One Is the Loneliest Number

By Shawn Kennedy, AJN editor-in-chief

The great Bartholdi statue, liberty enlightening the world: the gift of France to the American people. Speculative depiction published the year before the statue was erected. In this depiction the statue faces south; it actually faces east/Wikimedia Commons The Bartholdi statue, liberty enlightening the world: the gift of France to the American people. Speculative depiction published the year before the statue was erected. In this depiction the statue faces south; it actually faces east/Wikimedia Commons

I’ve been struck recently by how the United States sometimes seems to stand apart from other nations. This is sometimes called “American exceptionalism.”

The most obvious example of this is the recent push—temporarily put on hold due to the emergence of negotiations about the possible handover of Syrian chemical weapons to Russia—to garner support among other nations for a military strike against the Syrian government in response to its use of chemical weapons against its own people.

By now, most of us have seen the graphic videos on media outlets and they are indeed disturbing. There are signs of neurotoxicity in […]

2016-11-21T13:06:34-05:00September 13th, 2013|health care policy, nursing perspective|2 Comments
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48 Years of Medicare (and Counting)

By Shawn Kennedy, AJN editor-in-chief, and Jacob Molyneux, senior editor

Next week marks Medicare’s 48th anniversary. President Lyndon Johnson signed the legislation creating Medicare on July 30, 1965, guaranteeing health coverage for the elderly. With the gradual implementation of the Affordable Care Act (ACA; 2010), Medicare, along with other government and private forms of health insurance, is undergoing changes, with efforts being made to rein in rising costs, combat fraud, tie quality of care to reimbursement, and so on.

PPresident Lyndon B. Johnson signing the Medicare Bill at the Harry S. Truman Library in Independence, Missouri. Former President Harry S. Truman is seated at the table with President Johnson. Photo: National Archives and Records Administration. President Lyndon B. Johnson signing the Medicare Bill. Former President Harry S. Truman is seated at the table with President Johnson. Photo: National Archives and Records Administration.

With the ACA’s date for mandated purchase of health insurance fast approaching, some states are setting up state-run health insurance exchanges to provide consumers with a standardized menu of […]

2016-11-21T13:06:55-05:00July 26th, 2013|health care policy|0 Comments
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ECRI Conference Notes: Creating and Replicating ‘Systemness’ within Health Care Delivery

By Joyce Pulcini, PhD, RN, FAAN, Policy and Politics contributing editor, AJN

The ECRI Institute’s 19th annual conference (November 28–29) looked at system-level innovation and quality in the health care system. It brought together experts from many fields, including medicine, nursing, hospital or health system administration, informatics, health care quality, policy makers, journalists, and academics. ECRI Institute is an independent, nonprofit organization that researches the best approaches to improving the safety, quality, and cost-effectiveness of patient care. The goals of the conference were to address the following:

  1. What is “systemness”?
  2. Which elements within mature health care systems result in the best clinical outcomes?
  3. Are approaches taken by long-established systems transferable to smaller, newer, or less integrated systems?
  4. Are financial incentives enough to drive change?
  5. How can electronic health records (EHRs) help improve “systemness”?
  6. Do transformation units within health care systems produce results?

The conference essentially tried to attack in a creative way the issues around the creation of systems that function optimally. Truly changing culture and providing optimal care delivery should always result in putting the patient at the center of care. The conversation was open and the conference succeeded in fostering important dialogue among the speakers and the audience.  A major focus was on creating systems, looking at technological or financial solutions, and measuring outcomes.

The session on team care (“Creating teams to improve inter- and intra-health care systems: Does evidence show a benefit?”)  highlighted the vexing issues around how to truly foster optimal teams. Lisa Schilling, RN, MPH, VP National HC Performance Improvement, Director, Center for […]

2016-11-21T13:08:48-05:00December 5th, 2012|digital health, health care policy, nursing perspective|0 Comments
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Michelle Obama: Health Care Reform the ‘Right Thing to Do’

The full transcript of Michelle Obama’s moving convention speech can be found here.

Here she is on making difficult decisions:

“But at the end of the day, when it comes time to make that decision, as President, all you have to guide you are your values, and your vision, and the life experiences that make you who you are.”

On health care reform:

“When it comes to the health of our families, Barack refused to listen to all those folks who told him to leave health reform for another day, another president. He didn’t care whether it was the easy thing to do politically – that’s not how he was raised – he cared that it was the right thing to do.

He did it because he believes that here in America, our grandparents should be able to afford their medicine…our kids should be able to see a doctor when they’re sick…and no one in this country should ever go broke because of an accident or illness.

And he believes that women are more than capable of making our own choices about our bodies and our health care…that’s what my husband stands for.”

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2016-11-21T13:09:24-05:00September 5th, 2012|health care policy|0 Comments
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Campaign-Inspired Hot Summer Friday Thoughts

By Shawn Kennedy, AJN editor-in-chief

Commuting in and out of Manhattan gives me plenty of time to listen to the radio and of course, with Election Day a mere 90 days away, the presidential campaign offers reporters a lot of fodder for commentary. And of course, the evening papers and television stations—both national and local—augment what’s on the radio all day. Here’s a sampling of health care–related campaign news that I’ve heard and read this week.

According to the Kaiser Foundation’s Health Tracking Poll, July figures show that overall, two thirds of Americans support Medicaid expansion under the Affordable Care Act (ACA), but when it comes to whether their own states should expand programs, support drops to less than half (49%), while 43% want to keep the status quo. Importantly for candidates, “four in 10 Americans say they could still change their minds on the law.”

My take: The failure of the Democrats to adequately explain the reforms, together with the misinformation from the Republicans (death panels—need I say more?), are leaving the public confused.  The winner in November will be the candidate who can convince the voters that the ACA is either good or bad for them on a person level. (And yes, the economy is now the overriding issue, but health care will keep resurfacing as an emotional and “values” issue in the coming months.)

Senate Majority Leader Harry Reid (D–Nevada) accused candidate Mitt Romney of not paying taxes for 10 years while he was […]

2016-11-21T13:09:30-05:00August 10th, 2012|health care policy, nursing perspective|0 Comments
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