Christina's Considerations

New Orleans Tricentennial

This year marks the tricentennial of New Orleans (celebrated on May 7th) due to the city being settled in the Spring of 1718.  The exact date is unknown.  I share this here because from time to time I've posted on my home state of Louisiana, including the Katrina events of 2005. 

Explorers passed through what is now the New Orleans area in the 16th and 17th centuries, but it was not until 1718 that Jean-Baptiste Le Moyne, Sieur de Bienville founded New Orleans on high ground 100 miles from the mouth of the Mississippi River.  This high ground was built up by the shifting banks of the Mississippi River and surrounded by swamp; that had been  home to Native Americans of the Woodland and Mississippian cultures.

Watch this video and visit http://2018nola.com/ to learn more about the celebration and history of a grand old city!

 

My history in New Orleans dates back to the 1960's, and the arrival of ancestors as far back as the 1600's.  My, how far we have come!

Tea and Southern Me!

Some are reminded of tea when Summer nears.  For me, a girl from Louisiana, ice(d) tea is an all year thing.  Fortunately, even  Santa Barbara's winters, I can put a pitcher out on the patio table for some sun brewed tea.  But, tea isn't just good iced.  It is also a comforting and calming hot drink when the weather is cold, relaxing is desired (work or home), or in my case - it is an IVIG morning and I need to drink plenty of fluids!

Being a girl from the south in the 60's - 80's, all I knew was black tea - hot or cold. And, you only got it one way... sweet! Today there are many options and flavors.  Good Earth has an organic emerald green tea that is very fresh and not at all like green tea I've tried in the past.  While it is great hot, I'm prompted to try it iced with this honeybee recipe with some of our own, endless supply, of honey.

For those of you who really are black tea fans, they also make a berries and roses tea that not only smells and tastes wonderful, but it also is beautiful with its red rose petals.  

So do like me.... get out of your comfort zone and try some loose leaf tea that is like nothing you have had in a teabag on a string.

 

Patient Safety: Assessing Adolescent Health Literacy

Imagine being released from the hospital with a confusing diagnosis, stacks of papers to read and more questions than answers about what to do next.

The "REALM-TeenS" tool can quickly assess how well teens understand health information.

That is the reality for a large percentage of Americans; including teenagers. Many have a limited ability to obtain, process and understand health information and services presented to them - also known as low health literacy. Yet, adolescent health literacy research remains limited compared with adult populations.

A new study, published in Pediatrics  by an associate professor in Public Health is a collaborative effort to develop a brief assessment tool  to identify adolescent health literacy limitations in less than 30 seconds. It's called Rapid Estimate of Adolescent Literacy in Medicine, short form "REALM-TeenS."

 

The tool requires adolescents to read 10 health-related words from a list of common health care terminology. For example, "diabetes," "asthma," "exercise" and "bronchial." The concept is that if an individual has difficulty pronouncing these words in isolation, he or she is likely to have difficulty with comprehension.

Studies indicate low health literacy is linked to negative health outcomes in adults., however, limited research has been performed with adolescents.  REALM-TeenS offers researchers and clinicians a brief screening tool that can be used to quickly assess adolescent health literacy in a variety of settings.

"REALM-TeenS" is a shorter version of a longer assessment tool "REALM-Teen," which was developed in 2006 by Terry Davis of the Louisiana State University Health Sciences Center, one of the new study collaborators. The original tool required adolescents to read 66 health-related words in three minutes.

The health literacy scores from the 10-word assessment correlated highly (92 percent) with the 66-word assessment and decision consistency was 80 percent across both forms. The researchers compared data from two sources, including a total of 665 youth aged 12 to 19 years old.

Health professionals and researchers have limited time with patients, but hopefully this new tool will provide the incentive to measuring health literacy when working with adolescent populations.  This is especially important for helping care teams effectively communicate important health information, medication instructions, and follow-up supports.

