1. During the summer of 2013, Nathan Hunkins had reached a pinnacle in his life. He had a great job, his wife was almost nine months pregnant, and they had just closed on their first house. As Hunkins was packing to move, he missed the bottom stair, lunged forward, and put his right hand through a glass window. After more than six hours of surgery, he woke up and asked his surgeon what happened. His surgeon delivered the good and bad news—the surgeons made a full repair, but such injuries can result in limited functionality. Hunkins lost it emotionally, a scene that repeated at subsequent visits. Before the accident, Hunkins knew patient experience was important, but his experience truly drove it home.

    Nathan Hunkins is a manager, business & systems development, with MN Community Measurement.

    # vimeo.com/121919560 Uploaded 12 Plays 0 Comments
  2. Nathan Wilson, a self-identified “qualitologist,” said that “nothing will agitate a group of physicians more than introducing patient experience surveys into their practice,” despite the benefits of incorporating the patient voice. When patient experience surveys were initially piloted, the results were positive. But, when the program expanded, Wilson found that physicians experienced the “four stages of grieving:” denial, fear, anger, and acceptance. Wilson’s group used the data, and the physicians with the worst patient satisfaction scores received bedside manner training—and saw their scores greatly improve. His group is still working on the final phase of grieving (acceptance), but the doctors know patient experience surveys are the way of the future.

    Nathan Wilson, MD, F.A.C.P., is the vice president of quality and safety at Southern Maine Health Care Internal Medicine.

    # vimeo.com/121918599 Uploaded 26 Plays 0 Comments
  3. In 1975, Mylia Christensen was a self-described “baby nurse.” One night, after the emergency department erupted into chaos, a switch flipped, and she knew her life’s calling would be health care. Some 30-odd years later, Christensen found herself on her first day of work for Oregon Health Care Quality Corporation. This patient’s vital signs were good: a spunky, 10-year-old organization with a great genetic blueprint, but in need of a treatment plan. Together, the staff and the board set about improving the quality of health care for all Oregonians. “These patients, our organizations, are never discharged,” Christensen said.

    Mylia Christensen, RN, is the executive director of Oregon Health Care Quality Corporation.

    # vimeo.com/121917987 Uploaded 11 Plays 0 Comments
  4. Lisa Lamkins’ son is obsessed with two things: weight lifting and his cystic acne. Lamkins went to the Internet in search of a quality weight-lifting bench and a good dermatologist. Which task do you think was simpler? Lamkins likened her experience in searching for a dermatologist to her experience as a consumer representative with the Wisconsin Alliance. During meetings, acronyms flew right over her head. She advocated for easy-to-use, easy-to-understand, and easy-to-interpret health information. Consumers too often have to do the heavy lifting in assessing health care quality choices. But now, because of Lamkins and others like her, that is improving in Wisconsin.

    Lisa Lamkins is the advocacy director with AARP Wisconsin and is a consumer representative to the Wisconsin Collaborative for Healthcare Quality.

    # vimeo.com/121917435 Uploaded 4 Plays 0 Comments
  5. To get the collaborative approach working, Cleveland’s Alliance had to overcome some history, according to J.B. Silvers. First, the approach was “just trust the doctor”—which, needless to say, did not work well. The second phase was to trust the managers and the free market to fix the system, but that resulted in managed care and subsequent frustration. Finally, a collaborative model emerged in Cleveland, and it has been a success. Cleveland focused on primary care, celebrated victories, and had trusted data because of the uptake of electronic medical systems. The best performers now share their secrets to success in a safe environment. They “help the people,” Silvers said. “Everything else is secondary.”

    J.B. Silvers is the John R. Mannix Medical Mutual of Ohio Professor of Health Care Finance and a Professor of Banking and Finance at the Weatherhead School of Management at Case Western Reserve University.

    # vimeo.com/121916701 Uploaded 2 Plays 0 Comments

Aligning Forces for Quality

Aligning Forces for Quality

Aligning Forces for Quality (AF4Q) is the Robert Wood Johnson Foundation’s signature effort to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities and provide models for national reform.

AF4Q asks the…


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Aligning Forces for Quality (AF4Q) is the Robert Wood Johnson Foundation’s signature effort to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities and provide models for national reform.

AF4Q asks the people who get care, give care and pay for care to work together toward common, fundamental objectives to lead to better care. The 16 geographically, demographically, and economically diverse communities participating in AF4Q together cover 12.5 percent of the U.S. population.

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