By Center for Healthcare Narratives
The podcast currently has 10 episodes available.
Today, Raj Ratwani, Vice President of Scientific Affairs at the MedStar Health Research Institute, Director of the MedStar Health National Center for Human Factors Engineering in Healthcare, and an associate professor at the Georgetown University School of Medicine, joins Tracy Granzyk to explore the intersection of patient safety and data in our U.S. Healthcare System. They explore the vulnerabilities introduced by electronic health records (EHRs) and artificial intelligence (AI) in healthcare, as well as the opportunities to improve the delivery of care using both tools. An expert in patient safety, digital health, and cognitive science, Raj engages in an informative and insightful conversation with Tracy highlighting patient safety, workforce readiness, and equitable AI applications in healthcare technology.
Raj begins by acknowledging President Biden's forward-thinking AI Executive Order, emphasizing its significance for healthcare and the need for proactive adaptation to AI integration. Central to the conversation is patient safety in the AI landscape, with a focus on establishing a comprehensive patient safety framework for AI. This framework centers on data collection, analysis, and dissemination to address AI-related patient safety concerns. The challenges of preparing the healthcare workforce, the importance of imparting essential AI knowledge, understanding potential challenges, and maintaining expertise in both traditional and AI-augmented healthcare are also discussed. Additionally, our duo touches on AI's broader impact across industries, emphasizing the importance of individuals acquiring AI-related skills to remain relevant in their careers. While addressing the fear of technological change, they highlight the opportunities that come from embracing AI and actively shaping its narrative. They also underscore the vital role of public-private partnerships in advancing AI while maintaining a balance between providing guidelines and fostering innovation in the dynamic AI landscape. Join Raj and Tracy today as, together, they guide us through the transformative era of AI in healthcare, prioritizing patient safety and excellence to ensure a safer and more equitable future.
Highlights:
Quotes:
"We have to make sure that these clinical algorithms have the right data sources that are underlying or leading to the development of them so that we have safe and equitable care for everybody."
"Patient safety is not always top of mind for people. To see that explicitly called out in the Executive Order, I think is fantastic."
"We have to look at this as an opportunity and latch onto this and figure out the right ways of integrating things that we're doing and take the best parts of it."
"We want to take all the things that humans are good at and preserve it and complement it with the computers and the artificial intelligence that can take care of all the things that we're not so good at."
"If we are going to take another decade to figure out AI from a safety perspective, we're in a lot of trouble."
Links:
LitHealth Homepage
MedStar Health
Raj Ratwani's LinkedIn Page
Joining Tracy for today’s episode is the truly remarkable Armando Nahum, a former patient advocate who has transitioned into an tremendously influential healthcare activist. Armando's inspirational story and educational presentations born out of his own family’s tragedy have left a profound mark on hospital administrations and frontline caregivers across the nation. Among his many achievements, he has become widely celebrated as the co-founder and president of Safe Care Campaign, an organization dedicated to infection prevention in hospital settings. He also holds key positions on various healthcare advisory boards and councils, including the CDC Council on Infection Prevention and the Georgia Hospital Association Advisory Board. In addition to being instrumental in establishing Patient and Family Advisory Councils (PFACs) aimed at enhancing quality and safety at hospitals across the country, Armando, in a highly significant achievement, was appointed to the Presidential Advisory Council for Combating Antibiotic Resistant Bacteria in February 2020. Most recently, he is a founding member of Patients for Patient Safety US in partnership with the World Health Organization (WHO), where he is leading influential healthcare policy change driven by patients and families.
In today's episode, Armando shares the patient advocacy journey that he and his wife, Victoria, embarked upon back in 2006 following a series of infections that impacted their family across three different hospitals in three states, and which tragically resulted in the loss of their son, Josh. He also shares sage insights, emphasizing the pivotal role of patient and family engagement in healthcare. The conversation delves deep into Armando's personal experiences and explores broader themes of patient advocacy, PFACs, and the critical importance of transparency within healthcare. Vitally important topics covered in this enlightening discussion also include the necessity of cultivating a culture of safety and the unification of patient experience and safety. Armando's remarkable journey from personal tragedy to impactful advocacy serves as a powerful reminder of the need for change and improvement in healthcare. Through education, transparency, and the establishment of a culture of safety, he advocates for the construction of a healthcare system characterized by integrity and compassion. Armando's legacy is a resounding call to revolutionize healthcare for the betterment of all individuals involved.
Highlights:
Quotes:
"You need to be aware that healthcare events can happen to anyone. It's not just a select few."
"In healthcare, we tend to spend more time on ‘after the fact’ than ‘before the fact’. We should spend more time before."