 

This is a rant! On Unintended Consequences of Politics and Healthcare

So, I just learned my daughter's trip to her dentist, for the last 15 years, will not be reimbursed and we will foot the entire $215 bill.  I have my annual visit coming up and it seems I'll have to come up with at least $231 to cover the cost, and that is if I change from the gynecologist I've seen for the last 20 years.

Top this with the fact that the premiums for Obamacare plans are on the rise... in a really big way.  

I'm pissed!  Not because I didn't know this was coming.  I did.  I'm pissed, because I was right and the politicians elected -- lied and played stupid.  They insulted the intelligence and integrity of the citizens who placed their trust in them.  

I support an expansion of insurance coverage, but tell me, up front, what it will mean... how much will it cost me... so I can prepare.  Don't lie and tell me if "you like your doctor, you can keep your doctor".

Here is what I fear!  

• Individuals and families at lower income levels will start to choose the penalty over plans on the Exchange , because of the cost of premiums and their co-pay
• Employers are going to start cutting back on full-time employees and have more part-time staff and adopt technology in place of people
• Employers, especially small, are going to start cutting back on subsidizing insurance plans for employees
• Individuals and families will start to make decisions to cut back on preventative care.  This will mean the diagnosis of diabetes, cancer and heart disease will come later and actually cost everyone more to treat
• Healthcare costs will start to rise for all of the above reasons.

These are the unintended consequences of rogue politicians thinking they know what is best for healthcare.  They are the unintended consequences of voters believing the lies of politicians and giving them a pass when they then play dumb.  

They insult our intelligence, integrity and bully people into doing what they think is "right" without any effort to collaborate and work toward a common vision.  Funny!  Collaboration across the care team is expected and the US government is pushing for this.  But, when it comes to collaborating on health policy, politicians are exempt.

So, here is the bottom line.  If you voted for Obamacare and its politicians, you reap what you sow.  If you didn't, I can only say, I'm sorry.  What we have here is a lack of critical thinking by voters and a lack of transparency and integrity by the politicians.

I'm spiritual, but even though from South Louisiana, not really that religious.  This all reminds me of a song, Jesus, Take the Wheel.  More than ever, I think we need some Devine intervention.

  

 

Impaired Presidential Candidate?

In medicine and healthcare, we administrators are concerned about the safety of our patients and employees.  One of the areas that we monitor closely is the health and wellness of our clinical professionals - doctors, nurses, pharmacists, etc.

When it comes to politics, as a society we are also concerned about the person sitting in the White House - the one who has access to special phones and buttons that could impact the safety of our country.

So, somewhere I must have missed something, because Hillary's health is being called into question. I remember back when she had a condition while Secretary of State, but recently a couple of physicians, and maybe more, are questioning her fitness to serve.

My old friend from Las Encinas Hospital, Dr. Drew Pinsky, and a new friend, Dr. Gerard Gianoli, are two who have started asking questions.  I'll let you visit the links below to see what they have had to say and draw your own conclusions.  I for one, agree that Hillary has a responsibility to obtain the evaluations she needs and attest that she is safe to serve as President... before the election.

Gerard Gianoli, MD

Drew Pinsky, MD

In healthcare we use TeamSTEPPS communication and teamwork techniques.  The I'M SAFE Checklist is one tool we ask professionals to use to assess whether they can perform their duties. Notice that "illness" tops the list.

When we notice any healthcare professional having serious performance issues that could jeopardize safety, we step in and take action to remove them from their responsibilities.  Let's not risk putting someone into office who will be challenged to safely serve and could potentially be removed (rework). We don't do it in healthcare and we shouldn't do it with our presidents.

Let us listen to the doctors and obtain the reassurance needed. 

Death of the Great Laboratory of Clinical Medical Science

 Note:  I'm happy to have a guest blogger, Dr. Gianoli, who specializes in neuro-otology and skull base surgery and is also a professor at Tulane University School of Medicine.  Please consider his perspective and leave a comment with your own.

by Gerard J. Gianoli, M.D.

