Podcast appearances and mentions of ariadne labs

In this special farewell episode of BACON, Heather and Mike welcome Dr. Asaf Bitton, keynote speaker for the upcoming MaineHealth ACO Value-Based Care Symposium on May 14. As Executive Director of Ariadne Labs and a leader in primary care innovation, Dr. Bitton shares insights from healthcare systems worldwide and discusses the evolving roles of primary care and specialists in risk-based models. Be on the lookout for our new podcast, Curbside Consult, in May!

In this episode, Dr. Atul Gawande joins Dr. Patrick Georgoff to share his experiences as a surgeon, writer, and global health leader. From his innovative work at Ariadne Labs and Lifebox to his current role as Assistant Administrator for Global Health at USAID, Dr. Gawande discusses the challenges and rewards of creating large-scale impact. He reflects on balancing creativity in writing with precision in surgery, lessons learned from managing teams, and the critical importance of strengthening global health systems.  Enjoy! Dr. Atul Gawande is the Assistant Administrator for Global Health at the U.S. Agency for International Development, where he oversees a bureau that manages more than $4 billion with a footprint of more than 900 staff committed to advancing equitable delivery of public health approaches around the world. The Bureau for Global Health focuses on work that improves lives everywhere--from preventing child and maternal deaths to controlling the HIV/AIDS epidemic, combating infectious diseases, and preparing for future outbreaks. Prior to joining the Biden-Harris Administration, he was a practicing surgeon at Brigham and Women's Hospital in Boston and a professor at the Harvard Medical School and the Harvard T.H. Chan School of Public Health. He is the founder and was the chair of Ariadne Labs, a joint center for health systems innovation, and of Lifebox, a nonprofit making surgery safer globally. From 2018-2020, he was also the CEO of Haven (an Amazon, Berkshire Hathaway, and JP Morgan Chase healthcare venture). In addition, Atul was a longtime staff writer for The New Yorker magazine and has written four New York Times best-selling books: Complications, Better, The Checklist Manifesto, and Being Mortal. Visit https://www.usaid.gov/organization/atul-gawande to learn more about our special guest.  To learn more about the Global Health Bureau, please visit https://www.usaid.gov/global-health.  Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Humans have always been obsessed with getting old, or rather staying young, but now science is beginning to catch up. Longevity has become a hot topic, from university laboratories to Silicon Valley startups. In the final episode of a special Science Weekly three-part mini-series on ageing, Ian Sample meets Dr Rachel Broudy, medical director at Pioneer Valley Hospice and faculty lead of eldercare at Ariadne Labs, to find out how we can stop fearing our old age, and perhaps even make it fun.. Help support our independent journalism at theguardian.com/sciencepod

After working alongside healthcare providers in under-resourced countries, today's Raise the Line guest Dr. Rebecca Weintraub came to see that the desire to serve patients and the curiosity to learn how to be the best clinician possible are universal, but the best tools to do so are not.  That's what led her to launch the Better Evidence program at Ariadne Labs which designs, tests and scales data-driven digital tools that help manage diagnostic and therapeutic uncertainty. Currently, Better Evidence engages over 200,000 current and future clinicians and public health leaders in a 147 medical schools and clinical sites across 182 countries. “If you are an isolated provider or a trainee, we believe evidence-based clinical tools help you improve your clinical confidence and clinical acumen. We're trying to help create the habits of educating yourself on the journey to being an excellent clinician.” In this illuminating conversation with host Hillary Acer, Weintraub also talks about other capacity-building work such as helping to prepare clinicians for major public health roles, and the critical importance of providers having reliable internet and cell connectivity, something she expects will improve in the near future. Don't miss this on-the-ground view of some key elements in improving the delivery of healthcare across the globe. Mentioned in this episode: https://www.better-evidence.org/

This week we talk about designing human-centered care, at home. Gregory Snyder is a clinical innovator and physician executive leading technology-enabled care delivery models to improve healthcare quality and safety. He is a graduate of Princeton University, Sidney Kimmel Medical College at Thomas Jefferson University, Brigham & Women's Hospital Internal Medicine residency, and Harvard Business School. He practices hospital medicine at Mass General Brigham Newton-Wellesley and is Entrepreneur-in-Residence at the Mass General Healthcare Transformation Lab. Greg is Clinical Assistant Professor at Tufts University School of Medicine, Associate Faculty at Ariadne Labs, and adjunct faculty for the Institute for Healthcare Improvement. He is focused on scaling virtual hospital at home programs and improving the quality and safety of home-based care as Vice President of Clinical Strategy & Quality Improvement for Medically Home. Greg has partnered with diverse healthcare technology ventures to improve healthcare quality, safety, value, and experience. Episode mentions and links:  Medically Home Greg's restaurant rec: Parc Philadelphia Follow Greg: LinkedIn Episode Website: https://www.designlabpod.com/episodes/125

Washington Post senior writer Frances Stead Sellers speaks with Michelle A. Williams, dean of Harvard T.H. Chan School of Public Health, and Asaf Bitton, executive director of Ariadne Labs, about the decline of life expectancy in the United States and assess what's driving these numbers. Conversation recorded on Monday, April 10, 2023.

Robyn Bolton is the Founder and Chief Navigator of MileZero, a consultancy that helps companies fuel innovation in their culture and products. As an expert in product strategy and innovation, she has worked with Nike, Nestlé, The Cable Center, Medtronic, Ariadne Labs, and Alexion, among many other leading names. Robyn's prior experience includes nearly a decade at Innosight, as Brand Manager at Proctor & Gamble, and as a consultant at Boston Consulting Group. Additionally, she has written for Forbes and Harvard Business Review and has been featured in The New York Times and NPR Marketplace. In this episode… Companies want their operations to be efficient, but they also want to be innovative industry leaders. Combining both these ideals can be challenging. Frequently innovation takes a back seat to the status quo of smooth operations. So how can leaders foster creative ideas within their organizations to stay ahead of the industry curve? This process is far easier said than done, with many converging reasons that keep innovation at bay. Great ideas are rarely given the proper consideration or the support they need to become something extraordinary. Robyn Bolton is an experienced consultant who has worked with countless leading brands, pointing them along the path toward innovation. According to Robyn, a lack of innovative ideas in your organization is due to a problem within the company's leadership. Leaders don't always realize that a culture that accepts new ideas doesn't exist within the company. In this episode of Next Wave Leadership, Robyn Bolton, the Founder and Chief Navigator at MileZero, returns to talk with Dov Pollack to break down innovation within the company structure and how it's a team sport. They touch on key leadership concepts and how they affect innovation, creating a culture that's conducive to fresh ideas, and why it's important to give accurate feedback early on in the process. Robyn also discusses essential questions that can create a positive impact throughout your company.

Josh and Brian are joined by Dr. Asaf Bitton, executive director of Ariadne Labs, and Associate Professor of Medicine and Health Care Policy at Harvard Medical School and the Harvard T.H. Chan School of Public Health. They discuss the need to move to value-based care and change the payment structure. They also reflect on the historical underfunding and undervaluing of primary care.

