The Institute for Clinical Systems Improving holds an annual conference on health care transformation. In their evaluations, attendees often say the event, which brings together 400 health care and health leaders, gives them hope to go out and do the hard work of improving our health care system.
This year, we found a poem that resonated with ICSI staff, and our President and CEO, Sanne Magnan, MD, PhD, shared the poem to launch our meeting. It was well received. So we want to share it to inspire all of you who are also working to achieve the Triple Aim of better health, better care and better costs.
The Gates of Hope—A Poem by Victoria Safford
Our mission is to plant ourselves at the gates of Hope—
Not the prudent gates of Optimism,
Which are somewhat narrower.
Not the stalwart, boring gates of Common Sense;
Nor the strident gates of Self-Righteousness,
Which creak on shrill and angry hinges
(People cannot hear us there; they cannot pass through)
Nor the cheerful, flimsy garden gate of
“Everything is gonna’ be all right.”
But a different, sometimes lonely place,
The place of truth-telling,
About your own soul first of all and its condition.
The place of resistance and defiance,
The piece of ground from which you see the world
Both as it is and as it could be
As it will be;
The place from which you glimpse not only struggle,
But the joy of the struggle.
And we stand there, beckoning and calling,
Telling people what we are seeing
Asking people what they see.
My wife and I recently celebrated 40 years of marriage by going to Kauai. It was a wonderful time of gorgeous scenery, warm weather, and relaxation. As I sat many mornings watching the surf roll in below our rented condo, I also found it a time of contemplation.
If you have never been to Kauai—especially in an April when it was still snowing in Minnesota, once you get there you try to figure out how to stay. There was a job opening at the Tropical Ice Cream Shop near Princeville. I knew it wouldn’t pay the bills, but that wasn’t the reason I’m back here working at ICSI.
As I looked at the surrounding paradise, I kept thinking everyone should be able to experience it. But most people are not as fortunate as me. I have siblings who cannot afford such a trip.
One of the reasons is the rising cost of health care. Forget exotic vacations. The unsustainable increases in costs are leaving fewer and fewer dollars for education, good housing, jobs, and clean environments that are known to contribute more to an individual’s health than health care itself.
ICSI’s 50 medical group and hospital members are committed to achieve the Triple Aim of better health, better care and more affordable health care. Some are engaged in programs like Choosing Wisely to ensure physicians and patients discuss appropriate care that improves safety and lowers costs. Others are working to help prevent avoidable hospital readmissions through the RARE (Reducing Avoidable Readmissions Effectively) Campaign. That effort has kept 7,300 people from returning to the hospital unnecessarily, saving an estimated $55 million in the process.
While there was some remorse as we boarded the plane for Minnesota, I was ready to come back to work (that’s kind of true). Our community has accomplished much in improving the quality and value of the care we deliver, but it is not enough, as the waves of baby boomers rolling into the health care system are just as constant as the waves off shore in Kauai.
So today I am wrapping up preparations for our annual Colloquium with its theme of “Building a Sustainable Health System.” I’m hoping the slate of leaders who will be presenting, and the lessons that 400 attendees take home and implement, will accelerate our efforts to achieve that Triple Aim. Accomplishing that will help others afford health care. And it will help me forget about that mocha chocolate almond ice cream cone.
The fifth annual County Health Rankings, prepared by the University of Wisconsin Population Health Institute, recently came out. Minnesota fared quite well nationally. But I was more interested in my county–Washington. We ranked #8, which was near the top among all Minnesota counties.
The report was more relevant to me this year because the Institute for Clinical Systems Improvement has been focusing on both health care and health improvement. So I was aware that the University of Wisconsin work estimates that “health care” accounts for only about 20 percent of our “health” and longevity.
We’re all feeling overwhelmed, perhaps threatened, and at times frustrated by what we’re seeing in the environment. The military has a term for it—VUCA (Volatility, Uncertainty, Complexity, Ambiguity). While it originated in the military, it seems totally applicable to the health care systems and communities we serve.
Recently, I attended a learning forum on ICSI’s work to integrate behavioral health into primary care. This forum reviewed five years of Minnesota medical groups implementing the DIAMOND (Depression Improvement Across Minnesota, Offering a New Direction) program for depression, and more recent work supporting the SBIRT (Screening, Brief Intervention and Referral to Treatment) program to address risky substance use.
