Biomedical subjects
Milt Hammerly
Publications and source records attributed to Milt Hammerly.
Commentary: patient-centered care, the sine qua non of collaborative medicine.
Collaborative medicine requires practitioners and disciplines with varied training and philosophies to work together toward a common clinical goal. Distinct differences between the various practitioners and disciplines can serve as both opportunities for synergy and barriers to collaboration. There must be a clear and compelling reason that motivates different practitioners and disciplines to do the hard work needed to overcome barriers to collaboration. Patient-centered care is the compelling reason, the defining characteristic that must underlie all collaborative medicine efforts. The practical application of this principle is illustrated by the experience of a large health care system (Catholic Health Initiatives). From a complexity theory standpoint, patient-centered care and collaboration can be thought of as simple rules that guide desirable behaviors in a complex system. The application of these two simple rules is as relevant in the microcosm of collaborative medicine as it is in the larger macrocosm of health care.
Rational and irrational clinical strategies for collaborative medicine.
Individual practitioners and health care systems/organizations increasingly understand the rationale for collaborative medicine. An absence of collaboration can compromise the quality and safety of patient care. But having a rationale to provide collaborative medicine without also having a rational clinical strategy can be equally compromising to the quality and safety of patient care. Reasonable evidentiary criteria must be used to determine whether specific therapies merit inclusion or exclusion in a collaborative medicine model. Ranking therapies hierarchically on the basis of their risk-benefit ratio simplifies matching of therapies with the needs of the patient. A unifying taxonomy that categorizes all therapies (complementary/alternative and conventional) on the basis of how we think they work (presumed mechanisms of action) facilitates development of a clinical strategy for collaborative medicine. On the basis of these principles, a rational clinical strategy for collaborative medicine is described to help optimize the quality and safety of patient care.
The IOM-CAM roller coaster.
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Retaining caregivers, improving care.
Text Summary In 2004, Centura Health's long-term care centers took part in a pilot project, sponsored by the Centers for Medicare & Medicaid Services, called "Improving Nursing Home Culture through Workforce Retention." A 30-member team comprising Centura leaders and long-term facility staff looked at Centura's eight participating facilities through residents' and employees' eyes. The goal of the team's reflection and subsequent changes was to create a culture in which decisions are focused on resident care and organizational policies are based on respect for employees. At the end of the first year, residents seemed happier and employee satisfaction and involvement increased at all eight Centura facilities.