In the second of this two-part ASCO Education Podcast episode, Drs. Stephen Berns (University of Vermont), Tyler Johnson (Stanford Medicine), and Katie Stowers (Oregon Health & Science University) continue their discussion about what it takes to deliver serious news to people with cancer effectively and compassionately. If you liked this episode, please subscribe. Learn more at https://education.asco.org, or email us at education@asco.org.   TRANSCRIPT [MUSIC PLAYING]   STEVE BURNS: Hello, and welcome to the second part of ASCO's Education Podcast focused on clinician-patient communication in the context of delivering serious news to patients and families. My name is Steve Burns. I'm an internist, hospice, and palliative care physician and associate professor of medicine at the University of Vermont College of Medicine. Once again, I'm joined by Katie Stowers, a hospice and palliative care physician and assistant professor of medicine at the Oregon Health Science University, and Tyler Johnson, a medical oncologist and clinical assistant professor of medicine at Stanford University. In our previous episode, we spoke about what constitutes serious news, the best modalities for delivering serious news particularly in the wake of COVID, who might be the best person to deliver it, and the importance of the care team as a whole. We left off on the question, how do we prepare for delivering serious news? Let's continue the conversation. [MUSIC PLAYING]   TYLER JOHNSON: Katie was talking about how we need to be realistic about the way that a conversation is going to impact us in addition to the way that it's going to impact the patient. And one thing that I have realized is that a headline, for those who maybe haven't had evals of training, is just a concise summary statement of sort of the big picture of what's going on, just like buying a newspaper article. And what I have recognized is that oftentimes, I have this almost visceral reaction against giving a headline. And if I drill down just a little bit, what I find is I don't want to give the headline because then I'm really going to have to say things the way that they are, right? If I give a five minute disquisition on creatinine and edema and chemotherapy, immunotherapy, therapeutic options and whatever, right? Then, I can just like talk a cloud around things and never actually say what it is that I'm trying to say, which then gives me the advantage of feeling like I said it, but actually sort of knowing that I never actually said it, right? And so I think the thing that the headline does is it forces me to say the thing. And then once the thing is out in the open, then we can talk about, if necessary and appropriate, some of the other nuances and whatever. But all of that is to say that often, the greatest barrier to doing that is an unwillingness to be real with myself about the information that I'm really trying to convey. KATIE STOWERS: I think this is another really great opportunity where when partners go in together, it's easier to get into the moment if you get the opportunity. Someone with a little bit of accountability, but also somebody to help you. Maybe you're able to get out the facts and they're able to tie-in the meaning. Or you end up going bigger than your headline and they're able to say, I think what you were trying to say was dah-dah-dah-dah-dah, and help really get back to that core. STEVE BURNS: It does say that we all, before we share serious news, making sure whoever you're going in with, you're on the same page. And having a pre-meeting is so important. And what I often do with my pre-meetings is I come up with the headline as the group, right? So we're all clear about what is that headline so that when we go in, we can, in some ways, also hold each other accountable for that headline. KATIE STOWERS: I think also, a little bit of who's going to say it too. Like, is that something that you feel comfortable saying, or would it be easier for somebody else to say? Are there parts of it, and then parts of it that I can do, I think, can be really helpful. TYLER JOHNSON: Yeah. It's funny, because sometimes, even though I'm pretty tuned into these things and I try really hard to do them well, I still find that there are times as a medical oncologist when the palliative care doctor who is unfailingly ever so nice and gracious about it, ends up being like the real human translator for my medical leads. So I, like, say some word cloud. And then the palliative care doctor, like Katie just said, is like, if I can say that what Dr. Johnson was trying to say right there is something in normal human English speak. And then, as soon as they do that, I'm like, oh. But that can actually be really helpful. And again, I think it's obviously not meant to slight me. It's not meant as an affront, right? It's just sometimes, it's just kind of hard to quite get there, right, and to quite say the thing. And sometimes, having someone to help. Like, you get 80% of the way there, and then having somebody else get the other 20% is really, really meaningful. And it also, in a strange way, kind of allows us to share the emotional burden a little bit, right? So that it doesn't feel like, oh my gosh, this is just me saying this thing. There's something about having other members of the team there to kind of hold your arms up as you're doing that that's really meaningful. KATIE STOWERS: I worry that part of this conversation is saying like, oh. Some people are really good at this. Some people aren't. I don't think that this is a palliative care physician's good the whole time. I think this is a normal human experience. This just happened to me. This week in clinic where my patient was like, you just told me like a five minute story of things I already know. And I still don't know any more information. And I was like, oh, that wasn't really clear at all, was it? So I mean, I think it's when our nerves pop up. When we are uncertain or unclear about what it is that we want to say or just really nervous about doing it, like, I think this is our normal human default to go back to beating around the bush. But it definitely, as Steve mentioned, is a skill that we can learn and continue to practice. And it's also really helpful to have somebody there who can hold your feet to the fire and help you in the moment. STEVE BURNS: Katie, I'm so glad you mentioned that. I just think about even for us as palliative care physicians, who do serious illness conversations all the time, catching ourselves doing some things because we are being affected by the conversation and our well-being. I remember a couple of weeks ago, how hard it was for me to say dying and death. And I know. I've been teaching my learners say the D word. It's OK. It's direct. It's straightforward. And then all of a sudden, I was in the middle of the conversation and I noticed I was struggling saying death. And so again, just to say we are human, that these conversations affect us. And having team support is so helpful in the moment. Because the chaplain who I was with said, what we're saying is we're worried that she's dying. And I was like, oh thank god. She said it. TYLER JOHNSON: And the other thing too, right, is that I think it's helpful in a sense to recognize that the difficulty with giving a headline or with saying death or dying or whatever is an impulse borne of human compassion. I mean, it's not because we're bad people. It's because we have good hearts and because short of maybe clergy members, there's really nobody else in the way that human ecosystems are set up that does this, right? It's just a hard thing to do. And recognizing that it's hard and recognizing that we ourselves are having a hard time with it, is not some failing of doctoring. I would say that actually, this is one of those weird instances where having that consistent struggle, that should be a tension that should define part of how we doctor. Because if the tension goes away, that's actually more worrisome than if the tension continues to be there, though we have to find productive ways to engage with it. STEVE BURNS: Yeah. We did a study in 2016, the Vermont Hospice Study, and similar to actually, what Cambia Health Foundation found, why people don't engage in serious illness conversations. And one of the biggest reasons was taking away hope or hurting people's feelings and in causing emotional distress. We also know with the literature that most patients, up to like 90%, 95%, want to know the truth because it helps them better make decisions. And I think we can deliver prognosis in a compassionate way. And I think practicing that in the kind and caring way that's person-centered, asking them, what do you know? Is it all right if we talk about this right now? Delivering in a headline and responding to emotion can help make that a more compassionate conversation. Although it still doesn't take away the human feeling that I'm worried I'm going to hurt someone in this conversation. TYLER JOHNSON: Almost always in my experience, patients who have metastatic disease, or for some other reason, disease that is known from the get-go to be incurable, in one of our first discussions, they will ask some version of the question of how long do I have, or what are things going to look like going down the road? There's good evidence to demonstrate, and it has also been my personal experience, that we're really bad at answering that question at the time of diagnosis, right? Because we don't know anything about the biology of the tumor, the response of chemotherapy, what the molecular markers are. There's a whole host of things that just make it so we almost always cannot answer the question accurately even if we try. And so what I will usually do is I will tell patients, I'll say, when they ask some version of that question, I'll say, look. I need you to know that, first of all, I can't answer that question right now. I'm not obfuscating. It's just, I would be lying if I gave you an answer because we just don't know. But I want to let you know that what is true is that I can usually tell when things are starting to go in the wrong direction. And unless you ask me specifically to do otherwise, I promise you, the patient, that as soon as I recognize that things are heading in a direction that I'm concerned about, I will tell you that in so many words so that you understand what I'm talking about. And then we will have a discussion about where to go from there. And then, when we get to that point, whether it's six weeks later or six months later, or sometimes six years later, I will say-- because I do this with all my patients-- I'll say, do you remember when I made you that promise way back when or a few months ago, whatever it is? And then I'll say, I hope that I'm wrong here. But I'm concerned that we may now be in that place. And I want to tell you why, and then I want to talk about where to go from there. Because that then situates this difficult discussion in the context of this relationship of trust that we've been building over however long I've known the patient. And I have found that that provides a trusting context within which to have the more difficult conversation that has been really helpful. STEVE BURNS: Noticing the time, I'm curious, how does the task of delivering bad news affect your own well-being? TYLER JOHNSON: Just to remind people, we said this before, but I just think it's important to recognize that this being a heavy thing is normal. And recognizing that is normal and that it really is-- I mean, there's some degree to which you can do this well and that will lighten the burden to some degree. But you have to make sure that you're filling your own reservoir, right? You can't pour empathy out of an empty reservoir. And so I think you have to make sure that you're filling that in whatever the ways are that you do. KATIE STOWERS: I just think I was thinking about that too, Steve. One other thing that I wanted to build off of, this fear and this worry that we bring to these conversations, that I'm going to send them into a tailspin of depression. Or I'm going to take away all of their hope. I think there is the other part of this that I get to see as a palliative care physician, which is the high degrees of distress that often come from not knowing this information, that's really helpful in preparing and planning for the future and almost this sense of relief. Even when it's unfavorable, even when it's not what they wanted to hear, there's a relief in knowing and being able to do something with it. So that limbo and uncertainty. the idea that something terrible is out there or they can't prepare for it can be really distressing. And so to some degree, we're helping to heal by being able to move into some planning. STEVE BURNS: Yeah, I totally agree that it's such an important thing to minimize the stress of uncertainty. And the other piece that I think about is these are really sacred moments where we can really connect with our patients, share the news, find out how they're doing with it, and then find out what really matters in their lives. I think that really helps be my north star when it comes to continuing the care that I'll provide for them in their families. TYLER JOHNSON: Yeah. You know, there's a really harrowing, in some ways, but beautiful moment. And many of you will probably have read the book Just Mercy, which is written by this lawyer who's fighting for justice, particularly racial justice, for people who have been unfairly treated by the justice system in the deep South. And there's this moment towards the end of the book where a person who he had been fighting for who was on death row has just finally been executed. And he goes home and sort of just collapses crying. And then he writes really beautifully about how this moment of sort of shared vulnerability, where he kind of recognized that the reason that this was so hard was because even though he was vulnerable and broken in different ways than the person who had just been executed, it was still sort of a shared sense of vulnerability. It was what made his work hard, but also what made his work beautiful. And I think that in a similar fashion, when we have these really difficult discussions, I think that while there is a real moral weight and difficulty to it, there is also just as you said, they also end up being some of the most meaningful, memorable, and beautiful moments. STEVE BURNS: As a clinician, what have you learned over the years regarding communication with patients that may help others navigate scenarios where they can deliver serious news? I was just on service with a trainee. The team was delivering serious news. It was serious news around lung cancer. And the team's like, this patient's just not getting it. And we tried to explain it over and over again. And they're not getting it. And then my trainee went in and attempted and said, yes. Here's your diagnosis. We're concerned it's incurable. And you likely will die in the next year or so. And the patient said, no. I'll be fine. So we hypothesized before going in the room with me, like, what it would be. And what it came out is maybe it's not they're not understanding it. Maybe it's emotion. So we went back in. And sure enough, my trainee did wonderful and responded to emotion and said. It must be really hard hearing this news. And the patient immediately got sad and said, I'm really scared. And we unpacked that a little bit. And when we left the room, he said to me, yeah. That was emotion. He totally gets it. He's just upset. And so I just want to reiterate the idea, sometimes, it's not that they're not understanding it. It's that it's a lot to process. And there's a lot of feelings behind it. KATIE STOWERS: Building on that, one of the things that I see happen a lot around emotion is the health system is not set for people to process and to come to terms with these hugely life things and life-altering things. There's not time for people to process what this means for their life to term and process that emotion. And we're constantly pushing. And sometimes it almost could feel like badgering, really trying to get a decision to come where, with some degree of autonomy and some degree of time, allowing them to really process. People, a lot of times, get to where they need to go. But it's a process of really being able to deal with. STEVE BURNS: Yeah. TYLER JOHNSON: Yeah, the only thing that I will add is that these conversations, when they need to happen, work best when I have been mindful of laying the groundwork for the conversation over the entire arc of the illness. Rather than thinking of, oh, this is the thing that I do right when someone is getting close to dying. Because if you've never laid the groundwork and then you try to have the discussion, then when the person is really, really sick and in the hospital or whatever, of course, there's still a better and a worse way to do that. But even the best conversation if it's that isolated incident, in my experience, is nowhere near as good as if we have been transparent and building trust and building a sort of a shared vocabulary with the patient over the course of the illness. So that then, when they get to having to have quote, "the discussion" unquote, it becomes just one part of this longer chain rather than an isolated happening. And that really gets to what I was saying earlier about the promise that I make my patients when they first ask that sort of big picture question. That even though I'm not in a good place to talk about it right then, that I promise them that when it comes time, I will talk with them about that with candor. That makes an enormous amount of difference. I know I had a trainee who was with me one time who was a continuity fellow with me and had heard me make that promise to a number of patients and the first time he was with that same patient when it came time to have that discussion. And I said, well, you remember that promise that I made the first time I met you? And he could, for the first time, see all of the dots connect over the arc of the illness. It was like, whoa. Like, there's just really this power that comes. But you have to have been building it piece by piece over time. STEVE BURNS: I think both of you are highlighting for me two reminders that I want to keep in mind every day when I'm delivering serious news. One is sort of having an agenda but being flexible with my agenda. And I remember during my training, one of my mentors said, keep your agenda out the door. Don't force your agenda on the patient, as Katie mentioned. And yet, have a plan and still go in with that plan. The other piece that Tyler, you're reminding me of, is the importance of the arc of the conversation and how continuity. Because we build off of conversations from visit to visit. And yet, sometimes, someone else is taking over for us or they end up in a hospital or they end up in a nursing home. And it reminds me how important documentation is to convey what happened in that encounter. What was said, what was the headline that was shared, how did the patient respond, and then what was the plan. And far too often, we usually just write the results of the conversation. TYLER JOHNSON: Yeah. One last thing that I want to put a specific plug in that I have found to be enormously important, I think all of us would agree that amidst all the conversations that we might have as part of taking care of a patient, this is the one where shared decision-making matters the most. And yet, if you ask most people, even experienced doctors, how do you engage in shared decision-making around this kind of question? That's really tricky, right? Because I think what often ends up happening is that we either default to being very prescriptive where we go in and say, well, you should do this or shouldn't do this. Or we default to being waiters with the menu. Like, well. OK, so would you like some intubation on the side of CPR? And so, I think that both of those models are equally problematic and that the tool, the specific tool that has helped me really learn about how to do shared decision-making and even provides the specific words, is what's called the Serious Illness Conversation Guide from the Ariadne group at Harvard, which is the group founded by Atul Gawande and his colleagues. And I think that that gives a very brief script which, I mean, you can literally almost just read. You can get a little card that you can carry in your pocket or whatever. And it gives-- and the entire conversation in most cases, takes maybe 10 or 12 minutes. But it gives you the point-by-point things to say and really allows you to meaningfully engage in shared decision-making so that you spend the first half of the conversation listening to the patient's priorities and values, and then the last maybe third of the conversation, using that to make meaningful recommendations. And so again, it's called the Serious Illness Conversation Guide. And I would really recommend to listeners that they look it up. STEVE BURNS: That's a really great segue to what training and resources are there for clinicians and oncology trainees to improve their communication skills. The three resources that I can think about are Vital Talk, the Serious Illness Conversation Program out of Harvard and Ariadne Labs, and then they have a rich program which is from the American Academy of Communication of Health Care. All three are different ways of approaching communication skills training. I always think about the Serious Illness Conversation Programs about raising the floor to make sure that we hit the basics. And then Vital Talk is if you want to flex your muscles or flex your skills when it comes to how do I respond to really intense emotion, or if someone's avoiding the conversation, what do I do? They train with raising the ceiling or their goals to raise the ceiling. And Vital Talk actually came out of oncology conversations first with OncoTalk almost 20 years ago. And really thinking about not didactic-based, but practice and skills-based training. And I certainly have found it rewarding and life-changing for me, where I could actually label the things that I do every day, give myself some feedback, and then teach my trainees. TYLER JOHNSON: And I will just add, as a medical oncologist who has both taken the Vital Talk course and now is trained and teaching Vital Talk courses, that this is not just for palliative care doctors. And I think that it is particularly-- I mean, you may not have the interest or passion to want to become a Vital Talk trainer, which is understandable if you're a medical oncologist, either a busy practice or a heavy research portfolio. But it's just to say that they offer 1 and 2 and various iterations of courses, depending on how intensely you want to study these things. But it's just to say that the skills that they teach are concrete. This is not some sort of head in the clouds theoretical exercise. I mean, they're taught very concrete skills that you can wake up the next morning and employ you in your practice. And that I think to a point that is often counterintuitive to us, I think that we are almost afraid, as oncologists, to know about this because we think, oh my gosh. I didn't have time to engage in these long discussions. There's no way. But my experience has actually been what this does at the end, is it actually makes you more efficient. I know that seems counterintuitive, but we spend so much time sort of beating around the bush around this stuff that we actually end up making ourselves take longer. And having really concrete skills for how to have these discussions can actually make your practice more efficient for things that otherwise can really eat up a lot of time. KATIE STOWERS: I do a lot of teaching in Vital Talk incentives. It sounds like both of you do as well. But the piece of feedback that I hear from trainees that come take courses-- and I do a lot with oncologists and oncology fellows as well-- is oh, these are the things that I've seen in conversations at work that I never had a name for. Like, you're putting a name on something that I've seen. And maybe I've done a couple of times, but I didn't know that I was doing it this way. And especially for my colleagues who are practicing providers who teach others, they really love having a name and a framework for being able to teach these skills to others. It's not some magic fairy dust that you either have or you don't. It's actually, here's a skill that I can pass on to you and you can practice. And I can watch for, and we can have some feedback about. And I have seen that being a really enjoyable part of doing this framework. We have that, right, for almost every other part of medicine. But because communication is something that's so innate and personal, that hasn't always been the case around communication. And so I really love that about Vital Talk, that they've taken these pieces and put names on them. Because this is how you give communication clearly, information clearly, is the headline. This is how you show someone that you care about them. These are empathic statements. And that's something that we can use as a third language when we're going into team meetings together or when we're teaching a trainee. STEVE BURNS: It's one of the most important skills that we do every day, and probably the most important procedure that we do on a regular basis in all of our fields. TYLER JOHNSON: And I think you can tell from the way that the three of us have discussed delivering a headline during this podcast, that this is not like a thing that we learned seven years ago and then just sort of left in a drawer somewhere, right? Like, this is something that we're actively thinking about as we actually take care of patients every day, which is to say that it really is very applicable. STEVE BURNS: I feel like that's the time for today. This has been a really great conversation. Thanks so much for both of your insights and participation in this episode of the ASCO Educational Podcast. KATIE STOWERS: Thanks for inviting us. It's been great to be here. TYLER JOHNSON: Thanks so much. It's been a pleasure. [MUSIC PLAYING]   SPEAKER 1: Thank you for listening to the ASCO Education Podcast. To stay up to date with the latest episodes, please click Subscribe. Let us know what you think by leaving a review. For more information, visit the comprehensive education center at Education.ASCO.org. SPEAKER 2: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