Free-market capitalism has brought unimaginable innovations to mankind in the last 200 years, more so than any other economic system in the history of the world: airplanes, telephones, personal computers, electric lightbulbs. Far less appreciated, even by those who are ardent advocates of free markets, are the innovations brought by private medical practices through the magic of free-market capitalism.

Philippa Thomson, who lives in Scotland, describes her battle with an inner ear condition known as superior semicircular canal dehiscence (SSCD) in a new book titled A Hole in my Life—Battling Chronic Dizziness. The picture of her struggle to get help within the socialized medical system of the British National Health Service (NHS) is not a pretty one. She is eventually tossed aside by a system that shows her little compassion. However, she doesn’t give up and she finds a specialist in the U.S. who can help her—me.

People may ask, “How is it that no one in the UK-NHS was able to help her, but a guy in private practice in Louisiana could?” Such people have been conditioned to believe that government or universities are the sole source of innovation. This is far removed from reality.

Throughout the last 70 years, the U.S. has been the greatest mover and shaker in the world of medicine. Most major medical innovations have either been born or significantly developed here. And, many of the major innovations have come from small private practices—certainly not from the government. Innovative changes do not come from out of our universities—they come from individuals who work at our universities. However, true radical, transformative innovations have often come from private practices.

Looking at my field of neuro-otology (inner ear disorders), three major innovations came from private practices. Dr. Bill House developed the cochlear implant, which provides hearing to the deaf. He was in private practice and was condemned by academics, who claimed it was an assault to shove a “wire” into someone’s ear. Dr. John Epley, a solo private practitioner, developed canalith repositioning, or the “Epley maneuver,” which was the single biggest advance in the treatment of vertigo—ever. He almost lost his medical license due to objections from the academics at the university. Now the Epley maneuver is routine everywhere. Dr. John Shea, also in private practice, developed stapedectomy surgery, which restores hearing to those who have otosclerosis, a disease that causes the last hearing bone to harden in place. This procedure was initially condemned by academia until eventually accepted and embraced.

You may have noticed a pattern here. Academic institutions are reticent to embrace radical transformative ideas. However, they are great places to refine those ideas, once accepted.

Academic physicians are paid to do research and write papers. While “publish or perish” is the rule, what gets published is often rubbish. The editors in chief of two of the most prestigious medical journals (the New England Journal of Medicine and Lancet) recently expressed their distrust of the published medical literature, estimating that half of what is published may simply be untrue. What is published has to be accepted by “peer review.” Unfortunately, “peers” usually frown on radical new ideas. Consequently, this restricts the academic to a narrow range of possibilities, or marginal advances rather than great advances. More often, the published papers simply entrench the established viewpoint, rather than challenging it.

In private practice, innovations can only succeed if they result in better patient outcomes and satisfied patients. If not, they are not repeated. There is no pressure to publish. The only incentive is better patient outcomes. The private practitioner’s focus is not constrained by what the peer reviewers will say—only what his patients will say.

Government intervention such as by the NHS in the UK and now Medicare and ObamaCare in the U.S. constrain physicians’ actions by “best practices” and cookbook medical decision trees. These constrained medical decisions have been institutionalized via the electronic medical record (EMR), which has been mandated by the federal government. This not only squelches innovation, but has a chilling effect on physicians’ actions, preventing them from doing anything beyond the regimented government-sanctioned prescriptions.

Imagine if the government had clamped down on doctors and ordered “best practices” in the 1950s? We’d still be stuck with 1950s medicine, without the cochlear implant, stapedectomy, or the Epley maneuver.

Unfortunately, ObamaCare is killing private practice with bureaucracy and nightmarish mandates. In the few years since Obamacare has been enacted, roughly half of doctors in private practice have left for hospital employment. ObamaCare is killing the great laboratory of clinical medical science.

 

Mardi Gras: A Social Norm for Some Communities

Every year on this day, I think of my family and friends in my hometown of New Orleans.  It is Mardi Gras Day - a fun time with family and friends and to share the culture with the young and visitors. Where I live in California, Mardi Gras isn't a social norm... life just continues to hum along.

