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Posts Tagged ‘Maine Quality Counts’

Maine Patient Safety Academy, Rising Tide Award

September 15th, 2013 2 comments

 

On September 13, 2013, I was recognized  for my work  by the Maine Patient Safety Academy.   It was their inaugural  award ceremony and I am extremely humbled and proud  to have been chosen for this award.  I was in the company of  a nurse from Maine Medical Center who dropped the CLABI rate to ZERO in her NICU and  a doctor whose serious determination, dedication and teaching has made patients at MMC and all over the State of Maine safer.

Maine Patient Safety Academy, Rising Tide Award

I am very grateful for this recognition from the PSA and to the people who nominated me for this award.

I remember the first time I attended the PSA.  3 years ago, I walked into the event, alone, and not knowing anyone.  I had been working hard at that time on MRSA prevention in Maine and on the national level.  I knew that many  in the Maine Hospital community were against what I proposed for the State,  Active Detection and Isolation for the prevention of MRSA in Maine Hospitals.  I am still a firm believer in that approach to MRSA prevention.  Not knowing who was at the event, except for Judy Tupper, the organizer of the event, I felt a little skeptical and nervous.  At the same time I knew I had to broaden my knowledge base and collaborate with others who are doing the work.    During my attendance,  I learned about the work that dedicated professionals were doing in my own State.  I was so impressed with this energetic conference, that I promoted it to my national group of Patient Safety Advocates with the Consumers Union Safe Patient Project.  By the following year, the CU  had formed a sub group called NEVER, or Northeast Voices for Error Reduction.   This smaller group joined me at 2012 at the Maine PSA!  I was so proud and excited to welcome them to Maine and to introduce them to some of the Patient Safety work that Maine was doing.  Three of us did a co presentation on Patient Safety as a break out session.  Inclusion of healthcare consumers and the Patient’s voice was a significant gesture of the PSA.

I continued to work doggedly for the past year.  I attended, helped to plan and participated in conferences here in Maine and nationwide.  This year when I attended the PSA, I knew a lot of the attendees, and even the keynote speaker.  I  met him at the Institute of Medicine event I attended last spring, and he  remembered me and came up to me to chat!  He is a wonderful young ER doc from Boston.  He and I share  similar tragic healthcare experiences with a parent.     My new participation in the Maine Quality Counts Consumer Advisory Council has opened even more doors for me to bring my ideas and the patient’s voice to healthcare reform in my State.  I also continue to advocate for individual patients, which is my most gratifying work of all.    More recently, I have reached out to my own city’s healthcare leadership to field the possibility of forming a Patient and Family Advisory Council in our community.

I don’t have a guidebook to do this work, but my path  becomes clearer as I go along.  My goals never change… they are accessible and affordable, safer, infection free care for all and inclusion of the patient’s voice in all levels of healthcare decision making.    I feel more comfortable in my own skin every time I go to another conference, event or meeting.

I have my beautiful award prominently displayed on my living room mantle.  I will bring it to my MQC Consumer Advisory Council meeting on Sept 20, 2013 and proudly share it with my consumer colleagues there.  But, I will not allow my head to swell, and I will keep my feet firmly planted on the ground and keep plugging away to make patients safer.

 

They called me crazy!

June 19th, 2013 33 comments

I recently ran into a doctor, that I knew during my work on MRSA prevention in 2009.  Well, actually I corralled him in a lobby after he did a presentation at a recent conference I attended.  He remembered me, and he didn’t call on me for Q&A, so I decided not to let him get away with that.  I have never been rude to anyone in my work, but I am certainly determined and honest.

His demeanor has changed drastically from when he testified against the bill I wrote in 2009, to prevent MRSA infections in Maine Hospitals.  I don’t know  if he was afraid of me because I am bigger than him, or if he agreed with others who called me crazy 4 years ago, but I sensed his discomfort while talking with me.    Even so, he was incredibly candid.  He actually told me that “they” called me crazy and they thought I would quit and give up on my endeavor for safer healthcare.  He was a more humble and agreeable man than I remember.  I believe that his personal healthcare experiences with his beloved parents  have changed his tune.  It’s amazing how humbling an experience with healthcare harm can change just about anyone’s perspective on the whole issue.

