Health AGEnda

Health Services Research Needs Good Theory to Turn into Better Practice

HospitalOlderWoman_400pLast week, the Journal of the American Medical Association (JAMA) published a large and well-designed study of a post-hospital readmission reduction program called the “virtual ward,” which grew up in the UK and was tested by our cousins to the north in Toronto.

The model partakes of some elements of other evidence-based work done by John A. Hartford Foundation grantees, including Mary Naylor’s Transitional Care Model, the Society of Hospital Medicine’s Project BOOST, and Eric Coleman’s Care Transitions Intervention.

A press release and JAMA Report video are available for those who don’t subscribe to JAMA.

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Remembering Kathryn Dineen Wriston, 75

Kathryn Dineen Wriston, right, with her beloved husband Walter B. Wriston, circa early 1990s.

Kathryn Dineen Wriston, right, with her beloved husband Walter B. Wriston, circa early 1990s. (Photo A)

Kathy Wriston was an elegant and accomplished woman whose delightful sense of humor and natural openness drew others to her—and to the causes she passionately supported. She will be sorely missed.

Her death at age 75 on Sept. 28, 2014 due to complications from a fall at her home in Sherman, CT, came as a shock to all of us who were fortunate enough to know Kathy, and leaves us with a profound sense of loss.

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Grappling with the Tough Questions of How We Live—and Die

SeniorsRoses_400pI think it would be safe to say that most of us have trouble facing our own mortality. The idea that tomorrow isn’t promised fails to get many of us to actually live that way (I know I’m guilty).

Longer term and more connected to the John A. Hartford Foundation’s  work, we don’t like to think of ourselves as “old”—let alone dying—and we don’t plan well for futures that will likely include the need for long-term care or services later in life.

Our health care system and policies reflect this short sightedness, as well. That’s why it’s been refreshing to see some provocative writing about these issues over the past few weeks that might help us all think and do more to live our final years in old age the way we would want.

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Building the Field of Palliative Care Together

Funders share information on investments in palliative care at the recent convening.

Funders share information on investments in palliative care at the recent convening spearheaded by the Hartford Foundation.

Palliative care is an essential component of care for the seriously ill. Yet, the term is often misunderstood by policymakers, the public, health care providers, and, no surprise, even those in philanthropy.

The John A. Hartford Foundation has been a longtime supporter of the spread of high-quality palliative care through its funding of the Center to Advance Palliative Care (CAPC), led by Diane Meier, MD (see Celebrating CAPC and Our 500th Blog Post!). Dr. Meier often refers to palliative care as an “extra layer of support” for the seriously ill and their families.

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Happy Birthday SIF! Celebrating Five Years of Public-Private Partnership

From left: Rebecca Brune, VP of Strategic Planning and Growth, Methodist Healthcare Ministries of San Antonio; Regina Bonnevie, MD, Medical Director, Peninsula Community Health Services in Port Orchard, WA; Peggy Cary, Senior VP of Finance & Internal Audit, Methodist Healthcare Ministries; and Diane Powers, Associate Director, Division of Integrated Care and Public Health, University of Washington AIMS Center, Seattle WA, talk following presentations at the Eisenhower Executive Office Building in Washington, DC.

From left: Rebecca Brune, VP of Strategic Planning and Growth, Methodist Healthcare Ministries of San Antonio; Regina Bonnevie, MD, Medical Director, Peninsula Community Health Services in Port Orchard, WA; Peggy Cary, Senior VP of Finance & Internal Audit, Methodist Healthcare Ministries; and Diane Powers, Associate Director, Division of Integrated Care and Public Health, University of Washington AIMS Center, Seattle WA, talk following presentations at the Eisenhower Executive Office Building in Washington, DC.

Last week, the Social Innovation Fund of the Corporation for National and Community Service celebrated its 5th Birthday. There was cake.

More importantly, there was a celebration of the good that philanthropy can do to address the pressing problems facing the country. The goal of the Social Innovation Fund is to bring federal and private money together to scale up the best, evidence-based innovations to address problems of education, poverty, and health.

