Volunteering in the U.S. – 64.5 million points of light

In his 1989 inaugural address, George H. W. Bush invited Americans to volunteer – to become one of a “thousand points of light”.  America was listening! According to data from the U.S. Bureau of Labor Statistics, there were 64.5 million volunteers who provided service at least once between September 2011 and September 2012. Most volunteers put in time through a religious or education/youth service organization; however, 7.8% – or approximately 5 million individuals – provided service in a hospital or health care setting.

The report, available online, provides a number of statistical analyses:

• Demographics: age, gender, race/ethnic group, educational attainment, marital status, employment status, parents of children under the age of 18 (it makes a difference!)
• Hours of volunteer service provided: almost 6% of all volunteers reported 500+ hours of service in the year; the median was 50 hours
• Number of organizations for which one volunteers
• Type of primary organization for which one volunteers: civic/political/professional/international, educational/youth service, environmental/animal care, hospital/health care, public safety, religious, social/community service, sport/hobby/cultural/arts, other 
• Main volunteer activity: the greatest number (10.9%) collected, prepared, distributed, or served food
• How volunteers become involved: self-directed, asked by someone else (boss, relative/friend/co-worker, someone in the organization, etc.)

The summary portion of the report also includes historical data back to September 2008.

Source: U.S. Bureau of Labor Statistics.  Volunteering in the United States – 2012.  [press release]  February 22, 2013. 
http://www.bls.gov/news.release/pdf/volun.pdf
   Earlier reports (back to 2002) are available at
http://www.bls.gov/schedule/archives/all_nr.htm#VOLUN
.

Patient and Family Engagement in Hospitals

What’s the evidence-base for effectively promoting patient and family engagement with hospital care? A new report released by AHRQ aims to answer that question.  The environmental scan was done to support development of a new toolkit — planned for release in mid-2013 — to help both patients and providers work together to improve care. Findings from the review are organized into three key areas:

1. Individual characteristics, needs, and perspectives of patients, families, and health professionals. Both patients and providers agree that the care they receive or give is generally good, even when that may not always be the case. It’s no surprise that they differ in their view of good care, however. Providers focus primarily on clinical issues, while patients and families see personal interactions as the key to good care. Engagement barriers for patients include fear, uncertainty, and health literacy. Barriers for clinicians are professional norms and experiences, litigation fear, and perceived level of effort.
2. Organizational context, including both hospital structures and processes that influence engagement. Leadership strength, organizational culture, and discretionary resources are some of the many organizational aspects that can impact engagement. Motivators include competition, legislation/regulation, public reporting, awards, the desire to improve, occurrence of a sentinel event, and altruism.
3. Hospital-based interventions and materials to enhance engagement of patients and their families, especially as it relates to safety and quality. Organization-level strategies to enhance engagement focused on health care teams, communication, increasing patients knowledge and skills, and patient/family input into management and processes. Individual-level resources available were reviewed.

Knowledge gaps identified for effectively improving patient engagement include:

• Strategies are not geared to the hospital experiences of patients
• Individual tools are lacking that support system-level strategies
• Actionable support is lacking for individuals to participate in engagement behaviors
• There are few complementary materials
• Key usability criteria are lacking for training tools/resources
• Implementation guidance on engagement strategies is limited

Bottom line:  While there’s reasonably strong evidence from related fields, there is still not robust evidence supporting the effectiveness for existing approaches and tools to better engage patients and families in their hospital care.

Sources:

Maurer M and others, American Institutes for Research. Guide to patient and family engagement: environmental scan report. Agency for Healthcare Research and Quality, May 2012.
http://www.ahrq.gov/qual/ptfamilyscan/

Engaging patients and families in the quality and safety of hospital care. Agency for Healthcare Research and Quality, June 2012. 
http://www.ahrq.gov/qual/engagingptfam.htm

Related post:
http://aharesourcecenter.wordpress.com/2011/03/15/achieving-exceptional-patient-family-focused-care-in-hospitals/

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

To boldly go where no medical device has gone before!

Rejoice all you Star Trek fans!  The race is on to produce the first fully functioning medical tricorder  – a handheld diagnostic device for those of you not familiar with the epic space adventure.  If a winner is declared, the Qualcomm Tricorder X Prize will be $10 million. 