"The patient experience has to encompass quality and safety. The minute you separate them, that's when trouble starts."
"People need transparency in healthcare. There's no reason for institutions to hide behind their attorneys."
“If you have a PFAC, you're not using it correctly unless they go out in the community and start educating. To me, education is at the forefront.”
Links:
LitHealth Homepage
Patients for Patient Safety US
Tracy welcomes esteemed patient safety advocate and President/CEO of Project Patient Care, Marty Hatlie, to the podcast today for a conversation that delves deeply into the core of patient safety and the integral roles patients and families play in elevating healthcare outcomes. Together, they engage in a timely dialogue which underscores the urgent call for a healthcare landscape that treasures transparency, equity, and the voices of marginalized populations. Marty's personal journey from a lawyer advocating for doctors to a fervent patient safety advocate is also unveiled, highlighting the challenges and potentials within patient safety.
Emphasizing the significance of systems thinking and accountability as catalysts for enduring transformation, Tracy and Marty reinforce the critical value of patient engagement and federal leadership while offering a revolutionary perspective for a new era of patient safety and equity. The episode also explores COVID-19's impact on patient safety and healthcare disparities, and introduces The Academy for Emerging Leaders in Patient Safety focusing on its mission to connect patient narratives with education to foster cultural change. As the episode concludes, our duo rallies listeners to partake in such patient advocacy and transparency endeavors as Patients for Patient Safety US. Join Tracy and Marty here today to gain crucial insights into this noble initiative to revolutionize healthcare for the betterment of all individuals and embrace a holistic vision of well-being, safety, and equality in the healthcare realm.
Highlights:
Quotes:
"We've lost the belief that the healthcare system can fix itself. It's just not going to. What we need is that paradigm shift towards systems thinking and transparency."
"The conflation of safety and equity is going to be a very exciting part of our next chapter, really looking at the data and looking at how some people just don't get the kinds of fairness in the healthcare system that we all deserve."
"This is a system that's supposed to work for me. And if it doesn't work for me, I'm entitled to speak up and say something about it."
"It shouldn't be our job ethically as patients and family members to be the agents for change. But again, it's been 20 years. We haven't seen it happen."
"We still fight with people just to get safety even on the agenda of the undergraduate curriculum."
"The challenges of driving transparency in healthcare are immense, particularly when the system resists change."
"COVID-19 exposed vulnerabilities within the healthcare system, particularly in nursing homes, leading to discussions about infection control and the importance of patient advocacy."
Links:
LitHealth Homepage
Project Patient Care
The Academy for Emerging Leaders in Patient Safety
Steve Burrows is a writer, director, performer, and producer who began his career in Chicago, joining Second City director Dell Close as a member of the critically acclaimed and groundbreaking improvisational comedy group ‘Baron's Barracudas’. After relocating to Los Angeles, Burrows began his film and TV career with an award-winning short film, "The Soldier of Fortune." Since then, he has gone on to win over 75 awards for writing and directing television commercials on five continents.
After Steve’s mom was harmed by medical care in Wisconsin, he took time out from his successful film career to advocate for her. In this episode of Lit Health, he touches upon his fascinating career, why stories matter, and delves deeply into his experience with the medical system, its need for policy reform, and the role he has taken on as an advocate in this space with our host, Tracy Granzyk.
Highlights:
Quotes:
"The medical industrial complex is so large and so powerful, it's hard for the average person to navigate."
"If you don't have a voice, you don't have a choice."
"We need more accountability in the healthcare industry."
"Patient advocacy is not only a right, it's a responsibility."
"The truth is the only thing that will set us free."
Links:
LitHealth Homepage
Steve Burrows
HBO Documentary: Bleed Out
Tracy’s guest on this episode is Clarinda Ross, mom of three and accomplished actress, writer, and special needs advocate. Clarinda began her journey as a patient advocate thirty-three years ago when her daughter Clara was found to have developmental delays, the experience of which she channeled into her one-woman show Spit Like A Big Girl. Clarinda begins the episode discussing her experience parenting a child with special needs and navigating the healthcare system two years before the Disabilities Act was signed into law. She describes how the challenges of getting the right care for Clara forced her to develop real gumption in ensuring that her daughter could live her best life, including letting her go when the time was right. She also discusses how forming an advocacy team, including speech and occupational therapists, helped ensure Clara’s needs were understood by the school and healthcare systems.