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Dying in America: There Must Be a Better Way

DyingInAmericaCover400pLast week, the Institute of Medicine released a new report titled Dying in America.

The committee that worked on the report included some long-time grantees and friends of the John A. Hartford Foundation,  such as June Simmons  of the Partners in Care Foundation, Jean Kutner, a Beeson Scholar  and faculty member at the University of Colorado, Diane Meier, leader of the Center to Advance Palliative Care, Patricia Bomba  of Rochester, NY’s Excellus Blue Cross/Blue Shield, and Joan Teno of the Center of Excellence in Geriatric Medicine at Brown University.

As always, we are proud to be associated with leaders who give their time to explore such urgent issues.

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MSTAR Program Shines at Reception for Supporters

Hartford Trustees Kathryn D. Wriston, left, and Lile R. Gibbons, at a recent reception honoring them as personal supporters of the MSTAR program.

Hartford Trustees Kathryn D. Wriston, left, and Lile R. Gibbons, at a recent reception honoring them as personal supporters of the MSTAR program.

Over the past 20 years, the Medical Student Training in Aging Research (MSTAR) program—a summer internship that draws physicians-in-training into the field of geriatrics and aging research—has supported more than 2,000 medical students.

We celebrated the program’s 20th anniversary and its remarkable record last week with a reception honoring John A. Hartford Foundation Trustees and other individuals who have personally donated to the sustainability of this initiative, administered by the American Federation for Aging Research (AFAR).

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Tools You Can Use: Webinar Series Covers Geriatrics-Competent Care for Medicare-Medicaid Population

Resources_Integrated_Care_400pMany of the John A. Hartford Foundation’s grant projects are working hard to improve the quality of health care for the older adults who are dually enrolled in both Medicare and Medicaid.

As a group, these low-income, older adults have more complex health conditions and a greater need for coordinated, geriatrics-expert care that meets their own individualized health goals.

To improve quality and reduce costs in this population, states are working with the federal government and local managed care health plans to integrate the financing and care delivered through Medicare and Medicaid. Changes are happening fast as states experiment with delivering care to this population of “duals” through these health plans, many of which have never had experience caring for an older adult population with complex conditions.

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Questions About Hartford Change AGEnts?
We Have Answers—and Opportunities

Change_AGEnts_logoSince launching our Hartford Change AGEnts initiative late last year, we’ve taken the first steps toward our goal of accelerating sustained practice change that improves the health of older Americans, their families, and communities.

Change AGEnts are connecting through our online community and the first two Change AGEnts Networks—focused on patient-centered medical homes and dementia caregiving—are already hard at work. We’ve funded nine Change AGEnts Action Awards and are currently accepting applications for our second cohort, and we’ve awarded collaborative pilot grants in partnership with the Change AGEnts program for our Centers of Excellence Scholars and for Beeson Scholars.

The initiative’s leadership team and our partners at the Gerontological Society of America (GSA) are working hard to support the Change AGEnts community and are ready and willing to help people engage. Since we get lots of questions about how people can get involved, we thought that addressing them in a Q&A would be helpful and highlight some immediate opportunities.

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Of Knights, Knaves, and Pawns: Physician Disillusionment and the Need to Realign Our Health Priorities

Doctored_Book_Cover_300pEver since I began working as a program officer at the John A. Hartford Foundation, I’ve tried to do my best to put myself in the shoes of the health professionals with whom we’ve worked and whose education and training historically has been one of our main concerns.

I’ve often found memoirs and other lightly fictionalized accounts to be the best way to get into the culture and daily experience of these health professionals. I’ve read Samuel Shem’s The House of God, countless memoirs of nurses and physicians, and even a very affecting memoir of a nurse’s aide in a nursing home.

One of the tricks of such reading is that we experience what our imagination and the author’s words together conjure in a special state of willing suspension of disbelief. Psychological research suggests that this process of imagination and purposeful lowering of critical skepticism is, in fact, what makes fiction so persuasive and engenders the feeling that novelists understand a truth about human character that other ways of knowing can’t match.

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