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On February 21st, Swedish Health Services in Seattle, Washington, announced that its CEO, Tony Armada, had resigned after a report by the Seattle Times that neurosurgeons were being incentivized to increase the volume of surgeries at its Neuroscience Institute and did so at times in ways that compromised patient safety. The Times reported that as a result of efforts to increase the volume of neurosurgeries at the Swedish Neuroscience Institute, nurses in the neuro intensive care unit were often assigned an unsafe number of patients and at times worked a dangerous number of hours—in some cases, up to 20 consecutive hours. The hospital was reported to have of high rates of blood clots, collapsed lungs and serious surgical complications.  One neurosurgeon noted for his high volume of complicated surgeries was hired by the hospital despite being under investigation in California for high rates of complications at another facility. When internal complaints about this neurosurgeon emerged at Swedish, the surgeon was promoted to a leadership position. Despite staff expressing concerns about inadequate patient care, inappropriate surgeries, poor documentation, a lack of accountability for postoperative complications and questionable decisions that resulted in patient harm and death, those who shared these concerns with hospital leaders often experienced intimidation and retribution.

In recent years, there has been tremendous pressure on hospitals and other health care organizations (HCOs) to grow larger, increase the volume of profitable services, and increase their profit margins. Some have done so in ways that compromise their missions of service to individuals, families and the communities they serve. With the chaos that’s surrounding the potential repeal of the Affordable Care Act, this pressure is likely to continue. In the face of such pressures and chaos, how should healthcare organizations behave and how should they be held accountable for the ways in which they operate?

Recently, the journal Academic Medicine published a paper on a new Charter on Professionalism for Healthcare Organizations that may serve as a guidepost for HCOs to stay focused on their mission, while preserving a healthy financial bottom line.

HealthCetera producer and moderator Diana Mason, RN, PhD, was part of the workgroup that developed the Charter. On an upcoming edition of HealthCetera, she talks with two other members of the workgroup about the Charter, why it was developed, what it contains, and how people might use it to improve the professionalism of HCOs. Her guests are Barry Egener, MD, an internal medicine physician, Medical Director of the Foundation for Medical Excellence that led the charter development, and Chair of the Charter workgroup; and May-Lynn Andresen, RN, BSN, DNP Candidate and Vice President for QHC Advisory Group, a healthcare consulting company.

This program was to have aired on March 9th but had to be postponed. So tune in on March 23rd on WBAI, 99.5 FM in New York City, or streaming at www.wbai.org. Or you can listen anytime here:

 

HealthCetera is sponsored by the Center for Health, Media & Policy.

On February 21st, Swedish Health Services in

Yesterday, the Trump administration released its proposed federal budget, which an incisive Twitter user described as “what a cartoon villain would propose.”

 

  • It would cut the Environmental Protection Agency by 31% and Health and Human Services by 16%.
  • The National Institutes of Health would lose $6 billion.
  • It would decimate support for after-school programs, Meals-on-Wheels, and the neediest college students.
  • And among so many other deprivations, it would kill the National Endowment for the Arts and the National Endowment for the Humanities.

 

The proposed cuts are all of a piece in their cravenness and cynicism, serving to boost military spending and so-called homeland security. For a strong analysis of this proposal’s radical conservatism, I recommend this piece at the Intercept.

 

Because I want to talk about poetry and stories.

 

Veneta Masson

This week the Annals of Internal Medicine announced it had chosen “Tinnitus” by Veneta Masson as the best poem it published in 2016. On Wednesday I spoke with Veneta, a poet and essayist, a nurse practitioner, and an instructor in ethics at Georgetown University, about the value of poetry and narrative in nursing, medicine, and health policy. Our discussion wasn’t overtly political, but I’m grateful today for the quiet affirmation she offered of the arts.

 

I asked her about the synergies being made between the literary arts and the health care industry. The Association of Writers and Writing Programs, for example, recently held its annual conference in Washington, DC, where Veneta presented on a panel called Crossing the Line: Writing as a Healing Practice. This seems significant: for years the arts have penetrated various health care arenas, but now issues related to health and health care are making their way into the country’s biggest conference for professional and student writers and writing faculty.

