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Day 17 1/27/11
Wow! After 17 days, 44 meetings, and countless learning opportunities, my time at ICSI has ended. I cannot stress enough what a wonderful experience this has been. Everyone at ICSI has been nothing but encouraging and helpful. These professionals have a real passion for what they are doing and are dedicated to improving healthcare. It is absolutely inspiring.
One thing that has continued to impress me over this month is the respectful collaboration that goes on between physicians, patients, and executives in the healthcare field. All of these people have different ideas of what healthcare should be, yet they work together to come to a solution.
The most valuable outcome of this internship is the amount of information that I am able to take away and use in my own nursing practice. So many of ICSI's initiatives focus on things that we are taught in class - patient-centeredness, engaging the family, using teach-back. Because of ICSI, I now know the importance of using these techniques in the real world.
I have gained so much understanding of how to work and communicate effectively in a team and what it means to collaborate with one another. In an area such as healthcare, we can come to better solutions when we work with each other, rather than on our own. ICSI has been a wonderful leader and example of that.
I want to thank those who have followed this blog, humble as it may be (Hi, Mom!). It has given me a chance to reflect on all of the important lessons I have learned in this short month. I hope to continue to use it as a resource as I continue in my education and career-path.
And to all of you at ICSI who have made my time so wonderful: Thank you. I have thoroughly enjoyed my experience here and take away greater knowledge of and appreciation for those working within our healthcare system. Please know that you truly are making a difference - I am honored to have been a part of it.
One thing that has continued to impress me over this month is the respectful collaboration that goes on between physicians, patients, and executives in the healthcare field. All of these people have different ideas of what healthcare should be, yet they work together to come to a solution.
The most valuable outcome of this internship is the amount of information that I am able to take away and use in my own nursing practice. So many of ICSI's initiatives focus on things that we are taught in class - patient-centeredness, engaging the family, using teach-back. Because of ICSI, I now know the importance of using these techniques in the real world.
I have gained so much understanding of how to work and communicate effectively in a team and what it means to collaborate with one another. In an area such as healthcare, we can come to better solutions when we work with each other, rather than on our own. ICSI has been a wonderful leader and example of that.
I want to thank those who have followed this blog, humble as it may be (Hi, Mom!). It has given me a chance to reflect on all of the important lessons I have learned in this short month. I hope to continue to use it as a resource as I continue in my education and career-path.
And to all of you at ICSI who have made my time so wonderful: Thank you. I have thoroughly enjoyed my experience here and take away greater knowledge of and appreciation for those working within our healthcare system. Please know that you truly are making a difference - I am honored to have been a part of it.
Day 14, 15, and 16 1/26/11
I can't believe it's my last week! This has been such a positive experience. I've spent the first part of this week attending pretty general meetings, including a Facilitator meeting and a Translation Team meeting. I must say, I have a soft spot for the Translation team. They (like all ICSI groups) do such important work and are so respectful to each other. I also love that I've been able to sit in on multiple meetings with them - it's nice to follow what they are doing consistently, at least for the month.
On Monday, I had my final meeting with Gary Oftedahl, as he will be traveling the rest of the week. It has been such a pleasure to work with him at ICSI. He has been nothing but welcoming, appreciative, and engaging. This man has read more books than anyone I know! He makes me want to learn as much as I can about the healthcare system and my place within it. ICSI and its members are lucky to have such a dynamic leader.
Tuesday, Tim and I attended an all-day conference for Reducing Avoidable Readmissions Effectively. This was a great collaborative session on one of ICSI's important initiatives. Eric Howell, a hospitalist and professor at Johns Hopkins University, addressed the issue of avoidable hospital re-admissions and the need to decrease them. Several hospitals and clinics attended with the hopes of improving their quality of care and lower these re-admission rates.
While this session was extremely interesting, it also weighed heavily on my heart. Throughout the day, it became increasingly clear that we have a broken system, and, to a person going into the healthcare field, that is a distressing fact. The issue of healthcare is so multi-faceted that it becomes overwhelming to attempt changes, or to even believe that things can change. Can you believe that 1 in 5 Medicare patients return to the hospital within a month? It is simply heartbreaking. As a nurse, I feel so much responsibility to heal others, not just to get them "well enough" and send them on their way, only to watch them return weeks later.