Next, Clarinda talks about Spit Like A Big Girl, how it developed from her experiences in childhood and parenting Clara, and the impact it’s had, particularly in making healthcare professionals rethink their approach to special needs patients and their families. In particular, she discusses the tendency for special needs diagnoses to be framed as death sentences and argues that while your child may have a different life than you imagined, it can still be one filled with joy. Tracy then asks Clarinda to talk about how she’s extended the skills she’s gained as an advocate for Clara into advocacy for other family members, including her mother and husband. Clarinda explains that while the healthcare system is improving in terms of listening to patients and sharing records, it’s still wise to take a trusted person with you when meeting with healthcare professionals to have someone who can take down all the details and back you up when necessary. And finally, Clarinda closes the show by sharing a little about how Clara’s doing today, at age thirty-three, settled in a group home, and living her best and most independent life.
Highlights:
Quotes:
“Somewhere around two, when I got some really definitive tests saying that the gaps were not going to close all the way, and this was going to be a lifelong care situation, I did not sit down. I did not, you know, cry. I thought, okay, well then what can I do to give her the best life? How can I do that? And I just… I just pushed on.”
“I came out the stage door, and there was an older man waiting there for me. And he was a doctor, and he just had tears in his eyes. And he said, ‘You made me think. You made me think about the way that I talk to mothers.’ He was a pediatrician there in the town, and I said, ‘Well, good. Yay! I’ve had a great day’s work.’”
“This play is a love letter to occupational therapists. I have a whole section in there that I call ‘the Church of Occupational Therapy.’ I used to be a Methodist, but now I am devoted to the Church of Occupational Therapy because it works.”
“It doesn’t have to be a death sentence. What it has to be is… it might not be the life that you thought your child was going to have and the relationship that you were going to have with this child, but it can be full of joy.”
“If it’s not like that, if it’s not you’re in a life-threatening situation, and especially if they are wanting to operate on you, take a minute before you do anything invasive. And ask questions, and get that person to come and sit with you, and get that other opinion, and another opinion.”
Show Links:
Tracy’s guest on this episode of Lit Health is Dr. David Mayer, Executive Director of the MedStar Institute for Quality and Safety, where he leads quality and safety programs in support of discovery and learning and the application of innovative methods to operational clinical challenges. A cardiac anesthesiologist by training and a medical educator by passion, Dave has spent the last three decades fighting for a safer healthcare delivery environment and recently served as CEO of the patient safety movement Foundation, where he led global patient safety efforts and initiatives in sixty-four countries and over 4,800 hospitals. He’s currently at work on a memoir of sorts, detailing his walk across pandemic-hit America during 2020 to keep all eyes on the continued need to make healthcare safe for patients and providers.
Dave starts the episode with the story of starting his cross-country walk and how it was inspired by his frustration with the lack of progress in healthcare safety during his thirty-year career and his desire to do something out of the ordinary to draw attention to this crisis. He then explains that the COVID-19 pandemic hit just two weeks into his walk and discusses the things that surprised him most about the country’s response, including the social unrest in many cities and the polarized reactions people had to masks (including threatening Dave for wearing one). He also points out one of the best things about his walk—being joined by patients and families who had lost loved ones to preventable medical harm—and speaks about the impact patient advocates have had on his career, as well as his realization that focusing on personal stories and narratives is necessary to help people understand the importance of healthcare safety on a human level. Next, Dave discusses his summer camp program, the Academy for Emerging Leaders in Patient Safety, its history and development, and its impact in informing and training emerging and future healthcare leaders in advocating for and implementing quality and safety concepts in their organizations. He also talks about the need to include the softer sciences, such as communication, leadership, and teamwork, in medical education and how the medical profession can learn about this from aviation and other high-risk industries. Dave then returns to his book, sharing his hope that it will help readers connect the statistics on preventable medical harm with the personal stories he’s gathered and encourage more people to take action by asking their leaders why more isn’t being done to make healthcare safe for patients and workers. And he wraps the episode up by explaining the developments he believes are necessary to improve quality and safety, including setting up a National Patient Safety Board and increasing transparency in quality and safety outcomes so that patients can make informed decisions on who provides their care.
Highlights:
Author Deanne Stillman, a widely published, critically acclaimed writer of literary nonfiction joins Tracy on the podcast today. Her latest book, Blood Brothers, won the 2018 Ohioana Book Award for nonfiction, received a starred review in Kirkus, and was excerpted in Newsweek. The book they’ll be discussing today is Deanne’s 2001 work Twentynine Palms, an LA Times bestseller and Best Book of the Year, which Hunter Thompson called “a strange and brilliant story by an important American writer.” Twentynine Palms tells the story of the murders of Mandi Scott and Rosalie Ortega by Marine Valentine Underwood, recently returned from the Gulf War. Through this tragedy, the book takes a deep look at socioeconomic health disparities through the lives of those who choose to call the desert home, living in the shadows of the world’s largest Marine base at the edge of Joshua Tree National Park.