But, in areas of Louisiana businesses away from the tourist areas or parade routes shut down and a drive down those streets can seem eerie (as I learned once after leaving the parade early to study while I was a Tulane graduate student.)  This is a time of fun and frolic before the the religious and serious Lenten season begins.

The months and weeks leading up to Mardi Gras Day are full of festive activities like float building, king cake parties, Balls, parades, costume making and preparations for spending a few hours sitting on the neutral ground or sidewalk to watch marching clubs and/or royalty and their courts pass by... and throw you beads, doubloons and other trinkets. 

Who are these royalty?  Really just ordinary people.  It is probably one of the few places where you can join a club, work (volunteer) hard, rise through the ranks and finally assume the throne as a king or queen to be toasted by all of those who come to see you as you lead a parade down the street.

Yes, for some of us, Mardi Gras is a social norm.  It is automatically a part of our life, even when we are removed from the environment.  I may not be at the parades today, but I'm thinking of them and how my family and friends are masquerading and being a part of the fun.  The day doesn't end until after the costume has been put on, all of the kisses for a paper flower are finished, the food/drink consumed, the parade ended, and the costume removed.  And then, as the clock strikes midnight, all is quiet.

Hotel Dieu (God's Hotel)

Growing up in New Orleans, I often drove past Hotel Dieu and thought it was a funny name for a hospital.  I never really knew much about their patient population... until I read the book  God's Hotel by Dr. Victoria Sweet.  It is the story of the transition (and struggles) of a former almshouse (caring for those who had no where else to go) and the impact of modern medicine and administrators.

Laguna Honda Hospital is where Dr. Sweet practiced "slow medicine" -  the art of observing patients and relying on the basics to come to the right diagnosis. I found several shared experiences with Dr. Sweet, even though we have never met.  We experienced, at the same time, the arrival of managed care and frustrations associated with the closure of state mental hospitals without the promised community supports for this challenging  and complex population. In addition, I have my own, but similar, stories of uncovering context or one's environment to understand challenges or barriers.

I learned that I am a "slow administrator" taking the time to arrive at the right decisions and in the process really saving costs, improving care and creating expanded capacity. I also appreciated learning about Hildigard of Bingen and the lessons we can still learn from early medicine and her  "gardening" approach.

If you appreciate the history and/or sociology of medicine and healthcare systems you will enjoy this book.

The United States Flag

Every now and then I like to deviate from healthcare.  Louisiana is usually my favorite deviation, but today it is the flag and Robin Williams interpretation of it.  This post is a great reminder for all Americans, as well as, a tribute to the wonderful mind of a very funny man who also seemed to have a warm heart.

 

Le bon tempe roule - making happy people in Louisiana

This is for all of my friends and family in the Great State of Louisiana!  Yes, people in Louisiana are generally happy.  They are a bit laissez faire and let things take their natural course, just as the Mississippi river does.  How can it not be a place of happy people when a common saying is  "le bon tempe roule" or let the good times roll!

Ethical decisions: It comes down to strong leadership and effective planning...

For months I've been listening to books for leisure, but with this latest I'm back on to my professional interests.  However, this one is also personal.

If you are involved in hospital, sub acute or SNF leadership or active with ethics, disaster planning or  emergency preparedness in your healthcare organization, you need to read this book.  You also need to read this book if you are a physician... or nurse.  

 

During and after these five days at the hospital I know as Baptist (my dad worked in Central Supply and Purchasing many, many moons ago) there was great pain, suffering and difficult decisions.  From hearing all of the "evidence" I must say it was all due to poor planning and unengaged leadership at the top.  The lack of strong leadership lead to delays in response and recovery and scenarios that placed hospital employees in difficult positions.

I know, I wasn't there!  However, several places along the way I know I would have made different decisions.  For one, if I were CEO/COO/CFO I would have been present, continually assessing the situation and adjusting plans accordingly.  I would NOT have just sat around and waited for the "government" to come and bail me out.

