Lit Health Center for Healthcare Narratives

Today, Raj Ratwani, Vice President of Scientific Affairs at the MedStar Health Research Institute, Director of the MedStar Health National Center for Human Factors Engineering in Healthcare, and an associate professor at the Georgetown University School of Medicine,  joins Tracy Granzyk to explore the intersection of patient safety and data in our U.S. Healthcare System. They explore the vulnerabilities introduced by electronic health records (EHRs) and artificial intelligence (AI) in healthcare, as well as the opportunities to improve the delivery of care using both tools.  An expert in patient safety, digital health, and cognitive science, Raj engages in an informative and insightful conversation with Tracy highlighting patient safety, workforce readiness, and equitable AI applications in healthcare technology.
Raj begins by acknowledging President Biden's forward-thinking AI Executive Order, emphasizing its significance for healthcare and the need for proactive adaptation to AI integration. Central to the conversation is patient safety in the AI landscape, with a focus on establishing a comprehensive patient safety framework for AI. This framework centers on data collection, analysis, and dissemination to address AI-related patient safety concerns. The challenges of preparing the healthcare workforce, the importance of imparting essential AI knowledge, understanding potential challenges, and maintaining expertise in both traditional and AI-augmented healthcare are also discussed. Additionally, our duo touches on AI's broader impact across industries, emphasizing the importance of individuals acquiring AI-related skills to remain relevant in their careers. While addressing the fear of technological change, they highlight the opportunities that come from embracing AI and actively shaping its narrative. They also underscore the vital role of public-private partnerships in advancing AI while maintaining a balance between providing guidelines and fostering innovation in the dynamic AI landscape. Join Raj and Tracy today as, together, they guide us through the transformative era of AI in healthcare, prioritizing patient safety and excellence to ensure a safer and more equitable future.
Highlights:
Patient safety and EHRsInteroperability challengesAI impact on healthcareEquity in healthcare techStakeholder collaborationMonitoring and regulationsPatient-centered careAI readiness and innovation
Quotes:
"We have to make sure that these clinical algorithms have the right data sources that are underlying or leading to the development of them so that we have safe and equitable care for everybody."
"Patient safety is not always top of mind for people. To see that explicitly called out in the Executive Order, I think is fantastic."
"We have to look at this as an opportunity and latch onto this and figure out the right ways of integrating things that we're doing and take the best parts of it."
"We want to take all the things that humans are good at and preserve it and complement it with the computers and the artificial intelligence that can take care of all the things that we're not so good at."
"If we are going to take another decade to figure out AI from a safety perspective, we're in a lot of trouble."
Links:
LitHealth Homepage
MedStar Health
Raj Ratwani's LinkedIn Page

Joining Tracy for today’s episode is the truly remarkable Armando Nahum, a former patient advocate who has transitioned into an tremendously influential healthcare activist. Armando's inspirational story and educational presentations born out of his own family’s tragedy have left a profound mark on hospital administrations and frontline caregivers across the nation. Among his many achievements, he has become widely celebrated as the co-founder and president of Safe Care Campaign, an organization dedicated to infection prevention in hospital settings. He also holds key positions on various healthcare advisory boards and councils, including the CDC Council on Infection Prevention and the Georgia Hospital Association Advisory Board. In addition to being instrumental in establishing Patient and Family Advisory Councils (PFACs) aimed at enhancing quality and safety at hospitals across the country, Armando, in a highly significant achievement, was appointed to the Presidential Advisory Council for Combating Antibiotic Resistant Bacteria in February 2020. Most recently, he is a founding member of Patients for Patient Safety US  in partnership with the World Health Organization (WHO), where he is leading influential healthcare policy change driven by patients and families. 
In today's episode, Armando shares the patient advocacy journey that he and his wife, Victoria, embarked upon back in 2006 following a series of infections that impacted their family across three different hospitals in three states, and which tragically resulted in the loss of their son, Josh. He also shares sage insights, emphasizing the pivotal role of patient and family engagement in healthcare. The conversation delves deep into Armando's personal experiences and explores broader themes of patient advocacy, PFACs, and the critical importance of transparency within healthcare. Vitally important topics covered in this enlightening discussion also include the necessity of cultivating a culture of safety and the unification of patient experience and safety. Armando's remarkable journey from personal tragedy to impactful advocacy serves as a powerful reminder of the need for change and improvement in healthcare. Through education, transparency, and the establishment of a culture of safety, he advocates for the construction of a healthcare system characterized by integrity and compassion. Armando's legacy is a resounding call to revolutionize healthcare for the betterment of all individuals involved.
Highlights:
Armando's journeyThe power of patient advocacyPatient and Family Advisory Councils (PFACs)The need for full transparency in healthcareCulture of safetyPatient experience and safetyPatients for Patient Safety US (PFPS US)
Quotes:
"You need to be aware that healthcare events can happen to anyone. It's not just a select few."
"In healthcare, we tend to spend more time on ‘after the fact’ than ‘before the fact’. We should spend more time before."
"The patient experience has to encompass quality and safety. The minute you separate them, that's when trouble starts."
"People need transparency in healthcare. There's no reason for institutions to hide behind their attorneys."
“If you have a PFAC, you're not using it correctly unless they go out in the community and start educating. To me, education is at the forefront.”
Links:
LitHealth Homepage
Patients for Patient Safety US

