Tag Archives: Pharmacy

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Study: Fluoride may decrease liver, kidney function in adolescents

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No one debates the many dental benefits of fluoride. They are widely established and scientifically backed. But in recent years, concerns have been raised regarding the appropriateness of the widespread addition of fluoride to drinking water and salt in North America.

Now, a study published by Mount Sinai researchers in Environment International asserts that fluoride exposure may lead to a reduction in kidney and liver function among adolescents.

The study examined the relationship between fluoride levels in drinking water and blood with kidney and liver health among adolescents. The group of young people was participating in the National Health and Nutrition Examination Survey, a group of studies that assess health and nutritional well-being in the United States.

The findings showed that exposure to fluoride might contribute to changes in kidney and liver function among youth in the United States, where 74% of public water systems add fluoride for dental health benefits. Fluoridated water is the primary source of fluoride exposure in the U.S. The findings also suggest that young people who have poor kidney or liver function may absorb more fluoride in their bodies than their healthy peers.

This subject is important to study because a child’s body excretes only 45% of fluoride in urine via the kidneys, while an adult’s body clears it at a rate of 60%, and the kidneys accumulate more fluoride than any other organ in the body. These facts are courtesy of the study’s first author Ashley J. Malin, Ph.D., postdoctoral fellow in the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai.

“This study’s findings suggest that there may be potential kidney and liver health concerns to consider when evaluating fluoride use and appropriate levels in public health interventions,” said Dr. Malin. “Prospective studies are needed to examine the impact of chronic low-level fluoride exposure on kidney and liver function in the U.S. population.”

This study’s findings, combined with other previous studies of childhood exposure to higher fluoride levels, show there is a dose-dependent relationship between fluoride and kidney and liver function. The findings, if confirmed in other studies, suggest it may be important to consider children’s kidney and liver health in drafting public health guidelines in the future.

Potential health side effects include renal system damage, liver damage, thyroid dysfunction, bone and tooth disease and impaired ability to metabolize protein.

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Viral infections among organ transplant recipients may be influenced by gut microbiome

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A study recently presented at the American Transplant College shows that the gut’s microbiome plays a significant role in whether a transplant recipient will develop a viral infection of not.

“Our results confirm and extend the novel association between the gut microbiome and the development of viral infections from stem cell transplant recipients to solid organ graft recipients,” Dr. John Lee and colleagues wrote in the abstract. “Altogether, these findings support targeting the gut microbiota as a strategy to prevent and/or treat viral infections.”

Dr. Lee works in the division of nephrology and hypertension at Weill Cornell Medicine in New York. His collaborators were infectious disease specialists from the Sloan-Kettering Cancer Center.

“Recent studies suggest that the gut microbiome plays a critical role in protecting its host from infections beyond Clostridium difficile,” Dr. Lee wrote. “Notably, butyrate-producing bacteria may be beneficial to gut health and have recently been associated with lower rates of respiratory tract infections in bone marrow transplant recipients.”

In the study, researchers looked at the relationship between butyrate-producing gut bacteria and the future development of viral infections in kidney recipients. Samples were collected from 115 kidney recipients two weeks following transplantation surgery.

Researchers said they profiled the gut microbiome using 16S rRNA gene-deep sequencing of the V4-V5 hypervariable region. The next step was determining the likelihood of patients with less than 1% relative abundance of butyrate-producers developing one of three very common viral infections within two years of transplantation. The viruses were BK viremia, cytomegalovirus viremia and respiratory tract (RV) infections.

The patients who had a low abundance of butyrate-producers were at significantly increased risk for developing RV infections than those who had a high abundance of butyrate-producers. Of the 115 individuals studied, 23 patients developed RV infections while 22 developed BK viremia and 15 developed CMV viremia; Fifty developed at least one out of the three.

The study results indicate the need to monitor the risk of infection closely in both solid organ transplant recipients and stem cell recipients, researchers say.