This book comes down to the ethical decisions that take place during emergencies and disasters including  intentionally ending a life.  It goes beyond the hospital staff to also include the community and political response and highlights the importance of having the most difficult conversations before disaster strikes

If you have read the book, do you believe each of key patients mentioned in this book were treated in a manner that would be deemed acceptable?  Would you have been proud of these results had you been the hospital CEO?  I think we can, and have, done better!  Lets learn from the mistakes and not repeat them!

By the way, on the discussion at the end I believe a team should make the needed decisions on a case by case basis weighing the resources available and the risks.  I also believe patients and families deserve an opportunity to contribute.

Creole and Crime: The pathologist finds the killer!

My blog seems to have opened up a floodgate of physician writers.  The first trickles came from Dr. Gelber and Dr. Parsons, but I've now been introduced to a couple of new writers and medical mystery and suspense is becoming a trend.  This post is on DJ Donaldson, a retired professor of Anatomy and Neurobiology at the University of Tennessee Health Science Center, who has seven forensic mysteries and five medical thrillers. 

 When I was first asked to review Bad Karma in the Big Easy, I was particularly excited by the fact that it is set in my hometown - New Orleans. In the aftermath of Hurricane Katrina, when the police force is still in disarray and records have been destroyed, the medical examiner is diligently fulfilling his responsibilities in the temporary morgue in San Gabriel (a place I passed on my way to LSU many times).  He discovers three nude bodies, all young women, none with water in their lungs, and realizes this is not an act of God. This pathologist will do what ever he can to find the killer. 

 The medical mystery, a realistic setting and description of working in an austere environment came together to make it a great read! I enjoyed the book and think my readers will too! 

Stay tuned, there is another physician author who will be covered soon.

12 Years a Slave and Avoyelles Parish

I haven't posted on Louisiana lately, but this one is a bit close to home.  As a result of my current commute, I just finished the book 12 Years a Slave and reviewed the additional research.  First, I loved the story.  I hate hearing about what happened to Solomon Northup, but love knowing he survived and made it back into the arms of his family and friends.

This post isn't about the book, but rather the part of Louisiana I've visited often since I was a small child.  My grandparents and many generations back are from this area and Marksville (historically known for the ancient mounds) was the big town in this very rural part of Louisiana.  I spent many summer vacations and weekends "in the country" visiting my beloved grandparents and was surprised to find that the setting of this book was mostly in Avoyelles Parish.  

I struggled to figure out where this all took place and at first thought it must be around Pineville, but that is in Rapides Parish.  Then the map helped me realize it was in the area of Bunkie - another small town in Avoyelles parish. Throughout the book, I heard so many "American" names, rather that the French names that are common in the region (Napoleon's soldiers settled the area). Hopefully, a bit of research will help me answer my questions.

By the end of the book, I was so proud of Marksville and the fact that they moved quickly to secure Mr. Solomon Northup.  They recognized the risk to his life and acted quickly - demonstrating leadership and their true passion for what was the right thing to do.

I wasn't around during slavery, but did experience integration both "in the country" and in New Orleans.  There were complex dynamics at play and I didn't always like what I saw, but do appreciate the progress (a bit slow at times) that has been made.   

 

 

 

DeLauro Statement on Public Health Emergency Medical Countermeasures

I received many press releases, but don't post on the vast majority.  But, the one below, from Congresswoman Rosa DeLauro on her comments at the first Labor-HHS-Education Appropriations Subcommittee Hearing Of 2014, is different.  It is different because I've been attending to emergency preparedness most of my career and most recently have been involved in the HPP program in three counties along the central coast of California.  So, I share the Congresswoman's comments here in their entirety.

WASHINGTON, DC--Congresswoman Rosa DeLauro (D-CT), senior Democrat on the Labor, Health and Human Services, and Education Appropriations Subcommittee, made the following opening statement at the subcommittee’s hearing today. The hearing focused on the future of public health emergency preparedness.