Although primary care is the lifeline of a health care system, the United States spends less on it, and more on specialty care, than other high-income countries. This sends a message to our primary care workforce: we don't value what you do. The result? Burnout, high turnover, physician shortages—all of which were dire crises before the pandemic but are even worse now. On the latest episode of The Dose, host Shanoor Seervai asks Asaf Bitton, M.D., executive director of the health innovation center Ariadne Labs, what it will take to rebuild the nation's broken primary care system. “What we've learned over these last 15 or 20 years is that primary care is a team sport,” says Bitton. A modern practice cares for a well-defined population using “technology in a different way… to start building a much more integrated primary care of the future.”

Press conference from the Harvard T.H. Chan School of Public Health with Rebecca Weintraub, director of vaccine delivery at Ariadne Labs. This call was recorded at 11:00 a.m. Eastern Time on Thursday, December 9th.

Dr. Neel Shah, MD, MPP is an Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School (part-time), and Chief Medical Officer of Maven Clinic, the largest virtual clinic for women's and family health. As an obstetrician-gynecologist at Beth Israel Deaconess Medical Center in Boston, Neel cares for patients at critical life moments that range from childbirth to primary care to surgery. As a scientist and social entrepreneur, he is a globally recognized expert in designing solutions that improve health care, and is listed among the "40 smartest people in health care" by the Becker's Hospital Review. His work to build equitable, trustworthy systems of care has been profiled by the New York Times, CNN, and other outlets, and is featured in a forthcoming documentary produced by Oprah Winfrey and Yance Ford. He has written more than 50 peer-reviewed academic papers and contributed to four books. Prior to joining the Harvard faculty, Neel founded Costs of Care, an NGO that curates insights from clinicians and patients to help delivery systems provide better care. In 2017, he co-founded the March for Moms Association, a coalition of more than 20 leading organizations, to increase public and private investment in the wellbeing of mothers. Neel serves on the national advisory board of the Office of Women's Health Research at the National Institutes of Health, and as founding director and senior advisor to the Delivery Decisions Initiative at Ariadne Labs. Bon and Neel talk about why so many women in the U.S. die in childbirth, affirming dignity in healthcare, and Neel's mission on redesigning childbirth.

