Six of the nation’s leading health care systems today announced a first-of-its-kind collaboration to improve health care quality while reducing costs.Dartmouth-Hitchcock, Cleveland Clinic, Denver Health, Geisinger Health System, Intermountain Healthcare, and Mayo Clinic will join The Dartmouth Institute for Health Policy and Clinical Practice to share data on outcomes, quality, and costs across a range of common and costly conditions and treatments. The group will determine best practices for delivering care for these conditions and will rapidly disseminate actionable recommendations to providers and health systems across the United States. In addition to achieving better quality and outcomes, the Collaborative intends to improve the efficiency of standard clinical care delivery to reduce the per capita cost in these conditions and to keep costs in pace with the consumer price index.The Collaborative will initially focus on eight conditions and treatments for which costs have been increasing rapidly in recent years and for which there are wide variations in quality and outcomes across the country. The conditions and treatments will be: knee replacement, diabetes, heart failure, asthma, weight loss surgery, labor and delivery, spine surgery, and depression, which together amount to hundreds of billions of dollars in direct medical costs each year.‘Increasing the value of the health care we receive, by improving the measurable outcomes and reducing the cost for delivery, is the goal of accountable health care organizations,’ said Thomas A. Colacchio, MD, president of Dartmouth-Hitchcock Health and a member of the executive committee of the new collaborative. ‘While a number of different collaborations between our institutions have been in place for some time, this particular initiative is an important step in generating and sharing quality and cost information at a sufficient level to more rapidly produce a significant impact on the lives of many patients as we work to achieve the healthiest population possible.’The six health care systems, with a combined patient population of more than 10 million people, will share data on outcomes and clinical protocols for the selected conditions and treatments to arrive at optimal care models which can then be implemented by many other health care systems. The Collaborative aims to see these best practices replicated across the country. The Dartmouth Institute will coordinate data sharing and analysis, and report results back to the Collaborative members to inform development of best practices. The Dartmouth Institute has twenty years of experience analyzing Medicare claims data and disseminating the findings. This same expertise will be applied to the work of the Collaborative.‘There is broad support from other health care systems across the country who want to participate in the work of the Collaborative,’ said Dr. James Weinstein, Director of The Dartmouth Institute. ‘It would be enormously valuable to have the broadest geographic and demographic representation in the sharing of outcomes and experience.’The Collaborative will first analyze Total Knee Replacement, a procedure that is performed more than 300,000 times a year in the U.S., with a cost that ranges on average from $16,000 to $24,000 per surgery. Simultaneously, Collaborative partners will build the metrics to study the care of the other selected conditions at their centers and arrive at best practices. Work to define best practices in diabetes and heart failure care will begin early in 2011.‘If we know that the treatment path for diabetes at one institution results in better clinical outcomes, higher patient satisfaction, and lower overall costs, then there is knowledge to be shared and replicated in other institutions’ said Dr. Robert Nesse, Chief Executive Officer of Mayo Clinic Health System and member of Mayo Clinic’s Board of Trustees. ‘We need to learn from each other and put systems in place that ensure that every patient gets the very best, most appropriate care, every time.’Developing models to reduce cost, while improving quality, is only part of the equation. An equally important goal is to impact the clinical care of patients across the country by disseminating these models quickly and working with providers and health systems to adapt them to local conditions. ‘In my view, the most critical piece of this initiative is the transfer of knowledge to other health systems,’ said Dr. Glenn Steele, President and Chief Executive Officer of the Geisinger Health System. ‘We need to aggressively implement a rapid learning network to disseminate our work and assist other systems in implementing these best practices, especially the highest cost systems.’Through The Dartmouth Institute, the Collaborative will also draw on the work of the Center for Health Care Delivery Science, established at Dartmouth College in May, 2010 and dedicated to research, education, collaboration, implementation, and public outreach to improve health and health care for patients, their families, providers, and populations.Source: Dartmouth-Hitchcock. 12.15.2010###
Renowned fly fishing author John Gierach has his fished in and written about countless fly fishing destinations throughout the course of his storied career. So when Gierach calls a particular destination “my favorite place to go in the whole world”, serious anglers tend to take note.For Gierach, that place is Labrador. The video below shows him and fellow anglers netting one immense Labrador brook trout after another in the remote Canadian province.Labrador‘s vast labyrinth of fresh water lakes and rivers is home to the world’s heartiest stock of wild brook trout. Gierach even goes so far as to headily declare the waters of Labrador the “center of the spiritual universe for brook trout.”Over the year’s, brook trout have been allowed to thrive here because of the remote nature of the waterways and the extreme measures that anglers must take just to fish for them. There is no stocking whatsoever, and catch and release practices are strictly implemented by local guides and camp owners.“When I step out of a canoe, I’m not sort of guessing, I’m positive that no human has ever put their foot their before,” says long-time Labrador fly fisherman and managing partner of Three Rivers Lodge in the southwest Labrador, Robin Reeve. “My foot went there, and that’s really exciting to me. That’s what has driven me for the last twenty-something years. My passion is sharing this with other people.”The best brook trout fishing in Labrador can be broken up into three general watersheds: the Minip and the Eagle River water systems in the Southeast and the Mackenzie/Woods River system in the west.