Tracy welcomes esteemed patient safety advocate and President/CEO of Project Patient Care, Marty Hatlie, to the podcast today for a conversation that delves deeply into the core of patient safety and the integral roles patients and families play in elevating healthcare outcomes. Together, they engage in a timely dialogue which underscores the urgent call for a healthcare landscape that treasures transparency, equity, and the voices of marginalized populations. Marty's personal journey from a lawyer advocating for doctors to a fervent patient safety advocate is also unveiled, highlighting the challenges and potentials within patient safety. 
Emphasizing the significance of systems thinking and accountability as catalysts for enduring transformation, Tracy and Marty reinforce the critical value of patient engagement and federal leadership while offering a revolutionary perspective for a new era of patient safety and equity. The episode also explores COVID-19's impact on patient safety and healthcare disparities, and introduces The Academy for Emerging Leaders in Patient Safety focusing on its mission to connect patient narratives with education to foster cultural change. As the episode concludes, our duo rallies listeners to partake in such patient advocacy and transparency endeavors as Patients for Patient Safety US. Join Tracy and Marty here today to gain crucial insights into this noble initiative to revolutionize healthcare for the betterment of all individuals and embrace a holistic vision of well-being, safety, and equality in the healthcare realm.
Highlights:
Marty Hatlie's leadership and career evolution from medical-legal defense attorney to his staunch patient safety advocacy and work reforming patient safetyAddressing decades of slow moving improvements in healthcare safety with a call to address the stagnation in patient safety advancement of lateThe urgent need for openness in healthcareConnecting patient safety with health disparitiesHealthcare transformation via federal leadership, accountability, and culture changeFostering change through systems thinking and safety science in healthcare educationRecognizing the role of patients and families in driving innovation and accountabilityCOVID-19 Insights
Quotes:
"We've lost the belief that the healthcare system can fix itself. It's just not going to. What we need is that paradigm shift towards systems thinking and transparency."
"The conflation of safety and equity is going to be a very exciting part of our next chapter, really looking at the data and looking at how some people just don't get the kinds of fairness in the healthcare system that we all deserve."
"This is a system that's supposed to work for me. And if it doesn't work for me, I'm entitled to speak up and say something about it."
"It shouldn't be our job ethically as patients and family members to be the agents for change. But again, it's been 20 years. We haven't seen it happen."
"We still fight with people just to get safety even on the agenda of the undergraduate curriculum."
"The challenges of driving transparency in healthcare are immense, particularly when the system resists change."
"COVID-19 exposed vulnerabilities within the healthcare system, particularly in nursing homes, leading to discussions about infection control and the importance of patient advocacy."
Links:
LitHealth Homepage
Project Patient Care
The Academy for Emerging Leaders in Patient Safety
a...

Steve Burrows is a writer, director, performer, and producer who began his career in Chicago, joining Second City director Dell Close as a member of the critically acclaimed and groundbreaking improvisational comedy group ‘Baron's Barracudas’. After relocating to Los Angeles, Burrows began his film and TV career with an award-winning short film, "The Soldier of Fortune." Since then, he has gone on to win over 75 awards for writing and directing television commercials on five continents.
After Steve’s mom was harmed by medical care in Wisconsin, he took time out from his successful film career to advocate for her. In this episode of Lit Health, he touches upon his fascinating career, why stories matter, and delves deeply into his experience with the medical system, its need for policy reform, and the role he has taken on as an advocate in this space with our host, Tracy Granzyk.
Highlights:
Steve’s background in comedy and storytellingHis experience with the medical system while advocating for his momHis award-winning documentary film, Bleed OutThe need for change in the medical systemThe need for more accountability in the healthcare industryThe importance of patient advocacy and how patients can protect themselvesThe role of the media in bringing attention to healthcare issuesThe potential for change in the medical system and the need for policy reformThe power of stories to drive change

Quotes:
"The medical industrial complex is so large and so powerful, it's hard for the average person to navigate." 
"If you don't have a voice, you don't have a choice."
"We need more accountability in the healthcare industry."
"Patient advocacy is not only a right, it's a responsibility."
"The truth is the only thing that will set us free."

