Category Archives: In the News

In Healthcare: Respect= Safety

Written by Deborah Caputo Rosen, RN, PhD

Finally!  Respect= Patient Safety. From that wise purveyor of direct- to- consumer information and education, Consumer Reports, comes a report written in easily understandable language that underscores the message of the Wilson-Stronks advocacy program: Improving Healthcare by Putting Patients in Patient Safety (How Not to Get Sick(er) in the Hospital).

Consumer Reports conducted a survey, of 1,200 recently hospitalized patients, funded by the Gordon and Betty Moore Foundation.  It demonstrated a clear link between participants’ perceptions of respectful treatment and their safety during the hospitalization. The survey defined measures of respect, including:  “the ways staff members and physicians communicated and, whether they acted with compassion, honored patients’ wishes and acknowledged mistakes”.

Whether it is called patient satisfaction, patient engagement, or patient and family-centered care, people who are actively involved in their own healthcare, experience better outcomes and have lower health costs than those who are not (Dentzer 2013). In the Consumer Reports survey, one-third of respondents felt doctors and nurses did not always listen to them without interrupting, 25% said staff did not always treat them as adults able to be involved in their own care decisions, and 34% felt their expressed wishes were not honored. Twenty-one per cent felt they experienced actual discrimination in their care.  Those who rated their experience of respect poorly were two and a half times more likely to experience a medical adverse event than those who described usually being treated respectfully.  And dismissive or poor treatment made survey respondents feel uncomfortable asking questions about their care and the steps being taken to keep them safe. Those who did not “Speak Up” were 50% more likely to have experienced at least one medical error during their hospital stay.

The Consumer Reports article also includes a table called Top and Bottom Scoring Hospitals for Safety and Respect. The data are drawn from the organization’s hospital ratings tools and are based on January 2014 data from CMS . Reported safety scores are based on mortality rates, infection rates and hospital readmissions.  Patient experience (respect) scores include doctor and nurse communication, communication about discharge and overall impression of the hospital.

Many consumers will benefit from the wide availability of this Consumer Reports coverage.  Their recommendations parallel what Wilson-Stronks teaches patients/families and providers in our advocacy curriculum: “Know-Ask-Speak”!

  • Choose the right hospital
  • Help providers see you as a person
  • Invite your doctor to have a seat
  • Have “Your People” with you
  • Know when errors tend to occur
  • Find a “Troubleshooter”
  • Be assertive and prepared but courteous
  • Keep the concept of partnership in mind
  • Write things down
  • If you don’t understand, ask again

Once healthcare consumers recall that they are the CEOs of their own healthcare teams; are purchasing services from healthcare professionals, and have choices, rights and clear expectations about the outcome of care, more than half of the work is done! Then, some expert coaching of necessary communication skills, negotiation skills and facts about their diagnosis and treatment options can restore a balance of power and assure a safer, more respectful healthcare experience.

Contact us to learn more about how we are “Putting Patients in Patient Safety”.

Work Cited:

Dentzer, S. Health Affairs. February 2013, 32:202. Accessed January 10, 2015
“How Not to Get Sick(er) in the Hospital”. Consumer Reports. February 2015, p. 32-37.)

Perks as an Intern: ACA Open Enrollment Call with First Lady Michelle Obama

Written by Kayana Marks
January 30, 2015

Over the past few months I have been granted many opportunities working as the intern for Wilson-Stronks, LLC. Many of these opportunities allow me to learn so much about many aspects of healthcare. When I was asked by Amy to join the call with First Lady Michelle Obama about Open Enrollment during the LGBT Week of Action I was thrilled because I knew I would learn so much more about the Affordable Care Act. Dialing into the call on January 15 I had an open mind and a willingness to learn as much as I possibly could about my future career field.

First Lady Michelle Obama was the opening speaker and she was very grateful for all the work healthcare advocates had done so far. She emphasized that because of the Affordable Care Act (ACA) millions of Americans have healthcare coverage for the first time. In light of the LGBT Week of Action, First Lady Obama mentioned that the ACA bans health insurance companies from charging LGBT persons higher rates. She stressed that now is the time for advocates to reach further back into their communities for Open Enrollment. As advocates for healthcare we are the leaders of our communities and the people trust us. First Lady Obama closed out her segment of the call by reminding us that we are indeed changing lives by making sure that every American has access to healthcare.

