January 3, 2014

             Reporter: Cal Lee     Editor: Ron Brown         Photographer: Leander Hauri                   

President:  Hays Englehart 2013 - 2014          

PRESIDENT-ELECT IS AN AUTHOR

Rest assured, Buddy!

Buddy Burke gave a couple of thoughts. One was from Jay Leno "Now there are more overweight people in America than average-weight people. So overweight people are now average, which means you've already met your New Year's resolution."

The other thought, attributed to Brad Paisley, can be interpreted as a commitment by Buddy himself, made immediately before New Year's Day: "Tomorrow is the first blank page of a 365-page book. Write a good one." No doubt he will.

GUESTS

Hays, always under the radar, Englehart!

Other than our speaker, there really weren't any, although the Prez tried to liven things up by telling how he hit the road for L.A. at 6:00 a.m. Christmas morning and made it in under five hours with three stops. (Actually it really wouldn't have been surprising if Hays had made it in under three hours with five stops.)

OCCASIONS

The aforementioned Buddy had an upper/downer. He and Birthday Girl Holly and her family went to the Rose Bowl. Buddy had his picture taken in front of the Rotary float. But then they all had to endure Stanford's loss. What they then should have done was to go to the Stanford-Cal basketball game the next day.

Thomas has it all!

Thomas Raeth is so spoiled. His birthday started with the whole family serving him breakfast, then a massage at the Claremont, then he was even allowed to watch the 49er game. You have already just seen the recognition amount. But Thomas gets his revenge with a challenge:   His age, which is between 50 and 60, is one year less than his birth date. How old is he?

EVENTS

Leander says, Time to clean up and clean out

Home Team Day, 1/25 (featuring Leander and Hays). Picking up and moving supplies at the Fulcher Shoppe. Also an opportunity to get rid of anything Rotarian which you have at home, adding it to our storage bin in Moraga which will then be cleaned and inventoried.

Future Vision, 2/11, 5:30-8:30 at Lafayette Library, with Past DG Laura Day. A follow-up of this event's creation five years ago. Each of us should take five minutes to summarize where we want the club to go. It's important to look forward.

Trip to India 2/25 with travel impresario Brad Howard, doing polio immunizations (see Hays' recent email).

Per Mark Roberts, the Reno train trip will be on for 2/28 to 3/2, with the signup deadline 1/27. The person in charge is David Pierce of the Orinda club.

Good idea Patrick

Speaking of polio, the good Dr. Harpole said there haven't been enough kudos for Rotary in this whole effort. To make up for that, the world's largest commercial will be appearing, to the effect that "we're this close" to ending polio. The only remaining countries are Afghanistan, Pakistan, and Nigeria (plus perhaps the impenetrable North Korea - they should check with Dennis Rodman). Patrick recommended taking a selfie, uploading it, and getting in the commercial. Skip McCowan was the quickest to volunteer.

Dennis goes all in!

The event right now, today, was that Dennis Kuramai won the raffle, won the white ball, and tossed it all to the Endowment

VOCATIONAL - OR IS IT?

Always the coolest guy in town, Mr Peeks

Thomas Peeks was the victim today, but he was probably the most relaxed of anybody. Especially since he indulges in yoga and meditation at 5 a.m. He's retired, you see. Just messes around all day. However, on cross-examination, he admitted to being a board member of Contra Costa Interfaith Housing and the Food Bank, a church usher, and just generally a professional volunteer. Last but not least, he is on the grant review team for District 5160, a very powerful position indeed.

CARING QUALITY

Lots about caring from one who knows!

Dawn Knight, president of the Las Trampas Board introduced by Pat Flaharty, one of her underlings, does a few other things as well. She was a health care executive at John Muir Hospital, where she focused on patient care and help. Dawn also is into setting quality care standards. She works with McQueen & Associates, helping government organizations navigate health care systems.

Quality care is quite subjective. In asking consumers what factors should be taken into account, answers include taking particular note of the building, access to care, experience, absence of harm, and dollar value. Most people, however, just go and get taken care of without knowing what's being done. A good bedside manner may do much to avoid a lawsuit.

The harm that is done is far more transparent in the 21st century. In 1999, a report by the Institute of Medicine entitled "To Err Is Human" shocked a world where there had been very little transparency previously. Most of its data came from records of the hospitals themselves. Figures from 44,000 to 98,000 people dying due to human error were cited, making this the sixth leading cause of death by unnatural causes. As might be expected, there was controversy and denial.

The leading sources of this difficulty were medical errors, lab errors, infection, and wrong procedure. Medical errors were the most harmful, but perhaps the most common situation was infection, which occurred to seven out of every 100 hospital patients. Amazingly, an ongoing difficulty is the failure to wash hands.

A lot of oversight has developed, including Licensure, mandatory reporting, medical record review, health care personnel oversight, med-licensing and privileges. There is a big push for growing transparency and public access.

Knowledge is power!

Public data is very available, on a big data base to which errors are required to be reported. The data is from charts which are reduced to highly regulated code, which is the source for hospital bills. Administrative penalties are self-reported by county, and these show on the website. The State reviews each error, although there is controversy over whether penalties may be counterproductive, in that they may cut down on complete reporting.

US Health & Human Services puts out hospital profiles. If you type in a hospital name, the site will show whether there is compliance with a great many standards. Most of this is from Medicare data.

There are also rating agencies such as US News & World Report, Leapfrog Group, and Zagat, which tend to have different data sources but can be useful.

Most hospital records are still handwritten in this technological age. Dawn showed a write-up where the error hinged on a dot - the reference to "8" was mistaken for "80", and giving someone 10 times the prescribed amount of insulin is not good. Regulations on how to write are being adopted but are still in progress.

Checklists are relatively new in medicine, although they are old stuff to airline pilots. They are still evolving and have met resistance for a long time. A picture of scissors left inside a patient was a powerful argument on this point.

So what is quality? Access = basic care available. Experience = be nice. Absence of harm = don't hurt me. In the end, you decide - try to be savvy and informed, don't assume, and bring support (of the human variety). Don't be shy - ask, ask, ask!

Next week: The dollar and the bitcoin, courtesy of Dennis Kuramai. We could ask, how many bitcoins has Rotary spent on polio.