Along with viruses, solid organ recipients are also at greater risk of contracting a Clostridioides difficile infection. The illness is caused bybacteria that causes bloody diarrhea and other intestinal complications. It poses greater risks for solid organ recipients.

A team of researchers from Columbia University Irving Medical Center in New York discussed the prevalence of CDI in solid organ transplant patients during the American Transplant College. Of 2.622 recipients, 8.5% experienced CDI within a year of transplant.

Of those cases, 64% were considered severe. Pancreas recipients had the highest rate of CDI at 12.5%. Lung, liver, heart and kidney followed in that order. The media time of transplant to CDI was 56 days, and nearly 30% of patients had recurrent CDIs.

All patients had a twofold increase in the chance of death. Since CDI is especially dangerous for solid organ recipients, researchers indicated “Novel strategies to prevent and effectively treat CDI in SOT are urgently needed,” in the abstract.

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Preventing chronic pain in lab mice

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According to data from the 2012 National Health Interview Survey, within a previous three-month period, 25 million adults in the U.S. had daily chronic pain, and 23 million more reported severe pain. Of those in pain, 27% suffer from lower back pain, 15% from severe headache or migraine pain, and 15% from neck pain.

In the U.S., chronic pain affects more people than cardiovascular disease, cancer, and diabetes combined.

Neuropathic pain persists after the initial injury has healed. The condition is notoriously resistant to treatment, with a prevalence of 7 to 10% in the general population.

When pain is chronic, signaling persists over time and can lead to biochemical changes in the nervous system. Options for treating chronic pain include oral (nonsteroidal anti-inflammatory drugs, acetaminophen, opioids) and topical therapies (ointment, cream, or patch applied to skin).

Other options include physical therapy, exercise, acupuncture, relaxation techniques, and psychological counseling. In a 2006 survey, more than half of chronic pain sufferers felt they had little or no control over their pain.

Effective drugs against chronic pain are not necessarily forthcoming. However, researchers have recently identified a protein as a future potential target for medicinal drugs.

Assistant professor Mette Richner is employed at the Department of Biomedicine and the DANDRITE research center of Aarhus University in Denmark. Richner, who began on the project as a Ph.D. student in professor Anders Nykjaer’s group, subsequently completed the project as a postdoc in associate professor’s Christian B. Vaegter’s research group.

According to Richner, once nerve damage has occurred, and the nerve cells go into overdrive, molecules are released, which start a domino effect that ultimately triggers pain. The domino effect can be inhibited by a molecule in the spinal cord called neurotensin, and her studies show that the neurotensin is captured by sortilin, so that the brake is itself inhibited. The protein sortilin is expressed on the surface of nerve cells and plays a role in pain development in laboratory mice.

Studying the pain-related puzzle in relation to the spinal cord arose from decades of research in both pain and sortilin. The initial studies involved mice that lacked the ability to form sortilin and were pain free despite nerve damage.

The researchers determined that normal mice also did not develop pain after nerve damage when the researchers blocked sortilin, ultimately explained by the regulation of the pain-inhibiting molecule neurotensin.They hope that investigations will continue to investigate whether it is possible to block sortilin locally in the spinal cord, so that the neurotensin can move freely and get the brake to function, thereby inhibiting the pain.

Vaegter speculates that although the research has been carried out on mice, some of the fundamental mechanisms are similar in humans and mice, providing an explanation of what is happening in people suffering from chronic pain.

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Noise: An invisible danger in sports and recreation

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While most people wouldn’t think twice about wearing hearing protection at a noisy workplace, it’s easy to forget that noise can be equally damaging when we’re at play.

As we leap into summer, let’s take a quick look at the sound level of our recreational activities.

Recreational activities with dangerous noise levels

Many things we do for leisure can put us at risk for noise-induced hearing loss. Dangerously high noise levels are inherent in sports involving ATVs, motorcycles and snowmobiles.

Interestingly, excessive noise isn’t always just produced by the machinery being used. For example, in motorcycle riding, the sound generated by the wind against the helmet can reach dangerous levels. When traveling between 75 and 80 miles per hour, wind noise is around 105 dB, reports hearing expert Brande Plotnick. This level is sustainable for only around four minutes without affecting hearing.