Imagine…calling me crazy.   Perhaps I was a little crazy.  I was crazy with anger and grief, because a downright dangerous healthcare system killed my father. His infection WAS preventable, but his facility failed him.    I believe that my craziness was justifiable.   My craziness  led to passion and an obsession of sorts.  That passion was to make a change in the lax and cavalier system that allowed this to happen to my father, and as I learned later, hundreds of thousands of others.   Passion led me to others, MRSA activists and experts, the internet, other MRSA victims and their families, legislators here in Maine,  media both written and TV, the Consumers Union Safe Patient Project, Maine Quality Counts, Maine Quality Forum, Maine CDC, CDC headquarters, the Federal DHS HAI stakeholder meetings, speaking and presentation opportunities, conferences, blogging….and on and on it goes.   My trip because of my craziness continues to be amazing.  The most amazing part of this work has been the other “crazy” people I have met.  Some of the most amazing patient safety experts and advocates in the world are on my email list.

Call me crazy, but I’m feeling pretty good about what I am doing….and if it helps to eliminate healthcare harm….we can add craziness to the list of necessary ingredients for success.

 

 

 

 

 

 

Sorry, but I am not accepting new doctors at this time

June 1st, 2013 No comments

This past week, I got an email from my independent doctor saying that she is going to close her practice.  Darn.  I have gone to her for about 10 years and I am pretty settled in.  I only had to get on her case a few times and she was pretty responsive to my ideas and complaints.  I wasn’t a whiner, but I never hesitated to pursue an issue with her.    So, after my July annual exam, I will be shopping for a new doctor.  Fortunately, I will be able to take my time, because generally, I am pretty healthy and I don’t deal with ongoing chronic health problems (well, except for excess weight).

Yesterday I was part of a “patient panel” at the Maine Quality Counts educational session for 75 Patient Centered Medical Homes.  Most of them were brand new to the PCMH brand and ideology. The model for PCMHs  includes Patient and Family Advisory councils for each practice.    This was the 3rd time that MQC has asked me to be part of a panel, so I am getting more comfortable with it as I go along.  3 other brilliant and engaged patients/consumers were also on the panel.  Our moderator was Bev Johnson, CEO of the Institute of Patient and Family Centered Care.  My only discomfort with being part of this panel was that I didn’t feel that I was prepared very well and didn’t really know what was expected of me.  The four of us met with Bev before the panel discussion, and she didn’t tell us what to do.  She gave us a simple format and the rest was up to us.  OK…I can handle that.  Bev is all about Patient Centeredness, and that must be what it is like to be in a practice or Hospital that embraces that concept.  The voice of the patient is wanted and necessary and the patients are  highly respected and honored.  Bev is such a wonderful, gentle teacher and so highly regarded for her work, and I completely understand why.

So, each of us patients introduced ourselves and told our stories of Patient engagement.  I was stunned by the powerful stories of the others on the panel. Amazing really!  When I finished my story about becoming engaged before my hysterectomy for uterine cancer in 2011, I added a little zest.

I told the audience…almost all of them providers…that I was not part of a PCMH, and in fact my independent doctor was shutting down her practice and I wasn’t a patient of anyone.  I said I lived in Bangor, on Pearl St, and that  I was up for bids!!   It was perhaps the lightest moment of the day….and the entire group cracked up.  BUT, surprisingly 2 Bangor PCMH practices bid on me.   That was so funny…   I told them if I chose one of their practices that I would help them with their Patient and Family Advisory council.   The one thing that occurred to me after I got home was that I didn’t make a choice after their bids.  Maybe I should have politely told them  “I’m sorry, but although my doctor is closing her practice, I will not be accepting new doctors at this time”.  Talk about turning the tables!  Patients hear that a lot…”Dr X is not accepting patients at this time”.  I spent 10 years in my previous practice under the care of a very young PA waiting to become a patient of the practice’s doctor.  When that PA told me she was leaving and I would get yet another very young, inexperienced PA, I asked again about becoming a patient of the doctor who co-ran the practice with her husband.  Again, I was told…”she isn’t taking any new patients”.  My arguments about being a patient there for 10 years didn’t pan out, so I found the newer doc….who is now shutting down her practice.

All joking aside, when patients lose their regular doctor for any reason, it is a big deal.  The established relationships, trust and the comfort that comes with a long time provider is gone, and we, the patients, are burdened with the chore of finding someone new.  There is nothing like the trust we put in our regular doctors….just think about it.   We engage with them on our  journey of staying well or attaining wellness. That patient/provider partnership is the key to success.  So, finding a new doc to fill an old doc’s shoes is a daunting proposition.  I will find one, but I will take my time and do some asking around and quality and review checking online.

