Helping Our Bodies, ourselves

A note from Judy Norsigian, Executive Director of Our Bodies Ourselves.

Like other valuable "social benefit" organizations, Our Bodies Ourselves is facing a very difficult financial period and needs your support more than ever. As we are approaching our 40th anniversary of the first publication of Our Bodies, Ourselves, we hope that you will visit our website, consider all that we do now, and contribute to our longstanding, non-commercial, public interest work that has benefited millions across the globe. I also hope that you will forward this message to others who might value and support what we do.

All contributions large and small greatly appreciated:

http://www.firstgiving.com/judynorsigian

Thanks so much for your consideration.

Best- Judy

Out with the bad air, in with the good

As the cold weather arrives, we all know how to button up our home to reduce energy loss, but sometimes we end up not allowing enough fresh air to enter the house. How to do it without losing lots of heat is the question. An answer is provided by an item in our online auction to benefit the Sidney Borum Jr. Health Center.

Company owner Mark Bernfeld has donated the Tamarack DreamAire 5000 home or office air purification system as an auction item. Here's his description of how it works:

This machine will kill viruses, mold spores and bacteria before entering the home. Every 30 seconds fresh outside air is brought into the home, filtered through an electrostatic precipitation process (ESP) heated (if so desired) and then reverses direction to pull stale inside air out of the home. Using only 15 watts of electricity the air replacement/filtering and cycling operates constantly. Extremely quiet, the DreamAire 5000 uses one 4" duct for bringing air in and exhausting it out of the home. Rated for 1,200 square feet, the DreamAire 5000 will clean the air in an entire home, office or classroom. Attractive LED control panel makes operation simple. Filter cleaning indicator will illuminate when necessary.

See more and bid here.

As good as cash, for The Borum

You can spend this weekend fighting traffic and shopping for holiday gifts, or you can bid from the comfort of your home for gift cards that support the Sidney Borum Jr. Health Center.

Cards include the following: $150 for Saks; $50 for L'Occitane; $110 for City Sports; $50 for John Dewar; and $500 to spend at any of 40 locations.

Need stocking stuffers? How about free admission coupons for National Amusements cinemas.

Here is the auction site.

Steps to change a culture

#IHI09 John Toussaint, CEO of the Thedacare Center for Healthcare Value, presented a session called Leading a Continuous Improvement Transformation at the IHI National Forum.

What does it really take to change a culture? He outlines several steps, requiring a focus on purpose, process and people, based on the Toyota Production System, or Lean, philosophy. Examples of success are Group Health of Puget Sound, University of Michigan, Thedacare Collaborative, and Gunderson Lutheran. All have made significant reductions in the cost of delivering care while improving quality. Bolton, in the UK, likewise showed dramatic improvements in clinical quality indicators.

Here are the steps.

Purpose: This comprises a general statement of mission -- e.g., to improve the health of the citizens of the communities we serve -- but it also must be translated into a more detailed strategy, and still more detailed goals.

Strategy: Deliver measurably better value to customers. For example, we want to achieve reliable quality, measured as 3-4 defects per million opportunities.

Understandable goals: Focus on only three! For example, Quality: Decrease defects and waiting time by 50% each year; Business: Increase productivity by 10% each year; Engagement: Number of suggestions implemented (number/employee). Set the bar high but pick clearly understandable measures.

Process:

Transparency of data drives change. (By the way, in terms of reducing harm, he notes, "Zero is possible, and from a leadership perspective, we should ask for nothing less.")

Metholodogy for achieving results: It is the leader's responsibility to create the system that allows people to solve problems. Use of A3's creates a rigorous approach to problem solving. This formalizes PDSA ("plan, do, study, act"). (There are 5400 active A3s going on in Thedacare!) This approach makes it easier to persuade others and understand others, to foster dialogue, to develop thinking problem solvers, and to do all this on the front lines.

Other TPS activities include: value stream analysis; rapid improvement events; continuous daily improvement; visual tracking. Improvement results in less staff "hunting and gathering." New standard work improves both logistics and care.

People:

White coat leadership <-- versus --> improvement leadership.

All knowing, in charge, autocratic, buck stops here, impatient, blaming, controlling <-- versus --> patient, knowledgeable, facilitator, teacher, student, helper, communicator, guide.

Continuous improvement is based on respect for people. The leader's job is to develop people.

Can you say yes to these three Paul O'Neill questions every day:

--Are my staff treat with dignity and respect by everyone, regardless of role or rank in the organization?

--Are they given the knowledge, tools and support they need in order to make a contribution to our organization and that adds meaning to their life?

--Are they recognized for their contribution?

New habits are needed by managers and leaders: Help define the problem; ask questions instead of providing answers; think of problems as golden nuggets instead of opportunities to blame; teach subordinates how to solve problems; mentor subordinates to replace you; be humble.

Participatory Action Research

#IHI09 Roger Resar (speaking) and John Whittington (with some audience participants), of IHI's R&D team, recently were involved in developing and testing an innovative approach to actively engaging physicians to provide evidence-based and effective care through "clinician-friendly standardization." The two engaged the Faculty Mindwalk attendees in a hands-on exercise.

Beyond the National Forum, Roger and John hope to try out "participatory action research" with the attendees to test novel solutions to tough problems. They want to create a network of the attendees to be involved with IHI as innovators who will "create new approaches to seemingly intractable health care delivery issues."

Katharine Luther, RN, from Texas Medical Center, gave an example. A local team did on-site work on the area of fall prevention while communicating with Roger at IHI to test out concepts, engaging in an iterative collaboration approach between the "field" and the resources back in Cambridge. The idea was to ask clinicians to discern between "usual" and "special" patients, 80% and 20%, respectively. About 50% of the falls occurred in each category, which, interestingly did not correlate with the usual Morse score for fall susceptibility. This led the team to a create a bundle of three items (more easily reached call buttons, lower bed height, better placement of IV stand) that could be used to reduce falls across the broad population of patients, notwithstanding the Morse score.

The lesson of this example, Roger concluded, was about co-learning between the field and the IHI R&D group, with the immediate benefits accruing to the local partner, but eventually offering advances that might also go beyond the particular local partner to a broader audience.

Mindwalk at the National Forum

#IHI09 -- The IHI National Forum just started with a session called Faculty Mindwalk for those involved in teaching sessions over the next three days. This is a nice opportunity to reconnect with others involved in the patient quality and safety movement and also make new friends.

Seen here are: Eugene Litvak, President and CEO of the Institute for Healthcare Optimization, with Vin Sahney of Blue Cross Blue Shield of MA; Mark Splaine, the newly appointed Director of the Center for Leadership and Improvement at the Dartmouth Institute for Health Policy and Clinical Practice, with Paul Batalden, his predecessor; and June Wylie, Jackie Ley, and Jane Murkin, from the NHS Quality Improvement program in Scotland.

Boston Baroque plays for The Borum

The Boston Baroque performance of Messiah is a Boston classic. The orchestra has generously donated a pair of tickets to the December 11 or 12 concert to support our online auction to benefit the Sidney Borum Jr. Health Center. Also included is a copy of Boston Baroque’s Grammy-nominated recording featuring highlights from Messiah.

The orchestra has also offered tickets to its wonderful New Year's Eve Gala Concert at Sanders Theatre.

Bid for both here.