To know how much noise certain devices and equipment generally produce, there are online resources like this comprehensive decibel chart. With apps that can be downloaded to your smartphone, it’s easy to see the decibel level of your recreational activities.

One single explosive sound can damage the delicate hairlike structures of the cochlea in the inner ear, resulting in permanent hearing loss. This is why hearing protection is a must for anyone who fires guns for sport.

The best type of protection will depend on the type of shooting you do, note Michigan-based hearing professionals in their blog. Options include muff headphones, which keep sound from reaching the cochlea; in-the-ear foam plugs with a Noise Reduction Rating (NRR) of 30 or more; combining the aforementioned for double protection; and, finally, electronic noise-cancelling headphones that allow a conversation to be heard but cancel the transient sounds of gunfire.

Maybe you don’t fire guns or always use protection at the firing range, but what about exposure to firecrackers and fireworks, which can exceed 150 dB?

Who goes to see the Fourth of July fireworks with hearing protection? Well, taking into account these helpful tips for enjoying your Independence Day fireworks without damaging your (or your child’s) hearing — we all should.

As stadiums compete to be the loudest, spectators need to beware

Even when we’re not participating at sport, we need to exercise care with our hearing.

The loudest spectator sport on the chart is stock car races, which sustain levels of 130 decibels near the track and 100 in the stands. While a great part of the excitement of auto racing is hearing the roar of the engines, Indianapolis Motor Speedway President Doug Boles has become an advocate for protecting the hearing of fans. With his own hearing in jeopardy, he urges people in this newscast before this year’s Indy 500 to bring hearing protection or purchase it at the race.

Yet spectators of other less noisy sports also need to exercise caution as the stadiums compete to be the loudest — at times exceeding 130 decibels.

“We’re really up against it with these sports stadiums pushing the crowd to be louder and louder, trying to be the loudest stadium,” confesses audiologist Tracy Winn. “Unfortunately, people like it! There’s truly a physical reaction to dangerous levels of noise, it stimulates vestibular system and people like it.”

In a fun blog listing the loudest events ever recorded on a decibel meter, we learn that Seattle Seahawks fans broke the Guinness Book record for world’s loudest stadium in 2013 when they reached an astounding 137.6 dB. In college sports, Kansas Jayhawks basketball fans generated 130.4 dB of crowd noise and hold the official record for indoor crowd noise.

Winn notes that such decibel levels or those posted on stadium boards to encourage fans are peak levels when everyone’s cheering, so they aren’t sustained very long. But here’s the catch — when you are up over 100 decibels, you can be exposed to it a very short time without causing permanent damage.

Exposure time and volume: the magic equation

So, what’s a dangerous noise level? As Winn suggests, there’s a clear equation for how long the ear can endure loud noises before permanent damage can occur.

Damage is linked to exposure to loud noise over time. There’s a magic number between duration and level — 85 decibels is the limit for eight hours of exposure in each 24-hour period per standards set by National Institute for Occupational Safety and Health (NIOSH). Beyond that level, if you’re an employee, you need hearing protection.

The problem is the decibel scale isn’t linear — for every three-decibel increase, the time you can be exposed without protection is cut in half. For example, as you get up to 88, exposure time is cut to four hours. At 91 decibels you are only good for two hours.

Checking this noise dose chart, you can see that the maximum exposure time for the 130 to 140 dB level, like that reached at the record-making stadiums, is less than one second per 24-hour period. What’s more, for children, the World Health Organization (WHO) recommends no exposure above 120 dB. You can bet there were a few children attending those events.

“We know that excessive noise exposure over time will cause hearing loss, yet since there is a genetic component there’s no standard rate at which noise-induced hearing loss develops,” explains Audiologist Jennifer Phelan. “Additionally, the effects are cumulative.”

