restorARTively

June is National Safety Month. There is alot of work to be done to keep children safe. On the ride home from a hospital presentation on Patient Engagement last Friday, I was caught off guard listening to the author of "Free Range Kids". I had heard of this woman who encouraged her nine year old son to ride the train in New York by himself. It seemed a bit insane to me but I had not heard or bothered to learn more about the details, so I had no place to judge. Her word choice for how she advocates raising children is scary - Free Range Kids - puts children and cattle on the same level. But again, that was me being judgemental. Listening to her speak on my local NPR station, the annoyance wore off and deep concern set in. She commented on the absurdity of products that are being marketed to parents as the must-haves to keep children safe making one wonder how did anyone survive childhood without these inventions? Kneepads for crawling babies? Helmets for toddlers (that do not...

Memorial Day 2002 was the first year that the holiday brought on new meaning; though at the time and in the years since I wondered what was making me feel so melancholy. Nine Memorial Days later, I finally get it. The flag. Read more at http://www.jamessproject.blogspot.com/ where I am transferring my blogging to to allow it to be more personal. More real. More about how preventable medical errors and patient-physician communication affect patients and clinicians on a day to day basis.

Deep within the 117 page 2009 annual report of the Pennsylvania Patient Safety Authority is a sliver of light into what neonatal hospitalized patients face. A study from 2006 at St Christopher's Hospital in Philadelphia on ventilator-associated pneumonias (VAP) is shared. VAPs are a preventable medical error. At St. Christopher's in 2006 after noticing an increased rate of VAPs that were significantly above the national average, the hospital proactively initiated a literature review and collaborated with other pediatric hospitals. Per the report, this "multidisciplinary team implemented a series of revisions to an existing pediatric ventilator bundle to better serve the neonate population." The changes that were implemented addressed standards for oral hygiene of neonates depending on their gestational age at birth, "securing endotracheal tubes using standard procedures, discarding all tubing and circuits from standby ventilators, altering the frequency of vent...

It is hard to maintain a restorative mindset when preventable death and pain keeps rearing its ugly head in pediatrics. This morning I learned of the death of a 40 day old baby who had been diagnosed with a treatable CHD (congenital heart defect ) - but the parents had never been told of the diagnosis. So the patent ductus arteriosus killed the child. I shed a tear and screamed in my heart. The parent should have been told. Of course, there is no guarantee as to the outcome - but what would have been guaranteed is that the family would have been a part of the treatment team. If tragedy still struck, there would have been a community of support built already the parent and the medical team. This brings me back to why I am here to begin with. Why James died. Why I ended up enduring the additional trauma of civil litigation. Why the book is titled, "Split the Baby ". Such a phrase can evoke disturbing imagery. Trust me. What James looked like after the medical interventions was...

The following article, written by a grieving member of The Compassionate Friends, sheds light on how Mother's Day came about and who it was designed to honor. This article does not mention, however, that the mother of Anna Jarvis (mentioned below) was actually trying to start a Mother's Day with the help of a friend in the 1870's - in the wake of the Civil War with thousands of freshly grieving mothers needing comfort. This is still quite timely as the United States has the worst infant mortality rate among industrialzied countries. At the same time, our sons and daughters have been fighting at least two wars on foreign soil for the past eight and a half years. "Mother's Day Revisited" Many of us in TCF do not look forward to Mother's Day. On this holiday, when the whole nation is celebrating the joys of parenthood, grieving parents often feel a special anguish. Mother's Day this year looms as particularly difficult milestone for me. Sunday, May 10, 19...

Still quietly (er, how quiet is blogging?) restoring my own health care. In the past two weeks I have done without all refined sugar while in the past week, I have added the challenge of getting 30 grams of fiber a day. I never knew just how hard that is! Artichoke's are my new best friend! But I hit a road bump yesterday as some emotions began to unexpectedly seep up to the surface and it was time to let them out after a long period of suppression. From the time my dad died and my very well-meaning doll of an aunt put a yellow bowl of Hershey Kisses in front of me, sweets were my friend in grief, anger and challenges. But I am not 12 anymore. I also realized yesterday, not too unlike the volcanic eruption in Iceland, being honest with those around you, sharing the anger or conflict in a constructive and meaningful way can actually be quite beautiful. It certainly remains scary and threatening, but working with others around us, we can set up boundaries and pathways to navigate th...

