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Friday, December 16, 2011

Heck YES!!! Walking Counts!!!


Like Taylor Swift writing about a bad break up, I feel the need to blog about something that seems to me to be an injustice.  I received a question, almost in the form of a plea, from a workflow consultant who needed help responding to a dilemma posed by a medical assistant.  The medical assistant is responsible for asking patient's about their physical activity level, or as KP HealthConnect labels it "Exercise Activity", is confused about what to document because the provider she supports has instructed her to enter a "0" if the patient states the exercise activity was "Walking".  I want to say that her doctor is probably just thinking that walking in general doesn't raise your heart rate enough to count as exercise, but why would KP have made it an option amoung the list of 50 plus exercise activities?


Now... Maybe my gut reaction is taking over here and I'm thinking too much like a patient, but if my provider told me that my walking didn't count I would be disheartened, upset, and frankly... irate.  
If this thinking is true, then what is the point of our Every Body Walk campaign and why did we build a Rose Parade Float encouraging people to walk?


If walking doesn't count, then why would George Halvorson create a 5 minute video discussing the benefits of walking just 30 minutes a day?


Why would Dr. Sallis encourage people to go out and exercise 30 minutes a day 5 days a week?

If walking doesn't count then why would we dedicate a 80 foot long interactive walking wall at our Center for Total Health in Washington DC?



From our Every Body Walks website...
Walking is a low-impact exercise accessible to just about everybody. It's safe, simple, and doesn’t cost anything. George Halvorson, Chairman & CEO of Kaiser Permanente, explains the numerous health benefits of a regular walking regime: reduced risk of coronary heart disease, stroke, diabetes, and other chronic diseases. Physical activity need not be strenuous for an individual to reap significant health benefits; just 30 minutes a day (or two 15 minute sessions) of brisk walking will do the trick. 


If walking doesn't count then why would Dr. Mike Moreno create a Walk With Your Doc program to encourage his patient's to exercise.




On a personal note, here is how walking has impacted my life.

Back in June of 2011, my fasting glucose came back indicating I had pre-Diabetes. At the time I was also suffering from insomnia, fibromyalgia, chronic migraines, asthma, weight issues, and if I'm being totally honest, depression. I was a mess, I know. I decided to take control of my health issues. Going to the gym isn't always easy because of my work schedule, but throwing on a pair of sneakers and walking whenever I had a free moment in-between meetings made exercise completely accessible. There are days when I only walk 15 minutes and there are days when I walk 6-10 miles. I would be heart broken if my doctor told me that my efforts didn't matter. Walking for me has made a significant difference in health and mental well-being. My insomnia is gone, I have signifcantly fewer fibromyalgia flare ups, the mood and spirits have brightened, my migraines have decreased significantly, and my fasting blood sugar is now at a healthy level.



In my book... I say "Heck YES... Walking counts!  In fact... I'm going to have to go for a walk now just to simmer down. 

Friday, November 18, 2011

Date Your CPAP


I have mild-moderate sleep apnea for which I was prescribed a CPAP machine to help control my breathing by forcing air into my nose as I sleep.  CPAP masks come in different shapes and my particular machine has two soft "pillows" that fit snuggly over my nostrils. The mask is connected to a long hose that is itself connected to a machine.  Try talking while you have the CPAP on and you will no doubt sound like Darth Vader, but other than the occassional slippage of air, the machine is pretty quiet.  Unfortunately, it is still a bit awkward and can take some time to get used to.

Two days after trying out a CPAP I had to go on a Complete Care Leadership site visit and I must have looked pretty wiped out from not sleeping because the CPAP was so awkward.  Tim Ho gave me some excellent advice though after asking me a couple personal questions.  The first question was... "Would you sleep with someone you just met or would you wait to get to know them?"  Of course I said "NO" (my husband can confirm that response).  His next question was "How would you get to know them better?"  "Dinner, movie, cuddled up on the couch, etc."  Dr. Ho's advice then followed... "You need to DATE your CPAP.  Get to know how it feels by using it during the day or the evening while watching TV, reading a book, etc.  Don't go to bed with it for at least 7 dates (one week)." 

I did as Tim instructed and have found great success.  Now it doesn't feel awkward or like a stranger to me. 

Saturday, November 12, 2011

Improving Quality, Setting Records, Having Fun


On Friday, November 5th, 2011 our Complete Care Leadership team had our monthly site visit with Kaiser San Diego, starting off the morning reviewing the operational challenges, opportunties, and successes at our Rancho San Diego MOB with Dr. Michael Moreno and his new Medical Office Adminstrator (MOA), Noreen Bristow.  This MOB has definitely had it's share of challenges over the past several months with a vacant MOA position and a few MD turn overs, but that didn't curtail their enthusiasm.  Noreen, having worked in PCM (Population Care Management) is well versed at pulling CSG and POE numbers to see where they need to make improvements and Dr. Moreno has challenged her to put that knowledge to use to help drive Rancho San Diego to be in the top sixty mob rankings within the next few months.  The staff were all aware of their current MOB ranking and seemed determined to climb that ladder together.  They were especially excited to share with us that they recently were given access to a mobile mammography unit which comes to the clinic 1 day a week which has allowed them to close mammography care gaps on the spot instead of sending the patient to the medical center or to a near by clinic to complete the mammogram since their clinic doesn't own a mammo machine.  It was also great to hear that this MOB has abondoned the idea of sending letters to their patients who are active members on Kp.Org and instead send them emails to their Kp.Org account to remind them of overdue care gaps.  They are also using the registration staff to contact members through live phone calls to members due for cervical and breast cancer screenings.  These are great examples of using the right staff to do the right work and taking advantage of the most cost effective, patient preferred communication. 

In our afternoon visit with the San Diego Leadership and Complete Care team after discussing our MOB visit and San Diego's overall performance, along with opportunties and successes, their leadership team distributed crazy sunglasses and asked us to take a group picture to help celebrate with them KP's success of reaching for the STARS.


The San Diego leadership team has a way of bringing people together to make the hard things easier to do by making them fun while staying focused on the end result.  One such way of unifying the staff to achieve great outcomes while making things fun is shown by San Diego's passionate obsessions with setting Guinness Book of World Records.  Below is a picture of their Guinness Book of World Record's Wall - less their lastest record which will bring the total to 11!!!



You can read about their latest record set for Breast Cancer Screening here. The new World Record will be Kaiser Permanente San Diego’s 11th World Record since 2010 to prevent illness and promote health and well-being.  You can also check out George Halvorson's July "Be Well" article on world records.

Other records set by KP San Diego:

Seeing STARS


Celebrating success in seeing STARS at our KP San Diego Complete Care Site Visit - San Diego Leadership and Complete Care team reminds us it's okay to have fun while working on reaching stars.