Even more so, why are we not seeing the fruits of patient-centered care if that is what future healthcare providers are being taught? Concepts such as "teach-back" and engaging the family are drilled into our heads as students, yet those skills are not being utilized in the real world. If they were, how much different would our system be?
Thankfully, organizations like ICSI do offer me hope. Just knowing that conferences like the one I attended on Tuesday exist remind me that there are people in the world who want to better healthcare. Personally, this experience has caused me to take much more seriously the skills I am learning and how important it is to use them to improve the care I give.
On Monday, I had my final meeting with Gary Oftedahl, as he will be traveling the rest of the week. It has been such a pleasure to work with him at ICSI. He has been nothing but welcoming, appreciative, and engaging. This man has read more books than anyone I know! He makes me want to learn as much as I can about the healthcare system and my place within it. ICSI and its members are lucky to have such a dynamic leader.
Tuesday, Tim and I attended an all-day conference for Reducing Avoidable Readmissions Effectively. This was a great collaborative session on one of ICSI's important initiatives. Eric Howell, a hospitalist and professor at Johns Hopkins University, addressed the issue of avoidable hospital re-admissions and the need to decrease them. Several hospitals and clinics attended with the hopes of improving their quality of care and lower these re-admission rates.
While this session was extremely interesting, it also weighed heavily on my heart. Throughout the day, it became increasingly clear that we have a broken system, and, to a person going into the healthcare field, that is a distressing fact. The issue of healthcare is so multi-faceted that it becomes overwhelming to attempt changes, or to even believe that things can change. Can you believe that 1 in 5 Medicare patients return to the hospital within a month? It is simply heartbreaking. As a nurse, I feel so much responsibility to heal others, not just to get them "well enough" and send them on their way, only to watch them return weeks later.
Even more so, why are we not seeing the fruits of patient-centered care if that is what future healthcare providers are being taught? Concepts such as "teach-back" and engaging the family are drilled into our heads as students, yet those skills are not being utilized in the real world. If they were, how much different would our system be?
Thankfully, organizations like ICSI do offer me hope. Just knowing that conferences like the one I attended on Tuesday exist remind me that there are people in the world who want to better healthcare. Personally, this experience has caused me to take much more seriously the skills I am learning and how important it is to use them to improve the care I give.
Day 13 1/24/11
Last Thursday was a great day in the office! I attended a few general office meetings in the morning, and then got to sit in on the Patient Advisory Committee meeting in the afternoon. Once a month, a group of about 20 patients gather to give feedback on ICSI initiatives. This week, two representatives from Minnesota Community Measures were there to hear the patients' opinions on a new online layout of physician ratings. It was wonderful to see such dynamic groups as ICSI and MN Community Measures take time to really listen to patients and get their feedback. This ensures that the initiatives are benefiting those who spend time in hospitals and clinics receiving care. Sanne Magnan, ICSI's new president, spoke that afternoon about how the patient is always present. It is the patient's hospital - the providers are simply guests into that person's life and care. What a wonderful, fresh way to look at providing quality care to those who truly matter.
Day 12 1/19/11
Today truly opened my eyes to the realities of our changing health care system. While Congress was working to repeal the health care reform bill, we at ICSI deeply discussed the best way to provide health care and meet the needs of ICSI members and sponsors.
One of the most important aspects of medicine is incorporating evidence into practice, which is something that the Translation team at ICSI assists health care providers with. We met with them today to talk further about guidelines and how ICSI can help practitioners utilize evidence-based research. This is, of course, a huge topic and one that will require a lot of time and energy. It's too bad that I'll only be at ICSI to see them meet one more time!
A large part of this discussion was spent on how to use technology and social networks to engage patients in their care. I had no idea how much social networking has impacted health care, but it is clear that patients are demanding up-to-date and valid information. The challenge is, how can health care providers, health plans, and organizations like ICSI provide that in an accessible format?
We no longer live in a world of health care where what the head physician says, goes. Patients are thirsty for information about their health and want an equal part in their care. Providers, therefore, must adapt their practice in order to allow for these collaborative conversations and shared decision-making.