Tracy begins the episode by talking about Twentynine Palms’ relevance to healthcare, pointing out its focus on social determinants of health, specifically the poverty that underlies the book’s desert community. She then hands the discussion over to Deanne, who speaks about her lifelong connection to the desert and its status as a sanctuary for many people looking to start their lives over, before setting out the story of Twentynine Palms and how she came across the murders of Mandi and Rosalie. Tracy points out the link between location and health and wellbeing, and Deanne speaks about the fatherless, rootless desert community depicted in her book and how its real focus is America’s working class. She also points out that, just like the desert, the US military provides escape from dire circumstances for people all over the world, including those women who marry into the armed forces. Tracy and Deanne discuss the #MeToo movement, how sexual violence affects women of all classes, and how important it is for everybody to have a voice in society. Deanne also relates the story of the Mandi Scott Scholarship, set up by Mandi’s mother, Debbie, and discusses how even a seemingly small amount of money can make a huge difference to a young person wanting to change their life. Finally, Deanne gives us a look at her new project, Ghost Cats, a book focusing on the last mountain lions of Los Angeles. An important conversation with a truly ‘important American writer’, today’s episode is one you absolutely do not want to miss. You can find 29 Palms via Angel City Press
Highlights:
- According to a recent Blue Cross Blue Shield survey, zip code predicts up to 60% of our wellbeing and our health. San Bernadino County has California’s highest rate of poverty relating to single mothers.
- Deanne’s essays have appeared in Lit Hub, The Independent, The New York Times, LA Times, High Country News, and The LA Review of Books, where she was formerly a columnist.
- She found her way into Mandi and Rosalie’s story after a hike in Joshua Tree when she stopped in at a local bar and overheard some gossip about two girls who had been “sliced up” by a Marine.
- Mandi’s family came west with the Donner party and managed to survive, settling in California; Rosalie’s family is Filipina, her mother grew up in a shack in the jungles of Batangas, marrying into the military as a means of escape.
- Absent or neglectful fathers are a theme that runs through the book, along with the nationwide epidemic of sexual violence against women.
- The murders took place on dollar drink night at the local bars, which occurs every two weeks on Marine payday and is a night that violence in town spikes.
- Some of the women and girls Deanne...
In today’s episode, Tracy is joined by Dr. Ronald Wyatt, a global healthcare patient safety and quality improvement expert, and well known health and healthcare disparity and equity champion. Dr. Wyatt is also a Senior Fellow at the Institute for Healthcare Improvement, former co-chair of the IHI equity advisory board, and currently serves as faculty for the IHI Pursuing Equity Initiative and facilitator for the ACGME Equity Matters collaborative. During his illustrious career, he has held the position of Chief Quality and Patient Safety Officer at Cook County Health in Chicago, and was the first Patient Safety Officer at the Joint Commission, as well as the first African American Chief Medical Resident in 1987-88.
The episode starts with Dr. Wyatt’s story of his experience with racism during an encounter with police in 1970s Alabama, a subject on which he wrote a paper describing the event. He talks about how that experience has stayed with him and how it relates to current issues around inequity, disparity, and structural racism, particularly regarding trust. He quotes surveys that demonstrate the low levels of trust the Black communities have in healthcare systems, and suggests that the disrespect experienced by these communities within the healthcare system prevents trust. Moving on, Dr. Wyatt addresses the challenges involved in getting those in leadership positions to acknowledge and address issues of structural racism and how, while there is still a long way to go, some progress is being made by medical institutions and governing bodies. He mentions initiatives that are attempting to educate the healthcare world on these issues and suggests that a major part of getting people’s attention is to make addressing inequity and disparity a prerequisite of accreditation. Dr. Wyatt points out the low representation of Black physicians and how that plays into disparities in healthcare quality. Finally, on a positive note, Tracy and Dr. Wyatt discuss one of the initiatives he’s involved with that is making significant progress in this area and how important it is to keep fighting and to believe that change is coming.
Highlights:
- The Kaiser Foundation’s “Undefeated” survey demonstrating the low level of trust Black and Latinx communities have for institutions such as the police and hospitals.
- Another survey showed that younger Black people, in particular, tend to have much lower levels of trust in health and healthcare.
- Dr. Wyatt’s biggest challenges in his career have been around getting people in leadership roles to accept and address the problem of systemic racism.
- Governing bodies, including CMS and the NCQA, are beginning to take steps to address racism, and Dr. Wyatt is hopeful this will lead to a national patient safety goal.
