Center for Total Health

A Visit from George Washington University Nursing Students

Last week, the Center for Total Health — along with Lu Casa, MSN, CRNP, CTTS — welcomed accelerated students from George Washington University School of Nursing (@gwNURSING). As always, we enjoyed hosting the future leaders of health, and hearing their ideas and questions about health care delivery. You can read more about the visit here.

GWU Nursing Students visit the CTH.

GWU Nursing Students visit the CTH

To see more pictures of their visit, click here.

What Exactly IS the Trail Modeling & Assessment Platform, and Why Do We Care?

Our guest blogger today is Tracy Hadden Loh with the Rails to Trails Conservancy.

Tracy Hadden Loh (right) and colleague with the pedestrian counter outside the CTH.

Tracy Hadden Loh (right) and colleague with the pedestrian counter outside the CTH. The counter was installed on one of the coldest days of this winter (high of 10 degrees!).

The Rails-to-Trails Conservancy is a national membership-based nonprofit dedicated to creating a nationwide network of trails from former rail lines and connecting corridors to build healthier places for healthier people. We serve as the national voice for more than 160,000 members/supporters, 30,000 miles of rail and multi-use trails, and over 8,000 miles of potential trail. When RTC was founded in 1986, there were less than 250 miles of rail-trail in the United States. Today, there are more than 21,000 miles of trails of serving some tens of millions of people each year.

However, that mileage number is about all we’ve measured with any precision. We don’t actually know how many people in the United States use trails each year. We know that these miles of trail are a great way to create healthier places and healthier people – for example, a recent meta-analysis of published research on the cost-effectiveness of population-level interventions to promote physical activity found that a rail-trail was the #1 most effective intervention. On the basis of similar evidence, the Centers for Disease Control and Prevention recognize trails as a proven strategy that works to increase physical activity, reduce risk of chronic disease, and improve mental health and wellness. So we know we’re on to something good – but how good? When it comes time to make room for trails in the budget, can we show a dollars-and-cents return on investment?

To that end, RTC has launched the Trail Modeling and Assessment Platform (T-MAP), a three-year research initiative to measure, model, and value trail use in the United States. The first phase of this project involves establishing a national network of trail traffic monitoring stations, so that we can continuously measure trail use across the different climactic zones of the US. We’ll use these data to develop two tools: a trail use demand forecasting model to estimate traffic volumes on existing trails or predict volumes on future trails; and a health impact assessment calculator for estimating health care costs avoided due to physical activity on trails.

Taken literally, RTC’s focus on “health” means that there are times when our mission overlaps with that of hospitals and health care systems. Under the Affordable Care Act, non-profit hospitals are now faced with a requirement to assess the health needs of the community, and based on that assessment draw up an implementation plan. We see that as an opportunity to make the case for trails!

Our partners at the Kaiser Permanante Center for Total Health already get it. Located in the heart of downtown Washington, DC right on the Metropolitan Branch Trail, the CTH is helping us implement T-MAP through the installation and maintenance of their very own trail traffic monitoring station, contributing critical data to the project from a unique trail location that is co-located with an urban sidewalk, and dominated by pedestrians. As they learn about how the trail relates to their facility, we’re learning about the trail and collecting the data necessary to accurately estimate the true magnitude of trail use in the United States, and what it’s worth.

 

Data from the CTH Pedestrian Counter

Data from the CTH Pedestrian Counter | February 15, 2015

You Too Can Have Healthy Meetings!

Panel discussion featuring, from left:  Kathy Gerwig, Marilyn Chow, Kelly Kearney, and Erin Meade.

Panel discussion featuring, from left: Kathy Gerwig, Marilyn Chow, Kelly Kearney, and Erin Meade.

On Monday, February 2nd, our friends at Kaiser Permanante’s Garfield Innovation Center hosted a great event focusing on delicious, healthy food. “A Taste of the Garfield Center” featured local Bay Area caterers to showcase menus that adhere to Kaiser Permanente’s “Healthy Picks” policy, along with a few presentations on healthy meeting and working practices.

I was certainly humbled to be on a panel with Kathy Gerwig, Marilyn Chow, both of Kaiser Permanente, and Kelly Kearney of Pacific Fine Foods (a favorite at the Garfield Center) – three incredible women. I was inspired that 100 Kaiser Permanente employees made time in their busy schedules to attend the event so that they could go back to the office with a better understanding of healthy picks to share with their teams. The audience included administrative assistants, lawyers, nurses, designers; many expressed trepidation about trying to change habits from their relatively junior positions. “After all,” said one assistant, “we aren’t all vice presidents.” Marilyn’s answer – sincere, honest, and inspiring – was simply, “We all lead from where we are.”