 “Today, this subcommittee is evaluating our efforts to become better prepared to deal with outbreaks of deadly diseases, particularly through development of new and better drugs and vaccines. Many of the efforts we will hear about today are aimed at limiting the harm from deliberate biological or chemical attacks, such as the spread of anthrax here in Washington twelve years ago. These programs were begun or greatly expanded in the last 10 or 12 years, in response to growing recognition of serious gaps in our public health preparedness.

 “There have been some successes. Take flu for example. There was a time in the last decade when we were down to just one manufacturer of flu vaccine in the United States, with only limited capacity to scale up production to respond to an epidemic. Today, we now have a much-improved production capacity for the flu vaccine.

 “That being said, I think there are serious questions as to whether the vast resources that are dedicated to these programs are being spent in the most efficient manner to protect the public health. For example, we find ourselves 10 years into the BioShield program, having spent a whopping $3.1 billion, and we have to look at what have to show for that.

 “Certainly an improved stockpile to deal with anthrax and smallpox. Yet there is clearly a much wider spectrum of threats that confront us. We also need to be much better prepared to deal with emerging threats that occur naturally. Threats like the spread of novel diseases like SARS, the emergence of microbes that have become resistant to the drugs used against them, and both pandemic flu and ever-changing seasonal flu viruses.

 “I realize that BARDA has produced a broader range of products that are still in the development pipeline, but when these efforts were launched a decade ago, we expected to be further along by now. So I think our track record in developing medical countermeasures is decidedly mixed. Just as important, we need to recognize that public health preparedness involves much more than simply developing and stockpiling drugs and vaccines.  

 “We also need enough well-trained epidemiologists and other health professionals to identify, investigate and track disease outbreaks.  We need enough laboratory capacity to analyze large volumes of samples and determine what pathogens are involved.  We need effective plans and enough supplies and personnel to efficiently distribute and dispense vaccines and treatments.    We need the surge capacity in our hospitals and other facilities to take care of large numbers of seriously ill patients. 

 “All of this work needs to be done through partnerships between federal agencies like CDC, state and local health departments, and the medical and first responder communities.  Unfortunately we have spent the past 5 to 10 years cutting federal support for these critical state and local preparedness activities. Adjusted for inflation, CDC funding to state and local health agencies has declined by nearly 50 percent in the past 10 years.

 “Similarly, the Hospital Preparedness Program, which provides grants to states to improve the preparedness and resiliency of their healthcare systems, has declined by about 60 percent These cuts are causing state and local health departments to eliminate staff, they cut training exercises, and forego critical medical equipment and technology.

 “Addressing all these needs has become a real challenge for our subcommittee, in light of the tight budget limits that are being imposed.   Much of the PHEMCE enterprise is really a new cost to this subcommittee that has to be fit within our constrained allocations.   Until this year, all of Project BioShield and most of BARDA had been supported from a ten-year advance appropriation made back in 2004 in the Homeland Security Bill. Much of the pandemic flu preparedness activity has been supported through balances of emergency supplemental appropriations made in 2006 and 2009. 

 “However, now, those funds are either expired or almost depleted, and this subcommittee had to start covering the costs—$800 million in FY 2014—through annual appropriations. Without a different scale of allocation for this subcommittee we had to take on the $800 million and that had to come from someplace. And it came from other areas.

 “These needs are all important and these investments provide tangible returns for the public.  The subcommittee will do the best it can to take care of them.  But as long as this subcommittee’s totals continue to be so tightly constrained, it will be extraordinarily difficult to provide adequate support to these countermeasure programs and adequately take care of our many other public health priorities.

 “I’ll just give you one: the NIH, which only saw roughly 58% of its sequestration cuts restored in its 2014 budget, that provide so much of the basic scientific support for these efforts, as well as the other pieces at CDC and elsewhere necessary for public health preparedness will suffer.