In the meantime, I will keep those two practices in mind, because they were brave enough and interested enough to actually  bid on ME!!

 

Institute of Patient and Family Centered Care

April 20th, 2013 No comments

From April 14 to April 18, I attended the Institute of Patient and Family Centered Care intensive training course.  I was alerted to this conference by my colleague Lisa Freeman.  I was unfamiliar with this approach to healthcare, but I had attended a very nice presentation by Bev Johnson, Director , for the Patient Centered Medical Home practices here in Maine.  She is a brilliant and kind teacher.  She recognizes that Patients and their families must partner  with providers to improve healthcare.   So, I knew that at least Bev’s involvement in this organization would make this training worthwhile.

I have been involved in Patient safety advocacy and activism for over 4 years now.  I belong to and affiliate with different organizations and I attend meetings, conferences, online webinars, phone conference calls, PLUS, I read everything I can get my hands on about Patient Safety.  The solutions are out there to make healthcare safer, better, and cheaper.  I know the problems and the negatives in Healthcare, but I also know that healthcare can be an miraculous cure for what ails you.  I have definite ideas about solutions for problems, but the quandary has always been…How do we get there?

The IPFCC training taught me how.  We include patients and families in every aspect of care, from the primary care office through discharge from the Hospital and into post Hospital care, whether it is in LTC, rehab, or at home.   Partnering WITH patients through out the journey of care is absolutely essential.  Patient and family advisory councils at every level are necessary.   TOs and FORs are removed from conversations regarding patients and families and in their place we put WITH.

I was skeptical.  What exactly is accomplished when providers partner with patients and honor them and their families? These are the measurable improvements that I heard about this week.

1. Reduction in HAIs (my initial reason and primary focus for doing this work!)

2. Reduction of medication and medical errors

3. Reduction of Hospital readmissions

4. Improvement of HCAPS numbers, improved Patient Satisfaction

5. Improvement of Healthcare outcomes.

6. Reductions of costs.

7. Elimination of Visiting Hours.   Family members are partners, not visitors.  Ability of all patients to have a 24 hours bedside advocate.

8. Increased honor and respect of patients and patient dignity.

9. Improved employee satisfaction and improved employee retention.

10. Patient Portals to Electronic Records and how to use them.

11. Addresses all 3 arms of the IHI Triple Aim.

This is the short list.  I heard stories of success, from patients and patient advisers,  and from Hospital administrators, providers and workers.  I learned that this work is not easy, but it is worth every minute of effort.    It is an approach that is inclusive of everyone involved and affected by healthcare  in a collaborative partnership.

Now what?  I plan to tell my colleagues at the Maine Quality Counts Consumer Advisory Council about my training.  I hope to mobilize them and MQC to do a survey of Maine Hospitals and to assess where Maine is at in PFCC. How many Patient and Family Advisory councils do we have in Maine, and are they honored, valued and included in the work of caring for patients?   Then we will go from there.  I has to happen.  I hope that it will happen very soon.  We need the change. We need to do whatever it takes to make patients safer, control costs, and preserve our ability to access care.

Last week I attended the Maine Quality Counts annual conference about achieving the Triple Aim in Maine.  This week I connected some big ole dots on how to do the work.

 

Maine Quality Counts Annual Conference, Afterglow

April 4th, 2013 4 comments

On April 2, Mike and I headed to Augusta for an overnight stay.  I had a very busy agenda lined up, mostly involving the MQC conference the next day. I helped to plan the event and I was going to participate in a couple of speaker panels.   But, I also planned to go to the Maine State House to testify in favor of LD 1066, an act to accept the Medicaid expansion for Mainers in need.  We arrived at around 1pm and with my 20 copies of testimony in hand and we left our car on the 4th floor of the garage across from the State House.  As we approached the door to the stairway, a woman suddenly collapsed in front of me.  She dropped like lead right onto her face, without breaking her fall in any way.   The woman with her was walking ahead and we all heard the thump.  Judy, the woman who fell, was knocked unconscious and she likely broke her nose and maybe other facial bones.  There was a lot of bleeding.  I immediately went to her side, plopped onto my rump on the ground and assessed her airway and pulse and her medical alert bracelet.  She was breathing, thank God.  I talked to her over and over, for about 3 to 4 minutes until she slowly came around.  I wasn’t the only one to help.  A group of complete strangers gathered and offered help.  One called 911.  Judy’s friend called her family and left messages for them.  Another lady brought a blanket to keep Judy warm.  Mike stood by in case we needed anything.  Then the EMTs arrived (heroes, each and every one of them).  Who knew that you cannot bring an ambulance up into that garage?  They lugged all their equipment up 3 flights of stairs.  They quickly and efficiently assessed Judy, and rolled her onto a back board, stabilized her neck, got some history from me, and then carried her back down those stairs.  They also facilitated Judy’s friend’s trip to the hospital ER, by telling her to bring her car around and to follow the second emergency vehicle…they showed her the way.  A very concerned and helpful  group of strangers rallied around Judy, to help her on her unexpected journey to the Hospital.