Protect your hearing from permanent damage

It’s never too late to begin to protect your hearing, assures Phelan. Saving your hearing boils down to three basic actions: use protection, distance yourself from the sound and reduce the sound level.

When possible, move away from the sound source. By doubling your distance, you reduce the decibel level by 6 dB, given that there’s no echo, according to the Dangerous Decibels site. If you experience 90 dB at 10 feet, the decibel reading will go down to 84 when you’re 20 feet from the sound source.

Phelan believes that not enough is being done to encourage adults to wear hearing protection. As you can imagine, there are many products available — some geared towards work environments while others are clearly targeting young concert- and party-goers.

If you’re at home and can turn down the sound on whatever device you’re using for entertainment, great. But if you’re going out to be entertained, best carry hearing protection with you — and use it.

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Court’s blockage of liver-sharing policy sparks conflict

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A plan intended to correct regional inequities among liver transplant recipients is on hold after a lawsuit to block its implementation was filed by transplant centers in the South and Midwest.

The United Network for Organ Sharing (UNOS) has worked to create a new way of distributing organs since 2012. The plan calls for the most critically ill patients within a set geographic parameter to receive organs first. For example, if a liver became available in Nashville, the sickest patient within a 500 nautical-mile radius would receive it.

For years, organ distribution has been carried out within 11 geographic areas. Each area maintained its own waiting list and when a liver became available, the sickest patient within the region received it.

UNOS has worked for years to revise the organ distribution system. Waiting lists on the coasts and in urban centers have always been longer than those in rural areas. Consider that the waiting list at Vanderbilt Medical Center in Nashville has about 171 patients, while the one at the University of California’s San Francisco Medical Center has more than 750.

Yet each center performs roughly 140 transplants each year. Plus, organ donation rates in the South and Midwest tend to be higher than those in more populated areas. The system also allows patients with more resources to work the system. Steve Jobs once bought a house in Memphis so he could join Tennessee’s waiting list, which is much shorter than California’s where his primary residence was located.

Transplant centers in less populated areas fear the proposed change will allow big-city centers to poach from their supply of organs. That’s why the proposal has created something of a turf battle among urban and rural transplant centers.

It’s not just patient care that concerns rural transplant centers. Transplants are extremely lucrative for the hospitals that perform them. According to a consulting firm, a single liver transplant results in $800,000 in billed charges. Dr. Seth Karp, director of Vanderbilt Medical Center’s program says the change could force smaller programs to close or scale significantly back.

“If the program in Mississippi closes, if the program in Iowa closes because of this, that’s a real national public health problem,” he said.

To keep the distribution from going into effect, transplant centers in the South and Midwest filed suit in late April. A temporary restraining order was denied on May 13, but a U.S. district judge issued a cease and desist order upon appeal. That means organs continue to be distributed within the 11 geographic regions until the case is taken up in court again.

UNOS has always maintained the new distribution method will save lives.

“This is good news for the sickest candidates waiting for livers,” said Brian Shepard, CEO of UNOS, in an interview with NPR. He said 100 additional lives would be saved each year with a more efficient distribution method. “Targeting the livers towards those folks who are really the most critically ill will result in fewer people dying on the waiting list.”

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What’s next for association health plans after federal judge’s ruling?

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U.S. District Court Judge John D. Bates found that the Department of Labor’s issuance of a final rule last June 19 that lets groups of small businesses offer association health plans (AHPs), are “clearly an end-run” around the 2010 Affordable Care Act’s consumer protections that became law under President Obama. Kev Coleman, president and founder of AssociationHealthPlans.com, disputes Judge Bates’ ruling.

“The new study on chamber of commerce association health plans painfully illustrates the insurance gains that will be lost to small businesses if the recent court ruling is not overturned,” Coleman said in a prepared statement. “Should the ruling stand, we will return to the prior unfair system where large companies will pay less than small companies for the same health benefits.”