Robyn Bolton, the Founder and Chief Navigator of MileZero, helps executives use innovation to unlock the potential of their organizations, get real results, and create a map for future success. Robyn began her career at Procter & Gamble, where she gained hands-on experience in corporate innovation by leading the North American launch of Swiffer and Swiffer WetJet. At MileZero, Robyn has worked with Medtronic, Ariadne Labs, Teachers Pay Teachers, and more to transform customer insights into viable businesses. She has also assisted organizations including Alexion, Sanofi, and The Cable Center in building their innovation capabilities and cultures. Before this, Robyn was a Partner at Innosight, the innovation and growth strategy consulting firm founded by Harvard Business School Professor Clayton Christensen. In this episode… How can you use innovation to unlock your business' potential and get real results? Building the skills and filling the gaps for business innovation can be difficult. But, according to Robyn Bolton, applying new ideas and having passion are the first steps. With years of experience in the world of innovation, Robyn knows how to unlock the potential that already exists within a business in order to produce real results. As she says, there is no innovation without people and their passions. Robyn helps companies decide with their hearts and justify with their heads — and use these emotions as the seeds to success. So, are you ready to travel the road to success? In this episode of Level Up, Nick Araco talks with Robyn Bolton, the Founder and Chief Navigator of MileZero, about how to use corporate innovation to create a roadmap for future success. Robyn discusses the importance of slowing down to find the right solution, navigating the waters of innovation to reach milestones, and staying focused on the problem you're solving. Stay tuned to learn how to achieve greater success today!

Press conference from the Harvard School of Public Health with Rebecca Weintraub, director of vaccine delivery at Ariadne Labs, Mansi Kansal, product manager at Google Health, and John Brownstein, chief innovation officer at Boston Children's Hospital. This call was recorded at 12:00 p.m. Eastern Time on Thursday, June 10th.

Press conference on coronavirus (COVID-19) from the Harvard T.H. Chan School of Public Health featuring Evan Benjamin, associate professor in the Department of Health Policy and Management and chief medical officer of Ariadne Labs, a joint center for health systems innovation at Brigham and Women's Hospital and the Harvard Chan School. This call was recorded at 11 a.m. Eastern Time on Friday, May 7th.

Press conference from the Harvard School of Public Health with Rebecca Weintraub, assistant professor at Harvard Medical School and an associate faculty member at Ariadne Labs, a joint center for health systems innovation at Brigham and Women's Hospital and Harvard School of Public Health. This call was recorded at 12:30 p.m. Eastern Time on Thursday, March 4th.

THE LEARNING ACCELERATOR AND THE PARABOLA PROJECT ALL ABOUT BRINGING EDUCATION AND PUBLIC HEALTH EXPERTISE TOGETHER DURING THIS PANDEMIC : Margaret Ben-Or of Ariadne Labs and Jin-Soo Huh a managing partner at Learning Accelerator are my guests CLICK THRU AND CHECK OUT  THE PREK-12 EQUITY CONSORTIUM, FREE TO EDUCATORS AT ACE-ED.ORG. READ OUR JOURNAL EQUITY&ACCESS WHILE THERE.  

THE LEARNING ACCELERATOR AND THE PARABOLA PROJECT ALL ABOUT BRINGING EDUCATION AND PUBLIC HEALTH EXPERTISE TOGETHER DURING THIS PANDEMIC : Margaret Ben-Or of Ariadne Labs and Jin-Soo Huh a managing partner at Learning Accelerator are my guests CLICK THRU AND CHECK OUT  THE PREK-12 EQUITY CONSORTIUM, FREE TO EDUCATORS AT ACE-ED.ORG. READ OUR JOURNAL EQUITY&ACCESS WHILE THERE.  

With COVID-19 vaccinations rolling out across the country, there's hope that more schools in the U.S. will soon go back to in-person learning. But there is also a sense of added urgency. But new strains of the coronavirus are emerging, bring a new sense of concern. Asaf Bitton, a physician, public health researcher, and executive director of Ariadne Labs, talks about how soon he sees a chance for kids to have "just a regular boring school day" again.

In this episode of Pandemic Planet we speak with Asaf Bitton, Executive Director at Ariadne Labs and a member of the CSIS Commission Strengthening America's Health Security. Asaf Bitton is a practicing primary care physician, a researcher and professor, and a leader in health system innovation. We discuss the vital role of primary health care in creating a healthier, more equitable, and safer world. Why do strong health systems remain an elusive goal despite decades of international commitment? How has the global pandemic impacted routine health services worldwide and what will be the long-term cost? How can accessible primary care services help identify and respond to emerging threats to global health security?   If you'd like to find out your place in the Covid-19 vaccine line (ranked out of 100), you can find the vaccine tool that Ariadne Labs co-created here.

“If your c-section is high that means that you’re not supporting people in labour, that’s just a fact.” - Dr Neel ShahA cesarean section, or c-section is the most performed major surgery on the planet, it is also the most controversial. In the many years since they have been introduced, mortality and morbidity rates - the rates which this intervention has been introduced to lower, have increased and women are more likely to die in childbirth in this generation, than their mothers. Today on the show we bring you the insights and experience of Dr Neel Shah, Assistant Professor of Obstetrics, Gynaecology and Reproductive Biology at Harvard Medical School. Listed among the “40 smartest people in health care” Dr Shah has written more than 50 peer-reviewed academic papers and contributed to four books, including as senior author of Understanding Value-Based Healthcare (McGraw-Hill). We talk equity and safety in maternity healthcare and reducing the C-section rate. Some alarming stats alongside lots of hope are in the pot today, grab your notebook and writing apparatus and enjoy the powerful slow cooked gen.“.. that means, in 2021, the biggest risk factor for a mother anywhere in the world to get a c-section, is not her personal risks or her personal preferences but which hospital she goes to”“The wellbeing of mothers is the bellwether for the wellbeing of all of us”“If mothers are unwell, society is unwell”. - Dr Neel ShahDr. Neel Shah, MD, MPP, FACOG, is an Assistant Professor of Obstetrics, Gynaecology and Reproductive Biology at Harvard Medical School, and Director of the Delivery Decisions Initiative at Harvard’s Ariadne Labs. As an obstetrician-gynaecologist at Beth Israel Deaconess Medical Center in Boston, Dr. Shah cares for patients at critical life moments that range from childbirth to primary care to surgery. As a scientist and social entrepreneur, he is a globally recognised expert in designing solutions that improve health care.Dr. Shah is also founder of Costs of Care, an NGO that curates insights from clinicians and patients to help delivery systems provide better care. In 2017, he co-founded the March for Moms Association, a coalition of more than 20 leading organisations, to increase public and private investment in the wellbeing of mothers. Dr. Shah currently serves on national advisory boards of the Planned Parenthood Federation of America and the Office of Women’s Health Research at the National Institutes of Health.Show links:Find more about Dr Shah here: https://scholar.harvard.edu/shah/home & https://www.hsph.harvard.edu/neel-shah/Harvard's Ariadne Labs: https://www.ariadnelabs.org/about-us/March for Mums: https://marchformoms.orgExpecting More: https://www.expectingmore.orgWe'd love to hear from you, if you have any questions/comments about this, other interviews or our work at PBB Media, shoot us a line at hello@pbbmedia.org.Guest: Dr Neel ShahProduced, edited and presented by Annalee AtiaThe Pregnancy, Birth and Beyond show is part of a wider nonprofit community media and journalism project, PBB Media.All rights reserved. www.pbbmedia.orgPregnancy, Birth and Beyond comes to you from Bundjalung Country at Cavanbah or Byron Bay and we acknowledge with respect and reverence the Arakwal people of the Bunjulung nation, neighbouring clans and people for caring for this country since time immemorial.

In this episode, I talk with Prof. Neel Shah, an Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, and founding Director of the Delivery Decisions Initiative at Harvard's Ariadne Labs. Neel completed his undergraduate studies in neuroscience at Brown University and went on to obtain an MD from Brown Medical School along with a Master's in Public Policy from Harvard Kennedy School before completing his Residency in Obstetrics and Gynecology at Massachusetts General Hospital/Brigham And Women's Hospital. He also serves as an obstetrician-gynecologist and a Harvard Medical faculty physician at Beth Israel Deaconess Medical Center in Boston. Prior to joining the Harvard faculty, Neel founded Costs of Care, an NGO that curates insights from clinicians and patients to help delivery systems provide better care. In 2017, he co-founded the March for Moms Association and currently serves on national advisory boards of the Planned Parenthood Federation of America and the Office of Women's Health Research at the National Institutes of Health. As a scientist and social entrepreneur, Neel is a globally recognized expert in designing solutions that improve health care and his pioneering work focuses on partnering with people giving birth to design solutions that enable them to thrive. We indulge in a splendid conversation about his fascinating path in science and medicine; the influence of his terrific mentors and advisors like the legendary Leon Cooper, a Physics Nobel Laureate turned Systems Neuroscientist, and Atul Gawande, a renowned public health expert; Neel's groundbreaking work on maternal wellbeing that lies right at the intersection of reproductive justice, gender equity, and structural racism; coming to terms with Trumpism and the post-truth world; how critical issues related to childbirth like maternal mortality transcend borders; celebrating mothers as mothers themselves; and many more things!!

Today on Boston Public Radio: We start the week off by opening lines and asking listeners: after Monday’s electoral vote, should the media stop covering President Trump’s legal efforts to challenge November’s election results? Boston Pops conductor Keith Lockhart offers news on The Boston Pops’ virtual holiday concert for 2020, and discusses the complicated logistics of putting on a safe and festive show, which is available through January 9. Dr. Rebecca Weintraub explains the U.S.’ current vaccine distribution plan, with inoculations beginning on Monday for frontline healthcare workers and long-care health facility staff. Weintrau heads Ariadne Labs' Vaccine Delivery initiative, and also helped create the New York Time’s “Find your Place in the Vaccine Line” tool.  Boston Globe travel writer Christopher Muther talks about some best practices for spurned travels looking to get refunds and rebates after pandemic-related cancellations. He also touches on a DOT crackdown on emotional support animals, and how President-elect Joe Biden’s win might boost U.S. tourism. Irene Monroe and Emmett Price, hosts of GBH’s All Rev’d Up, discuss COVID vaccine skepticism in the Black community, the legacy of 98 year-old civil rights activist Gloria Richardson, and their indifference to ongoing debate around President-elect Biden’s Catholic faith. TV expert Bob Thompson reviews NBC’s widely-panned “Grinch the Musical,” HBO Max’s “Love Boat,” and that 15 minute KFC ad featuring Mario Lopez, “A Recipe for Seduction.” We end Monday's show by returning to listeners to talk about the conflicting reality of “streamer burnout,” as the U.S. heads into month nine of the coronavirus pandemic. 