Kelly and the Pacific Fine Foods Team (showing off their VERY delicious kale chips)

Kelly and the Pacific Fine Foods Team

The Center for Total Health was one of the earliest adapters of the Healthy Picks guidelines, about a year ahead of schedule. As a team, we love helping our guests explore healthy AND delicious menus (ideally paired with some physical activity) for their meetings and events, and we are lucky to get to work with colleagues from inside and outside of the organization.

Now, I’m going to challenge YOU to make your next meeting healthier! Here are some tips and tools to help you start:

1. Get agreement for the concept of healthy meetings as a concept before introducing it for a specific meeting. Then hold people to it (especially the boss and other leaders).
2. Ease in! You don’t have to do a 180 degree change overnight. Try making healthy substitutions (lowfat yogurt, leaner meats, more fruits and vegetables) to start.
3. Healthy food can be tasty and fun – look for menu items with herbs and spices instead of sauces, and consider interactive options like a build your own salad bar to get people engaged in (and excited about) what they’re eating. Bonus: no one can complain about what’s in their salad!
4. If you’re ordering from a large chain, they are legally required to provide nutrition information on their menus. Use it! If you aren’t sure what is best, try consulting the USDA’s Healthy Plate guidelines or Kaiser Permanante’s own Healthy Picks guidelines. You might also like our Healthy Meetings Essentials toolkit, which has information about menus, activity, sustainability and more!

We’d love to hear more suggestions from you, and let us know if you’re working on making your meetings (or work environment) healthier!

Total Health Includes CPR Training

Today, the Center for Total Health team renewed our CPR certification. Most people will never have to preform CPR, but it’s an important skill to have. According the American Heart Association, 70 percent of Americans may feel helpless to act during a cardiac emergency because they either do not know how to administer CPR or their training has significantly lapsed. Add to that the fact that about 88 percent of cardiac arrests occur at home, and you can see why we should all be trained – the life you have to save may well be that of a loved one.

CTH team, recertified

CTH team, recertified

Doubt that CPR can save a life, or that your loved ones will ever need it? Check out this story about a triathlete whose life was saved by CPR during a road race.

If you aren’t CPR certified, or you don’t feel confident that you would know what to do in an emergency, you can find a course here.

When it Comes to Health Care, What Matters Most to Consumers?

Introduction from Bernadette Loftus, MD

Introduction from Bernadette Loftus, MD

Anyone who has had to choose a health insurance plan knows how confusing the process can be, even with the help of a friendly human resources professional. For the millions of Americans purchasing their coverage through exchanges, the process can be even more daunting.

Many consumers struggle to determine which plan is going to provide the best value – the coverage they need at a price they can afford. Dozens of organizations and publications – from the National Committee for Quality Assurance (NCQA) to Consumer Reports – rate health care plans each year. Some of these rankings are meant for the average consumer, but many are for industry insiders – laden with clinical terminology and detailed beyond what most people want to know.

On October 28, the Mid-Atlantic Permanente Medical Group and the Center for Total Health hosted what we hope to be the first in a series of events examining how we can translate these often technical ratings into something more consumer-friendly and how best we can get those ratings into the hands of the consumers.

Helen Burstin, MD, MPH, FACP, from The National Quality Forum, and Margaret O’Kane, from NCQA, set the tone for the day, reminding us that the patient must be at the center of all the industry does – not just care delivery. We must seek to provide our patients with the information they want in a way that is meaningful and accessible for them, while remembering that health care is a personal experience and much of what matters most cannot be measured. Dr. Burstin reminded us: Not everything that counts can be counted; not everything that can be counted counts.

Consumer Voices Panel

Consumer Voices Panel

Kaiser Permanente’s own Bernadette Loftus moderated a panel to understand what counts for consumers. Doris Peter, PhD, of Consumer Reports, emphasized that people can handle data.

“Just look at ESPN,” she reminded the audience, daring them to find a website with more data collected.

Dr. Peter and her co-panelists, Tina Reed of the Washington Business Journal, and consumer Iris Molotsky, agreed that uniform, consumer friendly terminology is a key step to making quality ratings more accessible for consumers. Ms. Molotsky, the president of Dupont Circle Village, a neighborhood association in Washington, DC, emphasized that “even well-educated, well-read, well-traveled” members of her community are confused by the complexities of standard health care language.

This sentiment was echoed by the last panel of the day, featuring the chief health officers of the District of Columbia, Maryland, and Virginia, as they lead their populations and health departments in the second open enrollment on the exchanges.

