TDI profs. consulted for health care policy

Here's an update on TDI in DC:
This article describes Elliott Fisher's concept for Accountable Care Organizations. Dr. Fisher is on the faculty here at TDI and will be presenting his idea to the Senate this afternoon.

-Sam W.

The Possibilities at TDI: A Dream Come True

My desire in coming to The Dartmouth Institute (TDI) was to gain the knowledge and skill set to ultimately become an effective health policy researcher and assist in the appropriate reform of U.S. health care. This desire has certainly come true; the opportunities at TDI to begin achieving your career goals are endless. I thought I'd relate one particular opportunity I had while studying here.

As MPH students, we are obviously required to complete a thesis. While the requirements are strict, there are various tracks you can pursue depending on your unique academic/career interests (e.g. Analysis of a Population Health (PH) Problem, PH Intervention Plan, PH Research Grant Proposal, etc.). Since I wanted to pursue a career in health policy research, I chose the grant proposal track and spent the last 6 months working on it. While not required, I wanted to ultimately submit it to the NIH for funding, and so I worked with two orthopaedic surgeon scientists and a biostatistician as my content experts to better ensure its success.

Long story short, after an intense last month of writing and editing according to their critiques, we just submitted it to the NIH last week! It was a very satisfying feeling. If funded, we will be getting $1 million over 2 years to study outcomes of total knee and hip replacement in the United States--the number one cost-driver for Medicare inpatient services. In the end, we hope to generate knowledge that will inform all stakeholders (the orthopaedic community, patients, and policy-makers) and significantly improve these outcomes, while decreasing cummulative costs by reducing the need for revisions (repeat procedures).

I can't wait to see the NIH's decision and hopefully begin working to literally fulfill the motto at TDI to generate "knowledge that informs change."

Spring. . .

Spring is here! And the upper valley is in a heat wave. Who would’ve thought it could be 80 degrees in April?
We are approaching the midterm of spring semester at TDI and that means graduation is just around the corner. I have been so busy this year that time has flown by and I cannot believe it is almost time to move on and start using the information I have learned here. During this year we have learned to identify issues in health care, how to track these issues, the process of analyzing them, and implementing strategies to fix the problems. I look forward to using my knowledge in the coming years of health care reform.
Betsy B.

Clinical Microsystems

TDI is fortunate to have the geographic proximity and the support from leaders at Dartmouth-Hitchcock Medical Center. We have the option of taking a Clinical Microsystems class in the Spring which I was told by several alumni and former professors was one of the electives not to miss. Taught by some of the leaders in quality improvement, Paul Batalden and Gene Nelson, we learn the fundamentals to create and redesign health care microsystems in the efforts to improve delivery of care to the patients, patient's satisfaction, and attain better outcomes for the patients.

Even better, we are given the opportunity to work with a "site" that gives us the chance to apply some of the skills we are learning in the classroom and apply them to a real microsystem. Building on our communication, research, and quality improvement skills, we enter our designated site with the guidance of committed leaders in that field that share the same vision for improvement and better patient care. In the past recent weeks, my partner and I have visited the Ultrasound department right across the street at DHMC and spoken to the director, the head sonographer, and an Ultrasound scheduler to better understand the wait times in this microsystem. We soon will be able to follow patients to get a first-hand look at how we can make a patient's visit to an Ultrasound a delight every time (the Kano Model)! Working side-by-side with the staff of the microsystem and getting the opinions of those that interact with this department from the mesosystem and macrosystem gives us an incredible insight into make every step of the process patient-centered, and efficient, and effective. 

We are really lucky here at TDI to get these opportunities. 

-Shaili

Dartmouth in DC

Staying current on healthcare reform is a key focus at TDI. We read the recent journal articles, white papers, and policy briefs that guide key decision makers in Washington, D.C. and elsewhere. Our instructors also keep us abreast of happenings since they influence these debates directly (see the 2nd headline here re: Dr. Fisher's testimony: North Shore LIJ Health System testifies before House Ways and Means Committee...). Sometimes though, it's hard to keep up with how the theories we talk about in class here in New Hampshire are applied.

Julie Lewis stepped in today to show how TDI works in the real world. She spoke at the Dartmouth Medical School about the stimulus package, and how she and other TDI leaders are advising politicians on what to do with the healthcare-related financial outlays in the bill. Julie is very connected to what's going on in Washington. She has worked with Nancy Pelosi to direct quality improvement policy for the American College of Surgeons. Julie now serves as Director of Health Policy at TDI and manages TDI's partnership with the Brookings Institution. She's also very accessible to students. I've met with her a few times to review my resume and plan job-search strategies. Julie showed how relevant TDI is in today's healthcare reform debates, and she's part of the reason why it's exciting to be a TDI student right now.

-Sam W.

The snow is melting...

The snow is melting around Hanover and TDI classes are back in full swing.

Sorry for the break in posts over the last few weeks. Most of us were focused on finals during the middle of March and then spring vacation provided a break in the action. Some students went on vacation, a few stayed in New Hampshire to work on projects, and others mixed business and pleasure. For example, one student spent part of her spring break interning in Washington DC, and I spent a week vacationing in Mexico then stopped in New York City to deliver a presentation before returning to school.

Now that school has started, most are wrapped up in thesis and internship projects. Despite the workload, there's still time for extracurricular adventures. One group spent Sunday hiking up to Tuckerman's Ravine, skiing the headwall, and biking out. Although I missed that excursion, I reserved some time yesterday to attend a talk delivered by visiting scholar Dr. Milt Weinstein, and then to watch the NCAA finals with a friend who's a UNC alum. It's a busy time for TDI students but we still make time to enjoy the non-classwork opportunities in the area.
-Sam

Healthiest Nation in One Generation

In conjunction with National Public Health Week 2009, the American Public Health Association has initiated a campaign to build a foundation for healthier nation.

http://www.generationpublichealth.org/

This video is short and well done. It hits a lot of the points we've been talking about all year.