Redesigning Patient Care by Engaging Patients.
The best doctors can’t cure chronic conditions in 15-minute office visits. Increasingly, providers need to harness the efforts of other professionals, and particularly of their patients’ family members, friends and neighbors, to improve a population’s health. We have organized and taught professional and lay advocates in numerous ways.
Discovering best practices
For professional and family patient advocates, Patient Safety Blog contains hundreds of tips that patients and their family members have learned through their medical care misadventures. The book, Getting Your Best Health Care: Real-World Stories for Patient Empowerment, summarizes and supplements these practices. For the Society for Participatory Medicine, our review of the literature quantified the value of patients’ participation in their care. For the Consumer Health Quality Council, we ascertained the variety of hospital practices that patient representatives on their Patient/Family Advisory Councils had stimulated.
Coaching clinicians to use best practices for patient-centered care
Many behavioral health organizations each realized several hundred thousand dollars of additional yearly revenue by accommodating same-day appointments (“open access”). These and other client engagements are described in case studies of an urban alcohol/drug treatment provider, a psychiatric center, and statewide improvement. We have also helped acute hospitals to deliver medication much more safely; six case studies are described in the Journal of Clinical Outcomes Management.
Coaching and organizing volunteer advocates
We have coached family members to act as patient advocates in crises following a loved one’s discharge from a hospital or nursing home, or after medical errors, etc. We coordinated the work of 30 pre-med student volunteer Advocates who connected low-income parents with community resources, in testing ways to reduce the inappropriate use of the public hospital’s Emergency Department for their infants, and spur the use of the patient-centered medical home.
In pro bono work during two terms as President of the Consumer Health Quality Council of Health Care for All, Ken convened and led victims of medical errors, developing web-based educational materials, tracking hospitals’ use of Rapid Response Methods to rescue failing patients, and tracking hospitals’ use of Patient/Family Advisory Councils. Earlier, Ken had coordinated volunteers with the Greater Boston Interfaith Organization in getting universal health insurance on the ballot and into law in Massachusetts. For coordinating volunteers for the Massachusetts gubernatorial campaign of Dr. Don Berwick, Ken was designated the “Activist of the Week” in July 2014.
Patient-Centered Medical Homes
For a suburban pediatric medical home, we quantified the financial gains from four of their numerous innovations. For a PCMH based in a children’s public hospital, we directed statistical analyses of the effects of attempts to increase the use of the medical home and reduce inappropriate Emergency Department use by young children of low-income families. For a PCMH in Chicago, we tested the use of assessments of low-income families’ needs for basic resources while patients were awaiting medical appointments, as a possible way to improve patient satisfaction. We wrote a white paper to assist C-level leads of medical groups in achieving Recognition by the National Council for Quality Assurance (NCQA) as a Patient Centered Medical Home.