You need look no further than the corruption on Wall Street that has spun the world into today’s financial meltdown rivaling 1929 to see the importance of our right to justice in a courtroom. Now more than ever, consumers need open doors to the court house to enable us to seek justice. Marketing civil justice as “frivolous” is itself frivolous. For years, those on Wall Street have used bogus stories about “frivolous lawsuits” as a marketing tool to create a negative impression of the civil justice system and help improve their bottom dollar. By using the myth of “frivolous lawsuits” to push for legal reform, corporate interests hope to prevent our access to a court room when they operate irresponsibly. They also have been successful in “polluting” the minds of citizens who serve on juries to create a prejudice against viable lawsuits. The truth is that there is nothing faulty or frivolous about our civil justice system. The civil justice system is the last resort for people who have be...

"These are very complex issues, but it is really all about relationships." ~Madeline Albright, first female United States Secretary of State Whether international relations, law building or health care delivery it is all about the relationships. Not only the relationships between insurance companies and the insured, but also between insurance companies and the uninsured, between physicians, between physicians and nurses, between risk managers and the patients who walk through the door. Some of these entities never cross paths in person but they have a direct impact on each other's choices an decisions in medical care. My youngest son spent a full week in the NICU before coming home. The twenty four hour access to their new babies that parents are offered on 8 Ravdin at The University of Pennsylvania NICU allows relationships to be built. Relationships are built between parents and the clinicians, parents and other parents, and especially between parents and their new babi...

There are alot of broken hearts and relationships in my life and I always wonder when I see humanity's resilience take a positive hold somewhere how I can get a little "peace" of that. How is a movie about violent prisoners relevant to the health care discussion? Watch this brief trailer of "The Dhamma Brothers". Many of the questions raised by the stakeholders in this movie can be considered for the benefit of all stakeholders in health care. Is humanity being locked away in the delivery of medical care? What are we breeding in our hospitals? Bu ignoring the humanity of every provider and every patient a passive and, sometimes, active violence comes creeping in through sarcasm, carelessness;, aggressive responses in daily discussions; defensive stances in communications; laziness, risky behavior; dismissal of best practice policies as invasive, overbearing, and not beneficial; immodesty, cruelty, poor word choices; intolerance for imperfection; bullying; unwill...

Week 1 down - many more to go The first week of the hundredth time I gave up refined sugar is Easter week. Planning continues to be a challenge in my fourth decade. Exercise was consistent all week. It consistently woke up the muscles I didn't know I still had in areas I can't see under the flab. This time is not the same. Reforming my health is about more than the extra poundage I have accumulated. It's about how it got there, why I hold onto it, and the biggest challenge in getting rid of it. Forgiveness. My Facebook status on Easter Sunday mentioned my prayers "that I can forgive". Forgive myself that is. I forgave the doctors, nurses, hospital, and health system that were party in James's wrongful death. I cannot forget and I may not agree with most of them on most everything. I do forgive them though; which is what has made it possible for me to seek post-verdict conversations with a couple of them. Forgiving myself is much harder. How do you forgive a mo...

Spring is sprouting. People and plants are busy dusting off and opening up. Hopefully, there is always time to take care of yourself. I keep telling that to myself so maybe I will actually do it. Chanticleer here I come!

I have just struggled through breakfast. First one I have had in months. Generally I eat one meal a day, snack throughout, and enjoy sugar way too much . All that has added up to one overweight - yup, fat - mama. So,in the hopes for new health for all Americans, I will follow the advice of a trusted physician friend and start reforming my own health care. And in the spirit of transparency and community, I am sharing the journey with anyone who cares to join me. From what I hear, finding a community of support helps success. I started a few days ago with keeping track of what I was eating. I was not eating much but the simple math was clear: NO breakfast + sweet tooth + little exercise = Fat Fortunately, I have low blood pressure, low cholesterol levels, and normal glucose levels. So, healthy for now except too big for my britches (so to speak). So, today I suffered through a measured 1/2 cup of Quaker oats and raisins. I tried sweetening it with cinnamon and a tablespoon of applesauce ...

It is always a challenge to be restorative - especially when things hit close to our hearts and our passions. The current debates surounding health care are hitting many hearts and passions. Despite what I may personally feel about the insurance mandate within the new health care law, an expensive lawsuit taxpayer funded by one group of elected officials against another group is counter-productive to the end goal for all parties. Again, the acute and longterm needs of consumers (patients, families, and physicians) will be lost in the arguement. Please consider drafting a letter or make a phone call to your attorney general. Ask that they please stop this lawsuit and sit down and discuss the issues with the other elected officials. Your constituency has put faith in you and this group of legislators to put the little guy first. Here is my letter to my attorney Tom Corbett who is also running for governor this year. Dear Attorney General Corbett: Thank you for your service to our state. ...

