How do you measure a WELL building? Our Preliminary Audit


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We’ve completed our preliminary audit on the way to full WELL (@WELLCertified) certification.

The WELL Building Standard® is an evidence-based system for measuring, certifying and monitoring the performance of building features that impact health and well-being.

The audit includes testing of air, sound, light, and water, performed by an objective third party, in this case Delos (@DelosLiving). As most things I have encountered as a physician in the total health space, I learned that there is much more in our environments that can be measured and managed that we are taught about in medical school.

Fortunately though, there are fellow professionals in health, who are working along side us to make all of our work more impactful. You can see from the photos that the work involves applied science and the judgement to understand what is the best environment for the task. Many of the improvements to be made are not costly, all that’s needed is to know what’s needed.

The Preliminary Audit is a stage in the process to full WELL Building Certification. The Center for Total Health is the perfect place, on many levels, to go through the process, with many experts here to help us!

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Left to Right: Brendan O’Grady, WELL AP, Delos; Madeline Evans, WELL AP, LEED Green Associate, Delos; Kathy Gerwig, vice president of Employee Safety, Health and Wellness, and Environmental Stewardship Officer at Kaiser Permanente, and Carol Corr, AIA, LEED GA, EDAC, design program manager, National Planning and Design, National Facilities Services, Kaiser Permanente

Preview: Better Together Health Returns to CTH


Next week, the Council of Accountable Physician Practices (@accountableDOCS) will host the second in a series of Better Together events at the Center for Total Health. The program will focus on patient expectations accountable physician practices.

The transformation of American health care means more than reducing costs and improving quality scores. Healthcare systems have to focus on closing the gap between what patients actually want and what they are experiencing, especially for those with chronic illness. How can we bring true accountability to the system? The Council of Accountable Physician Practices and the Bipartisan Policy Center invite you to hear patients and doctors tell their stories of what patient-centered care really looks like.

To attend in person or gain access to the live webcast, REGISTER HERE.

The first event, focused on technology-enabled interactions between patients and physicians. Two of the personal patient stories shared at the event – Emma, a baby with severe burns, and Karen, an oncology patient- can be seen here.

If you have questions about this year’s event, please contact Elizabeth Keating via this link.


Health Care as Part of the Climate Problem and Part of the Climate Solution


Hospitals and health systems, particularly in the most industrialized settings, make a significant impact on the climate. In the United States alone, health care contributes 8 percent of the country’s greenhouse gas emissions.

Globally, communities are already suffering health impacts of climate change as a result of extreme weather, disruption of food and water supplies, wildfires, air pollution, mass migration and changes in prevalence of diseases — such as those borne by insects — all resulting in health consequences including asthma, cardiovascular disease and mental health problems, among many others.

Read more of this article here


Celebrate today!



A positive outlook on life can make a big difference to your overall well being. For a happier, healthier you, try a little gratitude.

Take a break from your day, especially during this busy time of year, to practice gratitude and to connect yourself and others.

Laugh! Laughing boosts the immune system, so catch up on a favorite TV show, watch that new stand up special, or connect with your funniest friend or colleague.

Brain Boost! Try something new to keep your mind stimulated – pick up a new instrument, whip up a new recipe, or discover a new route home from work.

Power Down! Don’t take your tech to bed; pick up an old fashioned book instead. You’ll sleep better and give your imagination some exercise, too.

Check out this infographic for more gratitude ideas and information, and find more suggestions here.

Kaiser Permanente Encourages Mental Health Awareness for National Depression Screening Day


After his wife died, Tom found himself in a very dark place and he didn’t know how to get out.

He knew he needed to do two things: Get a mental health evaluation, and if it confirmed what he already suspected was the case, he needed to get care.

“I was having some trouble with depression and anxiety,” said Tom, a Kaiser Permanente member whose real name is not being used to protect his privacy. “I was distraught after my wife passed away. I really needed someone to say, ‘Hey man, do this because you are screwing up.’ I wanted to get a handle on myself. I wanted to be less depressed. I just wanted to get a grip again.” 