In this week’s episode, Tom is talking with Dr. Beth Rabbitt and Dr. Asaf Bitton about the state of global health, how it relates to schools, and a new initiative called the Parabola Project, which offers education leaders tools and strategies to minimize health risks while maximizing learning when reopening schools. Dr. Beth Rabbitt is the CEO of The Learning Accelerator, a national non-profit that is working to make the “potential” possible and practical for every teacher and learner. Underpinning TLA’s work is a drive to ensure that each student receives an effective, equitable, and engaging education that supports them to reach their full, unique potential. Dr. Asaf Bitton is Executive Director of Ariadne Labs, a joint center for health systems innovation at Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health. Together, Dr. Beth Rabbitt and Dr. Asaf Bitton have partnered to launch The Parabola Project to help schools minimize COVID-19 health risks while maximizing learning. Listen in as Tom speaks with Beth Rabbitt and Asaf Bitton about what schools should be doing during the pandemic, and what the current research shows.   Key Takeaways: [:10] About today’s episode with Beth Rabbitt and Asaf Bitton. [1:05] Tom welcomes Beth and Asaf to the podcast! [1:24] Dr. Bitton shares about Ariadne Labs; their mission, vision, and what they have accomplished thus far. [2:27] Dr. Beth Rabbitt speaks about The Learning Accelerator (TLA); their mission, vision, and what they have accomplished thus far. She also shares about the origin of The Parabola Project. [6:50] Should kids be in school right now? Dr. Bitton shares his insights. [9:03] What can schools do to safeguard staff members in an in-person school setting? [10:51] Dr. Bitton’s thoughts on the risk associated with staff members’ circles of interaction outside of a school setting. [13:43] Practices that can be put in place to minimize transmission risk. [15:07] Beth offers some suggestions on how superintendents could frame a community dialogue to bridge the gap between parents who want their children back in school and teachers with concerns about returning to a public setting. [18:08] Should schools be paying attention to testing, tracking, and tracing when it comes to COVID-19? And if so, how might they? [20:04] What could school districts and the government be doing better? Does Dr. Bitton see things getting better in the next few months in terms of a coordinated public health response? [23:34] What Beth is telling schools about sports. [25:27] If a school or a district doesn’t have room to bring all of their students back in a safe and distant way, is a hybrid schedule still the best approach? [27:12] Dr. Bitton’s advice for local health officials and school officials on how they can build a sense of trust about the path forward in terms of precautions, protocols, vaccinations, and strategies. [31:31] How should school and system leaders think about the gaps that seem to be accelerated for the most vulnerable students? [34:44] Dr. Bitton offers some holiday advice to keep in mind in the coming months. [36:43] Where to learn more about The Parabola Project. [37:33] Tom thanks Dr. Rabbit and Dr. Bitton for both joining the podcast.   Mentioned in This Episode: The Parabola Project Beth Rabbitt Asaf Bitton Learning Accelerator Ariadne Labs   Get Involved: Check out the blog at GettingSmart.com. Find the Getting Smart Podcast on iTunes, leave a review, and subscribe.   Is There Somebody You’ve Been Wanting to Learn From or a Topic You’d Like Covered? To get in contact: Email Editor@GettingSmart.com and include “Podcast” in the subject line. The Getting Smart team will be sure to add them to their list!  

In this episode of Stillbirth Matters, Chris Duffy visits with Dr. Neel Shah, MD, MPP, FACOG, an Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, and Director of the Delivery Decisions Initiative at Harvard’s Ariadne Labs. As an obstetrician-gynecologist at Beth Israel Deaconess Medical Center in Boston, Dr. Shah cares for […]

In this episode of Stillbirth Matters, Chris Duffy visits with Dr. Neel Shah, MD, MPP, FACOG, an Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, and Director of the Delivery Decisions Initiative at Harvard’s Ariadne Labs. As an obstetrician-gynecologist at Beth Israel Deaconess Medical Center in Boston, Dr. Shah cares for […]

This conversation with Dr. Rachel Broudy covers how caring for elders can be reciprocal, the illusionary notion of independence in our old age (and younger years too), the difference between health and well-being, the dignity of risk, single-payer health coverage, how to keep a meaningful life even when life changes, hospice care and preparing for aging. Dr. Broudy has spent her career in Geriatrics and currently is leading a research project at Ariadne Labs aimed at improving the delivery of care in nursing homes, with a focus on the wellbeing of older adults. She is also the current Medical Director of Pioneer Valley Hospice and Palliative Care in Greenfield, MA.Previously, Dr. Broudy was the Medical Director of two PACE programs: the Elder Service Plan at Cambridge Health Alliance and Mercy LIFE with Trinity Health in Western Massachusetts. As a PACE Medical Director she has gained extensive experience in program development, quality improvement and team-building. She also served as the Medical Director of the Senior Care Program at Cambridge Health Alliance, a post-acute and long-term care program. She completed her residency in Internal Medicine at Brigham and Women’s Hospital and is boarded in Internal Medicine and Hospice and Palliative Care. She completed the Faculty Scholars Program at the Geriatric Center of Excellence at Boston University and the American Association for Physician Leadership Institute.Rachel is passionate about building a future where healthcare for frail elders is based on well-being; where our interventions integrate older people more fully into our communities; and our systems of care prioritize and encourage agency, social connection and sense of purpose.

"Surgery and anaesthesia; you very much recognise right away that that is considered a luxury in many place of the world" Do you work in a low-resource setting or support partners and organizations that do? The Lifebox pulse oximeter is specifically designed for high-use, low-resource environments. Hear about how Lifebox came into existence and discover how you can help. The World Health Organisation's Surgical Safety Checklist is here: https://www.who.int/patientsafety/safesurgery/checklist/en/ Recorded live at Anesthesiology 2019, Orange County Convention Center, Orlando and presented by Desiree Chappell, with Sol Aronson, and their guests Alexander Hannenberg, M.D. Senior Research Scientist, Ariadne Labs; Principal Consultant, ORDx&Rx Surgical Safety Solutions, 2010 president of the American Society of Anesthesiologists (recently served as its Chief Quality Officer) and by Kris Torgeson, Global CEO, Lifebox Foundation. Find out more here: https://www.lifebox.org

In this episode we hear from Dr. Bill Berry, Co-founder of Ariadne Labs, as he discusses how provider communications around patient safety have evolved alongside managed care. Listen as Dr. Berry provides insightful recommendations for how healthcare leaders can turn policy into meaningful action. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Dr. Mary Brindle is a pediatric surgeon at the Alberta Children's Hospital in Calgary, Alberta. We had a unique discussion about the relationship between art and surgery, and how those two disciplines interact with each other. We also heard from Dr. Brindle about her work on updating the safe surgery checklist and her work on ERAS in pediatrics. Links: 1. ROSCOE magazine. "Art and Surgery: A conversation between Mary Brindle and Andrew Seal: https://cags-accg.ca/wp-content/uploads/2018/10/Roscoe_II_2018_FINAL_pages.pdf 2. Dave Chang interview w/ Jerry Saltz on podcast "The Dave Chang Show": https://www.youtube.com/watch?v=YXIZY8iATv4 3. Revision of the WHO Safe Surgical Checklist: http://www.cspsteam.org/revision-of-the-who-surgical-safety-checklist 4. "Managing COVID19 in Surgical Systems" Annals of Surgery paper: https://journals.lww.com/annalsofsurgery/Citation/publishahead/Managing_COVID_19_in_Surgical_Systems.94654.aspx 5. Mary Brindle & colleagues. "Embracing Change: the era for pediatric ERAS is here": https://link.springer.com/content/pdf/10.1007/s00383-019-04476-3.pdf 6. Ariadne Labs: https://www.ariadnelabs.org/about-us/people/affiliate-members/mary-brindle/ 7. The Ambassadors: https://www.nationalgallery.org.uk/paintings/hans-holbein-the-younger-the-ambassadors 8. J-M Basquiat: https://www.wikiart.org/en/jean-michel-basquiat 9. Mastery in surgery: https://www.journalacs.org/article/S1072-7515(16)31635-0/fulltext 10. Dr. Brindle's colleague David Haughton's website: https://www.haughton-art.ca/ 11. Dr. Andrew Seal's website: https://thechangingpalette.com/author/seal45/

Dr. Asaf Bitton talks about the importance of social distancing and what Ariadne Labs is working on to help health care workers during the COVID-19 pandemic. And an update on the latest coronavirus news. 

We're all self-isolating, but the show goes on. Maria and Julio are joined by Laura Barrón-López, national political reporter at Politico and ITT All-Star Astead Herndon, national political reporter with The New York Times to discuss the latest with the coronavirus pandemic and how they're dealing with social distancing. They also give their insights into Sunday's Democratic debate and the upcoming 2020 primaries.ITT Staff Picks:In this video, residents in Italy share the message they'd tell themselves 10 days ago, via A Thing By. Ariadne Labs presents the case for social distancing during the coronavirus pandemic, via Medium.Democratic Debate Fact Check: Joe Biden has advocated cutting social security for 40 years, via The Intercept. See acast.com/privacy for privacy and opt-out information.