 

“Writing gives you new energy for your work,” Veneta said. “It’s like you need to do this to resolve what’s unresolved in the mind and heart. One time I was writing about a mistake I made or what could have been a mistake and the guilt about what I could have done. I had to find a way to put myself at rest. In that case it was in the form of a poem.”

 

Veneta told me about a Literature and Medicine group at George Washington University that met for dinner to discuss one of her books of poems. “I had written about an immigrant woman and her child, and a man approached me afterward. He said, ‘I couldn’t say this in the group, but I felt you were writing about my mother.’ What more could a writer want, as far as connecting with another person?”

 

Indeed, those connections appear to be neurological, as well as sociological. Veneta mentioned an article written by physician and fiction writer Louise Aronson, Story as Evidence, Evidence as Story, published in 2015 in JAMA. Aronson writes:

 

Mounting data, and the entire historical record across cultures and continents, suggest that human beings are uniquely wired for story and that stories, with their linking of the cognitive to the emotive, are often both more memorable and more persuasive than other sorts of information.

 

Veneta’s prize-winning Annals poem is behind a paywall, but she gave me permission to reprint another poem first published in the online journal Pulse, called The Whole Story. It’s a beautiful melding of narrative momentum and lyric concision. With just a few images and happenings she makes a world I want to inhabit, one with sunflowers and war talk, plus the unexpected poignancy of a shy bride waiting her turn at the door to a funeral.

 

After I spent hours fretting over the proposed budget, reading Veneta Masson’s poem restored me, somehow, to my right mind and to a couple of simple truths: humans need poetry, and health care is stories.

 

The Whole Story

 

After she died

there was talk of war

the stock market crashed

the cat didn’t eat for three days

her youngest came home from school in tears

her husband grew a beard.

 

I do not lie when I tell you these things

nor do I tell the whole story.

 

I do not say that her funeral day dawned bright

and unrepentant

 

or that all the sunflowers in the city

were gathered at her wake.

 

I do not mention the ruffled bride

also in white, waiting discreetly outside

the door of the chapel.

 

I do not tell how, at the gravesite

smiling children blew

soap bubbles over her casket

 

and how they were not buried with her

but were borne up and away,

carried gently on a light wind.

 

And check out Veneta’s Notebook, her observations of matters literary, medical, and otherwise. In one entry she writes about writing: “that’s where I find out what I’m thinking and (like Descartes) what’s true and what isn’t.”

 

Yesterday, the Trump administration released its proposed

Source: Bipartisan Report; http://bipartisanreport.com/2017/03/14/new-cbo-analysis-reveals-startling-obamacaretrumpcare-comparison-image/

This week the Congressional Budget Office scored the American Health Care Act, also known as Trumpcare even though he doesn’t want it branded with his name (wonder why…), the bill that Paul Ryan and the Republicans put forth to repeal and replace the Affordable Care Act, or Obamacare. The CBO, as it’s called, is a nonpartisan Congressional office for assessing the potential impact and cost of legislation put forth by Congress.

The CBO reported that the bill will reduce federal deficits by $337 billion over the 2017-2026, but 14 million people will lose their health insurance in 2018 and 24 million by 2026. Paul Ryan is said to be playing up the cost savings to get conservative Republicans on board with supporting the legislation and he may be successful in the House of Representatives. But the bill will be blocked if three Republican Senators vote against the legislation.

Today on HealthCetera, we’ll discuss Trumpcare, what it does and its impact on people and community health centers. HealthCetera producer Diana Mason discusses the major features of Trumpcare and why it will increase the number of people in the country who are uninsured.

So tune in on Thursday, March 16, 2017 at 1:00 on WBAI, 99.5 FM in New York City or at www.wbai.org. Or you can listen anytime by clicking on the following link:

[caption id="attachment_12245" align="aligncenter" width="700"] Source: Bipartisan Report;