The study, “Chamber of Commerce Association Health Plans Building Political Bridges While Refuting Opposition,” finds, in part, that: “Through the new Department of Labor regulation, the same large company insurance model that already covers roughly 95 million Americans was made available to small businesses through associations. This change has been a matter of market access. The definition and rules related to large company health insurance have not changed. Instead, the playing field between small companies and large companies was leveled with respect to health insurance costs.”

An improved and more level field of play between large and small companies regarding the prices of health insurance is less than meets the eye, though, according to David I. Levine, a professor of law at University of California Hastings, where he teaches civil litigation and remedies.

“It looks as if the federal judge was on very solid legal ground in rejecting the labor department regulations,” he told MultiBriefs via email. “If the administration wants to make the necessary changes to allow these plans, the changes must be done through legislation approved by Congress.”

That branch of government, not the White House, must deliberate and legislate AHP changes.

Anthony Wright, head of Health Access California, a statewide healthcare consumer advocacy coalition, also agrees with Judge Bates’ action. “In California, we have already banned so-called short-term plans and have put strong standards for association health plans,” Wright told MultiBriefs in an email interview, “but it benefits our whole health system to prevent these junk plans at the federal level. These substandard plans not only trap people in junk insurance that may not cover them when they need it, but also destabilize the overall market and raise premiums for the rest of us.”

America’s Health Insurance Plans (AHIP), a political advocacy and national trade association, declined a MultiBriefs request to comment on Judge Bates’ recent ruling. However, after the DOL finalized its AHP rule in June 2018, the AHIP did comment on possible outcomes.

“We remain concerned that broadly expanding the use of AHPs may lead to higher premiums for consumers who depend on the individual or small group market for their coverage,” Kristine Grow, AHIP senior vice president of communications, said in a statement.

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Are e-consults right for your practice?

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Studies show that referring a patient to a specialist can often be a stressful and time-consuming enterprise for a primary care physician. Not only does that PCP have to identify the correct doctor to refer to, he or she must then set up a meeting in many cases to discuss the patient’s case.

What’s the latest high-tech solution to save this kind of effort and energy? Electronic consultations, often called e-consults or e-referrals. The process works this way: a PCP who needs to ask a specialist about a specific patient’s care — such as a symptom that needs to be discussed or further info about testing — emails a specialist. Then, the PCP and specialist discuss the patient’s situation through messages.

Often, the process cuts the need for a patient to even see a specialist altogether. The electronic ease by which PCP and the specialist cooperate helps foster better communication, according to research from Brigham and Women’s Hospital, Harvard Medical School, and Massachusetts General Hospital.

Implementing an e-consult system into a practice works as described in research from San Francisco General Hospital and the RAND Corporation: A doctor submits a referral request to a specialist through a predesigned web-based program or service, often embedded in the doctor’s overall electronic health record system.

The doctor then enters a consult question in free text format. A designated specialist then reviews and responds to each referral request directly. The system can eliminate inappropriate referrals, move urgent cases more quickly, and assure a complete primary care work-up before a patient even schedules a specialist appointment.

Are e-consults right for your practice? Consider the following possible benefits:

  • Specialist costs for patients lacking insurance can be eliminated completely.
  • You can take more Medicaid patients into your practice; this allows these patients more comprehensive complete care. Previously, they may have not had sufficient access to specialists.
  • Travel time and costs will be less for patients who live at a distance from a specialist’s office you would normally refer them to.
  • Waiting times will be cut for patients who do need to be seen by specialists, since you as their PCP and the specialists you consult can communicate easily prior to the visit. Also, less prep time is needed for patient appointments.
  • You’ll enjoy expanded efficiency in your office — e-consults can allow doctors to preserve more time during their workdays.
  • High satisfaction. Research reviews have shown both doctors and patients find the e-consult process medically accurate and very convenient.

Practice size is not a factor when it comes to using e-consults, although practices with larger populations can benefit more expansively from the process.

Interested in trying the idea out? Talk to your organization’s administration — and ask your patients if they like the idea. E-consults can be a great way to streamline a key medical process when implemented correctly.