Great connections were made during the Mad Tea Party

Great connections were made during the Mad Tea Party

A Perfect Storm Brings Health Care, Government and Business Together for a More Sustainable DC

There was a “perfect storm” of activity in the nation’s capital last week, and if you weren’t tuned in closely, you might have missed it.

The Sustainable DC pledge awaits formal signatures from health care representatives signifying their commitment.

The Sustainable DC pledge awaits formal signatures from health care representatives signifying their commitment.

This perfect storm was not another Superstorm Sandy. In fact, one might argue that one of the aims of this perfect storm was to build resilience to any such storms in the future. This perfect storm brought together representatives from 21 different health care organizations and local government officials at Kaiser Permanente’s Center for Total Health pledging to make the District of Columbia “the most sustainable city in the United States.

So what makes this newsworthy? The health care sector is certainly no stranger to coming together under the umbrella of sustainability. Over the past 20 years, the sector has been leading its very own “green revolution,” with hospitals and health care systems of all sizes looking hard at their contributions to environmental waste and pollution and what they must do to flip the equation and support more environmentally sustainable health care approaches.

What makes the Sustainable DC effort special is its focus on a single urban community, on bringing together leaders from health care, government and business sectors in a particular place, concentrating their efforts across governance, jobs and the economy, equity and diversity with the goal that, “By 2032, the District will be the healthiest, greenest, most livable city in the nation by using sustainability solutions to address core challenges.” The Sustainable DC plan outlines specific goals, targets and actions to get there. And the plan makes it clear that health care organizations to be at the table to bring the mighty vision to fruition.

Hospitals in America contribute an estimated 8 percent of greenhouse gas emissions, generate more than 2 million tons of waste each year and draw upon natural resources like water in ways that often counteract efforts to support the health of individuals and communities. Recognizing this paradox, many health care leaders have joined efforts like the Healthier Hospitals Initiative, Practice Greenhealth and Health Care Without Harm to green their own health care systems.

Kathy Gerwig, chief environmental stewardship officer for Kaiser Permanente, chronicles this green movement in her recent book, Greening Health Care: How Hospitals Can Heal the Planet. In the book, she notes the reasoning behind why health care organizations would move to join forces with each other and government to move the needle on environmental health:

“In the final analysis, most health systems engage with their communities not because they are incented to do so by federal and state tax law, but because they are mission-driven organizations that care deeply about the health of their communities. They know that individuals’ health depends on the health of the communities in which they live, work, learn, and play, and that the health of those communities depends on a healthy environment—health-sustaining air, water, soil, and all natural resources. They strongly believe, on the basis of compelling evidence, that when they invest their dollars and their expertise in promoting healthy social and physical environments, they are benefiting their communities and contributing to the health of everyone.”

That mission-driven energy was palpable on October 23, 2014. The energy in the room was exciting, collegial and activated. There was much talk of the sustainability progress that is already converging in DC – from an extensive array of green roofs and LEED-certified buildings across DC to the build out of the Metropolitan Trail to provide safe, physical activity and active transportation options. And there was a clear conviction expressed by health care leaders who were gathered, as well as the Mayor’s office, that this coming together for a more sustainable DC was just setting the stage for a convergence of efforts that would echo progress even beyond DC limits.

We can only hope that, as DC leads the way in sustainability, so goes the rest of the country.

Representatives from DC area health care organizations gather with Mayor Vincent Gray at the Center for Total Health after the signing of the Sustainable DC pledge.

Representatives from DC area health care organizations gather with Mayor Vincent Gray at the Center for Total Health after the signing of the Sustainable DC pledge.

Kaiser Permanente applauds the Sustainable DC plan, and we are pleased to be among the pledge-signers and the hosts for this momentous step forward. We have pledged our support and look forward to working with fellow health care system leaders to advance the goals outlined in the plan.

Kaiser Permanente physician director for the Center for Total Health, Ted Eytan, along with Keith Montgomery, executive director for the Center, nicely set the stage for the day’s event in their welcome remarks. Ted offered his follow-up reflections in a blog post that summarized the vision for total health that everyone in the room intuitively if not concretely echoed that morning. He writes, the Sustainable DC plan is “not just about the environment, it’s about everything that goes into creating an ‘equitable, prosperous, society.’”

You can watch the full signing ceremony in this video.

Photo of the Day: Human Resources in Action

The Center for Total Health team was excited to host our colleagues from the area Human Resources Department for their quarterly meeting yesterday. They were truly models of health, with a meeting that included skits, walking breaks, and healthy meals. We asked them all to strike a favorite pose or stretch, and here’s what we got.

Action!

When asked what their passion in health is, we heard great responses ranging from service to innovation to happiness. Here’s to this great group for working hard to keep the Kaiser Permanante team healthy and happy!