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it's the largest gathering of Anesthesiologists and Anesthesia providers in the world. Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action. Alongside some reflections on the American Society of Anesthesiologists this piece is focused upon a fascinating foundation, Lifebox, the only NGO devoted to safer surgery and anesthesia in low-resource countries. Find out more here: https://www.lifebox.org Presented by Desiree Chappell with Sol Aronson and their guest Alexander Hannenberg, M.D. Senior Research Scientist, Ariadne Labs; Principal Consultant, ORDx&Rx Surgical Safety Solutions, 2010 president of the American Society of Anesthesiologists and recently served as its Chief Quality Officer. They are joined also by Kris Torgeson, Global CEO, Lifebox Foundation.

We spoke with Dr. Kimberly Dever of South Shore Hospital and Amber Weiseth of Ariadne Labs about the Team Birth Project. This collaborative effort changes the standard approach to clinical care and has earned national attention. Their strategies foster communication and empower women and families with the goal of improving the safety and dignity of childbirth.   Kimberly Dever, MD, FACOG, is Vice President of Medical Affairs for South Shore Health and Chairman of the Department of Obstetrics and Gynecology at South Shore Hospital. After attending Boston University School of Medicine, Dr. Dever began her career in the US Army where she served and cared for women in the military and their family members while training at Walter Reed Army Medical Center. As a senior leader at South Shore Hospital, she strives to offer the best care to patients through open communication and strong relationships.    Amber Weiseth DNP, RNC-OB is the Associate Director for the Delivery Decisions Initiative (DDI) at Ariadne Labs, where she oversees the design, measurement, and implementation of the Team Birth Project. Amber has been an obstetric nurse for 15 years, specializing in quality improvement and project implementation. Prior to joining Ariadne Labs, Amber served as Assistant Director for Maternal-Infant Health Initiatives at the Washington State Hospital Association where she led safety and quality work in the state’s birthing hospitals.   Listen and Learn: What the Team Birth Project is working to achieve What is being done to solve for the grey How the Team Birth Project initiative has affected the cesarean rate Patient and clinician experiences with the Team Birth Project What’s next for the project   Resources & Mentions: Ariadne Labs

We spoke with Dr. Kimberly Dever of South Shore Hospital and Amber Weiseth of Ariadne Labs about the Team Birth Project. This collaborative effort changes the standard approach to clinical care and has earned national attention. Their strategies foster communication and empower women and families with the goal of improving the safety and dignity of childbirth.   Kimberly Dever, MD, FACOG, is Vice President of Medical Affairs for South Shore Health and Chairman of the Department of Obstetrics and Gynecology at South Shore Hospital. After attending Boston University School of Medicine, Dr. Dever began her career in the US Army where she served and cared for women in the military and their family members while training at Walter Reed Army Medical Center. As a senior leader at South Shore Hospital, she strives to offer the best care to patients through open communication and strong relationships.    Amber Weiseth DNP, RNC-OB is the Associate Director for the Delivery Decisions Initiative (DDI) at Ariadne Labs, where she oversees the design, measurement, and implementation of the Team Birth Project. Amber has been an obstetric nurse for 15 years, specializing in quality improvement and project implementation. Prior to joining Ariadne Labs, Amber served as Assistant Director for Maternal-Infant Health Initiatives at the Washington State Hospital Association where she led safety and quality work in the state’s birthing hospitals.   Listen and Learn: What the Team Birth Project is working to achieve What is being done to solve for the grey How the Team Birth Project initiative has affected the cesarean rate Patient and clinician experiences with the Team Birth Project What’s next for the project   Resources & Mentions: Ariadne Labs

Asaf Bitton MD, MPH is our guest this week. Asaf talks with us about what he sees as crucial steps in improving primary care in the US and what we can learn from primary care systems globally, particularly drawing on a recent healthcare system reform in Costa Rica which he wrote about last year in Health Affairs. We also talk about a noteworthy editorial he wrote in the Annals of Family Medicine laying out what he sees as a path forward in primary care, with parsimony and also being clear-eyed about the limits of current capitation efforts. Dr. Bitton is the Director of Primary Health Care at Ariadne Labs where he leads the Primary Health Care Performance Initiative, a joint effort with the Bill and Melinda Gates Foundation, The World Bank, the World Health Organization, and The Results for Development Institute. He is also a senior advisor to the Center for Medicare and Medicaid Innovation (CMMI) on their Comprehensive Primary Care Plus initiative. He practices primary care in the Boston area. We love to hear from our listeners, so please tweet us @RoSPodcast or @HMSPrimary care, leave us a message on facebook, or send us an email with comments and suggestions at contact@rospod.org. Thanks for listening! Audio Player

This episode starts with a question: “what if the architectural design of an obstetric unit influenced the c-section rate in that unit?” That question occurred to obstetrician/gynecologist Neel Shah when he attended a presentation by Michael Murphy, the co-founder and executive director of Mass Design, an architectural design and research firm that focuses particularly on healthcare architecture. Neel thinks about c-section rates all the time and is a leading researcher in the field of maternal health. C-section rates vary widely throughout the US – from 7 to 70%, and where a woman delivers better predicts whether she will get a c-section than her own personal risk factors. So, Michael Murphy’s contention that “Architecture is never neutral. It either heals or hurts” stayed with Neel and inspired him to pursue a research initiative between Mass Design and his research group, Ariadne Labs. Neel Shah and two of his collaborators, Amie Shao and Deb Rosenberg, researchers and architects with Mass Design, join us to talk about their collaboration and the report they produced. Amie Shao is a director with MASS Design Group, where she oversees research focusing on health infrastructure planning and evaluation. In addition to guiding impact research for MASS built projects, she coordinated the production of National Health Infrastructure Standards for the Liberian Ministry of Health and has been involved in the design and evaluation of healthcare facilities in Haiti, Africa, and the United States. Deb Rosenberg joined MASS in 2015, with a unique background in healthcare and architecture. Throughout her career in nursing and architecture is a common ambition to promote health and well-being, and she believes that the spaces where people live, work and heal have the capacity to greatly support or restrict our human potential. Neel Shah, MD, MPP, is Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, and director of the Delivery Decisions Initiative at Ariadne Labs. His team is currently collaborating with hospitals across the United States, and using methods from design, systems engineering, and management to reduce the epidemic of avoidable c-sections. If you enjoyed the show, please give us 5 stars wherever you listen. Tweet us your thoughts @RoSpodcast and check out our facebook page at www.facebook.com/reviewofsystems. Or, you can email us at audreyATrospod.org. We’d love to hear from you, and thanks for listening.

This episode starts with a question: “what if the architectural design of an obstetric unit influenced the c-section rate in that unit?” That question occurred to obstetrician/gynecologist Neel Shah when he attended a presentation by Michael Murphy, the co-founder and executive director of Mass Design, an architectural design and research firm that focuses particularly on healthcare architecture. Neel thinks about c-section rates all the time and is a leading researcher in the field of maternal health. C-section rates vary widely throughout the US – from 7 to 70%, and where a woman delivers better predicts whether she will get a c-section than her own personal risk factors. So, Michael Murphy’s contention that “Architecture is never neutral. It either heals or hurts” stayed with Neel and inspired him to pursue a research initiative between Mass Design and his research group, Ariadne Labs. Neel Shah and two of his collaborators, Amie Shao and Deb Rosenberg, researchers and architects with Mass Design, join us to talk about their collaboration and the report they produced. Amie Shao is a director with MASS Design Group, where she oversees research focusing on health infrastructure planning and evaluation. In addition to guiding impact research for MASS built projects, she coordinated the production of National Health Infrastructure Standards for the Liberian Ministry of Health and has been involved in the design and evaluation of healthcare facilities in Haiti, Africa, and the United States. Deb Rosenberg joined MASS in 2015, with a unique background in healthcare and architecture. Throughout her career in nursing and architecture is a common ambition to promote health and well-being, and she believes that the spaces where people live, work and heal have the capacity to greatly support or restrict our human potential. Neel Shah, MD, MPP, is Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, and director of the Delivery Decisions Initiative at Ariadne Labs. His team is currently collaborating with hospitals across the United States, and using methods from design, systems engineering, and management to reduce the epidemic of avoidable c-sections. If you enjoyed the show, please give us 5 stars wherever you listen. Tweet us your thoughts @rospodcast and check out our facebook page at www.facebook.com/reviewofsystems. Or, you can email us at audreyATrospod.org. We’d love to hear from you, and thanks for listening. Listen at the end of the episode for a promo code to receive 15% off registration fees for an upcoming conference from the Harvard Center for Primary Care: Primary Care in 2020 – Future Challenges, Tips for Today.

HHS Secretary Alex Azar and other officials this week unveiled new payment pilots that they say will transform primary care. Are they right? POLITICO's Rachel Roubein and Paul Demko join Dan Diamond to discuss the payment pilots (starts at the 1:30 mark), the latest Obamacare changes (starts at the 9:35 mark) and new developments in the "Medicare-for-All" debate (starts at the 17:10 mark). Then Asaf Bitton, the new leader of Ariadne Labs — the Atul Gawande-founded think tank — joins PULSE CHECK to discuss his vision for Ariadne and his experience as an adviser on this week's primary care reforms (starts at the 25:10 mark). MENTIONED ON THE SHOW HHS on Monday unveiled new payment pilots intended to reward primary care providers for high-value care. In a speech, Azar called it a "historic turning point in American health care." CMS last week finalized new rules for the Obamacare marketplace in 2020, which the Center on Budget and Policy Priorities said will hit many consumers' pocketbooks. A new Kaiser Family Foundation poll found that "Medicare for All" has fallen behind other priorities like lower drug costs. POLITICO's Rachana Pradhan and Dan Goldberg looked at blue states' fight to create "public option" health plans. Meanwhile, Bitton was named the new leader of Ariadne Labs, succeeding Gawande, and laid out his strategy.