One of the things that impressed me most during this meeting is that, despite many passionate and sometimes differing opinions, each ICSI member respectively listened and responded to each other intelligently and appropriately. I can only hope Congress had that much success!
One of the most important aspects of medicine is incorporating evidence into practice, which is something that the Translation team at ICSI assists health care providers with. We met with them today to talk further about guidelines and how ICSI can help practitioners utilize evidence-based research. This is, of course, a huge topic and one that will require a lot of time and energy. It's too bad that I'll only be at ICSI to see them meet one more time!
A large part of this discussion was spent on how to use technology and social networks to engage patients in their care. I had no idea how much social networking has impacted health care, but it is clear that patients are demanding up-to-date and valid information. The challenge is, how can health care providers, health plans, and organizations like ICSI provide that in an accessible format?
We no longer live in a world of health care where what the head physician says, goes. Patients are thirsty for information about their health and want an equal part in their care. Providers, therefore, must adapt their practice in order to allow for these collaborative conversations and shared decision-making.
One of the things that impressed me most during this meeting is that, despite many passionate and sometimes differing opinions, each ICSI member respectively listened and responded to each other intelligently and appropriately. I can only hope Congress had that much success!
Day 11 1/18/11
Today was a busy (and exciting) day! First, we had the opportunity to meet ICSI's new president, Dr. Sanne Magnan! All the staff ate breakfast while she talked a bit about herself. Dr. Magnan was ICSI's president from 2006-2007 but has worked the past few years in Minnesota's Department of Health. She said that she isn't coming back to ICSI - rather, she is coming forward. I thought that was a wonderful way to look at a changing institution.
I also sat in on a Cultivating Quality Series debrief to discuss the seminar held last Thursday, an internal presentation and ICSI Ideagora about shared decision-making, and a Stable Coronary Artery Disease guideline meeting. Though all were interesting, I really enjoyed the ICSI Ideagora. This is a conversation that is held once a month for ICSI members to learn about different health care topics. I am very interested in the subject of shared decision-making, which is the process of taking into account and validating the individual patient's preferences, values, and beliefs when providing health care. Dr. Dawn Stacey, an expert on shared decision-making, led the discussion and raised a particularly intriguing point on informed consent. She stated that true informed consent means that the patient is choosing this treatment out of the options presented to him or her, rather than consenting simply because that is the treatment prescribed. Dr. Stacey called this "Informed Choice." I think that this is a valuable and important perspective for any health care provider to carry into practice and should always be considered when providing patient-centered care.
I also sat in on a Cultivating Quality Series debrief to discuss the seminar held last Thursday, an internal presentation and ICSI Ideagora about shared decision-making, and a Stable Coronary Artery Disease guideline meeting. Though all were interesting, I really enjoyed the ICSI Ideagora. This is a conversation that is held once a month for ICSI members to learn about different health care topics. I am very interested in the subject of shared decision-making, which is the process of taking into account and validating the individual patient's preferences, values, and beliefs when providing health care. Dr. Dawn Stacey, an expert on shared decision-making, led the discussion and raised a particularly intriguing point on informed consent. She stated that true informed consent means that the patient is choosing this treatment out of the options presented to him or her, rather than consenting simply because that is the treatment prescribed. Dr. Stacey called this "Informed Choice." I think that this is a valuable and important perspective for any health care provider to carry into practice and should always be considered when providing patient-centered care.
Day 10 1/17/11
I am constantly amazed at how far ICSI's work reaches. At a meeting on Friday afternoon, the Technology Manager, Mark, reported that a quarter of a million people visited the website in 2010! In addition, the guidelines that ICSI developed are used in 140 countries - including China and India! It is amazing to be part of something that has the potential to improve healthcare all across the world.
This Friday, those global guidelines were the focus of our meeting. About 25 physicians, healthcare payers, and "lovers of healthcare" gathered to discuss the future of ICSI guidelines and brainstorm ways to make them more applicable in the changing world of healthcare today.
As I've mentioned before, it absolutely amazes me that intelligent, hardworking people full of ideas can listen, respectively critique, and work with others to come to a realistic solution. My favorite part of the day was meeting two Mayo Clinic physicians - one, a family physician and Ole grad, and another, an OB/GYN who oversees the Nurse Practitioner program. Meeting people like this makes my future in health care seem all the more real. I can't wait to see what is ahead!
