Today we explore something that connects you, me, 8 billion people, and every living thing on our planet. One Health recognizes that human health, animal health, and the ecosystem are deeply linked. And if one part gets sick or damaged, its effects ripple through the whole system. Michael Wilkes tells us about how he combines medicine, his One Health work in Rwanda, and his career as a journalist. From rabies and bird flu, to superbugs and mountain gorillas, we hear about how One Health isn't just about reacting to crises like pandemics. It's about being better prepared for emerging health challenges.

Despite an increasing focus on person-centered care, patients frequently have little influence in matters that affect them the most. Hear how patient advocates amplify the voice of the patient and how these change agents work at the core of healthcare improvement efforts. Integrating the perspective of people ultimately affected by medical decisions identifies gaps in care that are often missed. Anna Edwards tells us about her journey as a person with a chronic condition and her years of experience in making sure that health systems hear the voice of the patient.

Kindness in healthcare, like in other settings, is contagious. It spreads through social networks and can trigger a chain reaction where people feel the need to pay it forward, a phenomenon called prosocial contagion. Initiatives to promote kindness in healthcare improve clinical care and patient outcomes, and reduce stress and burnout among healthcare staff. Kris Vanhaecht tells us about the Mangomoments initiative in Belgium that demonstrated the ripple effects of small unexpected acts of kindness in clinical settings on patients and healthcare workers.  

It might seem paradoxical. The very industry dedicated to healing and promoting health is also a significant contributor to the climate crisis. If global health care was a country, it would be the world’s fifth largest carbon emitter. Jeffrey Braithwaite tells us about how health systems, hospitals, and clinicians in Australia are working to reduce their carbon footprint.  Hear how making informed choices about tests, treatments, and procedures, and considering their environmental impact alongside their clinical effectiveness and cost is a vital part of this effort.

From epidemics, hurricanes, earthquakes, to cyberattacks, the ability of a health system to withstand and recover from shocks is crucial. Power dynamics, social pressures, religious beliefs, political structures, and global economies all influence how a health system handles strains. Events like the West Africa Ebola outbreak in 2013 and the recent COVID-19 pandemic highlighted just how fragile and interdependent health systems can be. Elom Otchi tells us about how his team in Accra, Ghana is working to build resilient health systems to maintain quality healthcare during a crisis.

Healthcare environments can be intense. A lot happens, sometimes very fast, and the stakes are high. Hospitals use incident reporting systems to identify and track adverse events and high-risk situations. These systems give healthcare facilities critical insights to prevent or reduce risks to patients. But adverse events in healthcare are underreported worldwide. Shin Ushiro tells us about Japan’s journey to building a national medical adverse event reporting and learning system and how to consider cultural, organizational, and political contexts in developing incident reporting systems in healthcare.

Places selling products and services, whether they are your favorite household goods store or your doctor’s office, want to measure what you think of them. In this episode we talk about PREMs and PROMs — Patient Reported Experience Measures and Patient Reported Outcome Measures. These are surveys that seek patients’ views and opinions on their health and their experiences at clinics and hospitals. Ezequiel García-Elorrio tells us about his experience with understanding patient experience in Argentina and cultural contexts to consider in collecting, interpreting, and using this information.

Artificial Intelligence can prioritize which patients to treat based on the severity of their symptoms and their risk of clinically worsening. It can review tests like mammograms 30 times faster than humans and bring down the need for unnecessary biopsies. Wearable technologies can monitor vital signs and symptoms and deliver personalized health recommendations. And AI scribes can document conversations at medical visits and increase clinical efficiency. These advances also bring up issues around trust, liability, privacy, bias, and patient safety. David Bates tells us about the kinds of tasks AI can best help clinicians with and how this is changing the way health care will be delivered going forward.

Despite astounding medical advances there are people all around us who face gaps in accessing the healthcare they need. Children of color are less likely to receive painkillers for appendicitis, fractures, and migraines. Women with dementia get worse medical care than men despite living longer with the condition. And people with disabilities get less preventative care such as blood pressure checks, cholesterol screening, and mammograms. Pamela Abner tells us about how her team at the Mount Sinai Health System in New York City works to collect valid and reliable data that helps them identify and tackle health disparities in their community.

Communication failures in healthcare can lead to medical errors and patient harm. Hear how huddles moved from the sports field at a college for the deaf and hard of hearing to the world of healthcare. Peter Lachman tells us about S.A.F.E. or Situational Awareness for Everyone, a program that he led for the Royal College of Paediatrics and Child Health at 50 hospitals across England. The program helped medical teams use huddles to improve their communication with each other and with families of children, and kept patients safe from errors in hospitals.