Immediately following First Lady Michelle Obama, Sylvia Burwell, the Secretary of Health and Human Services, addressed the audience. Mrs. Burwell wasted no time in reminding everyone that the ACA has assisted many people in experiencing greater equality and greater healthcare coverage. Mrs. Burwell brought this to life by sharing a story of a lesbian woman who once said, “health insurance was always out of reach” for her. Now that she has more options she finds that “the relationship [with her partner] is respected”. Mrs. Burwell also pointed out that healthcare coverage can also be affordable now. Eighty-seven percent of those that have signed up for insurance have financial assistance. The many millions of Americans that the ACA has helped has shown to be the greatest increase in the last four decades. Mrs. Burwell noted that the Affordable Care Act has helped healthcare all around; from quality to equity.

As the call rounded up with questions I realized that we have come a long way, but we still have a long way to go. As an intern in the healthcare field, as a future medical student, and as a future physician I could not help but think of my role in healthcare. I appreciate what I am learning now and I look forward to how I will apply my acquired knowledge to improve healthcare.

*This blog entry ONLY reflects the views and experiences of Kayana Marks.

Ferguson

The following post was written by Ken Haller, MD a pediatrician in St. Louis MO.  It is  used here with permission.

Follow Ken’s blog at http://drkenhaller.blogspot.com/ 

#ferguson

In the coming days no one knows what exactly is going to happen when the Grand Jury in the Darren Wilson case hands down its recommendation regarding whether he should be indicted for the killing of Mike Brown. I daresay we all hope for peace and justice, and we all hope that everyone will remain safe.

I have been a pediatrician for just over thirty years now. I moved to Missouri in 1986 and practiced in East St. Louis for ten years. For the past eighteen years I have practiced in St. Louis at SSM Cardinal Glennon Children’s Medical Center. I have always worked in what are euphemistically called “underserved communities.” This usually means people who are poor. This usually means people who are black. This usually means people who are both. I have seen parents endure terrible hardships to keep their families together. I have seen grandparents heroically taking on the care of children years after they thought they were done with childrearing. I have been humbled by seeing kids who have done remarkable things under circumstances that, as a kid, would have sunk me.

Sadly, I have also seen families who have not been able to withstand the pressure of being poor, overworked, and marginalized. I have seen families fall apart. I have seen kids who have developed behavior problems because their brains have to be on high alert because of various ongoing threats in their environments. I have seen parents unable to continue to be parents because of the constant strain of wondering how they can feed their kids and keep a roof over their heads while working two or three minimum wage jobs that do not make ends meet.
I have also read posts on Timelines all over Facebook saying that these people just need to “get a job,” “calm down and go home,” “pull their pants up.” These commentators have all been white. They do not understand, and do not wish to understand, what it is like to live another reality, one where you are always, automatically suspect, one where you will not be shown houses in certain neighborhoods, one where your family had no alternative but to send you to a crappy public school. They know that they are doing better than the African-Americans who live a few miles away, and they actually believe they deserve it. They believe that their relative success is all due simply to their work ethic and their good choices. They do not believe in White Privilege, i.e., that being white in America confers certain advantages over non-white persons, because, when you have it, it is nearly invisible, and if you know you have it, your first reaction is to feel really guilty about it. So they deny it because it’s initially too painful to accept it.
But it’s true, and I know how I benefitted from it. I grew up in a safe, white, middle class suburb on Long Island, with excellent schools (our high school had a full time Russian language teacher), lovely parks and beaches, dependable pubic services, where my dad had a good-paying job as an aerospace engineer that he got as a result of a college education on the GI Bill. All that prepared me to go to an excellent college where I got scholarships and to medical school to do the work I am privileged to do today.

I could tick off, one by one, how many of those advantages are withheld from the kids who come to my office, as well as from their parents and families. The strange thing is not that Ferguson is happening; it’s that it’s taken this long to happen.

As I said above, I am a pediatrician. And in that role, I just want to make one plea to anyone who reads this about what may happen in the coming days: I would ask everyone who may be involved in public displays over the next few days to be aware of how this will affect the children in your lives.

Children are not just small adults. As we learn more about child development, we know this to be true on every level: physical, psychological, cognitive, emotional. What children need – and the younger they are the more they need this – is stability, predictability, and a feeling of safety. As a species, humans are altricial, that is, we are born more immature than just about any other mammalian species our size. That means that babies need nurturing, caring, feeding, swaddling longer than do infants of other species. The payoff, of course, is enormous in terms of intelligence, creativity, and the ability to love. Part of that process, though, requires that children know who will be tucking them in, who will feed them, who will bathe and dress them, when that will all happen, and who will love them. They need this to be the same from day to day, as much as possible. They need all this because they are trying to figure out how the world works. As infants mature from beings who, at about two months, smile at everybody, to babies who, at around six to eight months, begin to know who loves them and to choose them over strangers, to toddlers who will run off and jump and climb and fall at the slightest provocation, children have unique needs are various stages of life. What does not change is that they always need to be supervised, and they always, always need to feel safe.