This Friday, those global guidelines were the focus of our meeting. About 25 physicians, healthcare payers, and "lovers of healthcare" gathered to discuss the future of ICSI guidelines and brainstorm ways to make them more applicable in the changing world of healthcare today.
As I've mentioned before, it absolutely amazes me that intelligent, hardworking people full of ideas can listen, respectively critique, and work with others to come to a realistic solution. My favorite part of the day was meeting two Mayo Clinic physicians - one, a family physician and Ole grad, and another, an OB/GYN who oversees the Nurse Practitioner program. Meeting people like this makes my future in health care seem all the more real. I can't wait to see what is ahead!
Days 8 and 9 1/14/11
One of my favorite parts about working at ICSI is that I am exposed to a wide range of new and exciting projects all the time. Everyday, I get to sit in on different meetings and discuss all sorts of topics, from personal (palliative care) to institutional (quality improvement). On Wednesday, I attended a meeting with the Scientific Document team to outline the work they are doing concerning guidelines, order sets, and protocols. Though that was interesting, I really loved the next meeting - an Obesity Guideline collaboration. I sat with ICSI members, physicians, and surgeons from around Minnesota who were assembling a guideline to standardize care of obesity. It was amazing to watch professionals from all different backgrounds discuss realistic solutions to this growing problem. These guidelines allow for consistency of care by using evidence-based practice when treating a patient. To me, a guideline seems to be a handbook of sorts, providing physicians with empiric data to make the best care decision possible.
Thursday was a much different day. Tim and I attended a Cultivating Quality workshop at the Maple Grove Community center. This was an opportunity for ICSI members to get together, learn, and brainstorm ways to improve quality within their institution. It was a really fun day with lots of energy - I even met two Oles! Again, it's wonderful to see so many people committed to improving the quality of our healthcare system. These individuals' passion and drive for promoting change gives me great hope for the future - I can't wait to see what improvements their hard work brings!
Thursday was a much different day. Tim and I attended a Cultivating Quality workshop at the Maple Grove Community center. This was an opportunity for ICSI members to get together, learn, and brainstorm ways to improve quality within their institution. It was a really fun day with lots of energy - I even met two Oles! Again, it's wonderful to see so many people committed to improving the quality of our healthcare system. These individuals' passion and drive for promoting change gives me great hope for the future - I can't wait to see what improvements their hard work brings!
Days 6 and 7 1/12/11
This week has been great so far! On Monday, Tim and I attended a meeting with the ICSI Facilitators, who work with the different ICSI members and assist them in making quality improvements within their organization. The facilitators are working through a consulting book called Flawless Consulting by Peter Block in order to better help their members. Though this book is typically geared towards business consulting, I found it to be incredibly interesting. In fact, I think this was my favorite meeting so far! It was so eye-opening to realize the parallels between nursing and consulting - truly, nurses are consultants. We consult our patients concerning medical treatments, we consult families, and we consult with each other to find solutions to complex problems. One point that stuck out to me the most was that we, as consultants, have no power. Rather, the power lies with those actually making the change. This was especially applicable to nursing because we often want to change our patients, yet it is so important to remember that they are the only ones capable of making that change. Instead, we must strive for leverage and impact in our interactions with others in order to facilitate lasting change. When I read that, a light bulb went off in my head. Making the connection between business consulting and nursing is one that can be very valuable in my individual practice as well as on a larger policy scale. I can't wait to share some of what I've learned with my professors and fellow nursing students!
On Tuesday, after a long, snowy drive in to Bloomington, we had the opportunity to sit in on the monthly board meeting. It was amazing to see a dozen or so physicians, nurses, and businessmen speaking calmly, maturely, and passionately about current health care issues. One doctor, a family physician, even spoke words of warning to us as interns - "This is a peculiar organization - you would be hard pressed to find something like this anywhere else." I feel so blessed to be in a place where important topics can be discussed among intelligent individuals in order to better our health care system. The exchange of ideas and knowledge that goes on is exciting and hopeful - I can't wait to see where it leads!
Some exciting news...ICSI's new president, Sanne Magnan, has been announced! Please check out the Links page to read more about her!