October 8 is a day dedicated to helping people like Tom get the help they need. This year marks the 25th observance of National Depression Screening Day, dedicated to raising awareness about the importance of screenings for depression and related mood and anxiety disorders.

blue background with circular green that makes a tree. The blue inside the green makes a person with arms raised which is the trunk of the tree with leaves. National Depression Screening Day logo.

According to Screening for Mental Health, the non-profit organization that established this annual screening day, depression screening is effective in linking at-risk individuals with treatment options. A 2009 independent research study by the University of Connecticut and commissioned by Screening for Mental Health showed that 55 percent of participants who completed an online depression screening and who agreed to participate in a follow-up survey sought depression treatment within three months of the screening.

Kaiser Permanente’s offers an online self-assessment tool that can be used by members and non-members to help identify signs of depression and learn more about it.

Committed to total health

Kaiser Permanente members like Tom can be assured that providing high-quality mental health care is a key priority for the largest integrated non-profit health care system in the nation. With its mental health therapists, psychiatrists, primary care physicians, and pharmacists coordinating care for its patients, the organization is well-positioned to meet the needs of the growing population of Americans in need of mental health care, and ultimately provide a model for the delivery of such care in the community.

“We are committed to the total health of our members, and that means caring for the mind, body and spirit,” said Patrick Courneya, MD, executive vice president and chief medical officer at Kaiser Permanente. “The goals of National Depression Screening Day are the same ones our primary care physicians and behavioral health specialists pursue every day. We strive to eliminate any stigma associated with depression, anxiety and any other similar conditions and to provide the tools and care our members need for emotional and mental well-being.”

Learn more about Kaiser Permanente’s integrated approach to health care by reading the rest of the article here.


Another rung on the ladder towards achieving a high-performing health care system – to be or not to be?


Does the word learning associated with a health care system cause concern? Most people want to be assured that their care providers already understand all there is to know. In fact, a learning health care system is synonymous with care that is constantly evolving and improving based on new evidence. The concept of creating a voluntary certification for health care organizations to achieve designation as a learning health care system was fodder for an exploratory discussion among a small group of health care thought leaders at a September convening of the National Academy of Medicine in Washington, DC.

As a representative of the nation’s largest, private, not-for-profit health plan, serving more than 10 million people, the Kaiser Permanente Institute for Health Policy was invited to join the discussion. Also present were experts from academia; government agencies such as the Centers for Disease Control and Prevention, the Food and Drug Administration, and the Agency for Healthcare Research and Quality; The Joint Commission; Association of American Medical College; American Medical Group Association, and others.

Best-care-Lower-Cost-300x225In its 2012 publication, Best Care At Lower Cost: The path to continuously learning health care in America, The Institute of Medicine laid out a definition of a learning health care system, which is a key component to achieving higher quality care at lower cost. “A learning health care system is one in which science, informatics, incentives, and culture are aligned for continuous improvement and innovation, with best practices seamlessly embedded in the care process, patients and families active participants in all elements, and new knowledge captured as an integral by-product of the care experience.”

With this goal in mind, the group spent time debating the nomenclature – learning health care system. To me the word “learning” denotes humility, but more so suggests to consumers and those of us on the inside that health care is dynamic, self-aware, and willing to change to make good use of new information. But other attendees suggested that the word might possibly have the counter-effect, raising anxiety in consumers who believe that the health care system is fully informed.

The primary goal of creating this certification would be to accelerate progress toward continuous learning in health care to improve health outcomes. One might logically ask: has anyone seen a learning health care system before, and how would we know when we’ve come in contact with one? Well, a number of health care organizations deem themselves as such, and are also acknowledged by others in the field, accordingly. Not surprisingly, these organizations are kindred spirits – they resemble one another in more ways than one. Some household names are: Kaiser Permanente, Geisinger, Intermountain Health Care, Mayo Clinic, and the Cleveland clinic. On the public side, the Veterans’ Administration is also considered a learning health care system by many. When we examine these organizations, we find common characteristics that exist among them that are in concert with the idea of learning. Included are visionary leadership, data-enabled care, complete transparency (or a goal thereof), incorporation of new knowledge (through research activities) into care processes, promotion of patient engagement activities, and seeding of innovative ideas for scale and spread. Several in the room encouraged the group to think about implementing a tiered certification program in consideration of the needs of the smaller, and in some instances, rural health systems that may not have the resources/capital and full complements of the larger systems named above, or the means to get there.

