Getting this going ... Inspiration, Incubation, Germination, Rumination

Getting this going ... Inspiration, Incubation, Germination, Rumination

Well, I guess this is a starting place.

And for starters ...

What exactly might a grassroots initiative for healthcare quality be about?
Why bother?
What makes it different from any other grassroots social issue venue/venue?
What makes it different from any other healthcare venue/organization?
What unique/radical enabling frameworks can we establish that will contribute to our overwhelming success?

Enough for starters!!!!!

Thanks for your ideas and willingness to be here for this birth.

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Jesse, This seems both profound and to the point.

Thank you so much for posting this reflection. It really points to the need for system-level solutions to system-level problems. And, as you point out in different words, with too many rules - regardless of how necessary - the rule structure itself becomes yet another system primed for failure.

And thank you so much for sending me this video. I want to share it with the group here because it addresses the issue you raise with such eloquence and force.


Story on Kernicterus

I wanted to leave this as a comment on the Kernicterus story, but couldn't figure out how to get that to work. Please read that story first, or this comment isn't going to make a whole lot of sense.

In reading the story last night, I was reminded of a chapter in Outliers (Malcom Gladwell) that talks about plane crashes. More specifically, its about what causes them.

Quote:

"Plane crashes rarely happen in real life the same way they happen in the movies. Some engine part does not explode in a fiery bang. The rudder doesn't suddenly snap under the force of takeoff. The captain doesn't gasp, 'Dear God,' as he's thrown back agaisnt his seat. The typical commercial jetliner--at this point in its stage of development--is about as dependable as a toaster. Plane crashes are much more likely to be the result of an accumulation of minor difficulties and seemingly trivial malfunctions."

The story on Kernicterus, and for that matter most stories about healthcare failures follow the same theme. The failure is not a result of a big thing that goes wrong, but rather a series of small mistakes and oversights. These types of issues can be controlled for with checklists and audits, and there are a few cultural training issues around things like power distance that can be put in place to facilitate error checking. But of course, if that was the full story, the system wouldn't be so broken.

The question as I see it, is how do you create a system of rules and proceedures that doesn't end up discouraging thought on the part of the practitioners. It seems clear to me that there is a need for more clearly specified and more thought out proceedures, but rules and proceedures can become a sheild for incompentence. The commonly suggested answer to this is something along the lines of creating incentives for the practitioners to use good judgment, but that can be tricky.

Behavioral economics has identified that people seem to have two versions of themselves and their decision making. One of these is based on community and responsibility, and the other is monetary. When you are trying to appeal to the community and responsibility side, it is ineffective to use money because it will trigger the monetary side of the persons decision making.

I don't have an answer to this part of the problem, how do you encourage or incent people to use good judgment in addition to following proceedure? How do you quantify what good judgment means with reference to patient centeredness?

Brilliant Quote Describes Our Effort Well

Just came across this awesome quote. Seems both inspiring and apt for the endeavor that we are involved with here.

Quote:

We, the unwilling, led by the unknowing, are doing the impossible for the ungrateful. We have done so much, for so long, with so little, we are now qualified to do anything with nothing.


Mother Teresa

Can grassroots initiatives really work? How?
Comments?

Meeting face to face sounds good to me!

Christopher,

I love the idea of sitting down together. And of seeing what that might ignite.

My guess right now is that not too many folks are yet listening. I know that not too many are responding.

I would propose that you "Create and Event" on the blue panel at the left. Pick a time that works for you. And invite other people - both online and off. You can use the invite link on the panel at the left for a quick email to multiple friends or associates.

I would be happy to offer my house for the event.

hey Jack and all,   i have

hey Jack and all,

 

i have a proposal:

why don't we all (or as many as interested) meet in person.  Have a visioning potluck with some drumming thrown in. i'd offer my space but it would be squished space.

 

takers?

christopher 

Why Bother? Read Even a Piece of This ...

Very real example of the bumper sticker "If you're not outraged you're not paying attention ..."

Absolutely frightening and astonishing lay press article ( Life Extension Magazine) documenting the overview statistics of medically generated (iatrogenic) harm. Gathering a broad collection of harm related statistics in a single location, it collects the results of landmark studies to paint a call to action. 3/4 million patients annually impacted by adverse medical events. Third leading cause of death in the US??? (check this)

This document needs to be re-purposed in book or linked page form to make it more accessible and digestible

DeathByMedicine.pdf <---click here

Christopher, Thanks so much for being the first to contribute!

There is so much in your post. Seems like each point could be a whole discussion

  • You speak of a need for Balance and Health [in healthcare]
  • You describe a need - almost a plea - for healing in the care delivery system
  • You espress the need for fundamental questions and that they be asked.
  • You ask, for example, "Is healthcare a right or privilege?" (I would add ..quality healthcare..)
  • You mention an unbalanced paradigm of greed and self interest

Some of these seem like insights ... some questsions ... some ideas.