Dr. Neel Shah is an assistant professor of obstetrics at Harvard Medical School and director of the Delivery Decisions Initiative at Ariadne Labs. Dr. Amy Edmondson is a professor of leadership and management at Harvard Business School. Dr. Thoralf Sundt is a professor of surgery and chief of cardiac surgery at Massachusetts General Hospital. Dr. Lisa Rosenbaum, the moderator, is a national correspondent for the Journal. L. Rosenbaum. The Not-My-Problem Problem. N Engl J Med 2019;380:881-885.

About the Author   Atul Gawande, MD, MPH, is a surgeon, writer, and public health leader. He is CEO of the non-profit-seeking health care venture formed by Amazon, Berkshire Hathaway, and JPMorgan Chase to deliver better outcomes, satisfaction, and cost efficiency in care. He practices general and endocrine surgery at Brigham and Women’s Hospital. He is a professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and the Samuel O. Thier Professor of Surgery at Harvard Medical School.   He is the founding executive director and chairman of Ariadne Labs, a joint center for health systems innovation, and chairman of Lifebox, a nonprofit organization making surgery safer Globally.   Atul has been a staff writer for The New Yorker magazine since 1998 and has written four New York Times bestsellers: Complications, Better, The Checklist Manifesto, and Being Mortal: Medicine and What Matters in the End.   He is the winner of two National Magazine Awards, AcademyHealth’s Impact Award for highest research impact on healthcare, a MacArthur Fellowship, and the Lewis Thomas Award for writing about science.   (Source: http://atulgawande.com/about/) About the Book   The Checklist Manifesto is a book about how the most complex and complicated scenarios can be better managed with the structured approach of the simple (but powerful) checklist. It includes examples from operating rooms, flight decks, hurricane recoveries, kitchens and construction sites.   As life and work gets more challenging and specialised, this book documents the practical journey Atul and his team went on to develop a safe surgery checklist to reduce potentially fatal errors in operating theatres which was adopted in hospitals around the world. Ultimately the message is one of humility; no matter how experienced or clever you are, there is always a need for a process and a checklist to aid your own judgement. BIG IDEA 1 (3:30) - Checklist helps save lives and money better than humans. In the ICU having a checklist helps avoid complications on 178 actions for a typical patient per day. In an environment that can be stressful, a checklist helps systematize the process.   In investment, a checklist is very important in decision making. It helps people make more balance decision without having their emotion get in the way the can cloud the judgement.  Important and critical moments should have a checklist to be systems driven and consistent.   In this age of complexity, the checklist helps us keep things in check.   BIG IDEA 2 (5:23) - How to checklist. You need to check the checklist with different teams and cultures; know what is important and make sure the language is clear. Confusion can arise if the language is too complicated, too wordy or if there aren’t enough words because it’s too concise.   Two types of checklist are read/do checklist and the do/confirm checklist. Both types of checklist if well-defined and and well-designed will change the communication of the team in a scenario.   In designing a checklist it’s important to have the pause point to make sure that there are clear points where the checklist is deployed and clear stages in a process.  Vitally, it’s important to know everyone’s role related to the checklist. Which brings us to... BIG IDEA 3 (7:47) - Don't let the leaders run the checklist. For someone who have been doing something for years, ego can get in the way, for having to use a checklist. Know who’s role it is to run the checklist and don’t let that be the leader. While the leader doesn’t run the checklist, their judgement and experience that comes with time allows leaders to use them in a better, more structured way whilst reducing human errors. Click here to buy on The Book Depository  Music: Hyrule by Theevs Music    Let's Connect LinkedIn: www.linkedin.com/steph-clarke Instagram: @stephsbizbookshelf For full show notes, tweetable and 'grammable quotes, useful links and more visit www.stephsbusinessbookshelf.com   Enjoying the podcast? Please hit subscribe so you don't miss an episode and leave a review on iTunes to help others find us.

Although healthcare system mergers can improve standardization of care, they also carry risks as physicians try to navigate new administrative expectations. Because of the inherent challenges, guest Susan Haas, MD, MSc, of Ariadne Labs advises focusing on patient safety at the start of consolidation planning.

As a critical care doctor, Jessica Zitter has seen plenty of “Hail Mary” attempts to save dying patients go bad—attempts where doctors try interventions that don’t change the outcome, but do lead to more patient suffering. It’s left her distrustful of flashy medical technology and a culture that insists that more treatment is always better. But when a new patient goes into cardiac arrest, the case doesn’t play out the way Jessica expected. She finds herself fighting for hours to revive him—and reaching for a game-changing technology that uncomfortably blurs the lines between life and death.    Resources Talking about end-of-life stuff can be hard! Here are some resources to get you started. (Adapted from Jessica Zitter’s Extreme Measures: Finding a Better Path to the End of Life. Thanks Jessica!)   I want to…  ...figure out what kind of care I might want at end of life: Prepare uses videos of people thinking about their end-of-life preferences to walk you through the steps for choosing a surrogate decision maker, determining your preferences, etc.  ...talk with family/friends about my preferences (or theirs!): The Conversation Project offers a starter kit and tools to help start the conversation.  ...put my preferences in writing (an advance directive):  Advance Directive forms connects you to advance directive forms for your state.  My Directives For those who like their documents in app form! Guides you through creating an end-of-life plan, then stores it in the cloud so it’s accessible anywhere.  Guests Jessica Nutik Zitter, MD, MPH, Author and Attending Physician, Division of Pulmonary/Critical Care and Palliative Care Medicine, Highland Hospital Thomas Frohlich, MD, Chief of Cardiology, Highland Hospital Kenneth Prager, MD, Professor of Medicine and Director of Clinical Ethics, Columbia University Medical Center Daniela Lamas, MD, author and Associate Faculty at Ariadne Labs David Casarett MD, author and Chief of Palliative Care, Duke University School of Medicine   Footnotes Read the books: Jessica Zitter’s book is Extreme Measures: Finding a Better Path to the End of Life. Daniela Lamas’s book is You Can Stop Humming Now: A Doctor’s Stories of Life, Death, and In Between. David Casarett’s book is Shocked: Adventures in Bringing Back the Recently Dead Read the memoirs of Amsterdam’s “Society in Favor of Drowned Persons,” the Dutch group that tried to resuscitate drowning victims (including Anne Wortman) Learn more about ECMO, its success rates, and the ethical questions it raises (Daniela also wrote an article about it here) Read Daniela’s study about quality of life in long-term acute care hospitals (LTACHs). And for an introduction to LTACHs, here’s an overview from The New York Times Watch Extremis, the Oscar-nominated documentary (featuring Jessica Zitter), about families facing end-of-life decisions in Highland Hospital’s ICU. Read some of Dr. Zitter’s articles about life support tech (here and here) and the tough decisions doctors and patients face in the ICU (here and here)   Credits This episode of Undiscovered was reported and produced by Annie Minoff and Elah Feder. Editing by Christopher Intagliata. Original music by Daniel Peterschmidt. Fact-checking help from Michelle Harris. Our theme music is by I Am Robot And Proud. Our mid-break theme for this episode, “No Turning Back,” is by Daniel Peterschmidt and I am Robot and Proud. Thanks to the entire Science Friday staff, the folks at WNYC Studios, and CUNY’s Sarah Fishman. Special thanks to Michele Kassemos of UCSF Medical Center, Lorna Fernandes of Highland Hospital, and the entire staff at Highland.

As a critical care doctor, Jessica Zitter has seen plenty of “Hail Mary” attempts to save dying patients go bad—attempts where doctors try interventions that don’t change the outcome, but do lead to more patient suffering. It’s left her distrustful of flashy medical technology and a culture that insists that more treatment is always better. But when a new patient goes into cardiac arrest, the case doesn’t play out the way Jessica expected. She finds herself fighting for hours to revive him—and reaching for a game-changing technology that uncomfortably blurs the lines between life and death.    Resources Talking about end-of-life stuff can be hard! Here are some resources to get you started. (Adapted from Jessica Zitter’s Extreme Measures: Finding a Better Path to the End of Life. Thanks Jessica!)   I want to…  ...figure out what kind of care I might want at end of life: Prepare uses videos of people thinking about their end-of-life preferences to walk you through the steps for choosing a surrogate decision maker, determining your preferences, etc.  ...talk with family/friends about my preferences (or theirs!): The Conversation Project offers a starter kit and tools to help start the conversation.  ...put my preferences in writing (an advance directive):  Advance Directive forms connects you to advance directive forms for your state.  My Directives For those who like their documents in app form! Guides you through creating an end-of-life plan, then stores it in the cloud so it’s accessible anywhere.  Guests Jessica Nutik Zitter, MD, MPH, Author and Attending Physician, Division of Pulmonary/Critical Care and Palliative Care Medicine, Highland Hospital Thomas Frohlich, MD, Chief of Cardiology, Highland Hospital Kenneth Prager, MD, Professor of Medicine and Director of Clinical Ethics, Columbia University Medical Center Daniela Lamas, MD, author and Associate Faculty at Ariadne Labs David Casarett MD, author and Chief of Palliative Care, Duke University School of Medicine   Footnotes Read the books: Jessica Zitter’s book is Extreme Measures: Finding a Better Path to the End of Life. Daniela Lamas’s book is You Can Stop Humming Now: A Doctor’s Stories of Life, Death, and In Between. David Casarett’s book is Shocked: Adventures in Bringing Back the Recently Dead Read the memoirs of Amsterdam’s “Society in Favor of Drowned Persons,” the Dutch group that tried to resuscitate drowning victims (including Anne Wortman) Learn more about ECMO, its success rates, and the ethical questions it raises (Daniela also wrote an article about it here) Read Daniela’s study about quality of life in long-term acute care hospitals (LTACHs). And for an introduction to LTACHs, here’s an overview from The New York Times Watch Extremis, the Oscar-nominated documentary (featuring Jessica Zitter), about families facing end-of-life decisions in Highland Hospital’s ICU. Read some of Dr. Zitter’s articles about life support tech (here and here) and the tough decisions doctors and patients face in the ICU (here and here)   Credits This episode of Undiscovered was reported and produced by Annie Minoff and Elah Feder. Editing by Christopher Intagliata. Original music by Daniel Peterschmidt. Fact-checking help from Michelle Harris. Our theme music is by I Am Robot And Proud. Our mid-break theme for this episode, “No Turning Back,” is by Daniel Peterschmidt and I am Robot and Proud. Thanks to the entire Science Friday staff, the folks at WNYC Studios, and CUNY’s Sarah Fishman. Special thanks to Michele Kassemos of UCSF Medical Center, Lorna Fernandes of Highland Hospital, and the entire staff at Highland.