Full details of the competition, as well as application forms, can be found on the website of the X Prize Foundation at 
http://www.qualcommtricorderxprize.org/
.  The criteria are few, but challenging:

• The device must weigh less than 5 pounds (handheld, remember?)
• The device must be user-friendly (the intended audience is consumers, not health care professionals)
• The device must be able to accurately diagnose a set of 15 diseases independently (no input from any kind of health care professional or provider)
• The device must be safe to use (no chance of electric shock, chemical exposure, punctures, infection)

The goal of the competition is to inspire a technological breakthrough that has the potential to revolutionize health care access and delivery by putting the necessary tools in the hands of the patient – literally!

To quote another famous Enterprise captain – “Make it so!”

Source:  Page, D.  Beam me up, Scotty!  Hospitals & Health Networks.  86(6):37. 
http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/06JUN2012/0612HHN_FEA_Wireless&domain=HHNMAG

X Prize Foundation. 
http://www.xprize.org/

Patient satisfaction scores comes home

Data from the Home Health Consumer Assessment of Healthcare Providers and Systems (HH-CAHPS) debuted on the Home Health Compare site - 
http://medicare.gov/homehealthcompare/search.aspx
 - on April 19, 2012.  Based on the results of a 34-question survey, the data are designed to help consumers make decisions about Medicare-certified home health agencies using both qualitative and experiential information.  Some of the questions include:

• When you started getting home health care from this agency, did someone from the agency ask to see all the prescription and over-the-counter medicines you were taking?   Yes     No    Do not remember  [question 5]
• In the last 2 months of care, did you and a home health provider from this agency talk about pain?   Yes    No [question 10]
• In the last 2 months of care, how often did home health providers from this agency treat you with courtesy and respect?  Never    Sometimes    Usually    Always  [question 19]
• When you contacted this agency’s office, how long did it take for you to get the help or advice you needed?  Same day    1 to 5 days    6 to 14 days    More than 14 days    I did not contact this agency  [question 23]

The official HH-CAPHS website is at
https://homehealthcahps.org/Home.aspx
, providing access to the survey in multiple languages, the protocols and guidelines manual, instructions on data submission, and other support material.

Patient-family councils – case study in person-centered care

Who: Catholic Health Initiatives

What: Patient-family advisory council (system-wide initiative)

When: Planning was initiated in 2009; implementation began in 2010 and has been completed

Where: Englewood, CO-based hospital system with 76 hospitals in 18 states

How: Read article, including side bar on “How CHI Rolled Out Its National Program”

Why: To support CHI’s philosophy of person-centered care -

• Personalization of care according to patient and family needs, preferences, and values
• Comprehensive care encompassing body, mind, and spirit
• Collaborative care that links patients and their families to providers

Source: Haycock, Camille.  Patient-family councils make the difference.  Health Progress.  93(2): 24-29, March-April 2012.  Full text at
http://www.chausa.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=8147

The weight of the world: the obesity epidemic in OECD countries

The Organization for Economic Co-operation and Development (www.oecd.org) has released Obesity Update 2012, a policy brief updating an earlier study on the economic impact of obesity in the 34 OECD member countries, including the United States. 

• Before 1980, fewer than 1 in 10 people were obese.
• Today, the majority of the population are overweight or obese in 19 of the 34 OECD countries.
• Some countries – Korea, Switzerland, Italy, Hungary, England - have stabilized the growth of the epidemic.
• Korea and Japan have the lowest prevalence rates, at 3.8 and 3.9 percent of the population, respectively
• The U.S. edges out Mexico as the most obese country: 33.8 percent of the total population is overweight or obese
• Estimates allocate 1-3% of health expenditures to obesity-related problems; in the U.S., the estimate is 5-10%

The paper includes brief discussions on child obesity, the social disparities of obesity, and what governments can do to combat the problem, including a lengthy sidebar on “fat taxes” – special taxes on foods and beverages that are considered to be unhealthy.  Some countries that have imposed fat taxes include Denmark, Hungary, Finland and France.  The sidebar analysis includes brief descriptions of what food and/or beverage groups incur the additional tax.

