Understanding Who Your'e Working With

      Managing a successful healthcare organization like a hospital can be difficult due to many different factors. One of the most problematic relationships is between the administration and the clinical side. This has been an ongoing conflict for quite sometime now. I personally can speak from experience and say there is a misunderstanding between the patient and the medical staff sometimes as well. The patient has a different perspective and understanding of things than the medical staff does and I believe this is the same situation with the administration side and clinical side of the hospital. The CEO and administration side wants everything to run smoothly and provide the best outcome for the patient but this isn't always easy when the administration starts telling the clinical side how to do things. A Chief Physician Executive at a hospital presented to my health management class. He spoke a lot about this conflict. The physician made a comment that really caught my attention and that was, " Physicians are the best judges of one another because we understand what the other physicians are doing and how to best critique each other.". I find this to be extremely important because physicians are not trying to ignore other's ideas and critiques but physicians can provide the best advice to other physicians.  They may have experienced the same situation or one very similar and have first hand experience. Many physicians know how one another feel and understand situations the same way.
     Spreading knowledge and educating all medical staff that new ideas are welcomed but staff in similar specialities will critique each other best could be an important step towards closing this conflict gap. Understanding that nurses know nurses best, physicians know physicians best, and administration knows administration best, may help ease change and improvement. Educating nurses, physicians, and administration on each other's understanding is also essential to closing the gap. Understanding who you're working with and understanding the patient's best interest is critical in all health care organizations. 

Health Policy Is Essential To Managing Care

     This week I want to talk more about health policy and how it relates to healthcare management. I think the Policy aspect of public health is often overlooked and or forgotten about. In my health policy class this week, we looked at a case known as "Monique's Case". To summarize her story, she was a 2-year old girl who had very poor living conditions because of led paint, mold, and bed bugs. On top of this, she had asthma, could not get Medicaid because her mother could not take work off to renew the paperwork, and he mother had very little income in addition to the fact that the father did not pay child support and was a violent substance abuser. Unfortunately, there are many families living in situations like these in cities all around us. We focused on Manchester, NH in this case.
     After looking over the New Hampshire State Improvement Plan (SHIP) I was able to see how many of New Hampshire's plans to improve health priorities could relate back to Monique and her family. Creating policies and improving just a few things under each problem can make a world of difference for so many. Some of NH SHIP's health priorities were substance abuse, maternal and child health and asthma. Any programs within these boundaries that could help improve the quality of life for people like Monique is very important because it gives Monique and her family the chance to use these programs that were not inlace before. Manchester also put many programs into place such as Neighborhood Improvement Plans and social workers in school that spoke multiple languages and could help speak with children about healthcare and Medicaid. These policies being implemented in the state are what is needed to improve quality of life for these young children and help make managing health care a bit easier. Without the policies in place, more and more people will slip into these poor living conditions and bad health because they have no other option.
     A few students and I were able to sit in on a video conference with second and third year law students who discussed this same case. One student brought up an interesting point that there is actually a law that claims the landlord Tennant must make the apartment livable and if it is inhabitable; contains mold, poor air and water quality, etc. then there must be changes made. I found this very interesting as did one of my professors because this policy is in place to maintain good health and living conditions. However, many people do not know about it and continue to suffer in these situations. It is policies like these that must be implemented, promoted, and executed to help improve managing health care and healthy living conditions as a whole. Promoting policies so that the community knowns about them for their own health and safety is essential.

Hello,

     Last week I dove right into things with my post on diabetes care and management. I wanted to take one step back and look at the overarching idea here. I care a lot about healthcare and I think it is incredibly important that we as a community focus on managing a healthy community as well as promoting healthy behaviors. Science and medicine is for ever changing and it is near impossible to be on top of any change in healthcare before we face a problem. However, I think laying down some groundwork and developing goals to lead towards a healthy environment is essential. A perfect world in health and medicine is never going to happen but we can create a vision of what we want to work towards. Thus why I named my blog 20/20 Health Vision. 