So to those who will choose to be part of a demonstration, I respectfully hope that you will choose not to bring your children. While I completely understand the desire that your children should be witnesses to history – and I have no doubt that Ferguson will be part of the litany that now includes Selma and Montgomery – young children will not remember this. Their brains are not wired to retain clear memories during the first few years of life. Everyone in St. Louis and around the world knows that the only thing we can predict about the upcoming days is that they will be unpredictable. And that is not an atmosphere that is healthy for kids. If they see their parents yelling, being yelled at, being assaulted, they will experience only fear and threat, and that is never healthy for a child. I know you love your kids, and you are doing this to make a better world for them. Please leave them with a responsible adult. Please make sure you get home to tuck them in. Please tell them the stories of these days when they are old enough to understand the sacrifices you made for them.

And to those in law enforcement, if you encounter demonstrators with kids, please be aware of how your interactions will affect these children. One thing that has amazed me, both before August 9 and since, is that when I ask African-American kids who come to visit me in my office what they want to be when they grow up, a significant plurality of the boys say, “Police.” So many of these kids already see you as people of power. Please do all you can to make sure that your interactions with them and with their parents leave them with a sense of respect for you and what you do, rather than fear.

I truly believe that both demonstrators and law enforcement want to assure that everyone remains safe in the coming days. I truly believe that both demonstrators and law enforcement are doing what they do to make the world a better place for our children. And I truly hope that everyone will keep their kids at home where they can be safe and be best prepared for this better world to come.

– Ken Haller, MD 11/19/2014

Follow Ken’s blog at http://drkenhaller.blogspot.com/ 

 

glma board white house briefing

Wilson-Stronks at the White House

Posted by Amy Wilson-Stronks

On July 24, 2014, Amy Wilson-Stronks, on behalf of Wilson-Stronks LLC and GLMA: Health Professionals Advancing LGBT Equality, was invited to and attended a special White House Briefing on the Affordable Care Act (ACA) and the LGBT Community, sponsored by the Office of Public Engagement. LGBT health advocates from across the country were engaged through presentations and panel discussions from grassroots policy and advocacy organizations working to support LGBT enrollment under the ACA.

Briefing highlights included the release of Out2Enroll’s Key Lessons for LGBT Outreach and Enrollment under the Affordable Care Act and President Obama’s proclamation declaring Lesbian, Gay, Bisexual, And Transgender Pride Month, 2014.

“It was incredible to see so many people come together to discuss solutions to healthcare access. LGBT people suffer disproportionately in access to quality healthcare, and that is why having targeted interventions to communicate, educate, and support the LGBT community during the rollout of the ACA is so important. Kudos to the White House, Out2Enroll, and all of the stakeholders for supporting access. Wilson-Stronks will work to do our part to share this valuable information.”—Amy Wilson-Stronks

As much as this briefing celebrated success, it also recognized some of the ongoing challenges including spread of misinformation outside of the ACA marketplace, lack of public understanding of the differences between the ACA and private marketplaces implementing the law within faith-based institutions (such as Hobby Lobby), access to specialized care for the transgender community, states that have not expanded Medicaid, and states without state exchange programs. Important questions were also raised regarding the limited choice of providers and the expansiveness of the network of providers for consumers enrolled in the marketplace.

Pictured (left to right from top row) GLMA Board members: Sarah Fogel, Henry Ng, Travis Sherer, Amy Wilson-Stronks, Adam Crosland, Hector Vargas (Executive Director), Ed Craft, Jesse Joad, and Laura Hein.

Improving Healthcare into the Future: The Wilson-Stronks Internship Program

Posted by Amy Wilson-Stronks

2014 was exciting for Wilson-Stronks as we launched what is proving to be a very successful internship program.  We have been so fortunate to have the interest of very talented, bright, and dedicated individuals to serve as research assistants through our internship program.  Alas, the success is bittersweet as our first intern heads back to school this fall, we welcome our newest intern who will be gearing up during her time at Wilson-Stronks to become the Doctor of the Future.  Read on below…

Katie Singer has worked with Wilson-Stronks since June 2014.  She became interested in the position because it provided a solid comprehensive experience that incorporated learning about health care, advocacy, consulting, and research.  Also, considering that health care is a “hot topic,” Katie knew that working with Wilson-Stronks would be a great opportunity to learn more about the healthcare system and its inner workings.  Additionally, she knew this would satisfy her interest in different cultures, different styles of life, and improving equality.