“In short, there are real and potentially grave consequences to the budget decisions we are making.  Weaker defenses against infectious diseases and slower progress in advancing medical science generally may well be one of those consequences. So today, I look forward to a discussion of both the current status of the PHEMCE programs and the challenges that we face ahead. Thank you again for joining us today and I look forward to your testimony.

Twitter Blocking Content - They don't agree with?

Last night I heard a news report about Twitter blocking posts that referenced a Pro-Phil Robertson site or included the hashtag #IstandwithPhil.  So, I did what any blogger would do and got out my phone and tried tweeting a link to one of the stories.  I wasn't tweeting a link to the site, but did include the hashtag.  

Just as it has been reported by many news outlets,  my post was blocked and I received the message that it was potentially spam.  (How could a Vanity article be spam?)  This morning I tried tweeting the same article and this time it worked.  

As I sit down to write the post, I now see Twitter has apologized for blocking the site and hashtag saying it was marked as spam by mistake.  Hummm! Not sure I believe this.

Whether you stand with Phil or not, I think Twitter's actions deserve some attention.  Twitter and other social media were expected to level the playing field - allowing all viewpoints to be heard.  Traditional media has a way of ignoring or spinning some of their reporting, but social media brings it all out in the open -- the good, the bad and the ugly.  Blocking content relating to a specific perspective is a dangerous slope and I believe is a business ethics issue and I'm happy to see it receiving so much attention.

In the end, Twitters action may have actually backfired on them.  They probably should have recognized that they only have control over one channel and learned from others in the blogosphere that word can still travel quickly in social media.  My guess is that the creators of the site and hashtag are thrilled with all of the attention Twitter has drawn to their cause.

If you are wondering what I think about Phil and his comment, I'll just remind my readers that I'm a Louisiana girl and know and understand the culture of his community.  I've never always agreed with some things in the northern part of the state, but I do respect their opinions and beliefs -- just as I respect the opinions and beliefs of the many people and cultures I come across in my travels.

 

Rare Historic Silent Video of New Orleans

I haven't posted on Louisiana lately, but must include this video from the Ford Educational Library.  It is a wonderful peak into the past.

 

The Gumbo Chronicles: Shedding Light on Recovery

One year ago I commented about the co-existence of oil and fisheries in my home state of Louisiana.  This year I share an article that seems to cut right through to the true status of the recovery.  Many times I've driven that stretch along Bayou Lafourche (once for the state high school football championship -- we lost) and to Grand Isle.  You can't help but see the signs peddling fresh fish, crab, shrimp and oysters.

If is true that the signs, and fishermen, are disappearing and dolphins are dying by the hundreds ... it is truly a sad day.  My only hope is that we are only seeing a short term impact and this area of the Gulf Coast will recover within the next couple of years.  It is too painful to think that it won't!

Low Health Literacy: Impact on Costs

The American College of Physicians has a YouTube video that demonstrates the impact of low health literacy on the healthcare delivery system and costs.  Healthcare administrators and clinicians should view this video to see the challenges for themselves.  Notice the potential for medication errors alone! 

It reminds me of Louise, the discharge advocate!

 

This video hits a little close to home since LSU Shreveport seems to have been involved and a few of the accents were familiar.  However, this is an issue across the US.

Measuring: Elmo and Healthcare

I learned something about measuring today - from Drew Brees and Elmo.  I thought of adding the video below since it includes two of my favorite things - the Saints and Sesame Street - and people - Elmo and Drew.

But, then I started thinking.  In healthcare we measure many things and some are rather objective -- like Drew's ruler.  However, it is also important that we not forget the more subjective measures and stories.  

Sometimes, those subjective measures are just as important, if not more important.  So keep this in mind as you go about your day in the hospital, clinic or other healthcare environment and set up your measures.  Remember the stories when it comes to patient experience, quality and all of those emerging technologies.

 

Tulane's New Football Stadium

 Tulane University has finally recovered financially from Hurricane Katrina and today announced the re-building of a football stadium on campus.  The old beloved and historic Tulane Stadium, built in 1926, was torn down in 1980.  This meant that I, as a graduate student in the late 80's, watched Tulane games in the Superdome.  The experience left much to be desired, especially for someone who came from LSU and the thrill of games in Tiger Stadium.