Would you consider capturing them in "Our Gems" ? (just make a page and give it the appropriate category ... insight, question, idea, etc)

 

And would you consider expanding a bit on how you see these in our healthcare system? Or how we might engage with these issues in our own communities?  With our own hospitals and practitioners?

healthcare needs a healing

okay so here we go.....

so to me grassroots health care is about people, the health of us all, as all of us with bodies are patients. 

health, balance, homeostasis is the middle way, that resting point of stillness.

healthcare needs a healing, a balance. 

as a "health care" provider i find that there is healing to be had amongst those of us wearing white coats and stethoscopes.

the healthcare delivery system is a business, but just as we have all witnessed for years, greed and self interest trumps all else, including health. so the delivery system needs healing, balance.

as an Interventional Radiologist suggested to me, the healthcare delivery system is a huge ocean liner, it will take a lot of effort and time to turn it in another direction and i suggest that the direction needs to be based on a tacit and almost universal paradigm shift towards balance, health. 

is healthcare a right or a privilege?

if we are to be our brother's and sister's keepers how will this really look in the venue of healthcare? 

there are fundamental questions needed to be asked!!! 

 so along with looking at metrics, healthcare standards, JACHO standards, Medicare, Medicaid, delivery systems, ICU check lists,

i suggest looking at our current paradigm and it's lack of balance, and finding the middle way. 

 

Similar Venture - Not the same ...

Here's a relatively new entry seeking to coordinate and capitalize on the community approach to healthcare reform.

ChangeNow4Health

Started and operated by Humana, Inc.

They have a vested interest and explicit license to freely use any ideas generated. They use paid bloggers. Offer a prize for ideas. They are writing a book of best ideas like we hope to.

Finally, the motherlode of related content, people, and energy

Been looking for a while to see why there is not more of a coherent discussion and movement already on the web around quality in healthcare delivery.


 

Still have'nt come across something quite as focused as what I'm hoping for here, but very close...


The operative word seems to be "Manifesto".

Had been thinking back to the Cluetrain Manifesto that some years back articulated and helped transform the way the internet and grassroots transparency would change business.

Came across the tip of what seems to be an iceberg. I would love to hear your reaction. If you're interested, check these out, wander through where some of their links take you and come back with impressions.

Hildi's Healthcare Manifesto

and ...

Healthtrain

and ...
the actual Healthtrain Manifesto here: Healthtrain: The Open Healthcare Manifesto
(including 18 principles:
1. Openness
2. Empowerment
3. Conversation
4. Empathy
5. Trust
6. Critical Thinking
7. Guidance
8. Control
9. Credentials
10. Transparency
11. Privacy
12. Anonymity
13. Scientific Validity
14. Conflicts of Interest
15. Sponsorship
16. Promotion
17. Controversy
18. Civility and Respect
)

and ...
Healthcare-Manifesto
and ...
Ted Kennedy's Healthcare Manifesto to Obama

and ...
Healthcare Cluetrain Manifesto

and ...
Healthcare Blogging Manifesto

Well ....

Well ....

I've been thinkiing a lot about this and wondering about general principles, what it might take to really engage people, inspire people, ignite people, encourage people, empower people and ...

The questions of who, what, and why keep comming up for me more powerfully and consistantly than answers.


Who are the people we are really talking about empowering? Is it just the healthcare consumers? Are there other stakeholders in this process that could use empowerment too? Or are they just part of a healthcare "empire' that needs to be torn down and started fresh?

From the standpoint of actually "controling" the improvement of quality in healthcare delivery, I find myself wondering if many of the stakeholders might actually be marginalized and disempowered by the *System* itself.

How could GrassrootsHealthCare be more beneficial, effective, sustainable, interesting, inspiring if we could serve and attract these other stakeholders who also struggle with the system to provide their piece of the quality puzzle?


To name just a few ...

Could doctors need engagement, inspiration, ignition, encouragement, empowerment (etc...) in improving quality in healthcare delivery?

Could pharmacists need engagement, inspiration, ignition, encouragement, empowerment (etc...) in improving quality in healthcare delivery?

Could dentists need engagement, inspiration, ignition, encouragement, empowerment (etc...) in improving quality in healthcare delivery?

Could nurses need engagement, inspiration, ignition, encouragement, empowerment (etc...) in improving quality in healthcare delivery?

Could healthcare executives and administrators need engagement, inspiration, ignition, encouragement, empowerment (etc...) in improving quality in healthcare delivery?

Could shareholders in corporate healthcare providers need engagement, inspiration, ignition, encouragement, empowerment (etc...) in improving quality in healthcare delivery?

Could vendors (providers of healthcare related products, pharmaceuticals, services, etc) need engagement, inspiration, ignition, encouragement, empowerment (etc...) in improving quality in healthcare delivery?

Could regulators need engagement, inspiration, ignition, encouragement, empowerment (etc...) in improving quality in healthcare delivery?


Could we all benefit from a breatlh of fresh air and some exercise?

Together?

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