     Pointing out basic ideas like organizing healthy meals to eat, managing stress and exercise, and making simple checklists may seem redundant and pointless but they have proven to be just the opposite. Doctor Atul Gawande is a practicing surgeon and has done a great amount of research on health care in the US. As many people in the healthcare field are aware, the US spends thousands of dollars more than any other country, yet we rank 30-something in life expectancy. How is that we can be spending so much money on healthcare and not be ranked at least top 5? There are a number of theories on why we spend too much money on healthcare. I have looked into and agree with many because I am concerned that we don't take these precautionary measures to look at why we spend so much money on healthcare and perform so poorly. Atul Gawande was approached by the World Health Organization for his work and implemented the WHO surgical safety checklist. After implementing this checklist in 9 hospitals he found that the patient death rate fell by 40% and patient complications fell by 33%. This is incredible that such a simple concept, a checklist, has proven to bring so much more success in the health field by eliminating error and excess medicine. The checklist has helped improve life as well as minimize our spending and will hopefully continue to do so.

     This is a prime example of why we need to pay attention to fine details and easy concepts to improve health management and organization which will in turn, improve medicine in our communities. These things will help us work towards that 20/20 health vision!

Kayli Mathews

Proper Diabetes Education and Care Management

     The time has come again.. summer has come to an end and the school year has officially begun.  Fortunately for me, I enjoy school and learning. I often try to incorporate my day to day life with my schooling, as it ties everything together and makes things more interesting for me. For my first blog post as a Health Management and Policy student I have decided to write about Diabetes care and management.
     I am a college student living with Type 1 Diabetes and I tend to be fairly open about the subject. I joined the College Diabetes Network (CDN) at UNH last year which is a new club on campus.  The club is a mixed group of students with Type 1 Diabetes and nutrition students, however, anyone is welcome. As this club became acclimated to UNH and the students I realized there are so many people who know so little about Diabetes. Even senior nutrition students didn't know much about the reality of the disease. When everything is taught out of a book, it is much harder to grasp and understand. I firmly believe that hands on experience, face-to-face conversations, and real life lessons are paramount.
      I had always wanted to work with children with Diabetes and or become a nurse that specialized in endocrinology. However, I fell in to the major Health Management and Policy and I could not be happier. I have begun to learn just how important it is to promote and live a healthy life. Living with diabetes is not easy and I would like to help teach people about living with the disease and help young children who are newly diagnosed as well. The CDN club has begun working out a plan to go to local hospitals and talk with newly diagnosed diabetics. I suggested this idea to the club and everyone agreed that this would have a positive impact on newly diagnosed diabetics in the hospital. I think it would be helpful to these newly diagnosed patients to hear about the disease, to learn the good and the bad, to hear that living with the disease is going to be ok, and sit and talk with other people, students for example, who live with the disease first hand and have been doing so for years.
     In addition to this, we have worked with nutrition students about the truths and the myths of diabetes. As well as incorporated and discussed some real life scenarios of taking care of diabetes on a day to day basis. First, to manage your diabetes well you must take your blood sugar 3-6 times a day and keep it in range (80-160). Diabetics with type 1 also must count carbs, do calculations for proper insulin amounts, and take insulin injections before eating! There is also the option of having an insulin pump deliver insulin through a catheter. Type 1 Diabetics can eat what they want as long as they are counting carbs and taking insulin. These are all very basic concepts  that diabetics must follow in order to keep their blood sugar in range. When someone's blood sugar gets to high or to low the body will react poorly and  symptoms and complications will begin to occur.  When one's blood sugar is too high, they must take insulin and when it is too low they need food..  most likely sugar!! Not properly caring for your diabetes by avoiding checking your blood sugar and avoiding taking insulin can lead to serious health complications like Ketoacidosis which can then lead to greater problems like amputations. Hundreds of people decide to void the fact they are living with this disease and this hinders their health in the long run. Being aware of the reality of the disease and managing it properly is serious and key to staying healthy. Those who are in danger of getting, or already have Type 2 Diabetes from obesity should manage it well and take precautionary measures so they do not become more severe. Living with this disease is much easier to do when people around you are aware of how to care for diabetes or live with the disease themselves.  Teaching other diabetics to live and appropriately manage the disease is something I enjoy doing and I would love to educate others on the disease as well.
     There is one last thing you should know.. Us diabetics get multiple comments per day and they can become very repetitive, annoying, and frustrating at the wrong time. " Is that a pager?", "Why do you have an MP3 player on your hip?", " Are you wearing a microphone?", " I don't know how you do it, I couldn't", and "You can't eat that!" are just a few you should try to avoid. 
     I would be happy to answer any questions and talk more in depth with anyone about the disease in general and how to manage and care for diabetes. Knowledge is power.