More on Community Access to Healthy Foods with Elevation DC

On Tuesday, June 24, an panel came together for a discussion about food in our neighborhoods – where it comes from, what barriers keep healthy foods from some communities, and solutions that are working. Kaiser Permanente and Elevation DC hosted the discussion right here at the Center for Total Health.

Food writer Mary Beth Albright moderated a lively conversation among Laine Cidlowski, an urban sustainability planner for the D.C. Office of Planning; JuJu Harris, culinary educator with the Arcadia Center for Sustainable Food and Agriculture; and Ted Eytan, MD, physician director at the Center for Total Health. Panelists shared different perspectives about D.C.’s food system and considered the economics of good health.

This discussion was a prime opportunity to consider the consequences as well as the opportunities related to food in neighborhoods. According to Cidlowski, communities of high poverty that are more than a 10-minute walk or one bus transfer away from a full-service grocery store are considered food deserts. D.C. liquor stores and fast food restaurants dominate some of the most vulnerable communities where grocery stores have gone out of business or have never existed. This condition leaves residents wanting – and to a large extent, vulnerable to chronic illness and low quality of life.

Organizations such as Arcadia farms, with its mobile market, are filling the gap by bringing fresh produce to people where they live and teaching residents about food selection and meal preparation. Harris, Arcadia’s culinary educator and SNAP outreach coordinator, hosts cooking demonstrations at the markets to help engage customers about what to do with the produce once they get home. She shared that even a 10-minute walk can sometimes be too much for people living in poverty.

Community gardens, gardening plots and urban farms are also part of the solution, however Cidlowski shared that with so much demand, there are now wait lists – some as long as three years – to use some green spaces. But with revitalization efforts in the city, much consideration is being given to food access in the District.

Eytan offered the physician perspective. He highlighted the connection between food and health and why this issue is integral to Kaiser Permanente’s total health mission. “We want to provide health care, not just sick care,” said Eytan, who encourages patients to make time for physical activity and healthy meal preparation, but acknowledges that healthy choices are difficult to make in many neighborhoods.

Enjoy more food for thought—read Elevation DC’s full story.

Secretary Hunt with NHS and Kaiser Permanante delegations

NHS and Secretary of State for Health, Jeremy Hunt, Visit the CTH

Representatives from the National Health Service of England, along with British Secretary of State for Health, Jeremy Hunt, paid a visit to the Kaiser Permanente Center for Total Health on June 2. This marks the second visit to Kaiser Permanente for the Secretary.

This time, he spent a half-day contemplating many issues in health care which we all acknowledge are global in nature. Representatives from Kaiser Permanente shared the health care organization’s deep knowledge and experience regarding topics such as management of complex patients with chronic disease, leveraging technology to augment care, and physician management.  The exchange was interactive and lively.

Taking part in the discussion from Kaiser Permanente were Kim Horn, president of the Mid-Atlantic States region; Bernadette Loftus, MD, associate executive director of The Permanente Medical Group; Philip Fasano, executive vice president and chief information officer; Murray Ross, vice president and director of the Institute for Health Policy;  Ted Eytan, MD, physician director for the Center for Total Health;  and Walter Suarez, MD, executive director of health IT policy and strategy.

Phil Fasano, CTO of Kaiser Permanante, leads discussion.

Philip Fasano, executive vice president and CIO of Kaiser Permanente, leads discussion.

We all agreed that we work for the patients and our decisions should be guided by that core belief. For our British colleagues, the afternoon session triggered new ways of thinking about and approaching the challenges faced “back home.”

Kaiser Permanente is committed to helping shape the future of health care globally. Sessions like this one and other international learning forums are coordinated by Kaiser Permanente International (KPI).

The Team

Inaugural Build Your Best Life Health Festival

On Saturday, May 31, the Center for Total Health hosted the first-ever Build  Your Best Life Total Health Festival in partnership with Capital Pride, Whitman Walker Health and several other organizations. We were excited to welcome more than 150 guests from the community to receive health screenings and information, enjoy a healthy snack, and even do a little dancing!
pride dance
It was a great day of learning, talking, and listening to better understand and navigate LGBT health in the national capital region, complete with workshops and presentations on topics from dating to retirement. Festival participants included many great partners:

• Kaiser Permanente
• Whitman-Walker Health
• AARP DC
• SMYAL
• Casa Ruby
• Mixology – Matchmaking with a Twist
• Rainbow Families DC
• SAGE Metro DC
• Freestyle Fitness
• Mary’s House for Older Adults
• Gay Love Project

A huge thanks to all who stopped by and our amazing partner organizations! Happy Pride!

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