#MEQAPI – Tweetchat Feb 9th 2017 3ET

Next tweetchat: Thursday February 9th, 2017 3:00-4:00 PM ET

Topic: Emergency Department Congestion – Patient flow and Healthcare Improvement

MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and includes everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

The following topics will be posed this week related to patient flow and how it relates to healthcare improvement and quality:

We have selected a mini case study based on ED physician tweets about ED crowding.
Process and quality issues are often seen first in the ED, so a good place to start when looking at improving healthcare. ED crowding is very common, with over half of EDs reporting frequent boarding.

ED is also a very busy and hazardous place, you want to spend as little time in the ED in your life as possible. ED boarding creates additional patient safety risks.

For this discussion, we are defining Boarding as a length of stay (LOS) of over 2hrs for acuity 1-2, or over 6hrs for acuity 3-5. ACEP takes a more functional view of boarding

  1. In a 90 bed ED, 80 beds are boarded, and the ED census is 120. What questions would you ask, and of whom
  2. What risks do you foresee in ED crowding, what risks, issues, and missed opportunities have you experienced
  3. What opportunities do you see for reducing ED crowding, and who should grasp them
  4. What role does/should technology play in improving care workflow
  5. How can providers and patients drive reduction in ED crowding

… and the numbers

meqapi-feb-9

 

Advertisements

#MEQAPI – Tweetchat Feb 2nd 2017 3ET

Next tweetchat: Thursday February 2nd, 2017 3:00-4:00 PM ET

Topic: Administrative and Clinical Workflow and Healthcare Improvement

MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and includes everyone from administrators to zoologists, and include physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

The following topics will be posed this week related to Workflow and how it relates to healthcare improvement and quality:

  1. What does care workflow mean to you, and where does care workflow start and end
  2. What care workflow risks and issues have you experienced, what harm or missed opportunity did you see
  3. How is poor care workflow contributing to the high rate of medical mistakes
  4. What role does/should technology play in improving care workflow
  5. How can providers and patients drive improvements in care workflow

Here’s some of those who attended the session:

 

meqapi-ppl

… and the Symplur analysis of the activity:

meqapi-perf

 

#MEQAPI – Tweetchat Jan 26 2017 3ET

#MEQAPI – Tweetchat Jan 26 2017 3ET

Next tweetchat: Thursday January 26th, 2017 3:00-4:00 PM ET

MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and will include everyone from administrators to zoologists, and include physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

Three healthcare domains in which we might want to pay close attention are Care Policies, Care technologies, and care flow.

The following topics will be posed this week related to Health IT and how it relates to healthcare improvement and quality:

  1. What successes are there in Health IT – what is working well and how does that manifest
  2. What Health IT failed at least one element of Safety, Timely, Efficiency, Effectiveness, Equitability, Patient Centered – how
  3. What role should the government play in making Health IT improve healthcare cost, quality, and accessibility
  4. What role do the medical NGOs, journals, and professional bodies play in improving Health IT
  5. How can providers and patients drive improvements in Health IT

 

#MEQAPI Tweetchat Jan 19 2017

Next tweetchat: Thursday January 19th, 2017 3:00-4:00 PM ET

MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and will include everyone from administrators to zoologists, and include physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

The format will follow a similar structure to the famous and well-loved examples of #HITSM, #HCLDR, and #IrishMed – guest moderators will pose 4-6 topics in sequence, aimed at igniting discussion and interaction.

Three healthcare domains in which we might want to pay close attention are Care Policies, Care technologies, and care flow.

The following topics will be posed this week related to Healthcare Policy and how quality can be seen in terms of risks, issues, and opportunities:

  1. How should governmental or organizational health policies be subjected to Monitoring & Evaluation
  2. What policies fail at least one element of Safety, Timely, Efficiency, Effectiveness, Equitability, Patient Centered
  3. How should we monitor cost, morbidity, and mortality effects of a policy or law
  4. What role do the medical NGOs, journals, and professional bodies play in healthcare improvement
  5. How can providers and patients drive improvements in healthcare policy

 

#MEQAPI Tweetchat: Jan 12 2017

When: Thursday January 12, 15:00-16:00 ET

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and will include everyone from administrators to zoologists, and include physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

The format will follow a similar structure to the famous and well-loved examples of #HITSM, #HCLDR, and #IrishMed – guest moderators will pose 4-6 topics in sequence, aimed at igniting discussion and interaction.

The following topics will be posed:

T1 What role should the government or international bodies play in healthcare improvement?

T2 What role should the public, and especially patients, play in process or quality improvement?

T3 In what areas of healthcare do you see the biggest need or opportunity for quality improvement?

T4 What quality failure have you personally experienced in healthcare, and what was the outcome?

T5 Do you feel comfortable reporting a quality issue, and if not, why not?

#MEQAPI TweetChat

On an average year, the estimates are that between 90,000 and 400,000 patients in America die untimely deaths due to medical error and missed opportunities. (The earlier IHI studies estimated 90,000, and more recent research hints at 400,000). The toll of injury related to medical error runs into the millions, and the financial cost of waste, medically unnecessary care, and dealing with sequelae of mistakes runs into the billions of dollars.