For more information, see the press release or http://tulanestadium.com/.

A Cat Out of the Bag!

October 17, 2013 Update:  A couple of retirements have reminded me of this post and it is probably time to add a couple of names.  Richard Bracken, currently the CEO of HCA, was at the time our group president and the one asking that one more name be added to the layoff list.  At the end of this year, he will retire.

I finally let a cat out of the bag for the world to see for an article about women and maternity leave.  It was a long time ago, but the feelings of being laid off after just returning from maternity leave remain in my memory.

My boss had made the comment about the few female CEOs in the company (Hospital Corporation of America) not having children at home almost two years earlier when I informed him I was getting married.  I do believe his intention, as a mentor, was to make sure I recognized the reality of the day.  I appreciated his concern.

I always had to fight against the current to accomplish my goals and just saw what lay ahead as one more challenge and another opportunity to prove my determination -- that I could "have my cake and eat it too." The reality was that my industry or company wasn't ready for me, or others like me.

At the time of my layoff, the environment was that we were having to re-invent the organization to survive through the tsunami of managed care.  (This was at a time when managed care wanted new moms out of the hospital fast. I had been asked what time I planned to leave the hospital just seven hours after delivering my daughter. Legislation later required a more appropriate length of stay.) 

I could understand the need to eliminate my position at that hospital, given the continual decline in census due to managed care. What I can't understand or even explain, is why my company, one I had worked for over many years, did not try in the slightest to find another position for me -- even in another area of the country.  Maybe it was the fact that the "Columbian's" were in charge.  Or perhaps, as my boss had cautioned, because I had just had a baby.

My boss continued to be a source of recommendations and referrals to opportunities, but the company let me down.  Now that the "Columbians" are gone, it seems that perhaps the company has evolved. Hopefully, others haven't or won't share this experience. 

 

Roman Candy

On a recent trip to Louisiana, I came across Roman Candy and brought some home.  I also found this YouTube video that describes the history and type of taffy.

 

I can still see the Roman Candy man parked on the corner of West End Blvd. and Polk Ave. in Lakeview.

Louisiana State Medical Society: Healthcare and Disaster Planning

I just learned about a resource on disaster planning for healthcare, a project of the Louisiana State Medical Society, and want to share it with my readers.  I've only quickly reviewed the 122-pages, but notice it has some great pictures to give readers a real perspective on the issues discussed.  I also noticed one chapter includes a section on leadership and organization effectiveness (one of my favorite topics), so I can wait to read this one.

Here in Santa Barbara County we continue to work on our hospital and public health preparedness and I look forward to learning from and incorporating Louisiana's lessons learned.

LSU Tigers in Print

The LSU Alumni Magazine included my book, Social Media in Healthcare:  Connect Communicate Collaborate in the Tigers in Print section of their Summer issue.  It might be cool for people who knew me when to see it and maybe I'll even get to reconnect with an old friend or two.

I loved my days at LSU!  Enough classes for a Communications Minor. The quite beauty (but not on football days) of the campus.  The warm and humid environment (really cold in the winter).  Being young and away from my family (a young girl's dream).  Off to Ft. Walton, FL for spring break, picking peaches in Clinton, LA and so many other new adventures!

It makes me smile! :)

Hospital Employees Devastated by Recent Disasters

Hospital employees are among those who have been devastated by the recent flooding and tornado disasters in Alabama, Arkansas, Georgia, Louisiana, Mississippi, Tennessee and Missouri.

The Care Fund, created in the aftermath of hurricane Katrina, is there to assist those hospital employees who experienced devastation and suffering. Contributions are tax deductible and funds are distributed by hospitals to those employees who need assistance. The fund is administered by the Alabama Hospital Association.

For information about The Care Fund, e-mail CareFund@alaha.org or call (800) 489-2542. You can also visit their Facebook page.