diabetes includes recommendations for certain disease management programs but insufficient evidence for self management programs in school settings or worksites.

All information on the interventions for a specific topic (as violence, diabetes, alcoholism) is carefully reviewed through a standardized step by step process.  systematic reviews. Each reviews includes summarized results of all related evidence.  These unbiased evidence-based reviews are also called systematic reviews.
[Click here for a good explanation of the systematic review process]

Each topic in this community guide answer questions  such as: c

  • What interventions have and have not worked?
  • In which populations and settings has the intervention worked or not worked?
  • What might the intervention cost? What should I expect for my investment?
  • Does the intervention lead to any other benefits or harms?
  • What interventions need more research before we know if they work or not?

Click on these tabs at the top of the  home page for additional information

April 14, 2012 Posted by | Public Health | , , , , , , , , | Leave a comment

Nimble Medicine | The Health Care Blog

Nimble Medicine | The Health Care Blog

This is an interesting blog posting on business models (old) and technologies (new) in health care delivery.
The author writes on why this is not working.

Specifically the author is advocating decentralization of health care delivery to reduce costs and reduce time in treating people at the onset of health problems (before and during treatment).

The author does provide a disclaimer, he is employed by a health care technology company.

Still, an interesting view of what health care industry trends.

 

February 13, 2012 Posted by | health care | , , | Leave a comment

New Thinking: Medical Hot Spots (Lowering Medical Costs by Giving Neediest Patients Better Care)

From the 2 August 2011 blog posting at Medical-Lee Speaking

Atul Gawande, associate professor of surgery and public health at Harvard and one of our most prolific contemporary physician-writers, adapts his New Yorker piece [full text of the article The Hotspotters] surveying innovative attempts to lower healthcare costs by better serving those patients with greatest need to a 13 minute PBS FRONTLINE report focused on one such program, the Camden Coalition of Healthcare Providers in Camden, New Jersey, led by Dr. Jeffrey Brenner, that is having unprecedented success.

August 8, 2011 Posted by | Public Health | , , , , | Leave a comment

IOM Report: Government Should Consider Public Health Implications Of All Major Legislation

A new report by the Institute of Medicine (IOM) says that strong evidence indicates that policies beyond the health sector have substantial effects on people’s health, and recommends that all levels of U.S. government adopt a structured approach to considering the health effects of any major legislation or regulation.

Excerpts from the report brief

Good health is not merely the result of good medical care but the result of what we do as a society to create the conditions in which people can be healthy. Public policy can be one of the most effective approaches to protecting and improving the health of the population. Unlike the one-on-one care provided by clinicians, laws, regulations, and other policies can affect the health of millions. This makes “healthy” public policy particularly important in a time of scarce resources, because it can diminish or preclude the need for other, more costly and potentially less efficient interventions.

The IOM report addresses three categories of law and public policy pertinent to health:

1. Laws that establish the structure, function, and authority of government public health agencies at the federal, state, and local levels.

2. Statutes and other policies that are designed to achieve specific health objectives, for example, taxing tobacco products and requiring immunization for school entry.

3. Policies in other areas of government, such as education, transportation, land use planning, and agriculture, that have health effects. In this area, intersectoral strategies are necessary—non-health agencies can contribute to improving health by considering the health implications of their policies. vices as the standard of practice in public health.

The report makes recommendations in these areas

  • Laws and policies should be updated to reflect current science, practice, socioeconomic conditions, and goals such as the CDC’s 10 essential public health services***
  • Legal and policy tools should be more effectively used, including regulations, taxation, and modification of the environment (as bicycle paths).
  • Inclusion of all health policy stakeholders should be encouraged to prevent unintended negative consequences of health policy and legislation. Examples includeThese stakeholders are potential allies in addressing related issues outside of the health sector, as housing, employment, and education arenas.

***From the US Centers for Disease Control and Prevention site

he Essential Public Health Services provide the fundamental framework for the NPHPSP instruments, by describing the public health activities that should be undertaken in all communities.

The Core Public Health Functions Steering Committee developed the framework for the Essential Services in 1994. This steering committee included representatives from US Public Health Service agencies and other major public health organizations.

The Essential Services provide a working definition of public health and a guiding framework for the responsibilities of local public health systems.

  1. Monitor health status to identify and solve community health problems.
  2. Diagnose and investigate health problems and health hazards in the community.
  3. Inform, educate, and empower people about health issues.
  4. Mobilize community partnerships and action to identify and solve health problems.
  5. Develop policies and plans that support individual and community health efforts.
  6. Enforce laws and regulations that protect health and ensure safety.
  7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
  8. Assure competent public and personal health care workforce.
  9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
  10. Research for new insights and innovative solutions to health problems.

June 25, 2011 Posted by | Public Health, Uncategorized | , , | Leave a comment

   

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