Birmingham-born Irishman Dan Martin has withdrawn from the Vuelta a Espana following a crash on Friday’s seventh stage. Martin, nephew of 1987 world champion Stephen Roche, wrote on Twitter: “Nothing broken, but the most painful crash (I’ve) ever had. “Sad to leave the Vuelta but can’t race with these bids flying round my head. “I hit a hole or rock in the road. Down I went.” Martin also criticised race officials for compromising on rider safety. He added: “Stunned at UCI (International Cycling Union) commisaires lack of compassion. Should concentrate on rider safety and less on UCI fundraising.” Press Association The Garmin-Sharp rider, who has enjoyed a strong season which included a Tour de France stage win and victory in one-day classic Liege-Bastogne-Liege, suffered a blow to the head and pulled out prior to Saturday’s eighth stage. He will now recuperate before leading Ireland’s bid for glory in the Road World Championships in Florence on September 28.
The County Agriculture Coordinator (CAC) of Grand Bassa County, Joyce Kolvah, has disclosed that most subsistence farmers in her county have become vulnerable to climate change.She made the disclosure in an exclusive interview with the Daily Observer newspaper recently in Buchanan City.According to Madam Kolvah, climate change is a serious problem leaving farmers vulnerable in Grand Bassa County.“Climate change is a serious problem for farmers in Grand Bassa County. Even this January, the county is still experiencing constant rainfall causing flooding in the fields of vegetable farmers. Our rice farmers, who are in the uplands cannot burn their farms.She said that most farmers are still accustomed to the traditional upland farming methods in her county, making it difficult for them to succeed in agriculture.She disclosed that last year she noticed almost 36 farmers could not burn their farms to start the process of growing fresh crops.“This year it is raining more often, which could make the lives of farmers very difficult. They may not be able to succeed in farming to feed their families,” she reiterated.She said because of the effects of climate change, she is encouraging farmers in the county to prioritize lowland farming.However, Madam Kolvah stated that farmers are yet to grasp the concept of moving to the swamp for crop production.“Our farmers are so use to the uplands that they are not willing to move to the lowlands. We are asking them to compare the yield of their production from the lowland to that of the upland in the hoped they can learn a lesson.She said if the issue of climate change in the county is not fully addressed food production would remain scarce.Madam Kolvah also explained to the Daily Observer that she established a demonstration site at the county’s office to train farmers.The country specific report released on climate change in April, 2013, by the United States Forest Service (USFS) states that the major challenge in addressing climate change is how to improve the conditions of rural subsistence farmers whose livelihood squarely depend on agriculture.It furthers that the opportunity for Liberian farmers to rebuild their lives after the protractive civil crisis is to become resilient in the face of climate change.Lofa, Bong, Bomi, Cape Mount and other counties were named in the report as places where farmers are vulnerable to the effects of climate change.Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)
Win or lose, Hedges and Team Canada will be winning a medal this Saturday. In what was a fairly close game, Canada led 33-27 at the game’s halfway point, but proceeded to pull away in the third quarter. The third saw Canada outscore Great Britain 24-10, and never surrender the lead from that point.Canada’s Patrick Anderson was a man possessed on the court. In his 35:26 minutes of floor time, Anderson scored a game high 17 points, distributed a game high 11 assists, and pulled in 9 rebounds.Anderson also had 2 steals, and caused 3 turnovers, while drawing 7 fouls from Great Britain.- Advertisement -Baldonnel-born Bo Hedges also contributed in the big win. During his 25:38 minutes on the floor, Hedges scored 12 points, earned an assist and pulled in two defensive rebounds.The undefeated Canadians will now play for a gold medal in wheelchair basketball for the second straight Paralympic Games, but hopefully this year will produce the opposite results as in Beijing.In 2008, the Canadians lost to Australia 72-60 in the gold medal game. Coincidentally, the two powerhouses will once again square off for international wheelchair basketball supremacy.Advertisement