Source: Sassi, Franco, and Devaux, Marion.  Obesity Update 2012.  Paris, France: Organization for Economic Co-operation and Development, February 2012. 
http://www.oecd.org/document/55/0,3746,en_2649_37407_49715511_1_1_1_37407,00.html

Obesity and the Economics of Prevention: Fit Not Fat.  Paris, France: OECD, 2010.  This is the original 265-page report published in September 2010.  An executive summary, background notes, and additional ancillary material is available at
http://www.oecd.org/document/31/0,3746,en_2649_37407_45999775_1_1_1_37407,00.html#Executive_Summary
.  The entire report is for sale through the OECD online bookstore.

Research priorities report debuts

The Patient-Centered Outcomes Research Institute (PCORI), established by the Affordable Care Act, released its first major report on January 23, 2012 – Draft National Priorities for Research and Research Agenda – with a comment period open to the public until March 15.  The report does not identify specific diseases or conditions on which it intends to focus its generous funding ($4.5 billion through 2019); rather, it outlines broad categories under which research projects might be submitted for consideration:

• Comparisons of prevention, diagnosis, and treatment options
• Improving health care systems
• Communication and dissemination
• Addressing disparities
• Accelerating patient-centered and methodological research

PCORI is looking for participation from patients, caregivers, researchers and the general public.  General information can be found at
http://www.pcori.org/2012/priorities-agenda/
.

Source:  Patient-Centered Outcomes Research Institute.  Draft National Priorities for Research and Research Agenda, Version 1.  January 23, 2012. 
http://www.pcori.org/assets/PCORI-Draft-National-Priorities-and-Research-Agenda-2.pdf

Paul M. Ellwood, JR., M.D., in First Person

In retirement, Dr. Paul M. Ellwood, Jr. still wrestles with the big issues that have fascinated him for much of his career – what is the best way to organize the health care delivery system?  What are the most effective models for group practices and managed care plans?  How can consumers make informed decisions about choosing health care providers based on quality? 

On September 17, 2010, Tony Kovner, professor at the Wagner School at New York University, interviewed Dr. Ellwood at his Bondurant, WY, home. In these video selections from the interview, Dr. Ellwood talks candidly about the HMO movement, formation of The Jackson Hole Group, and his views of the way that national health policy was shaped in various administrations. 

 The edited transcript of the entire oral history is available at no charge on the Center web site. 

Posted by the American Hospital Association Resource Center, (312) 422-2050, rc@aha.org.

Designing a “no wait” emergency department

Hospitals have long struggled with the need to reduce patient wait times in the emergency department (ED). According to data collected by Press Ganey, the total time spent in the ED–much of which may be spent waiting–is directly related to a patient’s overall satisfaction with the ED visit. In recent years, hospitals have begun to create and promote “no wait” emergency departments. To achieve a  “no wait” ED, hospitals must successfully bring together facility design, patient flow, a team culture, and a targeted marketing strategy. The following resources may offer some helpful guidance.

• Faulkner, J. Creating a no-wait emergency department. Healthcare Design. Nov. 1, 2006.  
  http://www.healthcaredesignmagazine.com/article/creating-no-wait-emergency-department
  
• Crane, J., and Noon, C. Strategies of a “no-wait” ED. Executive Insight. Dec. 13, 2010.  
  http://healthcare-executive-insight.advanceweb.com/Archives/Article-Archives/Strategies-of-a-No-Wait-ED.aspx
  
• Millburg, S. No-wait ED doesn’t even have a waiting room. Radiology Daily. October 21, 2011.
  http://www.radiologydaily.com/daily/diagnostic-imaging/no-wait-ed-doesnt-even-have-a-waiting-room/
  

Posted by the AHA Resource Center, (312) 422-2050, rc@aha.org.

Vital Records – Vitally Important Information

“Can you send me a copy of my birth certificate?” 

“Where can I get a copy of my marriage license?”

These are simple questions, but depending on the nature of your organization and the types of inquiries you handle, they may not be as simple to answer.  Enter the National Center for Health Statistics!  NCHS has put together an online directory of the state agencies that can supply certified and/or official copies of vital records: birth certificates, death certificates, marriage licenses, and divorce notices.  Fees are noted where applicable and complete addresses and phone numbers are supplied for initiating requests.

 Where to write for vital records:
http://www.cdc.gov/nchs/w2w.htm