More Gems from the Estes Park Institute Healthcare Conference

Here are a few more tidbits from my Estes Park Institute conference notes:

Collegial Intervention:

• The suicide rate for male physicians is 1.5 X higher than the general population.
• The suicide rate for female physicians is 2 X higher than the general population.
• Collegial intervention programs can help.  Develop policies that encourage early intervention by medical staff leaders, and procedures that legally protect their efforts.

Conflict of Interest:

• When a member of a voting body has a conflict of interest with regard to a matter under consideration, not only should the individual refrain from voting on the matter, they should leave the room (or be asked by the Chair to leave if necessary) prior to any discussion about the issue.  Minutes should reflect that the individual with the conflict left prior to any discussion.

Environment of Care:

• The need for medication prescribed to modify mood and behavior was significantly reduced (40% or more) when a nursing home was redesigned to be esthetically pleasing and comfortable, suggesting the enormous impact our environment has on wellness and healing.

Leadership:

• The higher an individual's rank in an organization, the less honest feedback they can expect to receive, both positive and negative.  Leaders must find ways to seek and reflect on feedback.

Legislation:

• The Patient Safety and Quality Improvement Act was passed in 2005.  The open comment period for rules ended 4/12/08, and final rules are expected to be published by the end of 2008.

Risk Management:

• Presenters encouraged timely group debriefing after a near-miss event.  If something adverse almost happened, what prevented it?  If it was prevented simply by chance, not by fail-safe measures, prompt redesign can be facilitated by the group.
• When recommending process changes, defer to knowledge and experience over rank.

Future Directions:

• Web-based healthcare is literally, just around the corner.  One presenter forecast that within five years web-based subscription healthcare, paid for in nominal monthly fees, will serve as a resource for basic health information and physician referral.  Patients will use these services as a way to manage and coordinate their care. The repeatedly asked question was, "Will patients receive this information and referral service from your organization or from someone else's?"