IHI online open school optional assignment: Students complete the online curriculum and assessment for certificate program. To provide greater detail and context for the material covered in class. Recommended for students pursing a certificate in quality and safety.
In this session, we will consider how organizations, including healthcare systems and public health institutions, promote the health and well-being of entire patient populations by addressing problems that impact large numbers of people. We will readdress topics that were introduced in week 1, including thinking broadly about what constitutes “health” and how we can address some of the social determinants of health. In order to do this, we need to define “population health” and understand what is meant by this term.
In addition, this session focuses on the “Triple Aim.” The Triple Aim involves three goals that are critical to improving the health of populations, whether here in the United States or elsewhere:
Improving the individual experience of care.
Reducing the per capita costs of care for populations.
This reading is intended to help students gain further detail on population health terminology and distinctions between population medicine at the clinic level and public health focused on larger populations.
Remember the World Health Organization definition of health we learned in Week 1: Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
Remember the definition of public health from Week 1: Public health is the science and the art of preventing disease, prolonging life, and organized community efforts to prevent, identify, preempt, and counter threats to the public’s health.
Population health aims to address health disparities and improve health outcomes for the entire population of a specific geographic area.
Population medicine aims to address health disparities and improve health outcomes for the population served by a given care provider (clinic, hospital, etc.).
Both public and population health efforts rely on data that may often be limited; physicians can help improve public health data by reporting patient outcomes as required by law.
All physicians can contribute in some way to health improvements at the population level by supporting public and population health programs
UW School of Medicine Students who have a special interest in making social determinants of health and advocacy part of their medical careers are encouraged to explore information on the joint MD-MPH programs offered by the UW School of Public Health. Information on the different programs available can be found at: http://sph.washington.edu/mph/. The programs most relevant to social determinants of health are health services (focused on the US health system), global health (focused on health systems in resource-limited settings), environmental health (focused on climate change, worker health, etc.), and epidemiology (focused on the distribution and determinants of diseases and other health conditions). Interested students are encouraged to reach out to those programs for information on program structure and content and on the application process and deadlines.
These IHI modules are optional – IHI online open school. Supplementary activity to provide greater detail and context for the material covered in lecture. Recommended for students pursing a certificate in quality and safety. Improve understanding of aim statement by providing additional examples.
QI 102 Lessons 3, 4, and 5 (optional) – Identify steps in the model of improvement framework for choosing measures, developing changes, and testing changes.
These lessons will introduce the steps in the model of improvement framework by providing knowledge regarding types of quality measures, change concept tools for developing changes, and methodology for testing changes.
QI 103 Lesson 2 (optional) – Discover how to use data to learn about the impact of changes.
These lessons will inform the student on the purpose of data and how data may be organized, examined, and presented using a run chart.
QI 103 Lesson 1 and 3 (optional) – Determine how to collect quality measurement data and how to learn from data.
These lessons describe the planning process, data sampling, scale, and scope in data management.
QI 104 Lessons 1-3 (optional) – Recognize the use of charting tools for interpretation of data.
These lessons expand on interpretation of data using run charts, control charts, and other measurements.
Goal: Explain the ethical conflicts involved in deciding if and when to provide medical care for family members.
Instructions/context for reading: Almost all medical students and physicians will receive requests for medical advice from family or friends at some point in their career. These requests can range from simple questions about routine medical care to complex inquiries about serious health issues or medications. Read this article about handling a request for medical care from a family member and consider how you might respond as a medical professional.
Goal: Explain the implications of the policy statements from the AMA Board of Ethics and explore the ramifications of providing medical care for family and friends
Instructions/context for reading: Responding to requests for medical care from family and friends in a manner that maintains professional integrity without compromising a personal relationship takes introspection and practice. Participating in class discussion will help students begin to analyze the nuances of these interactions and the ethical dilemmas involved in approaching requests from family and friends.
In this foundational article, social epidemiologists Bruce Link and Jo Phelan argue three main points:
social conditions (e.g., SES, inequality, racism, segregation) have a causal effect on health and well-being,
to understand patterns of disease prevalence and incidence, we need to contextualize risk factors and understand what conditions put people “at risks of risks” (i.e., people in poor neighborhoods have an elevated risk of exposure to crime which increases the risk of stress accumulation), and
researchers need to acknowledge that social conditions are not just distal causes of disease, they are FUNDAMENTAL causes, meaning that the relationship between the social conditions (e.g., SES) and health is robust and will remain present even as the risk factors for disease and the leading causes of disease/death change.
This is because high SES individuals are afforded flexible resources that they can use to avoid risks and minimize the consequences of disease.
Discussions about race and racism can be inherently uncomfortable. Acts of racism can take all forms and it is important to consider intent versus impact when racist behavior is exhibited. Much of this is driven by societal norms and socialization.
This video in an excerpt from the 1994 film The Color of Fear. Eight men of different backgrounds, races and ethnicities were gathered by director Lee Mun Wah, for a dialog about the state of race relations in America as seen through their eyes. This is a response by David C. after hearing about experienced racism from other members of the group.
Your goal for each activity
Create a personal definition of white fragility.
Understand how societal norms can lead to power differentials that exist between racial groups.
Create a framework for discussions that may be difficult or challenging.
Create a framework for understanding why talking about racism may be more difficult for some than others.