While working at Wilson-Stronks, Katie has had many note-worthy experiences: attending chamber events, developing a social media platform, and researching language access and faith-based healthcare information.  She most enjoys being able to see the multi-faceted process of this business.  Every part of this business, from the advocacy to the research, has provided her with an impressionable experience that she will be able to use for her future endeavors.

Katie appreciates working with and learning from Amy and Deborah because they provide a great perspective from their experiences with health care and advocacy.  Working at Wilson-Stronks has improved her outlook on healthcare quality, cultural competence and equity.

This fall Katie is returning to Lawrence University in Appleton, Wisconsin as a part of the class of 2017.  We are going to miss her, and we hope she comes back during her breaks to help us improve healthcare!

Wilson-Stronks is excited to welcome the newest member of our team, Kayana Marks!

At the age of two, Kayana decided she wanted to be a doctor. Although she does not yet know what field of medicine she would like to work, she is passionate about caring for others.

Kayana is excited to be a part of the Wilson-Stronks team and learn more about the relationships that exist between patient care and the business side of healthcare. In her past experiences in the healthcare field, Kayana learned that many employees in doctor’s offices do not witness the healthcare side of their business, creating a lack of understanding between the employees and patients. After observing this disparity, she became interested in strengthening the connection between patients and healthcare providers. Similarly, she is interested in using advocacy and consulting as tools to bring awareness of healthcare issues to communities and companies, ultimately decreasing existing inconsistencies in information and knowledge.

Kayana intends to utilize her experience at Wilson-Stronks to better understand the entirety of healthcare in order to better serve her future patients.

Kayana Marks is a 2014 Graduate of Howard University in Washington, DC. She graduated with a Bachelor’s of Science in Biology and a minor in Chemistry. She plans to attend medical school in the fall of 2015.

Please join us in welcoming Kayana! She can be reached at kayana@wilson-stronks.com.

Happy Coming Out Day

Today marks the 25th anniversary of national coming out day. This year’s theme is “Coming Out still Matters” recognizing the importance of coming out as lesbian, gay, bisexual, transgender or as an ally to promote positive change. The Human Rights Campaign recognizes that when an individual knows someone is LGBT they are more likely to support equality laws.

On this National Coming Out Day, I’m encouraging everyone who can come out to do just like that- come out at work. It’s only by talking with our coworkers about the truth of our lives- that people like us can be fired just for being who we are – that we can get laws passed that will protect us on the job. -Kylar W. Broadus, Senior Public Policy Counsel, Trans Civil Rights Project, National Gay and Lesbian Task Force

Open enrollment: Getting everyone on board.

Open enrollment in the Health Insurance Marketplace begins October 1st, enabling many Americans to purchase health insurance for the first time. It is estimated that 48 million Americans are without insurance, and it is estimated that about seven million people will purchase insurance through the marketplace.

But what about the hard to reach populations? While more Americans will now be able to purchase insurance, it is going to be very important to reach out to some of these “challenging” populations in the coming months to ensure that these populations are educated about their insurance options and have the resources to enroll in the health plan that is right for them.

Amy Wilson-Stronks recently attended a White House briefing on the Affordable Care Act and the LGBT community and was able to learn about targeted efforts to communicate with the LGBT community about open enrollment and new rights under the ACA, including banning discrimination of withholding healthcare services based on gender. http://www.americanprogress.org/issues/lgbt/view/

Resources to share with the LGBT community:

A new website that will be providing educational resources for the LGBT community over the coming months: http://out2enroll.org/

Tressa Undem’s presentation on communicating to the LGBT community about open enrollment:
Video footage of Secretary Sebelius at the White House briefing : http://www.youtube.com/watch?v=EG5RoWm2rSE

Individuals who speak English as a second language pose another set of challenges for ensuring healthcare access. Many legal residents will become eligible to purchase health insurance for the first time: http://www.battlecreekenquirer.com/article/20130921/NEWS01/309220009?nclick_check=1#!

