Healthcare Employees Can Work in a ‘Culture of Fear’, Where Speaking Up is Discouraged

MedicalResearch.com Interview with:

Professor Mary Dixon-Woods Director, The Healthcare Improvement Studies Institut (THIS Institute) University of Cambridge

Prof. Dixon-Woods

Professor Mary Dixon-Woods
Director, The Healthcare Improvement Studies Institute
(THIS Institute)
University of Cambridge 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The challenges around employee voice are well documented. For various reasons, employees in all industries are often reluctant to raise concerns when they witness disruptive or unsafe behaviour from their colleagues. But it’s crucial that they speak up – especially in healthcare. Patient safety may depend on it.

Our study focused on a large academic medical centre in the US that wanted to improve employee voice. Despite having reporting mechanisms in place, the organisation still had issues with disruptive behaviour from group of powerful senior individuals that went unchallenged and contributed to a culture of fear.

Through confidential interviews with 67 frontline staff and leaders and the organizational actions that followed, we learned it’s important for employees to feel that their concerns will be dealt with authentically. It also helps when healthcare organisations have clear definitions of acceptable and unacceptable behaviour and well-coordinated response mechanisms. Once someone does raise a concern, organizations need good, fair and transparent systems of investigations and be prepared to implement consequences for disruptive behaviour consistently.  Continue reading

With Aging Comes Increasing Cost of Life-Extending Medications

MedicalResearch.com Interview with:

Jonathan H. Watanabe, PharmD, PhD, BCGP Associate Professor of Clinical Pharmacy National Academy of Medicine Anniversary Fellow in Pharmacy Division of Clinical Pharmacy | Skaggs School of Pharmacy and Pharmaceutical Sciences | University of California San Diego La Jolla, CA 

Jonathan H. Watanabe, PharmD, PhD, BCGP
Associate Professor of Clinical Pharmacy
National Academy of Medicine Anniversary Fellow in Pharmacy
Division of Clinical Pharmacy | Skaggs School of Pharmacy and Pharmaceutical Sciences | University of California San Diego
La Jolla, CA

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: As a clinician in older adult care and as a health economist, I’ve been following the news and research studies on older patients unable to pay for their medications and consequently not getting the treatment they require. Our goal was to measure how spending on the medications Part D spends the most on, has been increasing over time and to figure out what prices patients are facing out-of-pocket to get these medications.

In 2015 US dollars, Medicare Part D spent on the ten highest spend medications increased from $21.5 billion in 2011 to $28.4 billion in 2015.  The number of patients that received one of the ten highest spend medications dropped from 12,913,003 in 2011 to 8,818,471— a 32% drop in that period.

A trend of spending more tax dollars on fewer patients already presents societal challenges, but more troubling is that older adults are spending much more of their own money out-of-pocket on these medications.  For patients without a federal low income subsidy, the average out-of-pocket cost share for one of the ten highest spend medications increased from $375 in 2011 to $1,366 in 2015.  This represented a 264% increase and an average 66% increase per year.  For patients receiving the low income subsidy, the average out-of-pocket cost share grew from $29 in 2011 to $44 in 2015 an increase of 51% and an average increase of 12.7% per year.  This may not sound like much, but for those living close to the federal poverty level this can be the difference between foregoing necessities to afford your medications or choosing not to take your medications.   Continue reading

Rally Health Gamifies Digital Platform To Support and Engage Consumers

Rally HealthMedicalResearch.com Interview with:
Brian Dolan
Chief Strategy and Partner Integration Officer
Rally Health

MedicalResearch.com Editor’s note: On February 3, 2015, Rally Health launched a New HIPPA compliant Digital Engagement platform that gives consumers the support and tools they need to better manage their health and well-being. Brian Dolan, the Chief Strategy and Partner Integration Officer at Rally Health, was kind enough to answer questions regarding the new health care interface for the readers of MedicalResearch.com.

MedicalResearch: What is the background or vision for the Rally Health digital engagement platform?

Mr. Dolan: We designed the platform to give consumers the support and tools they need to better manage their health and well-being. Rally leverages the power of personal health data, social networking, and gamification to encourage consumers to take control of their health. Rally’s proven behavior-changing technology encourages consumers to manage their own health by inspiring sustained action and offering intrinsic and extrinsic value-based incentives for engagement. Members can also meet other Rally users for ongoing support and encouragement. With the right balance of social and digital connectivity, Rally Health creates a modern consumer experience that makes getting healthy personal, relevant and fun.

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Power Toothbrushes Can Harbor Surprising Number Of Bacteria

Donna Warren Morris, RDH, Med Professor, Dean's Academy of Distinguished Teaching Scholars Houston, TX 77054  MedicalResearch.com Interview with: 
Donna Warren Morris, RDH, Med
Professor, Dean’s Academy of Distinguished Teaching Scholars
Houston, TX 77054

Medical Research: What are the main findings of the study?

Answer: Power toothbrushes can harbor microorganisms that have been shown to cause disease and infections. A solid-head design was found to have less growth of microorganisms than two others with hollow head designs.
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HIV Epidemic Still Surging Among Young Gay and Bisexual Men

Anna Satcher Johnson MPH Division of HIV/AIDS Prevention Centers for Disease Control and Prevention (CDC) Atlanta, GeorgiaMedicalResearch.com: Interview with:
Anna Satcher Johnson MPH
Division of HIV/AIDS Prevention
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia


Medical Research: What are the main findings of the study?

Answer: The new analysis confirms historical trends suggesting that we’ve made significant progress in reducing HIV in the U.S. over time – overall and among several key populations, including injection drug users and heterosexuals.  Overall, new HIV diagnoses from 2002 to 2011 declined 33 percent.  However, these findings underscore continued concerns of a surging HIV epidemic among young gay and bisexual men.  We found a significant increase in HIV diagnoses among young men who have sex with men between the ages of 13 and 24.
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HealthCare Quality: Should “Willful Neglect” Be a Criminal Offense?

Karen Yeung Professor of Law Centre for Technology, Ethics Law & Society King's College London London WC2R 2LSMedicalResearch.com Interview with:
Karen Yeung
Professor of Law
Centre for Technology, Ethics Law & Society
King’s College London
London WC2R 2LS

MedicalResearch.com: What are the main findings of the study?

Professor Yeung: This study found a gap in existing legal regulation of healthcare quality in the UK.  While patients receiving treatment under mental health legislation are protected by the criminal law against wilful neglect or ill treatment, other patients are not subject to the same level of protection, although many such patients are just as vulnerable as those who are mentally incapacitated.  Hence we argue that a new criminal offence of ‘wilful neglect or ill treatment’ of patients in the healthcare sector is needed.
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