In contemplating next steps, this certification could offer other potential values. On one hand, it could be something that distinguishes a hospital system and serve as a differentiator in the marketplace, or a “feather in their hat,” that allows them capitalize on the designation of a learning health care system as marketing tool. Likewise, the value of the designation might benefit consumers who are, increasingly, faced with decisions about their health care – plan choices, provider choices, and care sites. One might argue that it’s not hugely different from the mom who seeks out and chooses to deliver her baby at a hospital that has achieved “mother-friendly/baby-friendly” designation for its maternity program.

If we agree that this certification would yield a cadre of high-performing health care institutions and the by-products would include continuous learning, improvements in care delivery, organizational goals matched with patient goals, increased transparency, improved health outcomes – what is the barrier to forging ahead? Or is this just too disruptive to the status quo? While many will need to take a multitude of steps to become a learning system, the good news is that this is not uncharted territory; so existing models such as Kaiser Permanente, and others, can lead the way.


Rx2Move Graphic

A Prescription to Move (#Rx2Move): How Health Care Providers Can Encourage Physical Activity for Patients and Communities


Only about half of Americans meet the recommended 150 minutes a week of moderate aerobic activity. To help get people moving, health care providers need to become better health advocates. The first step is spreading the word, which is why the Kaiser Permanente Institute for Health Policy and American College of Sports Medicine are offering three strategies for health care leaders to promote physical activity and to shape environments to support active living. These include: encouraging physical activity in conversations with patients, redesigning health care environments, and investing in community health.

“Health care providers are under pressure to find new and more effective ways to help patients address obesity and other chronic diseases that are influenced by inactivity,” said Brian Raymond, MPH, senior health policy consultant at Kaiser Permanente. “This campaign is about changing how health care providers perceive their role in improving physical activity and ultimately encouraging innovative action.”

Titled, A Prescription to Move (hashtag #Rx2Move), the campaign includes three webinars, a policy brief, and a series of infographics that highlight the various ways that providers can promote active living and make environments more suitable for physical activity. Here’s a little more on the three core principles.

  1. Having Conversations with Patients – Making Exercise a Vital Sign: Conversations between primary care providers and patients about physical activity and more active lifestyles can improve health.
  2. Designing Active Health Care Environments: Design innovations adopted by hospitals and health systems can encourage physical activity and give patients, visitors, and staff opportunities to engage in “active transportation” (walking, biking, and using public transit).
  3. Investing in Community Health: By advocating for and investing in active transportation, public recreational spaces, and school-based health initiatives, health care providers can promote more active, healthier communities.

There are three ways you can support #Rx2Move:

  1. Join the #Rx2Move Webinar Series and Pass along the Invite

The first of a three-part Rx2Move webinar series, Making Physical Activity a Vital Sign, is scheduled on Tuesday, October 13, 12:30-1:30 PM Pacific/ 3:30-4:30 PM Eastern. Registration and additional information is available at:

  1. Spread the Word about the #Rx2Move Online Issue Brief

Our new online issue brief, How Health Care Providers Can Encourage Physical Activity for Patients and Communities, highlights emerging strategies health care providers are using to encourage exercise amongst their patients and the communities they serve. The issue brief is available at:

  1. Participate in the #Rx2Move Social Media Campaign

Join us in using Twitter, Facebook and Linkedin to raise awareness about the #Rx2Move key messages. Infographic banners and sample messages supporting the social media campaign are available at:   ‎We encourage you to use the #Rx2Move hashtag in your digital conversations.

Caffeine: How Much is Too Much?


Sure, many of us love our cup of joe every morning.  Some might like it so much that one cup becomes three or four.  We joke about it.  We laugh about it.  It is part of our culture as Americans.

