Saturday, July 18, 2015

Indiana Jones and the Ominous Bridge

As a community and through sharing our experiences we discovered a lot about the current bridge for patients to self management, achieve health literacy and getting well at home.  This bridge looks and feels a lot like the ominous bridge in "Indiana Jones and the Temple of Doom".  We could say it exists but it would take Indiana Jones to cross it.  So how can we release patients and expect them to take the responsibility to cross this scary, rickety, collapsing bridge over crocodile invested waters?  We shouldn't be surprised when so many return, don't make it or even the bravest and most prepared get half way there, look down and then freeze. 

It is not just about giving the patient support to cross this bridge, we need to build a new bridge together.  Our goals are starting to converge.  Patients want nothing more than to get home and get well at home.  And now health systems because of the Hospital Readmission Reduction Program (HRRP) and as of October 1, 2014 the Medicare Spending Per Beneficiary (MSPB) are making it a priority to get patients well at home. 

Together we can build a bridge that is person centered and looks at the factors beyond just health.  This bride would invite patient to be part of their care and let them know there will be people to support them.  This bridge can be  welcoming, sturdy and have benches to rest along the way.  There are many kinds of bridges that can be built but all should have the same destination for patient to get and stay well at home.  

Here are our architectural drawings of the bridge we designed together over the last 4 months.  All the elements are important but there were two particular elements that seem to be the foundations of our bridge.  
  1. An invitation to the patient to be part of their own care. (Ed inserted a quote from some famous person "people don't like to take orders, they like to take part."  This summarizes why the invitation is so important.
  2. A patient created and updated medication list.  We believe this could be the keystone element that triggers a patient's knowledge and confidence in their health.  See below for a bit more detail. Also read Charles Duhigg's book "The Power of Habit" and specifically the section on the new Alcoa CEO's commitment to shareholder to focus solely on 100% Safety with an absolute commitment to 0 safety incidents and how focusing on Safety allowed management and union to come together, created record profits and quality.  
We are excited where our journey has led us and know it is time to test out our bridge by welcoming patients to take the first step.  Indiana Jones might be disappoint by the lack of adventure crossing this bridge. 

Take this with you to your doctor visits and pharmacy and keep it in case of an emergency. Go to your pharmacist every six months to have them review your list. Keep it up to date.

List your team especially know your friendly pharmacist who can coordinate and review your medications and list all your doctors, nurses and other team members so care professionals know who they are working with.

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