As healthcare providers, public health workers, and advocates for all types of individuals, it is our responsibility to spread the word. Open enrollment begins October 1st: www.healthcare.gov

White House Briefing on Obamacare and the LGBT Community

This Thursday, September 12th, Amy Wilson-Stronks along with other LGBT advocates have been invited to attend a White House briefing on Obamacare and impacts on the LGBT community. The briefing will discuss particular needs that members of the LGBT community face, including limited access to health care, insurance, and preventive care, and how the Affordable Care Act is addressing these needs.

According to the the invite, the briefing aims to provide LGBT advocates with information and resources to help their communities access more affordable health care. When the individual mandate goes into effect and health care exchange enrollment begins, it is especially important that members and leaders of the LGBT community are aware of protections in place, including the prohibition of discrimination for pre-existing medical conditions and gender-based discrimination.

The event will feature Kathleen Sebelius, Secretary of Health and Human Services as the keynote speaker. New research will be presented on how LGBT communities perceive and access health care, and suggested messaging strategies for reaching key sub-communities, followed by a panel discussion of best practices by community organizations, and breakout sessions to connect local leaders and plan regional enrollment events across the country.

Wilson-Stronks is interested to hear your opinions, comments, and questions about this event and how the Affordable Care Act will affect members of the LGBT community. Please email info@Wilson-Stronks.com or leave comments on our Facebook page and we will post as many questions with answers as we can. Wilson-Stronks is proud to be able to offer you up-to-date information during these changing healthcare times.

Update: Video footage of remarks by Secretary Sebelius and Valerie Jarrett at the White House Briefing on the Affordable Care Act and the LGBT Community: http://www.youtube.com/watch?v=EG5RoWm2rSE

Health Care Rights for Transgender Individuals: A New Precedent?

A recent state ruling in Colorado finding an elementary school guilty of discriminating against a first grade transgender student may set the precedent for transgender individuals across the nation. The New York Times highlighted the story of Coy Mathises, a six year old who was born biologically male, but from an early age identified as female. Her parents informed the school to treat her as such, and the school complied, to a point. The six year old was told she could no longer use the female restrooms and must use the staff bathroom or gender neutral restrooms; the school feared that as Coy grew older, other students may feel uncomfortable with Coy in the restrooms.

Colorado clearly found that the school violated the state’s anti-discrimination laws. What does this mean for healthcare? Currently 17 states offer legal protections for transgender individuals. Hospitals in these states, and in all states, should abide by policies to reduce discrimination against transgender individuals by acknowledging individuals by the gender they identify as and by considering implementing gender-neutral restrooms. This is by no means a simple issue, but there are pro-active steps hospitals and healthcare systems can take to avoid discrimination. Hospitals should start by adapting anti-discrimination policies in their hospitals and by learning their state’s legal rights. In states with anti-discrimination laws for transgender individuals, hospitals are generally considered places of public accommodation and should abide by these rules. In states without protections for transgender individuals, hospitals and health systems should still consider adapting anti-discrimination policies. It is against federal law for hospitals to turn away an individual from an Emergency Room for any reason, including a transgender individual.

Know your state’s health rights:

http://www.aclu.org/lgbt-rights/know-your-rights-transgender-people-and-law

http://www.nclrights.org/site/DocServer/StateLawsThatProhibitDiscriminationAgainstTransPeople.pdf?docID=7821

NY Times article:

http://www.nytimes.com/2013/06/24/us/agency-says-district-discriminated-against-transgender-student.html?_r=0

Discrimination Against HIV-positive Patient Results in Termination of Funding for California Surgeon

This announcement just came across my email: “The U.S. Department of Health and Human Services announced the termination of Medicaid funding to a California surgeon who intentionally discriminated against an HIV-positive patient by refusing to perform much-needed back surgery.”
The announcement went on to conclude that the surgeon had violated Section 504 of the Rehabilitation Act of 1973. This act prohibits disability discrimination by healthcare providers who receive federal funds.

I will point out (though I am not an attorney), it is my understanding that medical malpractice insurance does not cover violations of federal civil rights laws.

Tip: Healthcare organizations and providers should educate themselves and their staff on issues of discrimination, specifically what it is; who it involves; how to recognize it; how to prevent it; and how to report it. As those advocating to promote diversity and inclusion, cultural competence, and patient- and family-centered care are very aware, cases such as this can often be prevented with appropriate training and education. While I cannot comment on the specifics of this case, I do hope it serves as a wake-up call to healthcare that discrimination oversight exists and that no one is immune from it. For my colleagues and fellow advocates, we should view this as a sign that the journey toward inclusiveness and non-discrimination continues; our work as important as ever.