- Dr. Wyatt participates as a facilitator at the Accreditation Council for Graduate Medical Education in Chicago and sits on an Equity Matters collaborative there, supported by insurers Blue Cross and Blue Shield of Illinois.
- This initiative aims to educate healthcare workers about topics including inequity, disparity, racism, allyship, and the impact trauma has on inequity. It also focuses on how graduate medical education can evolve to address issues of structural racism.
- Dr. Wyatt points out that attaching financial penalties to ignoring inequity and disparity is the most effective way to get people’s attention.
- When Dr. Wyatt was at the Joint Commission, he witnessed care teams reporting incidents of racism because they felt they had nowhere else to go.
- The number of Black physicians in the US is ~5%, with the total number practicing medicine at 3%—the same number it was in the late 1800s, however the number of black medical students is increasing.
- Dr. Wyatt states that the ability to sit with people who...
On this inaugural episode of Lit Health, host Tracy Granzyk is joined by Rosemary Gibson, author and Senior Advisor at the Hastings Center. Rosemary’s most recent book, China Rx, highlights the centralization of globally supplied medicines in a single country and the implications of this in the event of a global pandemic, natural disaster, or geopolitical event. Published in 2018, China Rx has been recognized as prophetic in the wake of the COVID-19 pandemic, and Rosemary’s expertise has subsequently been sought by the House Energy and Commerce Health Subcommittee, the CIA, and all fifty states’ emergency preparedness directors.
First, Rosemary discusses how she researched the then-untold story of US dependence on other countries for the supply of medicines. She traces the history of outsourcing drug manufacturing to China and the lack of standards there, which led to long supply chains (a particular problem during a global pandemic) and problems with the quality of medications. She also reveals that hospitals in the US suffered shortages and had to ration some medicines over the last year as global demand spiked and that this is directly related to the lack of generic medications manufactured domestically. Rosemary then discusses the problems with quality control of foreign-manufactured drugs, the harm that has been done to patients as a result, and the importance of being an engaged patient when dealing with prescription medications. Finally, she calls out US companies for prioritizing cheap products over high-quality ones and expresses her concerns at the diminishing power of the FDA to assure the quality and safety of medicines sold outside the US.
Highlights:
- Rosemary’s impressive resume.
- China Rx came about as a result of Rosemary searching for her next book topic and discovering how great the US’ dependence on other countries for medicines was, as well as how this affects patient safety.
- The early-to-mid-2000s push to outsource production of generic drugs to China, where there were virtually no standards.
- Long supply chains have become the norm, but they don’t work during a global pandemic.
- In 2020, the US was weeks away from not having access to sedatives that help people on ventilators and was rationing antibiotics.
- Allegedly, the US was dependent on China for about 90% of the core materials to make basic drugs used in hospitals, especially during COVID.
- The US does not make medicines including penicillin, aspirin, and even vitamin C. However, recently it was announced that a company based in Tennessee will buck this trend by making penicillin again.
- China has threatened to withhold medicines from the US, creating a national security issue.
- China Rx has had an impact on the drug industry, with companies making different and better decisions about their supply chains because of it.
- Medical harm due to poor prescription medication quality is hard to track, so the number of patients who die as a result of them isn’t known.
- The FDA couldn’t keep up with the onslaught of companies wanting to sell hand sanitizers to the US, with the result that some products containing methane slipped through and blinded customers.
- There are 900 footnotes in China Rx, and nobody has refuted anything in it.
- Rosemary is concerned by the diminishing role of the FDA in setting global standards.
- How to protect you and your loved ones from poor-quality medications.
- Country of origin is often missing from medicine boxes to avoid objections from customers.
- Find a pharmacist you can talk to and trust about these issues.
Quotes:
“There...
Welcome to Lit Health – lighting a fire underneath the status quo of healthcare through interviews with authors, healthcare leaders, and policymakers who are working to create a healthcare environment that is equitable, transparent, and that welcomes the needs of every patient – especially our vulnerable populations including the mentally ill, people of color and women who feel they are at risk in our current system, and anyone who feels bias or the isms affect their health and quality of life.
Join us to stoke the fire! We want to hear the health-related stories from our listeners on both sides of the bedrail, the courtroom, and the aisle.
I’m Tracy Granzyk, host of Lit Health, Executive Director of the Center for Healthcare Narratives at the MedStar Institute for Quality & Safety, and Editor-in-Chief, of Please See Me, an online literary magazine looking to elevate the voices and health-related stories of vulnerable populations and those who care for them.
The podcast currently has 10 episodes available.