Day 1 :
University of Saskatchewan, Canada
Time : 09:10-09:35
Jawahar Jay Kalra, an educator, researcher, and quality health care advocate, is a Professor of Pathology in the University of Saskatchewan and has served as Head of the Department of Pathology and Laboratory Medicine. He is recognized for his many contributions as a clinical scientist, academic leader, and health system administrator. He has been a pioneer in establishing guidelines for thyroid-function testing, quality assurance program and contributed nationally and internationally in the area of total quality management. He has published extensively and is the author of the book “Medical Errors and Patient Safety: Strategies to reduce and disclose medical errors and improve patience safety.”
Disclosure of an adverse event is an important element in managing the consequences of a medical error. We have previously reported the Canadian provincial initiatives encouraging open disclosure of a critical event and have suggested its integration into a ‘no-fault’ model. We reviewed and compared the various medical error disclosure initiatives across the globe (USA, Australia, New Zealand, and United Kingdom) to analyze the progress made in this area. In Australia, disclosure policy integrates the disclosure process with risk management analysis towards investigating the critical events. In New Zealand, in any adverse event, patients are rehabilitated and compensated through a no-fault state funded compensation scheme. The United States Joint Commission on Accreditation of Healthcare Organizations mandated an open disclosure of any critical event during care to the patient or their families’. Effective communication between health care providers, patients and their families throughout the disclosure process is integral in sustaining and developing the physician patient relationship. The Canadian provincial initiatives, though similar in content, remain isolated because of their non-mandatory nature on disclosure. In conclusion, the designing of an error disclosure policy requires integration of various aspects including bioethics, physician-patient communication, quality of care, and team-based care delivery. The complexities of medical error disclosure to patients present ideal opportunities for medical educators to probe how learners are balancing the ethical complexities involved in error disclosure. We suggest that a uniform policy centered on addressing errors in a non-punitive manner and respecting the patient’s right to an honest disclosure be implemented.
Ochsner Health System, USA
Time : 09:35-10:00
rnAndrew W Gottschalk, MD trained in Sports Medicine at both Mayo Clinic and Cleveland Clinic. His extensive experience includes treating athletes of all levels of competition, including those in the NFL, NBA, MLB, and NCAA Division I. As the Ochsner Health System’s Director of Primary Care Sports Medicine, he serves as Head Medical Team Physician for the NBA New Orleans Pelicans. He is also an avid writer; his multiple publication projects include his regular newspaper column, “The Sports Medicine Doctor.” He is the current Musculoskeletal Health Editor for the medical journal Evidence-Based Practice.rn
Recent studies demonstrate dramatically improved health outcomes when a multidisciplinary care team model is utilized in the treatment of complex medical diagnoses. These studies have focused on improving outcomes in the treatment of chronic conditions such as diabetes mellitus, hypertension, and congestive heart failure. The multidisciplinary care team model has been shown to reduce medical complications, reduce number of hospital admissions, and improve overall quality of life in patients with these diseases. So strong is the evidence in favour of these models that they have become the standard of care in many medical systems in the United States and around the world. The multidisciplinary care team approach is now being evaluated for application in more acute settings, such as post-operative recovery. Studies confirm that the coordinated efforts, shared knowledge, and ongoing communication of the multidisciplinary care team significantly improve outcomes in these more acute settings as well. Applying the multidisciplinary care team approach in the treatment of sports concussions is as necessary as it is promising. In our model, when an athlete is concussed we immediately assign a Medical Team, a Home Team, and a School Team. Each team is responsible for well-defined aspects of the concussed athlete’s treatment, including symptom monitoring, symptom reporting, and treatment. The ultimate goals of this multidisciplinary care team approach to sports concussion treatment are to: reduce concussion symptoms and improve patient comfort; maximize safe and healthy brain recovery and; minimize time away from sports participation.
Mayo Clinic, USA
Time : 10:00-10:25
Marc Matthews graduated from the University of Maryland School of Medicine and completed his residency training at the Mayo Clinic. His first task at Mayo was to redesign a community health clinic around the community’s definition of health, and this work led to a deeper understanding of how the healthcare system is not very aware of what it means for a community to be healthy. He is the Associate Medical Director of the Mayo Clinic Office of Population Health Management and an Assistant Professor of Family Medicine. In these roles, he focuses on rethinking the way large healthcare organizations deliver care.
Primary care is at a critical crossroads. Our current delivery systems are unsustainable and lack the resilience to survive in new environments where total cost of care, patient experience, and patient centered outcomes are the primary determinants of success. In order for primary care to remain relevant and viable, new solutions must be created that are practical and transformative, attract and retain new patients and provide high value, high satisfaction services that meet their consumer needs. Our cost of care must come down and our quality must remain high in order for us to be able to deliver affordable care in future reimbursement realities. Our institution approached this problem by using the tools of design thinking to develop a novel patient centered approach and then implemented this population health management model across primary care clinics in multiple geographic areas. Population Health Management has become a hot topic of conversation in medical literature and popular media, but the concept is poorly defined and implementation of a population health framework is not well understood. Here we report the initial results of our implementation, which suggests increased patient and staff satisfaction with little impact on finances in a fee for service environment. We also uncovered significant cultural barriers to implementation that are likely to be universal.