Judy was a kindred spirit.  She was on her way into the State house that day to testify against the use of insecticides on School yards and playgrounds.  She wanted to help protect our children from the toxic harm of chemicals.   She is just like me, she is an activist.

Judy’s fall impacted me in huge way.  Her fall is an example of how in one single second, our lives can change.  I suspect that Judy had a brain hemorrhage because of the medication she was on and the nature of her fall.   If I am correct, her life was altered in one second.  She was just beginning her healthcare journey, and already a dozen or more strangers had rallied to help her.  All of us were people who were not afraid to get our hands dirty to help another human being.

800 Mainers, also mostly strangers to each other, showed up on April 3, 2013 at the Augusta Civic Center to get their hands dirty, and to rally around Maine patients.   They came to hear the messages that Rosemary Gibson, and Dr Donald Berwick brought.  There were Healthcare providers, payers, consumers and leaders.  The messages they heard from our fierce bold speakers were that our healthcare system is unsustainable, unless we want to do without everything else we have grown accustomed to in our lives, like schools, libraries, snowplows, and food.   We heard that there is more than one way to get our hands dirty and take care of human beings.  Dr Berwick called them airplanes…..he talked about  discussions in Washington DC, where some said machines can’t fly, and he said “YES THEY CAN, LOOK UP, SEE THEM CIRCLING OVERHEAD!”   Because 800 people came to listen to-oh-so smart speakers and their dire message, I think they are willing to rally.  They are willing to do the work and address the costs and quality issues that we need to improve and sustain our healthcare system.

I was honored and so proud to be part of the MQC event.  I took part in a television interview seated next to Dr Lisa Letourneau and Rosemary Gibson!   I wouldn’t have even imagined that a year ago.  I managed to get back to the State House on April 2 to testify for the Medicaid expansion because I’d hate to think of any Maine woman having uterine cancer (like I did)  and not getting checked for it, because she couldn’t afford the visit to the doctor.  That evening, the MQC  hosted  a dinner at the Senator restaurant for the event planners, staff and speakers.   It was a very warm and inviting group. Everyone introduced themselves and each other.  Then we all trouped off to our homes and hotels to rest and prepare for our huge event April 3.

Judy’s unexpected fall and injury reminded me that she is what our work is about.  Her only thoughts must be to get back on her feet, safely and quickly (without breaking the bank)  and to get back home to her family.   And, eventually, when she is well again she can get back to the State House with her message.   Isn’t that exactly what we all want for ourselves when we are sick, and for all of the patients we work for.   I do believe healthcare reform is happening in Maine.

Although I am very inspired and enjoying the afterglow from the MQC annual conference, I have determined that helping Judy was the most important thing I did during my two days in Augusta.  She grounded me, and removed the stars from my eyes and taught me that helping and humanity is what it is all about.

Addendum:  I got this message just now, about the State of the State show interview.

This our State of the State Show with Rosemary Gibson, Lisa Letourneau and Kathy Day, it will air between April 16-26th

Time Warner Cable affiliates statewide air State of the State on Channel 9 on Tuesday the 16th and 23rd at 7:00 p.m., Thursdays the 18th and 25th at 6:00 p.m., and Friday the 19th and 26th at 10:00 a.m. However, air times may vary due to periodic program preemptions and rescheduling. To check the current Time Warner program schedule in your area, click here.

Other community television stations that are running the program are WOGT, Ogunquit; WVACTV Channel 2, Bethel; CATTV, Baileyville; Harpswell (for latest listings,click here), Freeport; Bath Community Television Channel 14, Mt. Blue Community TV, and Brunswick TV (for latest listings, click here)

April 16-26

Transforming Health Care in Maine

Guests:

Rosemary Gibson, National health policy advocate, speaker and author. Author of The Treatment Trap.