While we may object to various technical aspects of the research papers, find fault with elements of the methodology, or just plan balk at the thought of physicians killing patients, clearly healthcare is in need of quality improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and will include everyone from administrators to zoologists, and include physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

The format will follow a similar structure to the famous and well-loved examples of #HITSM, #HCLDR, and #IrishMed – guest moderators will pose 4-6 topics in sequence, aimed at igniting discussion and interaction.

If you would like to moderate a #MEQAPI tweetchat or suggest some topics, please contact us at @MEQAPI, or email mloxton@meqapi.org.

Oh, and the first #MEQAPI chat will take place on Thursday 12th Jan at 15:00-16:00 ET

See you there!

The Three Horsemen of the Coming Healthcare Apocalypse

Ok, so not really – It’s not about horsemen, it’s already partially here, and it won’t be an apocalypse either. It is however going to be a very big problem, it’s going to bankrupt some people, destroy some industries, and it’s going to put a massive hurt on almost everybody for many decades to come.

There are three healthcare issues that interact with each other, and which would have been a huge problem individually, but are going to slap us hard across the face when put together. I am talking about the Aging Population, Obesity, and Climate Change.

Aging Population

Here’s the thing. 10,000 Boomers are retiring per day, they did a horrible job of preparing the next generation to take the helm, and there are fewer of the next generation to do so anyway. We already have a looming shortage of nurses and doctors and medical technicians, and when a bolus of them retire and need medical help, we simply won’t have enough replacements to take care of the aging population. If your organization didn’t have a knowledge management, and training and recruitment plan already in motion ten years ago, the bottom line is that it’s too late. The chances are that you won’t save your organization from collapsing, and the best you can do is arrange a slightly more elegant landing than a straight-up belly flop from the highest diving board.

The medical schools have been focused on keeping profits high, the APA on keeping competition down, and who in heck knows what legislators were doing. Probably nothing. Maybe just pulling practical jokes on each other. So we have let the Magic Sparkle Fairy of the Invisible Market and siloed interests and perverse incentives drive how we scaled, staffed, and recruited for medical schools, and we are going to be massively, monstrously, marvelously short. We are already short, and it gets worse.

We are going to have the same problem across every part of healthcare, and our normal go-to plan of stealing skills from other countries isn’t going to work because they have the same problems.

That was the good news.

The bad news is it’s going to be much, much, much worse than I said. We didn’t invest in the infrastructure or save for this either, so this is going to be a huge, nasty drag on getting anything done in healthcare.

Obesity

The entire world is getting heavier, and the US is one of those leading the charge. I mean of course the people are getting heavier. All ages, all genders, all races. All income groups. Some a bit more than others, but all of them are slowly getting heavier. Actually, not so slowly. Kinda fast. In fact, very fast – the rate has doubled globally since 1980. Obesity is now something that 35% of Americans can call their own, and the number is climbing.

With obesity comes a rapid increase in a whole raft of medical conditions, including diabetes, coronary disease, cancer, depression, and so on. All of them very expensive, chronic, and thoroughly entangled in social determinants of health and perverse incentives. One example is that we subsidize corn production. That creates cheap corn syrup. Corn syrup is added to every food and drink imaginable. It contributes to obesity, diabetes, stroke, and tooth decay. Wonderful stuff. So we fund a thing that kills us. Wonderful. We do that a lot.

We have entire industries whose focus is to craft very unhealthy food that is very appealing to our instincts, the way our brains work, and are kinda habit forming. The more money they make, the sicker we get, and they like making more money.

Climate Change

Despite Congress being really conflicted over whether it is happening, whether we are causing it, whether it is more important to bring out tortuous laws about gender assignment and public restrooms, Climate Change is increasingly a topic in healthcare. The anticipated effects of Climate Change of healthcare can be seen in research papers, conference sessions, and lectures at medical schools. The news isn’t very good. Well, actually not “good” as much as really bad.

There is almost no healthcare problem that is not made worse by Climate Change. On its own, Climate Change would be a darned pest. It will disrupt the agricultural supply chains, submerge some of our business transport links and cities, and increase damage to infrastructure through storm surges, hurricanes, tornados, and other forms of interesting peak weather. However, that’s just the entertaining stuff. It will also lead to resurgence of old medical enemies, shift vectors into novel regions, and hike up emergency visits for everything from asthma to zoonotic infections.

Conclusion

So even together these three aren’t an apocalypse, and won’t end the planet, our species, or even halt the amount of sports we watch. From the couch. With a Big Mac and Fries. And a soda. A big one. The super-slurp one that’s five times the size of our bladders and has enough corn syrup to kill off a platoon of insulin-producing beta cells. Not an apocalypse.

While it won’t be an apocalypse, each one will be a bit like getting a backhander through the face. On a cold morning. With a fish. A large wet fish. The three together will be like getting three individual fishy-slaps through the face, followed by another, bigger fish. With spines and slime. And frozen. A hearty backhander though the face on a cold morning with a large frozen fish, wielded by an Olympic medalist in fish throwing.

A bit like that.

Are you ready?