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Healthcare leaders around the country recognize that engaging patients through collaborative and personalized care is a key to reducing costs and improving outcomes.

To advance this cause, Massachusetts Health Quality Partners (MHQP), with the help of its Consumer Health Council (CHC), has created a new section on the MHQP website dedicated to supporting patients who wish to become more actively involved in their care and more engaged consumers of healthcare services.

The experienced patient advocates and activists on MHQP’s CHC took more than two years to research and compile the most helpful tools, guidelines and information related to patient engagement, and have now assembled and organized them for easy access for consumers on MHQP’s website.

“Finally, all of the best resources to help patients be more engaged and more empowered are available in one single place,” said Nancy Finn, a healthcare journalist and member of the CHC who helped lead the effort.

Among the specific categories in the resource are:

• What It Measures to Be an Engaged Patient
• Your Health Insurance Coverage and Options
• Talking About Healthcare Costs
• Communicating with Your Clinicians and Other Healthcare Providers
• Collaborating with Your Clinician to Plan Your Care

And many more…

“Our healthcare system is unduly complicated and extremely difficult to navigate,” said MHQP President and CEO Barbra Rabson. “This is an essential roadmap to help patients interact with their providers and with the healthcare system at large. We are so grateful to the volunteers on our CHC for dedicating so much time and effort to create this resource to benefit patients everywhere.”

MHQP sees this resource as an important element in shared decision-making and care planning. It was developed primarily to target patients who would most benefit from being more engaged in their care, such as those with chronic and/or high-cost conditions, and those with a new diagnosis who may be unfamiliar with navigating a new part of the healthcare system.

“We hope healthcare providers refer their patients to this resource and recommend that patients use it on their own, as a way to encourage them to become more actively involved,” said Rabson.

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GOAL 1. CREATE POSITIVE WORK ENVIRONMENTS: Transform health care work systems by creating positive work environments that prevent and reduce burnout, foster professional well-being, and support quality care.

GOAL 2. CREATE POSITIVE LEARNING ENVIRONMENTS: Transform health professions education and training to optimize learning environments that prevent and reduce burnout and foster professional well-being.

GOAL 3. REDUCE ADMINISTRATIVE BURDEN: Prevent and reduce the negative consequences on clinicians’ professional well-being that emanate from laws, regulations, policies, and standards promulgated by health care policy, regulatory, and standards-setting entities, including government agencies (federal, state, and local), professional organizations, and accreditors.

GOAL 4. ENABLE TECHNOLOGY SOLUTIONS: Through collaboration and engagement of vendors, clinicians, and expert health information technology system developers, develop health information technologies to support clinicians in providing high-quality patient care.

GOAL 5. PROVIDE SUPPORT TO CLINICIANS AND LEARNERS: Reduce the stigma and eliminate the barriers associated with obtaining support needed to prevent and alleviate burnout symptoms, facilitate recovery from burnout, and foster professional well-being among learners and practicing clinicians.

GOAL 6. INVEST IN RESEARCH: Provide dedicated funding for research on clinician professional well-being.

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The changing landscape of the U.S. health care system – how care is provided, documented, and reimbursed – has had profound effects on clinical practice and the experiences of the professionals who provide patient care (“clinicians”), students and trainees in the clinical learning environment (“learners”), and patients and their families. Mounting system pressures have contributed to an imbalance in which the demands of the clinician’s job are greater than the resources available to complete the job effectively.

This job demand–job resource imbalance is intensified by the increasing push for performance improvement, technology that hinders rather than supports patient care, changing professional and societal expectations, and policies that are insufficiently aligned with professional values or the goal of better patient care. Adding to these health system pressures is an explosive increase in medical data and a growing demand for health care as the U.S. population ages and many disciplines experience workforce shortages. Overwhelming job demands and insufficient job resources cause physical, psychological, and emotional stress, including burnout – a workplace syndrome that is characterized by high emotional exhaustion, high depersonalization (i.e., cynicism), and a low sense of personal accomplishment from work.

Studies estimate that between 35 percent and 54 percent of U.S. nurses and physicians have substantial symptoms of burnout, and the range for medical students and residents is between 45 percent and 60
percent.

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The Worksite Wellness Council of Massachusetts has announced the winners of its annual WorkWell Massachusetts Awards, recognizing employers that show outstanding performance in worksite health promotion, which includes programs to address workers’ physical and mental health, social connectedness, community involvement, and financial security.

The application process for the awards asked employers to complete the HERO Health and Well-Being Best Practices Scorecard in Collaboration with Mercer to assess an organization’s overall wellness programming. A supplemental application requested additional details on strategic planning, organizational support, program design and implementation, participant engagement, and measurement/evaluation process. A peer review committee of independent industry experts evaluated all applications and provided a free consultative assessment of the programs

The following MHA members are 2019 WorkWell Massachusetts Award winners:

Gold: Cambridge Health Alliance, Dana-Farber Cancer Institute, and Signature Healthcare.

Silver: Berkshire Health Systems, Boston Medical Center, and UMass Memorial Health Care

Community leader (Those that lead activities that have a profound effect on the health and wellness of a community): Boston Medical Center

More information is available at WWCMA WorkWell MA. Information on the application process for the 2020 WorkWell Massachusetts Award Program will be available in the early spring or can be requested by e-mailing awards@wwcma.org.

Take a look at South Shore Medical Center’s new state-of-the-art facility, located in the heart of Quincy Center at 1495 Hancock Street.