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Tips to help your staff prevent patient data breaches

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As a hospital administrator, you know how important it is to reduce any risk of a patient health information (PHI) data breach. Yet, breaches continue to be a vexing and dangerous problem.

A study from Michigan State University found that about 1,800 large data breaches over the course of seven years had to do with lax hospital policies putting information at risk. How can you best assist your staff and your IT to secure the data at your organization?

Let this research-based advice be your guide:

Monitor unintentional mistakes.

A second Michigan State study determined that half of the recent PHI breaches at U.S. hospitals were not caused by hackers; instead, they happened because of internal issues, often because employees were simply unaware that things they did were putting data at risk.

Behavior such as transferring PHI to personal devices, mistakenly sending protected info to the wrong parties via email and disclosing PHI without knowing how to seek the proper authorization are common ways employees contributed to breaches.

Ask your department managers to review employee behavior, and then work consistently to emphasize procedural do’s and don’ts whenever their workers handle sensitive data.

Provide more options for compliance.

Research from Washington State University found that when employees are given options as to how they can make the info they handle more secure, they do a much better job at locking that information down in a company system.

The researchers recommend avoiding cold, commanding language when issuing security messages. Instead, you should give options about different ways to choose passwords or carry out existing safeguard tasks in a conversational way. When employees think they are collaborating to make a difference, they stay on top of data protection much more stringently.

Break bad habits.

Employees can become desensitized to signs of email phishing over time — including phishing scams targeting critical PHI. Your staff members may not be picking up on clues that indicate an email is suspicious if they are distracted by multitasking.

Stress the importance of being completely focused on the red flags of suspicious emails by setting aside specific times per hour to check email, rather than doing so constantly when focus may be split.

Make security training a monthly mandate.

Up the frequency of your training workshops and refresher courses for each of your departments. Make sure the info you’re providing your workers is completely up-to-date and useful by conferring regularly with your IT managers.

Do your own homework.

Read up regularly on innovative technology regarding hospital data protection and alert your hospital CEO to updates you feel should be implemented within your organization. Being as personally proactive as you can in terms of PHI protection knowledge is the best way to stop breaches before they happen.

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Growing the muscles of communication in healthcare

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In most every aspect of healthcare, communication is key to positive patient outcomes, stellar teamwork, and the seamless operation of organizations and facilities of every size and type.

A Tower of Babel scenario in a healthcare-related circumstance is never acceptable; thus, excellent communication must be at the forefront of the education of healthcare providers and serve as a central pillar of any high-functioning institution.

How, why, and when we grow our individual and collective muscles of discourse and conversation are of utmost importance. If you, your colleagues, your leaders, or your employing institution itself are lacking in this regard, it’s not too late to change that calculus for the better.

Why Communication Matters

For nurses, physicians, case managers, executives, and other members of the healthcare team, having high-level communication skills is paramount, although many may fall short in this regard. Your ability to communicate with compassion, clarity, and coherence is essential, as is your colleagues’ abilities to do the same.

Communication is like rocket fuel for the engine of healthcare delivery — when it’s practiced well, everyone benefits, not just patients. Communication within the healthcare milieu can occur in many forms, including but not limited to:

  • Nurse-patient relationships
  • Doctor-patient relationships
  • Staff members’ relationships with one another
  • Communication between executive leadership, management, and staff
  • Institutional communication with the general public and surrounding communities
  • Inter-facility relationships
  • Cooperation and conversation within and between teams

Casual conversations occur over lunch, in the hallway, at the water fountain, and in the parking lot. In the clinical setting, urgent transmission of key information occurs during a code, in the emergency room, and any other situation requiring the flawless conveyance of crucial data, orders, and feedback.

For patients, being educated well about their symptoms, disease processes, and treatment options could not be more important. If you hear a patient complain about their healthcare experiences, it’s sadly not a surprise if they explain how they’d been left in the dark about some aspect of their care — this is unacceptable for any possible reason and no excuses can possibly hold water.