A recent news story highlighted the plight of a newborn boy, Houston, born with a congenital heart defect. The child's defect is known as transposition of the great arteries. For a full term infant with no other anomalies, the typical treatment is a surgical repair in the child's first month of life. It is often rarely diagnosed prenatally. Houston's parent's insurance company designated his birth defect as a preexisting condition. On those terms, it denied the child health insurance coverage the day after the president signed the new health care bill into law. Read the full story here. There are a number of issues and concerns that this story brings up for me. To be able to fully understand my own discomfort for this reality is to figure out what questions I have. I will focus on one now and perhaps share more later. The First Query: Without promoting one side or the other - I am surprised that the pro choice movement would let this slip or that the pro life movement h...

Among Tom Corbett's top priorities if he were to be elected Governor of Pennsylvania : " Excessive and frivolous lawsuits hinder job growth and hurt Pennsylvania taxpayers by increasing costs for businesses, healthcare, and consumer goods and services. As part of Tom Corbett’s plan to revitalize Pennsylvania’s economy, he will work to pass meaningful legal reform." In the past decade, republican legislators have taken the lead to limit court access to individuals harmed in the health care industry. In 2002 in Pennsylvania, limited tort reforms were passed. Pennsylvania has seen a significant decrease in the number of medical malpractice cases on our court dockets, while in the same time frame there has been a significant increase in the number of sentinel events endured by Pennsylvania's patients (PA Patient Safety Advisory 2008 Annual Report). For a foundation, Dictionary.com offers this definition of frivolous: ~characterized by lack of seriousness or sense ~self-...

Anyone who has read even the most minimal about me knows I sued a doctor. To be precise, at initial filing I brought civil suit against four -five docs, a large health care system, a hospital and its supporting foundation. There is a mountain of research based evidence to explain why I, or any medical malpractice plaintiff, litigates. (For those new to the conversation, the short answer is - communication & prevention. Read more here .) What remained a mystery to me (and it appears most of the world) is in light of all this practical and real evidence, why don't risk managers encourage doctors, hospitals and health care systems to communicate and find resolution with injured plaintiffs? Well, that was a mystery until last June when I presented to the local chapter of the health risk management association. In my talk, I told the story of how I reached out to a defendant doctor even after years of painful litigation, more painful discovery of how preventable my son's death w...

Someone recently compared me to the game, "Whack a Mole". Affectionately, he described me as a person who kept sprouting up in a variety of arenas, sharing a different skill he didn't know I had or had interest in. Roaring in laughter, I agreed it seemed a spot-on description and reason why I might get so many headaches. In sharing a variety of experiences, opinions, successes and failures, I have been beaten around a little bit for them. Including a recent unexpected series of harassing phone calls and emails from a surgeon who seemed to misunderstand (and appeared quite threatened by) my goals for transparency and disclosure in health care. Whether it has been a tragic rift with family & friends because of poor or lacking communication or a medically trained clinician I have never met, my head still hurts from the blows. I never seem to know where they will come from, so like other grievers I go undercover to protect myself. My assessor explained what he was seeing....

Politicians are struggling with bipartisanship and meaningful transdisciplinary conversations over health care insurance. Debate has begun to shift to one of the major factors of steep costs in health care - medical malpractice. Most of the media focus has been on "tort reform" which is symptomatic of the problem, not the problem itself. Pennsylvania Patient Safety Authority board member and lawyer, Cliff Reiders, wrote in the summer of 2009 how the tort reforms made into Pennsylvania law in 2002 have significantly reduced the number of medical malpractice claims while at the same time the reports of medical errors in Pennsylvania hospitals have increased . These numbers are significant to Philadelphia and its surrounding area as it houses at least 6 major hospitals and health systems - most internationally recognized as leaders in innovative medicine. Though the worst medical cases may end up in Philadelphia's hospitals, there are many simple patient cases that fall...