Kathy Day, Maine Quality Counts Consumer Advisory Council

Lisa Letourneau, MD, Executive Director, Maine Quality Counts

Maine Quality Counts Consumer Advisory Council

February 16th, 2013 2 comments

Since April 2012, I have met monthly with other healthcare consumers as part of the Consumer Advisory Council of the Maine Quality Counts organization (MQC CAC).

http://www.mainequalitycounts.org/page/895/who-we-are

In 2009, I was the lone healthcare consumer representative on the Maine Quality Forum Multi Drug Resistant Organism Metrics (MQF MDRO) committee. I was the only uncompensated volunteer. Other members were infection control nurses from Maine Hospitals, an attorney from the Maine Hospital Association, representatives from the Maine Health Data organization and a couple of epidemiologists.   I was there because my father died of hospital acquired MRSA and because of my passion to do stop MRSA infections in Hospitals. My goals were very straight forward and simple.   The committee worked on the legislative rulemaking for our new law to screen all high risk patients in Maine for MRSA.  I had already spent months working with my State representative, other stalwart supporters and MRSA victims to get that law passed.  The monthly  MQF meetings  were brutal.  Without the skilled mediation of our noble physician leader Dr Josh Cutler, the meetings would have been dominated by one physician, who challenged almost everything I said.  In our first meeting, he said the new law was “irrelevant” and that was how we started.    Back then Patients and/or healthcare consumers were rarely represented on healthcare committees and their opinions were generally disregarded.  There was a prevailing attitude that they were doing us a favor.    Suffice to say that healthcare committees were not accustomed to having an educated and  assertive consumer like me in their midst in 2009.  I disrupted their business as usual when I doggedly pursued better outcomes for patients.  MRSA infections certainly should never be accepted as “part of doing Hospital business”.  I remember sitting in those meetings in 2009 and feeling my face grow red and the pressure behind my ears.     I struggled to stay respectful and polite, but I never succumbed to the dominating and paternalistic behavior I was confronted with.   When I left those meetings, I was exhausted and so frustrated.  We never came to consensus.  When we “finished” our work in that  MQF committee, it was far from finished. We had not completed the work of MRSA prevention in Maine  Hospitals, and it still has not been completed.  Because the MDRO metrics  committee was shut down, my consumer “position” was eliminated and I was effectively and efficiently removed from the work.  I have repeatedly expressed an interest (to the powers that be and through the State and  Federal CDC ) in participating in the work on Hospital Acquired Infections in Maine with the Maine Infection Prevention Collaborative, but those requests have not been answered. I often wonder if there is a powerful patient’s voice in those meetings anymore. I also wonder if we have really moved beyond the perception that healthcare consumers are token representatives in healthcare committees.

When I was invited to be part of the MQC CAC my skepticism was well founded…..BUT,  these meetings are a complete turn around from the Maine Quality Forum MDRO metrics committee meetings.   I sit with other Mainers every month who are all working toward the same goals, but from many different organizational perspectives. We are all seeking safer, better, integrated and accessible  healthcare for all Mainers.  Staff of the MQC organization facilitate every meeting, and they do it with great skill, discipline and organization.   Each of the consumers on this council  was recommended by a consumer organization. I was recommended by the Maine People’s Alliance.  Others represent the  Area Agencies on Aging, the AARP, National Alliance of Mental Illness, Univeristy of Maine, NAACP, Deaf Community, The Homeless,  etc.  Each of us have already accomplished great things in our chosen advocacy work and together we are unstoppable.  Our group is making huge accomplishments for Maine patients, and we are giving them a voice!  We are all respectful equals and there are no tokens in this group.    Together we are strong, proactive and progressive.    The combined experiences and accomplishments of the healthcare consumers in our group are unmatchable.  Some of us have begun to share our work and our accomplishments from outside of the MQC circle, with each other inside the MQC circle.   How can it be that I have become part of this wonderful group of generous and brilliant Maine healthcare consumers?  Most  Maine patients will likely never know who we are, but there is no doubt in my mind that they will all benefit from our work.

It is different for me now.  My earlier days of advocacy and activism were more contentious, a struggle and very challenging.  I left meetings exhausted, angry and frustrated.  Now I leave  meetings exhilarated and inspired.   I contribute and share much of what I have learned during my 4 years of activism and advocacy to this group, and so do the others.  This group is a gift and a miracle in my work and my life.