Healthy Living

How Innovation brought Exercise as a Vital Sign to Life

Two years ago, a team from Kaiser Permanente’s Innovation Consultancy was given the task of transforming patient data on exercise into actionable information that health care providers could use to encourage healthy behaviors. They called this initiative Project Move.

In part five of her seven-part blog series on Exercise as a Vital Sign (EVS), Dr. Latifat Apatira describes how the Innovation team went about the work of better understanding patients’ barriers and motivations regarding exercise.

The Innovators traveled to several Kaiser Permanente regions to analyze interactions between health care providers and members. They learned that patients are less active because of busy lifestyles. As for health providers, it was determined that they did not have time nor established resources to address their inactivity.

The group came up with several ideas to make EVS more actionable that are outlined in detail in the EVS blog, including screening questions from medical assistants and licensed vocational nurses that get entered into the medical record and passed along to the next level of care. Depending on how members answer the first round of questions, follow-up questions can lead to exercise prompts or referrals to health and wellness coaches.

While the results of the work are still being analyzed, new innovations are underway, including a website that helps members find resources for physical activity.

The Thursday Dish: Healthy Stuffed Rainbow Peppers

Stuffed-Rainbow-Peppers_593x473pxToday, it’s another tasty recipe from the Food for Health blog — but this one has a twist.

There’s a great story behind this recipe, one that features a 12-year-old being recognized for her culinary creativity with an invitation to dine with First Lady Michelle Obama at the White House.

According to our friends at Food for Health:

Grace Wetzler is budding chef and healthy cooking advocate who took on the First Lady’s 2014 Healthy Lunchtime Challenge and decided to submit her recipe for healthy stuffed rainbow peppers into the contest.

“I was on spring vacation when I heard about the contest from my cousin. I thought about it and thought about it and tried to come up with some recipe ideas. And then the recipe just came to me on a whim. I put the ingredients together and it just worked! So I submitted my entry.”

Indeed, out of approximately 1,500 entries that were submitted, Grace’s delicious and nutritious stuffed rainbow peppers were among the 54 winners that made the cut. Grace was eventually notified that she was a winner and that she’d be headed to the White House to celebrate and enjoy a State Dinner with the First Lady and other dignitaries.

This colorful recipe is a great example of how Grace is already showing imagination in her cooking.  And it has the nutritional stats to back it up — 392 calories, 10 grams of fat, 40 grams of carbohydrates, and 27 grams of protein.

Check out the recipe here.

Helping patients ‘Find Their Thing’ is key to Exercise as a Vital Sign

Latifat T. Apatira, MD, MPH, fourth-year internal medicine and preventive medicine resident, believes that in order for Exercise as a Vital Sign (EVS) to succeed, health care providers need to help connect patients with resources in the communities where they live – outside of the exam room.

Part four of her seven-part blog highlights the community-clinic component of EVS, in which health care providers point their patients to a wealth of diverse programs and initiatives for fitness – what Dr. Apatira calls “finding their thing.”

The blog features several examples of community-clinic integration that Kaiser Permanente is exploring, as well as Dr. Apatira’s ideas of how to link patients to community resources.

Resources include:

  • City/Community Listings – Most official city websites have listings for activities that support physical activity.
  •  Parks Prescription – A movement to strengthen connections between the health care system and United States public lands, Park Prescription works with providers to encourage patients to get physically active at their local public parks.

Read the full blog to see more of Dr. Apatira’s health and fitness tips, including apps that track exercise levels.

In search of healthy recipes? Look no further than the Food for Health blog.

Has this ever happened to you?  You visit your local Farmers Market, feel overjoyed by all of the amazing produce, come home with an abundance of fresh fruits and vegetables — and then feel stumped about what exactly to do with your bounty.cherry-tomatoes-593x395

We’ve all been there.  Luckily, a new blog recently launched dedicated entirely to sharing recipes for healthy dishes.  Food for Health is published by Kaiser Permanente and features favorite foods of doctors, nurses and other organization leaders.  Check out this colorful recipe for roasted cherry tomatoes.

You can find many more recipes at the blog — like Mojito Fruit Salad, Mango Guacamole, and Saffron Yellow Pepper Soup, to name a few — so stop by and find a fresh new dish to try.

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.

Advice for New Moms’ First Hours, Days and Weeks Following Childbirth

After the BirthTotal Health Radio has had straight talk about pregnancy and truth telling about childbirth.  But what about those first days and weeks after giving birth?  In this episode, we focus less on the baby and more on the changes you are going through during that time – what’s normal, what’s not, and what may surprise you.  Packed with tips for making new moms more comfortable and advice on how spouses and partners can best provide support, this show is valuable listening for expectant parents – and the people who love them.

For more information on this episode and for links to additional resources every new mom should have at her fingertips, check out the Total Health Radio website.

Doc Talk: Finding the Right Way to Discuss Exercise as a Vital Sign

Talking about the benefits of physical activity is a win-win-win proposition for doctors and patients. Members gain the benefits of physical activity first hand. Clinicians have a technique for incorporating exercise into every visit. And the system as a whole wins when quality improves.

This is the impetus behind Kaiser Permanente’s Exercise as a Vital Sign initiative, in which medical assistants or primary care providers ask patients how many minutes they exercise per day and per week.

But finding the right way to talk about exercise during an appointment – when members have lots of pressing things on their mind – can be a challenge, especially given the limited time available for this very important interaction.

Dr. Latifat Apatira’s latest blog, the third in a seven-part series, addresses clinicians’ concerns about how to bring up physical fitness during an appointment. She offers techniques for ways to get in a few sentences about exercise while examining other vital signs, and likens doctors and medical assistants encouraging physical activity to dieticians counseling members on nutrition.

During each visit, despite a variety of circumstances, Dr. Apatira makes an effort to incorporate Exercise as a Vital Sign, an important component of Kaiser Permanente’s Total Health vision that looks at an individual’s physical, mental, and social wellbeing.

Physical Activity Saves Lives

We are hearing about it everywhere, and now there’s even more data to back it up. Two recent studies show physical activity reduces pulmonary disease and heart failure.

The Centers for Disease Control and Prevention has an entire plan — The National Physical Activity Plan — dedicated to making it possible for Americans to be physically active and to live and work in places that support that activity.

For info on how much physical activity is right for you and your family, check out the CDC guidelines — they have them for children and adolescents, adults, and older adults.

Walking the Talk: Despite Challenges of Implementation, Exercise as a Vital Sign Initiative is Thriving

EVS_Blog2_doc_patientIt is well known that 30 minutes of moderate physical activity, five days a week, can over the long haul minimize the effects of many chronic diseases. Kaiser Permanente has made it a goal to ask all patients their exercise information – How many minutes per day? How many days per week? – in an effort to help them become more active and therefore more healthy.

This initiative is called Exercise as a Vital Sign, and while it may seem simple for all medical assistants and primary care providers to ask their patients those two questions and record the data in the electronic health record, it is more complex than that. Even now, five years since the first members were being questioned, EVS continues to be a work in progress

Read Dr. Latifat Apatira’s article, the second of a seven-part series, about how enthusiasm for the project remains high, despite the challenges. Learn from experts why Exercise as a Vital Sign is at the heart of Kaiser Permanente’s Total Health strategic vision, where Total Health is defined as a state of physical, mental, and social well being.

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