As Orson Welles might have said: “We will evaluate no program before its time.”
One of the first things you learn in “foundation school” is how easy it is to kill even great programs by evaluating them before they are ready.
Nothing innovative starts working on day one as well as it will with practice, adjustment, and refinement. Even more deadly is an evaluation with low-cost methods that doesn’t really provide the information you want and need. One of the painful lessons I’ve learned is to always buy the highest quality and therefore most expensive evaluation you can afford, because it’s cheaper in the long run.
Last 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.
Before starting my internship with the John A. Hartford Foundation, the notion of improving health outcomes while decreasing costs appeared implausible. Securing strong patient-centered care for a loved one had to come at an extra expense—a large price tag for both the individual, his family, and the institution administering the care. After all, my family recently hired a home health aide to assist and advocate for my grandfather during his stay in the hospital and then during hospice, what is supposed to be one of the most patient-centered forms of care. My family believed that a consistent, if costly, presence and support system would serve him well during employee shifts and other downtime between caregivers.
And it made a difference. Our aide, Abdulai (last name withheld), served as my family’s lifeline, the person my grandfather could rely on for personalized and direct care, the person my mother could trust in clarifying medications and complicated procedures.
Author Caitlin Brookner (back, left) with her cousins and grandfather, Leonard Weisberg.
This is the second in a three-part Health AGEnda series on the Hartford Foundation’s 2013 Annual Report: Spreading Innovation Through Collaboration.
Although he was a star in a different field, something basketball legend Michael Jordan once said applies equally to the work of the John A. Hartford Foundation: “Talent wins games, but teamwork and intelligence wins championships.”
Here at the Hartford Foundation, we see great merit in not only spurring innovations and winning each “game,” but also generating long-term champion partnerships that pave the road for meaningful and lasting change.
Dr. Timothy W. Farrell, right, from the video series depicting a patient undergoing transitions of care across different locations of care.
It happens all too often: Older adults “fall through the cracks” of the health care system. They fall victim to bad transitions of care due to a host of issues, including poor communication, a lack of geriatrics expertise on the part of the health care provider, and a dysfunctional or non-existent team.
As a result, older adults are rehospitalized, frequently move across sites of care, and receive suboptimal and, too often, harmful services.
Our most recent annual report celebrated the John A. Hartford Foundation’s 30-year commitment to improving the health of older adults. As part of the online, interactive version of the report, we asked some of our long-time grantees to help us tell the Foundation’s story by sharing short and sweet video messages about our past successes, our current projects, and our new directions.
We want to highlight a few of these brief video clips, each only about one minute long, and invite you to browse and share the other messages in our dynamic online annual report.
In this first video, David Reuben, director of the Multicampus Program in Geriatric Medicine and Gerontology and director of the Hartford Center of Excellence in Geriatric Medicine at UCLA, points out the changes he’s seen over the past three decades in how geriatrics is incorporated into medical student education. Dr. Reuben was a beneficiary of the 1983 Hartford Geriatrics Faculty Development Awards, Hartford’s earliest program to build up the field of geriatrics.
While still shrouded in mist, the path to transforming our health care system is becoming more clear.
While the view is still hazy, last week the Centers for Medicare and Medicaid Services (CMS) took a major step to clarify how it will address the major challenge facing Medicare (and therefore our health care system): transforming an episodic, acute-care dominated, fee-for-service system into one that can meet the challenge of complex chronic care, improving the health of older people while reducing spending.
This is the challenge our new “downstream” grantmaking strategy is designed to address, making CMS’s proposal both very welcome and a high-stakes opportunity to advance our hopes.
What is the best way to sell umbrellas? We have tons of street vendors in New York who know the secret. Is it to have the best-made, reasonably priced umbrella on the block? That’s a good starting point.
Do you need an attractive sign or an attention-getting catchphrase? Good advertising certainly helps. But if you really want to sell your umbrellas, there is one sure-fire way to have them fly off your cart. You guessed it.
Jürgen Unützer, MD, brings the IMPACT model of depression care to Casper, Wy.
Given the John A. Hartford Foundation’s focus on improving the health of older Americans, it should come as no surprise that the Foundation has looked for opportunities to create a more comprehensive, coordinated and continuous health care delivery system.
Since the 1990s, we’ve done this by investing in the development, testing, and spread of effective and affordable Models of Care to address barriers to the provision of high-quality, cost-effective care for elders.
In recent months, the debate over how best to reduce avoidable hospital readmissions has become a hot topic in the national media. While many are just now joining the fray, the John A. Hartford Foundation has been working on this issue for years.
It also has been a topic we have written about extensively on our Health AGEnda blog as we seek to help shape the public debate about an issue that is at the very core of real and sustainable health care reform and of critical importance to older adults.