As director of marketing and communications at ICSI, usually I lead promotion for these events, or provide recaps of presentations. I played a different role this time—that of a patient with depression.
The goal of this project is to promote evidence-based patient-centered care in the primary care setting. We have developed a set of tools, including decision aids, to facilitate a conversation between the patient and clinician that incorporates the best research evidence and the patient’s preferences and values. We have also developed a ShareEBM implementation toolkit.
Our study will have two arms; one arm in which decision aids are passively disseminated and one strategically implemented with the study team assisting the adoption (ShareEBM Plus). Participating practices in both arms will have full access in perpetuity to the decision aids most pertinent to the primary care of patients with diabetes and concomitant chronic conditions (hypertension, depression, statin use, aspirin use, osteoporosis). Learn more about participation requirements and join us today!
Kicking off the 17th Annual ICSI Colloquium on Health Care Transformation — May 5-7, 2014 at the Saint Paul RiverCentre — will be Craig Brammer, Chief Executive Officer of the combined operations of the Greater Cincinnati Health Council, the Health Collaborative and HealthBridge. He will share lessons learned from overseeing the strategy and coordination of that region’s community health improvement initiatives. A much sought-after innovator and speaker, Brammer was previously at the Office of the National Coordinator for Health Information Technology, where he focused on the intersection of technology and payment policy, and led a $260 million federal technology innovation program.
He joins Kerry Sparling, our other keynoter, who will provide a patient’s perspective on how to curtail the rapid rise in diabetes.
Looking for more reasons to attend? Keep an eye on our website’s Colloquium page for all the details as our program develops, including:
- New tracks
- Opportunity to win free trip to 2015 Colloquium
- Tuesday reception
- Mobile app – better than ever
The theme of ICSI’s next colloquium, set for the Saint Paul RiverCentre on May 5-7, 2014, is Building a Sustainable Health System.
Kerri Sparling has been announced as one of our keynote speakers. Ms. Sparling, who has had type 1 diabetes for more than 27 years, is the creator and author of Six Until Me, one of most widely read diabetes patient blogs. Her work as a writer and consultant can be found at diaTribe, dLife, and in diabetes outreach like JDRF’s Countdown magazine.
As many as one in three U.S. adults could have diabetes by 2050, according to the Centers for Disease Control and Prevention. Ms. Sparling will present an engaging patient perspective on how to best meet the needs of this expected tsunami of people living with diabetes. Here is what a past Colloquium Planning Committee Member, Ben Miller, PsyD, Department of Family Medicine, University of Colorado School of Medicine, has to say about Ms. Sparling:
“You want authenticity? You want a challenge? You want to be engaged? If the answer to all three of these questions is ‘yes’ then look no further than Kerri Sparling. Kerri picks an audience up by their lapels and shakes them around convincing them that there is a patient in healthcare who often gets lost and ignored. She reminds us all of the importance of being truly ‘patient-centered’ and dispels any myths that focusing on pieces rather than wholes is a good idea for our health. Very few leaders in healthcare are able to address such complicated issues in healthcare as Kerri; and, she does so with grace, precision, and passion.”
Save the date and watch for more details as the program develops.
A reception with Tom Frieden, MD, Director of the Centers for Disease Control and Prevention (CDC), was held at ICSI in September in conjunction with Dr. Frieden’s visit to our state to learn how Minnesota has achieved the best control of hypertension in the country. Learning Minnesota’s best practices, he noted, might help the CDC and the Centers for Medicare and Medicaid Services reach the goals of their co-led Million Hearts™ Campaign—prevent one million heart attacks and strokes by 2017 through improved clinical and community prevention, and increase the number of persons in the U.S. whose hypertension is under control by 10 million. Learn more.
ICSI brought together more than 60 stakeholders who have been involved with the DIAMOND and SBIRT programs for a learning action forum on September 26, 2013. The “Evolving Integrated Care” forum focused on three areas: celebrating the stakeholders’ accomplishments over the past seven years in integrating behavioral health and primary care; engaging stakeholders on the impact of their work to date and opportunities for improving depression and substance use care in primary care; and exploring innovative strategies to sustain successful integrated care moving forward. Learn more.