On Tuesday, after a long, snowy drive in to Bloomington, we had the opportunity to sit in on the monthly board meeting. It was amazing to see a dozen or so physicians, nurses, and businessmen speaking calmly, maturely, and passionately about current health care issues. One doctor, a family physician, even spoke words of warning to us as interns - "This is a peculiar organization - you would be hard pressed to find something like this anywhere else." I feel so blessed to be in a place where important topics can be discussed among intelligent individuals in order to better our health care system. The exchange of ideas and knowledge that goes on is exciting and hopeful - I can't wait to see where it leads!
Some exciting news...ICSI's new president, Sanne Magnan, has been announced! Please check out the Links page to read more about her!
Days 3, 4, and 5 1/9/11
I know it's been awhile since I've updated, but the last few days have been such a whirlwind! ICSI keeps getting better and better. Everyday I feel more comfortable and "in the know" about what's going on. This week, I sat in on some interesting meetings in the office, but my favorite things that happened were a trip to Hennepin County Medical Center to discuss High-Tech Digital Imaging and a conference call with Marshfield Clinic in WI to discuss palliative care shared decision-making.
On Thursday, Tim and I headed over to HCMC with a few people from ICSI and two representatives from Nuance, a software development group that helped create a new diagnostic assistance tool. We met with physicians, radiologists, and other members at HCMC, where the program is being piloted, to talk about how the use of this diagnostic tool is going. The program is awesome! Basically, a physician can put in a patient's information and current and past health problems, and this computer program will calculate, based on evidence-based practice, which diagnostic tests are most beneficial to run on a scale of 0-9. Of course, there are still kinks to be worked out, but this could revolutionize health care by eliminating unnecessary (and expensive!) tests. Check out an article written by the Star Tribune about it on the Links page!
Friday afternoon, I was able to listen in on a conference call between two ICSI members and some people from Marshfield Clinic. ICSI is interested in having Marshfield participate in the palliative care shared decision-making initiative, which brings adaptive solutions to the issue of end-of life care concerning patients, families, and communities. I strongly identify with the idea of shared decision-making because the health care providers should never tell the patient what to do. Rather, it should be an equal discussion and sharing of information in order for the patient to make a choice based on their beliefs and ideas. Though Marshfield was skeptical at first and asked some tough questions, in the end they were incredibly impressed with the work ICSI was doing. In fact, one of the doctors thanked the ICSI members for their time and called their work "heroic." How cool is that?! It is amazing to see the impact of ICSI's initiatives both near and far to home.
On Thursday, Tim and I headed over to HCMC with a few people from ICSI and two representatives from Nuance, a software development group that helped create a new diagnostic assistance tool. We met with physicians, radiologists, and other members at HCMC, where the program is being piloted, to talk about how the use of this diagnostic tool is going. The program is awesome! Basically, a physician can put in a patient's information and current and past health problems, and this computer program will calculate, based on evidence-based practice, which diagnostic tests are most beneficial to run on a scale of 0-9. Of course, there are still kinks to be worked out, but this could revolutionize health care by eliminating unnecessary (and expensive!) tests. Check out an article written by the Star Tribune about it on the Links page!
Friday afternoon, I was able to listen in on a conference call between two ICSI members and some people from Marshfield Clinic. ICSI is interested in having Marshfield participate in the palliative care shared decision-making initiative, which brings adaptive solutions to the issue of end-of life care concerning patients, families, and communities. I strongly identify with the idea of shared decision-making because the health care providers should never tell the patient what to do. Rather, it should be an equal discussion and sharing of information in order for the patient to make a choice based on their beliefs and ideas. Though Marshfield was skeptical at first and asked some tough questions, in the end they were incredibly impressed with the work ICSI was doing. In fact, one of the doctors thanked the ICSI members for their time and called their work "heroic." How cool is that?! It is amazing to see the impact of ICSI's initiatives both near and far to home.
Day 2 1/4/11
What a great day! It's amazing how much more comfortable I feel after just one day. Today, Tim and I met with Gary again to further discuss what we've learned and where our interests lie. Though I went into this internship with a heavy interest in ICSI's palliative care initiative, their Health Care Home program has really gotten my attention.