But what about caffeine and kids?  Not only are kids drinking soda, they are also downing caffeinated energy drinks and coffee-based beverages.

feature-boy-doing-homework-274x168As kids head back to school, it’s a good time to consider just how much caffeine our kids are consuming; more importantly, how much is safe.  As school gets underway and kids must manage not only their academics but also extracurricular activities and jobs, it is easy to turn to caffeinated beverages for a quick pick me up.  But that habit can quickly grow out of control.

This episode of Total Health Radio can help.  Called Caffeine and Kids: What’s the Buzz?, the show shares one family’s personal story of the risks of caffeine consumption in kids.  It also features tips from a physician on recognizing signs of excessive caffeine — and for helping your kids know how much is enough…versus too much.

Summer is fun. Here’s how to keep it safe, too.


Excited about the arrival of summer? For good reason. Warmer weather brings with it favorite activities — vacations, swimming, camping, cookouts and lazy days in the sun.

To access a full-size PDF of perfect for printing, click here.

To access a full-size PDF of this infographic perfect for printing, click here.

But summer also means something less fun: an increase in visits to the emergency room. With kids out of school and spending more time outdoors — and especially around Independence Day — safety becomes a very real concern.

To help protect yourself and your family this 4th of July holiday weekend and in the coming months, here are highlights from the Centers for Disease Control and Prevention, the Red Cross and Kaiser Permanente on how to have a safe — and fun — summer.

Water Safety

Swimming and cooling off in the pool is one of the best things about summer. Be smart, and do it safely:

Spending Time in the Sun and Heat

When you’re spending time in the sun – or even if you are in the shade but the temperature is climbing – protect yourself from the sun’s rays and the summer heat.

  • Heat-Related Illnesses. Take them seriously and drink plenty of water. Dehydration, heat exhaustion and heat stroke escalate quickly and can be especially serious in children and the elderly.
  • Know Your SPF. Not all sunscreens are created equal. Learn why.
  • Sun Safety and Skin Cancer. Guard yourself and your family against the long-term dangers of the sun.

Healthy Getaways

Whether you’re taking a road trip with friends and family or the vacation of your dreams, plan ahead for a safe time away from home.

  • Camping. Keep campouts fun by planning ahead. Learn the ins and outs of insect repellent, safe food and water, campfires and cookouts, and emergency preparedness.
  • Travel. Before you embark on your journey, let your travel clinic or physician help. From vaccines to prescription medication, learn how to plan your travels with your health a priority.

Cooking and Eating

  • Summer Food Safety. Find out how to best protect you and your family from food poisoning, foodborne illnesses, cross contamination — and learn and the importance of cooking temperatures.
  • Grilling Safety Tips. When dealing with open flames, propane, charcoal or starter fluid, help prevent burns, injuries and damages with these precautions and general guidelines.

Injury Prevention

  • Sports. Know how to help your children prevent injuries from sports and recreational activities — including using the right protective gear or equipment.
  • Technology and Youth Violence. Learn more and talk with your kids about the emerging public health problem of “electronic aggression” among young people.

Bottom Line: Be Prepared

Even with the best planning, accidents still happen. You can ensure you’re ready to help if the need arises with professional training. Find a Red Cross class in First Aid and CPR near you and get certified — or take a refresher course.

Keeping the Men in Your Life Healthy


Screen Shot 2015-06-29 at 4.22.59 PMMany men avoid visiting the doctor. We often joke about it, but when our dads, brothers, partners or friends put off having something looked at, it can result in very real consequences. Even though women on average visit the doctor 20 percent more often than men, it is men who have much higher hospitalization rates for preventable conditions.

So why do men seem to go out of their way to prevent calling the doc? Many men simply aren’t used to communicating about how they feel and aren’t comfortable asking for help.

Total Health Radio has dedicated an entire podcast episode to this topic, including tips for supporting the men in your life in staying healthy. You can check it out — along with additional information and resources — at its official web page. You can also listen to it here, via Stitcher

And to see the above infographic in its entirety, click here for the full-sized version.