Links:
LitHealth Homepage
Steve Burrows
HBO Documentary: Bleed Out

Tracy’s guest on this episode is Clarinda Ross, mom of three and accomplished actress, writer, and special needs advocate. Clarinda began her journey as a patient advocate thirty-three years ago when her daughter Clara was found to have developmental delays, the experience of which she channeled into her one-woman show Spit Like A Big Girl. Clarinda begins the episode discussing her experience parenting a child with special needs and navigating the healthcare system two years before the Disabilities Act was signed into law. She describes how the challenges of getting the right care for Clara forced her to develop real gumption in ensuring that her daughter could live her best life, including letting her go when the time was right. She also discusses how forming an advocacy team, including speech and occupational therapists, helped ensure Clara’s needs were understood by the school and healthcare systems.
Next, Clarinda talks about Spit Like A Big Girl, how it developed from her experiences in childhood and parenting Clara, and the impact it’s had, particularly in making healthcare professionals rethink their approach to special needs patients and their families. In particular, she discusses the tendency for special needs diagnoses to be framed as death sentences and argues that while your child may have a different life than you imagined, it can still be one filled with joy. Tracy then asks Clarinda to talk about how she’s extended the skills she’s gained as an advocate for Clara into advocacy for other family members, including her mother and husband. Clarinda explains that while the healthcare system is improving in terms of listening to patients and sharing records, it’s still wise to take a trusted person with you when meeting with healthcare professionals to have someone who can take down all the details and back you up when necessary. And finally, Clarinda closes the show by sharing a little about how Clara’s doing today, at age thirty-three, settled in a group home, and living her best and most independent life.
Highlights:
Becoming a parent to a child with special needs How Clarinda ensures she and Clara live their best livesLearning to let go when your child has special needsThe impact of Spit Like A Big GirlBecoming a patient advocate for other family members

Quotes:
“Somewhere around two, when I got some really definitive tests saying that the gaps were not going to close all the way, and this was going to be a lifelong care situation, I did not sit down. I did not, you know, cry. I thought, okay, well then what can I do to give her the best life? How can I do that? And I just… I just pushed on.”
“I came out the stage door, and there was an older man waiting there for me. And he was a doctor, and he just had tears in his eyes. And he said, ‘You made me think. You made me think about the way that I talk to mothers.’ He was a pediatrician there in the town, and I said, ‘Well, good. Yay! I’ve had a great day’s work.’”
“This play is a love letter to occupational therapists. I have a whole section in there that I call ‘the Church of Occupational Therapy.’ I used to be a Methodist, but now I am devoted to the Church of Occupational Therapy because it works.”
“It doesn’t have to be a death sentence. What it has to be is… it might not be the life that you thought your child was going to have and the relationship that you were going to have with this child, but it can be full of joy.”
“If it’s not like that, if it’s not you’re in a life-threatening situation, and especially if they are wanting to operate on you, take a minute before you do anything invasive. And ask questions, and get that person to come and sit with you, and get that other opinion, and another opinion.”

Show Links:
a...

Tracy’s guest on this episode of Lit Health is Dr. David Mayer, Executive Director of the MedStar Institute for Quality and Safety, where he leads quality and safety programs in support of discovery and learning and the application of innovative methods to operational clinical challenges. A cardiac anesthesiologist by training and a medical educator by passion, Dave has spent the last three decades fighting for a safer healthcare delivery environment and recently served as CEO of the patient safety movement Foundation, where he led global patient safety efforts and initiatives in sixty-four countries and over 4,800 hospitals. He’s currently at work on a memoir of sorts, detailing his walk across pandemic-hit America during 2020 to keep all eyes on the continued need to make healthcare safe for patients and providers.
Dave starts the episode with the story of starting his cross-country walk and how it was inspired by his frustration with the lack of progress in healthcare safety during his thirty-year career and his desire to do something out of the ordinary to draw attention to this crisis. He then explains that the COVID-19 pandemic hit just two weeks into his walk and discusses the things that surprised him most about the country’s response, including the social unrest in many cities and the polarized reactions people had to masks (including threatening Dave for wearing one). He also points out one of the best things about his walk—being joined by patients and families who had lost loved ones to preventable medical harm—and speaks about the impact patient advocates have had on his career, as well as his realization that focusing on personal stories and narratives is necessary to help people understand the importance of healthcare safety on a human level. Next, Dave discusses his summer camp program, the Academy for Emerging Leaders in Patient Safety, its history and development, and its impact in informing and training emerging and future healthcare leaders in advocating for and implementing quality and safety concepts in their organizations. He also talks about the need to include the softer sciences, such as communication, leadership, and teamwork, in medical education and how the medical profession can learn about this from aviation and other high-risk industries. Dave then returns to his book, sharing his hope that it will help readers connect the statistics on preventable medical harm with the personal stories he’s gathered and encourage more people to take action by asking their leaders why more isn’t being done to make healthcare safe for patients and workers. And he wraps the episode up by explaining the developments he believes are necessary to improve quality and safety, including setting up a National Patient Safety Board and increasing transparency in quality and safety outcomes so that patients can make informed decisions on who provides their care.
Highlights:
Dave’s other achievements include founding and leading the annual Telluride International Patient Safety Roundtable and the Academy for Emerging Leaders in Patient Safety Summer Camp for the last thirteen years. He also serves on numerous boards and has been recognized multiple times for his leadership and work elevating safety and quality in medicine.Dave also co-produced the patient safety educational film series entitled The Faces of Medical Error… From Tears to Transparency, which won numerous awards, including the prestigious Aegis Film Society Top Short Documentary Award.In February 2020, Dave decided to walk across the country to raise awareness about healthcare safety for both patients and healthcare workers, planning to visit major league ballparks and take in a game at each one.Two weeks after Dave started his walk, the pandemic hit, eventually resulting in the book he’s working on, set during the worst pandemic we’ve had in a hundred years and a year which saw...