Learning Communication Skills

When they’re lacking or could be taken up a few notches, communication skills can be taught and learned in a variety of settings. Individuals, teams, and entire institutions can choose to up-level their communication skills — all it takes is the will to make it happen and securing the best method for such important learning experiences.

Medical improv” is growing in popularity as a strategy for teaching communication and listening skills, and there are a number of instructors and consultants who bring these instructional programs to medical schools, organizations, and hospitals.

Rather than being based on comedy improv like we see at clubs and on television, these are improv-based exercises that help healthcare professionals learn new skills, practice them in a safe environment, and receive and give feedback to one another in real time.

Additionally, online courses in communication are ubiquitous, as are books, audiobooks, podcasts, and other platforms.

Communication skills can be learned individually, in groups, and as a facilitywide initiative. For healthcare executives and leaders who wish to spearhead such endeavors, “walking your talk” and practicing what you preach is essential; rather than making a top-down edict about improving communication, we can lead by example and model the behavior we wish to see in the larger employee population.

Communication Leads to Success

When nurses and physicians have more effective conversations, care is streamlined and cohesive. When patients understand the education being provided to them, outcomes and adherence are improved. High-level inter- and intra-team communication are essential ingredients for success.

When healthcare institutions choose to communicate well with the surrounding community, alliances and partnerships can be formed while trust is simultaneously engendered.

As mentioned above, communication is like fuel for the engine of healthcare delivery, and the higher the quality the fuel, the more efficient and effective the engine. It’s a simple formula: improve communication on all levels, walk your talk, and watch the results roll in.

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What do elder care, robots and Japan have in common?

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While there is no shortage of attempts to stop or reverse it, we are all still aging. This year, for the first time in our history, there will be more of us over 65 than under 5 years old.

This demographic shift, combined with our increasing longevity, will continue to exacerbate the disparities between the elderly population and those available to care for them. Japan is at the forefront of this new world; providing lessons for us all to consider.

Relatable challenges

Two key concepts are critical to understanding the situation an increasing number of countries, including the U.S., are facing: demographic transition and dependency ratio. According to Population Reference Bureau (PRB), the first describes the long-term shift in birth and death rates.

For example, Japan and most countries in Europe are in what PRB identifies as the third phase, which is low levels of both fertility and mortality. A major implication of this being a shrinking working population and an increasing elderly population.

The second concept, dependency ratio reflects the relationship between the number of those who need care (children or elderly) and those who can provide care. In this case, Japan has a high elderly dependency ratio.

In addition to Japan’s aging workforce and increasing elderly population, its immigration laws, and language barriers are limiting its ability to supplement its shrinking workforce with skilled labor from other countries.

Domo arigato

These issues related to an increase in the aging population and a decrease in the labor pool able to care for them will become more common in more countries. Technology may provide some solutions and Japan is at the forefront of exploring these options.

Current real-world experiments to use robots for eldercare fall into the following categories, as outlined in this graphic by Reuters: lifting, moving, monitoring and entertainment and companionship.

While no one believes robots will replace the need for humans in caring for the elderly, robots and other technologies can address a significant number of tasks that then free up healthcare specialists to provide more specific, complicated, or individualized support.

Consider the tools we have now that already allow us to remotely monitor patients; conduct virtual video visits; alert emergency services; clean the floor; and order groceries. None of these options were available a generation ago. At the pace of technological development, we can expect even more advances within the next generation.

To infinity… and beyond!

As leaders, what can we do today to prepare for tomorrow? In addition to recognizing the significant demographic shifts around the world and keeping an eye on the tech pioneers making the link between robots and healthcare, those in the healthcare industry can stay ahead of the curve by thinking outside traditional solutions for opportunities to solve care problems.

In other words, cross-functional teams can work together to ensure we are maximizing the technology we already have, like video calling, email, and document sharing to provide care solutions instead of just addressing operational productivity. HR can begin to understand and plan for labor shortages by creating career pipelines that attract and grow new talent as well as draw from national and international sources. Leaders at all levels can support and embrace opportunities to participate in innovative professional development that embraces new technologies, like virtual reality.

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