Dhamber Ghalley learned from a reporter that the doctor he drove his sister to had previously had his medical license suspended. He learned this during the reporter's investigation into his sister's death after a procedure done by the same doctor, Kermit B. Gosnell. This story is an example of many tragic cases that happen across our city, state, and even the country. It is commonplace for patients to trust the medical providers they go to. Iatrogenic injury (injury caused by a medical provider) is as taboo as the procedure (an abortion at 19 weeks) Gosnell was performing on Ghalley's sister, Karnamaya Mongar. Regardless of the procedure or the doctor, patients and their families are becoming increasingly aware that they need to educate themselves when making decision regarding health care. While it is lacking in accessibility and transparency, there are some tools patients and families can use to garner some preliminary information on potential health care providers....

President Obama has released a new proposal for a Health Bill to be considered by the House and Senate which will culminate in a highly anticipated meeting on health care reform on February 25. There are current tools available to hospitals, doctors, pharmacists, nurses, insurers, and others close to improve care NOW - regardless, of the outcome of this summit. One of these tools comes from a well-established customer service industry leader. Two successful tools are the Patient's VOICE (tm) and Patient Satisfaction Skills(tm). The potential cost of the President's plan is about $950B (the Congressional Budget Office has not yet released a financial analysis of the proposal). This is a scary, hefty price tag. The health care industry has been aware of the out-of-control costs of its industry for well over a decade or more. This is new to many consumers and those outside of the industry. In Pennsylvania, legislators have continued to allow state funding for The Pennsylvania Hea...

Consider the true impact of medical malpractice. How does it affect patients, caregivers, siblings, parents, etc? What is the impact on society at large? What happens when you lose trust in a doctor? Or your local hospital? Or are a provider and you lose trust in a patient? What is available to help heal the iatrogenic injured bodies and souls? How much of a burden does medical malpractice put on our social services industries? Where do clinicians go to get help? Is there a place for patients and their families to reach out? Can patients and clinicians impacted help each other? In working one on one with both parties, each will move forward. What seems more challenging is meaningful healing that brings a sense of understanding and being understood. Absent understanding to bring peace, both impacted parties are stuck in a pattern of anger, grief and denial. Each party leans on whatever they can find available to fill the void left by anger and isolation. Alcohol, prescription drugs, fo...

Unfortunately this event was canceled due to the poor weather. We will reschedule when the weather is better! Thanks for your interest. In the meantime, please recognize Heart month by registering as a member at www.splitthebaby.com . Register by Valentine's Day and you will be in the raffle for a free "valentine" :) Thank you! The STB(Split The Baby) Project and the Congenital Heart Network invite you to enjoy a night of laughs at Helium Comedy Club (Philadelphia) on February 11 at 7:30 PM. Proceeds from this event will help support C.H.I.N., and the Split the BabyProject (Foundation - 501(c)3 pending), the work of fellow CHIN member MaryEllen Mannix. The project aims to bring pediatric disease specificorganizations together to collaborate, learn, and share information aboutpatient safety and best practices for sick children. We hope you will join us for a fun night night out! Tickets are $15.00/each. Visit here to order your tickets (your receipt will serve as your tick...

Occasionally Pennsylvania patients read or hear about this state government regulated agency. The Pennsylvania Patient Safety Authority (PA PSA ) was legislatively created as a result of tort reform in 2002 by Act 52. This organization is charged with collecting, analyzing, and disseminating the resultant learning of sentinel events reported by Pennsylvania hospitals, nursing homes, and clinics. The PA PSA has maintained its main goal is to work with hospitals and like healthcare institutions in PA to improve safety. They have an innovative program called PA-PSRS through which the healthcare providers can report these events without risk of exposure to liability or media. Consumers can access their website and review “Advisories” that contain general information about some of the challenging issues of PA healthcare providers. This is a great way for consumers to begin to educate themselves on issues and how to best advocate for themselves or a loved one in hospital or institutional hea...

Just in case you didn't hear yet - there is no such thing as the United Nations International Health Organization. I received an email forward from a dear friend who really means well. Unfortunately, there are many hoaxes and scare tactics being used to influence good hearted people that might just be too busy taking care of everyone else. This email is one of them. And there is no such article ever printed or considered for print by the Investor's Business Daily. Google it and you will find several references to this BOGUS article. The email forwards subject line is usually something to the effect: "Your Christmas Present from the Govt that you Never Asked for." The only people getting a Christmas present from the Senate & House bills are the insurance companies. Here are some current and interesting pieces on the health care issue: Statistically speaking this IS accurate: A Global Health care Snapshot from WSJ http://www.marketwatch.com/health-care/reform/snapsh...