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Choosing Wisely: Policy or Professional and Patient Responsibility?

My latest blog post on JAMA News Forum is on the Choosing Wisely initiative that was started by the ABIM (American Board of Internal Medicine) Foundation. The initiative identifies unnecessary and sometimes harmful and costly tests and procedures that should be eliminated or seldom done. The aim is to have physicians and patients use the lists (developed by various professional societies) to have conversations about testing and treating that can reduce unnecessary care. My JAMA blog discusses whether we need policy changes to be able to move more quickly on incorporating these discussions into care, whether through penalizing their use or incentivizing the crucial conversations about what care is necessary and safe and what care is not.

As of October, the initiative now includes the first-five list of nursing-identified unnecessary care, through work being led by the American Academy of Nursing (disclosure: I’m the Academy’s president). That list includes:

“1. Don’t automatically initiate continuous electronic fetal heart rate monitoring during labor for women without risk factors; consider intermittent auscultation first.

2. Don’t let older adults lay in bed or only get up to a chair during their hospital stay.

3. Don’t use physician restraints with an older hospitalized patient.

4. Don’t wake the patient for routine care unless the patient’s condition or care specifically requires it.

5. Don’t place or maintain a urinary catheter in a patient unless there is a specific indication to do so.”

I hope that all health care professionals and organizations will share the Choosing Wisely work with colleagues, health care organizations, and the public.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor of Nursing

December 5, 2014

author: Diana J. Mason

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My latest blog post on JAMA News

Health, Media Engagement, Policy

Healthstyles on December 4th

In 2011, Vermont became the first state in the nation to commit to a single payer system. It’s to convert to this system by 2017. And while Vermont is a small unique state, proponents of single payer systems will point out that Canada’s national health plan started by one province–Saskatchewan–reforming how it paid for care. So a lot of people are paying attention to what is going on in Vermont. This week’s Healthstyles program opens with co-producer and host Diana Mason, PhD, RN, interviewing Betty Rambur, PhD, RN, professor of Nursing and Health Policy at the University of Vermont approach to a single payer system. Dr. Rambur is one of five members of Vermont’s Green Mountain Care board, a new independent agency that will oversee the development and implementation of the single payer system. Vermont’s success or failure can inform proposals in other states that are considering adoption of a single payer system, including in New York. As you’ll see, it’s not an easy challenge.

Then Healthstyles co-producer Kenya Beard, EdD, RN, joins Diana in talking about health disparities and hypertension with Dr. Carla Boutin Foster, associate professor of medicine at Weill Cornell Medical Cllege and the Principal Investigator for the Center for Excellence in Health Disparities Research. Her research has focused on reducing health disparities in cardiovascular disease and cancer, with particular attention to the Harlem community of African Americans.

So tune into Healthstyles on Thursday, December 4, 2014, on WBAI, 99.5 FM or online at wbai.org. Or listen to the interview here:

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Healthstyles is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New Yori.

December 3, 2014

author: Diana J. Mason

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In 2011, Vermont became the first state

Health, HealthCetera, Media Engagement, Policy

Healthstyles on Thanksgiving: Turkey Talk

At 1:00 on Thursday, November 27th, 2014–Thanksgiving Day–radio listeners are likely to be in the kitchen or sitting at home contemplating a day alone. Regardless, WBAI and Healthstyles will keep you company.

Host Diana Mason, PhD, RN, introduces the hour’s program then suggests that those who are depressed about being alone on Thanksgiving might find comfort in joining an online chatroom called Lifeline Crisis Chat that provides online emotional support, crisis intervention, and suicide prevention services. You can access this service by going online to www.crisischat.org. If you cannot reach a Lifeline Crisis Chat specialist onlne, you can call 1-800-273-TALK (8255). She then discusses “turkey talk”–the idea promoted by some to use the Thanksgiving gathering of family members and close friends to have crucial conversations about end-of-life wishes, including advance directives and health care proxies. You can listen to the opening here:

Healthstyles co-producer Liz Seegert follows with an interview with Stephen Johnston, co-founder of Aging 2.0, about how technology can support a healthy lifestyle as one ages. To listen to the interview, click here:

The last half hour of the program is an interview that Diana conducted with nurse Donna Gallagher about her work over the years to build the health care and nursing workforce capacity of Liberia–efforts that are now terribly set back by the Ebola crisis in that country. Listen to the interview here: