WIHI - A Podcast from the Institute for Healthcare Improvement

Date: March 8, 2018

Featuring:

• Kate FitzPatrick, DNP, RN, ACNP, NEA-BC, FAAN, Chief Nursing Officer, University of Vermont Medical Center

Part of the appeal of mindfulness​ is the simplicity of its central tenet: bringing awareness and focused attention to the present moment. Mindfulness also offers a measure of control when everything else feels out of control.

As stress-reduction and other health benefits of mindfulness become better known, clinicians are discovering that they, too, need new ways to deal with stress…often on the fly. Practicing mindfulness can be restorative in the middle of a hectic day, create mental space to be more tuned into patients, and reduce the likelihood of medical errors.

So, what does practicing mindfulness look like, in practice? On the March 8 episode of WIHI, Mindfulness and Patient Safety, we learned from two leading experts on how mindfulness can intersect with the health care workforce, their tasks, and their interactions with patients.

Date: February 22, 2018

Featuring:

• Sarah L. Szanton, PhD, ANP, FAAN, Associate Director for Policy, Center on Innovative Care in Aging, Department of Health Policy and Management, & Johns Hopkins Bloomberg School of Public Health

One of the biggest challenges facing older patients with disabilities is that the care and support services needed to function optimally at home are often fragmented — and not always obtainable. Thi​s is especially true for low-income disabled adults whose home circumstances may not fit the bill, literally and figuratively, for what public insurers such as Medicaid and Med​icare will cover.

In a handful of communities in the US, a program called CAP​ABLE​ is demonstrating low-cost, practical ways to fill the void. The research into the health benefits and cost savings associated with CAPABLE are yielding impressive results. Learn how the model works and how it might be spread to other communities on this episode of WIHI: Aging in Place with a Disability and Dignity

Date: February 8, 2018

Featuring:

• Gordon Schiff, MD, Associate Director, Brigham and Women's Center for Patient Safety Research and Practice; Quality and Safety Director, Harvard Medical School (HMS) Center for Primary Care

We don’t like to think of the diagnosis process as causing as many problems as it’s trying to solve. But when the complaints are more chronic than acute, there’s growing concern that a plethora of diagnostic tests and procedures have raised expectations of always finding a precise answer or explanation. When that's not possible, or tests aren't recommended as the first line of attack, a provider's clinical observations and reasoning can seem less than satisfactory.

It’s this complexity of diagnosis and the difficulty of sometimes having to admit "there's no way to know for sure" that we explored on the February 8 WIHI: Practicing More Careful and Thoughtful Diagnosis. Our guests shared new thinking about better ways to engage with patients when diagnostic certainty isn't possible and how to create strong, trusting relationships that break from the mold of  “doing something” or “doing nothing at all.”

Date: January 25, 2018

Featuring: ​

• David M. Williams, PhD, Executive Director for Improvement Capability, Institute for Healthcare Improvement (IHI)

 Health care systems are under tremendous pressure to create and sustain transformative changes on multiple fronts: patient and worker safety, overall quality of care, moving from volume to value, and population health, just to name a few! The job of overseeing these efforts, and nurturing the culture and vigilance required to stay on track, is increasingly the province of the Chief Quality Officer or CQO.

 In many ways, the CQO functions as symbol, sense maker, and keeper of the flame for constant, unwavering, system-level change. The CQO also often marries quality aims with an organization's financial and strategic goals. He or she cannot spearhead these efforts alone, and field research suggests that having a designated CQO position sends the message to staff that leadership takes quality seriously.

 The CQO role is relatively new and still evolving​; in some organizations CQO-like responsibilities reside with an Executive Vice President, CMO, or CNO. Regardless of who is serving in this leadership position, it's important to ask: What do CQOs need to focus on most? We learned how some CQOs define their roles and priorities on the January 25 WIHI: What's in a Name? Health Care's Chief Quality Officer. ​​

Date: January 11, 2018

Featuring: 

• ​​Glenn Crotty, Jr., MD, FACP, Clinical Associate Professor of Medicine, West Virginia University; Executive Vice President and COO, Charleston Area Medical Center (CAMC)

As efforts continue to curb the opioid addiction epidemic in the US and reduce deaths from overdoses​, the underlying problem of overprescribing remains very much in the spotlight. There's growing evidence that clinicians writing prescriptions for Vicodin, Percocet, OxyContin, and the like are adhering to new, stricter guidelines, and doing a better job keeping track of their patients taking opioids. 

But with these changes in prescribing, experts and providers are now looking to alternative ways to treat chronic and severe pain, especially for people vulnerable to addiction. On the January 11 episode of WIHI, we talked to providers from West Virginia, Alaska, and Massachusetts about new processes to help providers make careful decisions about the use of opioids, including expanding the use of physical, traditional, and integrative medicine as alternatives to prescribing opioids. We were joined by IHI Director Mara Laderman, co-author of IHI's ​Addressing the Opioid Crisis in the United States white paper​,  who helped draw connections between improving pain managemnt and the other critical drivers of the opioid crisis in America. 

We looked at what these providers and organizations are doing to improve pain management and combat the opioid crisis and more on this episode of WIHI: Opioid Crisis: Changing Habits and Improving Pain Management. ​