This program is a framework model for what health care, in my opinion, should be. ICSI has outlined fundamental standards for care, such as treating the patient as a whole person and actively engaging the family and community during care. Rather than treating a set of symptoms, this program encourages health care professionals to work adaptively, assisting patients on their journey towards health.
Amazingly, this ideal health care is already being utilized in part around the country. I read about a clinic in Portland, Oregon called GreenField Health that provides comprehensive care in a trusting, joyful environment. The physicians truly care about their patient's well-being and actively work with them to achieve optimal health. They are even available for consultation by personal phone and email! Seeing such an inspiring model made me wonder why there aren't more programs like this.
Of course, there are many facets to the issue of delivering competent, patient-centered, value-driven care. In the next few weeks, I hope to learn even more about the Health Care Home program and hopefully provide a fresh look into realistic solutions. I would love to see more programs around the nation like GreenField, and am looking forward to researching and brainstorming ways to make that a reality.
This program is a framework model for what health care, in my opinion, should be. ICSI has outlined fundamental standards for care, such as treating the patient as a whole person and actively engaging the family and community during care. Rather than treating a set of symptoms, this program encourages health care professionals to work adaptively, assisting patients on their journey towards health.
Amazingly, this ideal health care is already being utilized in part around the country. I read about a clinic in Portland, Oregon called GreenField Health that provides comprehensive care in a trusting, joyful environment. The physicians truly care about their patient's well-being and actively work with them to achieve optimal health. They are even available for consultation by personal phone and email! Seeing such an inspiring model made me wonder why there aren't more programs like this.
Of course, there are many facets to the issue of delivering competent, patient-centered, value-driven care. In the next few weeks, I hope to learn even more about the Health Care Home program and hopefully provide a fresh look into realistic solutions. I would love to see more programs around the nation like GreenField, and am looking forward to researching and brainstorming ways to make that a reality.
Day 1 1/3/11
Today I began my first day as a shadowing intern at the Institute for Clinical Systems Improvement! After waking up VERY early (considering I was used to sleeping in over Christmas break), I hopped in the car with Tim, my fellow intern, and we headed off to the ICSI office.
After arriving to the headquarters, we met Dr. Gary Oftedahl, the Chief Knowledge Officer (what a title!) at ICSI. He is an incredibly intelligent and friendly man. He worked as an internist for 27 years and now works as a liason of sorts between ICSI and other physicians. After explaining more of what ICSI is involved in, he kindly gave us a tour, making sure to introduce us to everyone in the office. Everyone was welcoming, helpful, and eager to involve us. I immediately felt comfortable and can't wait to work with many of the employees!
We then had some time to look over a packet of materials that Gary had provided us. The programs that ICSI has initiated are incredible! I read a 24 page whitepaper about Health Care Homes, information on the palliative care initiative, and literature about high-tech diagnostic imaging. It was dense at times, but fascinating.
Fortunately, I had the opportunity to sit in on two meetings - one for high-tech diagnostic imaging, and one general staff meeting. Both were interesting and informative, but what amazed me the most was the impact of these programs. ICSI is heading initiatives to truly change the face of health care systems, which will ultimately impact thousands of lives by making healthcare more affordable and efficient. I am so honored and excited to be a part of this great organization!
After arriving to the headquarters, we met Dr. Gary Oftedahl, the Chief Knowledge Officer (what a title!) at ICSI. He is an incredibly intelligent and friendly man. He worked as an internist for 27 years and now works as a liason of sorts between ICSI and other physicians. After explaining more of what ICSI is involved in, he kindly gave us a tour, making sure to introduce us to everyone in the office. Everyone was welcoming, helpful, and eager to involve us. I immediately felt comfortable and can't wait to work with many of the employees!
We then had some time to look over a packet of materials that Gary had provided us. The programs that ICSI has initiated are incredible! I read a 24 page whitepaper about Health Care Homes, information on the palliative care initiative, and literature about high-tech diagnostic imaging. It was dense at times, but fascinating.
Fortunately, I had the opportunity to sit in on two meetings - one for high-tech diagnostic imaging, and one general staff meeting. Both were interesting and informative, but what amazed me the most was the impact of these programs. ICSI is heading initiatives to truly change the face of health care systems, which will ultimately impact thousands of lives by making healthcare more affordable and efficient. I am so honored and excited to be a part of this great organization!