Cambridge Health Alliance undertook an Agency for Healthcare Research & Quality-sponsored 15-month safety improvement program to reduce infections in the ICU at its Cambridge and Everett hospitals. The effort – involving an assessment of potential problems, increased staff education, use of proven best practices, leadership buy-in and more – resulted in a dramatic reduction in urinary tract infections as well as central line-associated bloodstream infections (CLABSI).

Specifically, the “working toward zero” philosophy at the health system resulted in just one CLABSI throughout 2019 and zero catheter-associated urinary tract infections (CAUTIs).

Hospitals tackling infections usually employ the comprehensive unit-based safety program (CUSP) method developed by the U.S. Department of Health & Human Services’ Agency for Healthcare Research and Quality. CUSP offers a series of toolkits to educate staff and build teamwork to get everyone on board – from frontline nurses to ancillary staff – in the effort to improve care.

The Cambridge and Everett CUSP teams consisted of the chief nursing officer, associate CNO for critical care, associate CNO for professional practice, ICU nurse managers, ICU educator, front-line staff nurses, infection preventionists, medical director of critical care, critical care doctors, and infectious disease physicians.

They first worked to define the problem, pinpointing the hospitals’ relatively high use of urinary catheters and central line devices, the lack of practice standardization, and the fact that previous safety practices and improvements were not regularly sustained. The team then determined the baseline rates of catheters and central lines, and developed an action plan to reduce them.

To improve the caregiver-patient link they instituted the “AIDET” communications framework, which is a process from the Studer Group that stresses five communications behaviors: Acknowledge, Introduce, Duration, Explanation, and Thank You. To improve nurse-to-nurse communication, they instituted a standard process for each patient handoff. CAUTI and CLABSI “prevention bundles” were developed to ensure standard protocols relating to decision-making, insertion, assessment and documentation, line care, removal, and more. A whole host of other detailed, step-by-step, repeatable processes were laid out and re-emphasized in ongoing team education programs.

Developing a culture of safety in a do-no-harm environment was established by creating modality bundles for CAUTI and CLASBI. This was the framework for the nursing staff in the ICU to consistently follow a strategic process that resulted in measurable outcomes.

Lynette M. Alberti, R.N., Cambridge Health Alliance’s Senior Vice President and Chief Nursing Officer, said, “While achieving zero harm may seem impossible, it is not. This work is an important step in our journey to becoming a high-reliability, zero-harm organization.” That statement has been the driving force behind the facility’s effort to build a culture of safety.

Perhaps the biggest improvement at Cambridge was a re-emphasis on the “culture of safety,” meaning that anyone on the team – but especially the front-line nurses – can question at any time the need, or continued need, for line/tube insertion. “Safety Bedside Shift Reporting” with the patient has become a new standard of practice and a key driver of reducing harm events in both hospitals. “Multidisciplinary rounding” means the team gathers and gets to talk openly about how the central lines and catheters are being employed.

Patricia Noga, R.N., MHA’s VP for Clinical Affairs, said the path Cambridge Health Alliance took for its improvement project is similar to what is occurring at other hospitals across Massachusetts.

“The sort of improvements in care that Cambridge Health Alliance showed in this project is contingent on a committed team ensuring that each step for every patient is given the team’s unwavering attention and best practice implementation,” she said. “It’s easy to waver from tried and true processes but CHA’s results show that creating a culture where all voices are listened to and respected ensures that everyone is more apt to stay on the path towards improvement.”

It’s a celebration of the strength of the recovery community and a reminder that treatment for substance use disorder works. 

Learn more and stay tuned for how MHA is helping recognize this important  #RecoveryMonth .

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Big news from Cape Cod Healthcare! Vision 2022, announced on the eve of the 100th anniversary of Cape Cod Hospital, includes a new 6-story patient care tower.

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Hebrew SeniorLife and Brown University have received a five-year $53.4 million grant from the National Institute on Aging (NIA) to lead a comprehensive, nationwide effort to address Alzheimer’s disease and related dementias. NIA is a division of the National Institutes for Health.

 The funding will support the creation of a research incubator or “collaboratory”, bringing together 30 research institutions throughout the United States to conduct pilots to test non-drug, care-based interventions for people living with dementia, and also to develop best practices for implementing and evaluating interventions for Alzheimer’s and dementia care and share them with the research community.

 Dr. Susan Mitchell, senior scientist at Hebrew SeniorLife’s Hinda and Arthur Marcus Institute for Aging Research and professor of medicine at Harvard Medical School is co-leader of the collaboration, along with Dr. Vincent Mor, professor of health services, policy and practice at Brown’s School of Public Health.

 Pilot projects throughout the country will benefit from the collaboratory’s experts, who will assist with ethical concerns (such as how to secure informed consent from people living with dementia); technical support and generation of data on participant populations; statistics and project design; advice on how to measure patient- and caregiver-reported outcomes; dissemination of results and efforts to maximize the likelihood of implementation; partnering with healthcare systems interested in conducting trials; project administration; training for junior researchers; inclusion of and applicability to people of all backgrounds and cultures; and best practices to engage people interested in this work, including people living with dementia and their caregivers.

 “It’s time for Alzheimer’s and other dementias to receive the same level of research focus and investment as cancer,” said Louis Woolf, HSL president and CEO. “We’re proud to collaborate with Brown University to address this national epidemic that affects not only patients, but their families and caregivers as well.”

What we need to do differently to generate enthusiasm and increase participation.

There is definitely an art to creating enthusiasm and generating participation in your company’s worksite wellness initiative.

From our perspective, based on practices of Well Workplace Award winning companies, we suggest organizing your participation with the some ideas.

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