- Is there a chance that focus beam brain radiation will make a difference to quality of life for a terminal patient?
- Will the treatment prescribed (any treatment) cause depression?
- Will acupuncture make a difference?
- Will all this attention to one family member negatively impact the other members?
- What do I do when my doctors disagree?
- Can we afford…
- Identify mechanisms and key success factors of patient-professional partnerships, patient engagement (actions individuals must take to obtain the greatest benefit from the health care services available to them), care coordination, shared decision-making
- The impact of peer-to-peer (patient-to-patient, family-to-family, caregiver-to-caregiver) relationships
- The impact of social determinants (conditions in which people are born, grow, live, work and age, including the health system) on best health
- Mutual goals and plans set by the health team (people, their caregivers and clinicians)
- Tools and relationships maximize the health team’s ability to follow the plans set to meet mutual goals
- Accessible evidence supports just-in-time health decision-making by people and their caregivers
- The entire health team works from the same goals and data set
- Transparent health care costs
- Healthy health care organizations
- Hardwired continual learning from evolving experience and evidence
- Financial and human incentive alignment
- Unintended consequences – trauma – can lead to powerful, positive outcomes for individuals, organizations, and the community
- Continual learning depends on open and honest communication
- To benefit from the whole health team, the whole health team needs support
Health Hats off to Linda Kenney and the growing family of MITSS at the start of their second decade!
- Bounce back
- Take on difficult challenges and still find meaning in life
- Respond positively to difficult situations
- Rise above adversity
- Cope when things look bleak
- Tap into hope
- Transform unfavorable situations into wisdom, insight, and compassion
- The capacity to make and carry out realistic plans
- Communication and problem-solving skills
- A positive or optimistic view of life
- Confidence in personal strengths and abilities
- The capacity to manage strong feelings, emotions, and impulses
A best health goal is a milestone in a health journey. These goals can be set individually or collaboratively with a health team. Goals can run the continuum from lose 10 pounds in the next 3 months to make an appointment with a dermatologist to stay alive until my grandson’s wedding. The goal can be one of several, such as walk 50 feet with assistance, manage pain without IV’s or injections, and have meals brought to my home so I can be discharged. Goals need to be specific, measurable, possible, and explicitly stated. One of the characteristics of valued members of my health team is that they help me set goals and attain goals. If they can’t do this, they aren’t part of my team. The goals that I have set with my team this past year include lose 35 pounds in 9 months, walk at last 5 miles per week, do eye exercises 10 minutes every day until the double vision decreases, and stretch my quads twice a day. I have been able to meet all but the last one. Factors for success for me have been that the goals were stated and written; I kept a log of my activity and progress; and these goals were discussed at every opportunity when I met with members of my team, including my wife and my family. As a nurse it’s inexplicable to me how disconnected goal setting can be from the patient. While every profession has a treatment, care, discharge plan, often the patient and family don’t explicitly collaborate in setting the goals and mapping progress happens in the patient record or between professionals and not consistently with the patient and family. How can we get better at setting explicit measurable goals with our health team?
What are my superpowers? What are your superpowers? Love having this conversation with my grandson. Today, he has atomic breath like Godzilla (especially in the morning). I first had this conversation with my son when we first knew he was dying of cancer. His superpower was poetry.
i am not things.
i am sums of things,
guessing that i’m part of God,
wondering if there is some place
where my soul will go
from where i might look down
with advantages my eyes did not have
and see the tops of trees
which i used to walk beneath for
shelter from rain and sun,
and see the way things go together
like continental tracts of land
punctuated by water and lights
and roads and other concrete artifices
Preface to “the way I become about dying” by Michael P Funk, 2002
When diagnosed with MS, my superpower became the ability to accept what is. Superpowers are a magic lever for best health.
What are your superpowers?
How have we redesigned healthcare to include more activity? In that last 20 years patients walk right away after surgery and recover much more quickly. When I was an ICU manager we incorporated more activity into our standard operating procedure. We needed to use the families and caregivers to increase activity. We struggled with reluctant patients. But more activity for patients led to fewer complications, shorter stays, and better outcomes. Good for staff as well. Have we taken this far enough? Do we build our organizational systems to maximize activity for staff? I wonder if the magic levers of best health are obvious but fundamentally challenging-like the golden rule. Obvious and tough.