Showing posts with label Anna Roth. Show all posts
Showing posts with label Anna Roth. Show all posts

Sunday, May 20, 2012

Quality is goodness

In the spirit of stealing shamelessly, I am going to plunder Anna Roths latest post from her blog. She summarises a talk by Dr. Don Berwick. Highlights include:


"Quality is Goodness"
"What do we need to do? This is the 2.6 trillion dollar question isn't it? Here is a list to help guide us.
1. Put patients first
2. Protect the disadvantaged 
3. Start at scale –move fast – go "all in"
4. Return the money
5. Act locally"

"The Ethics of Improvement
  1. Professionals have a duty to help improve the systems in which they work.
  2. Leaders have a duty to make 1. Logistical, feasible and supported.
  3. No excuses for inaction on 1 and 2 are acceptable.
  4. The duty to improve encompasses safety, efficiency, patient-centeredness, timeliness, effectiveness, and equity requires continual reduction of waste. The IOM six dimensions quality of are dimensions of goodness
  5. Those who educate professionals have the duty to prepare them for improvement work."
Wow, in 25 plus years of training, working, and teaching, no-one has ever said to me there is an ethical duty to educate professionals for improvement. Self evident but an indication of why we are finding healthcare improvement to be so challenging. 


Anna is always worth reading. Follow her blog and twitter. 

Sunday, March 20, 2011

Suicide

A very moving post by Anna Roth on her blog about the suicide of her brother in law. She has previously written about suicide, but not this powerfully. The statistics are terrifying, one of the most common causes of death in the 25-44 year old age group, worldwide! Incidence has increased worldwide by 60% over the last few decades. Most common methods are hanging, ingestion, (usually herbicides) and gun shots.
It is estimated that there are 30,000 suicides annually in the US. The most recent data I have seen for Ireland suggest that there are almost 600 reported deaths by suicide annually, a rate substantially higher than the US. The WHO report that the rate in Ireland (11.6 deaths/ 100,000 inhabitants) was 10-15% greater than the average rate in the EU-27.
Can anything be done, an especially pertinent question given our economic collapse and the likely toll that this will cause? While the HSE has a suicide office and a prevention strategy, I have no expertise with which to judge its efficacy. However there are healthcare delivery systems that have shown what can be achieved. The Henry Ford system in Detroit shows what can be achieved. In the first 4 years of the groups suicide prevention program, the rate decreased from 89 to 22 deaths/ 100,000 population. In the most recent analysis the rate over the previous two years had dropped further to zero deaths!
For details, click here. This in a city that has been battered economically over the last decade.
There is another very emotional piece in this weeks JAMA, again an account of suicide from the perspective of a family member. In a future piece, I hope to write about the risks of suicide amongst physicians and ways to reduce this risk.