This week we’re continuing to revisit a few of my must listen to episodes! This is such an important issue and episode, even if you did listen to the first release I would highly recommend revisiting this episode. The current US cesarean rates hover around 33%. However, the World Health Organization (WHO) recommends the cesarean rate should fluctuate between 10-15%.  They even state “Cesarean section rates higher than 10% are not associated with reductions in maternal and newborn mortality rates” and that “every effort should be made to provide caesarean sections to women in need, rather than striving to achieve a specific rate”. Clearly there is need to further exams why cesareans are performed at such a high rate and what can be done to lower them.  In this episode of Yoga | Birth | Babies, I speak OB/GYN, Dr. Neel Shah.  Dr Shah has been recognized for his work to help reduced unnecessary caesarean births in our country.  In this podcast, we explore why in the past 40 years, cesareans have increased 500% without seeing better results for moms and babies!  He also explains where you give birth can be one of the biggest factors in the risk of having a cesarean birth.  This episode is so important for any women who may become pregnant, expectant mothers and partners.  Please enjoy! In this episode  How Dr Shah got started on this path to exploring the caesarean rate in our country. The increased cesarean rate in the US since the 1970’s and what accounts for this. Are we seeing better results for mothers and babies with this massive increase in c-sections? Recognizing there is a place of caesarean births what is the sweet spot for best outcomes with cesarean births? World Heatlh Organization (WHO) recommends caesarean rates should be between 10-15%. Risks of a cesarean surgery for both mother and baby, both short and long term. Are the risks of a c-section well explained to mother ahead of timed? Minimizing the possibility of an unnecessary c-section The role of the care provider in the likelihood of a mother having a caesarean. What role does the hospital play in the likelihood of a mother having a caesarean ? The correlation between the hospital and the c section rate. Exploring an article authored by Dr Shah-  “In the United States it appears that about half the cesareans we do may be avoidable in hindsight. Getting to perfect may be hard but there is tremendous room for improvement.”  What might be some of the red flags that you see in hindsight that may have been avoidable? Are hospitals are always the safest place to give birth? What we can learn from other countries who have created a supportive system to offer home birth. The role of midwives in US birth.   About Dr Shah: Dr. Neel Shah, MD, MPP is an Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, and Director of the Delivery Decisions Initiative at Harvard’s Ariadne Labs. As an obstetrician-gynecologist at Beth Israel Deaconess Medical Center in Boston, Dr. Shah cares for patients during critical life moments that range from surgery to primary care to childbirth. As a scientist and social entrepreneur, he is a globally recognized expert in designing, testing, and spreading solutions that improve healthcare. Dr. Shah is listed among the “ Learn more about your ad choices. Visit megaphone.fm/adchoices

Between 2014-2016, Researchers from Ariadne Labs ran an ambitious trial to see if a simple checklist could improve childbirth care and prevent deaths in one of India’s poorest states. The randomized study of 300,000 women in Uttar Pradesh was one of the largest maternal health trials ever. Both the stakes and hopes were high; globally, 300,000 women a year die around the time of childbirth and five million newborns die as stillborn or in their first month of life. But the results of the study were mixed—what researchers call a "null" result. While the checklist improved the quality of care during labor and delivery, it did not reduce death rates. In this week's episode, we speak to Katherine Semrau, director of the BetterBirth program at Ariadne Labs and the lead author of the study, about why that “null” result can actually teach us a great deal about strategies to improve maternal health—and the way public health research is conducted.

Between 2014-2016, Researchers from Ariadne Labs ran an ambitious trial to see if a simple checklist could improve childbirth care and prevent deaths in one of India’s poorest states. The randomized study of 300,000 women in Uttar Pradesh was one of the largest maternal health trials ever. Both the stakes and hopes were high; globally, 300,000 women a year die around the time of childbirth and five million newborns die as stillborn or in their first month of life. But the results of the study were mixed—what researchers call a "null" result. While the checklist improved the quality of care during labor and delivery, it did not reduce death rates. In this week's episode, we speak to Katherine Semrau, director of the BetterBirth program at Ariadne Labs and the lead author of the study, about why that “null” result can actually teach us a great deal about strategies to improve maternal health—and the way public health research is conducted. You can subscribe to this podcast by visiting iTunes or Google Play and you can listen to it by following us on Soundcloud, and stream it on the Stitcher app or on Spotify. Learn more Checklist and coaching program in India markedly improved childbirth care but did not reduce death rates (Harvard Chan School news) BetterBirth program aims to improve maternal health (Harvard Chan School news) Ariadne Labs BetterBirth program

Surgeon and writer Atul Gawande interviews Katherine Semrau, an epidemiologist who leads the Better Birth program at Ariadne Labs, about how to improve maternal and newborn health worldwide in a special edition of PS Editors' Podcast.

Woo Do and Jason Bingham interview Dr. Alex Haynes (Director of the Safe Surgery Division at Ariadne Labs and a surgical oncologist at MGH) about the history of surgical checklists, Lifebox, and how sustainable global surgery is about strengthening systems. To learn more, visit: lifebox.org ariadnelabs.org facebook.com/lifeboxfoundation twitter.com/SaferSurgery lifebox.org/thechecklisteffect  

Date: October 26, 2017 Featuring: Fred E. Shapiro, DO, Chair, ASA Committee on Patient Safety and Education; Founder, Institute for Safety in Office-Based Surgery ​Alexander Hannenberg, MD, Faculty, Safe Surgery Program, Ariadne Labs; Chief Quality Officer, American Society of Anesthesiologists Jennifer Lenoci-Edwards, RN, MPH, Executive Director, Patient Safety, Institute for Healthcare Improvement These days, no one thinks twice about getting a mole removed or undergoing cataract surgery outside of a hospital. Heading to an office practice or an ambulatory care center for what's considered "minor surgery" tends to be more convenient for the patient and often more cost effective. According to recent figures, upwards of 20 million outpatient procedures are performed in the US each year — everything from cosmetic to knee to eye surgeries. As the numbers rise, so do concerns about safety. While serious harm, including deaths, remains uncommon in outpatient settings, adverse events can and do occur. When anesthesia is part of the surgical procedure, clinicians and staff need to know about the complications that might arise requiring immediate, lifesaving steps. What are the complications? What are the specific steps? It's all laid out in a new checklist on this episode of WIHI: A New Emergency Checklist for Office-Based Surgery.    

esarean delivery of a baby—or C-section—is the world's most commonly performed surgery. Rates have been rising across the globe, but there has been a particularly notable increase in the United States. The C-section rate in the U.S. has jumped 500 percent since the mid-1970s and 1 in 3 babies are now born via C-section. C-section is incredibly common, but the surgery comes with risks for mothers, including hemorrhage and infection. In this week's episode, we'll take a look at efforts to figure out what is driving rising C-section rates, and what can be done to prevent them. Neel Shah, director of the Delivery Decisions Initiative at Ariadne Labs, will explain why the hospital where a woman gives birth may the single most important factor in whether or not she has a C-section.

July 27, 2017 — Cesarean delivery of a baby—or C-section—is the world's most commonly performed surgery. Rates have been rising across the globe, but there has been a particularly notable increase in the United States. The C-section rate in the U.S. has jumped 500 percent since the mid-1970s and 1 in 3 babies are now born via C-section. C-section is incredibly common, but the surgery comes with risks for mothers, including hemorrhage and infection. In this week's episode, we'll take a look at efforts to figure out what is driving rising C-section rates, and what can be done to prevent them. Neel Shah, director of the Delivery Decisions Initiative at Ariadne Labs, will explain why the hospital where a woman gives birth may the single most important factor in whether or not she has a C-section. You can subscribe to this podcast by visiting iTunes, listen to it by following us on Soundcloud, and stream it on the Stitcher app. Learn more Delivery Decisions Initiative at Ariadne Labs Hospital management practices may put women at risk for C-sections, complications during childbirth (Harvard Chan School news)

In this episode of Yoga | Birth | Babies, I speak OB/GYN, Dr. Neel Shah.  Dr Shah has been recognized for his work to help reduced unnecessary caesarean births in our country.  In this podcast, we explore why in the past 40 years, cesareans have increased 500% without seeing better results for moms and babies!  He also explains where you give birth can be one of the biggest factors in the risk of having a cesarean birth.  This episode is so important for any women who may become pregnant, expectant mothers and partners.  Please enjoy! In this episode: How Dr Shah got started on this path to exploring the caesarean rate in our country. The increased cesarean rate in the US since the 1970’s and what accounts for this. Are we seeing better results for mothers and babies with this massive increase in c-sections? Recognizing there is a place of caesarean births what is the sweet spot for best outcomes with cesarean births? World Heatlh Organization (WHO) recommends caesarean rates should be between 10-15%. Risks of a cesarean surgery for both mother and baby, both short and long term. Are the risks of a c-section well explained to mother ahead of timed? Minimizing the possibility of an unnecessary c-section The role of the care provider in the likelihood of a mother having a caesarean. What role does the hospital play in the likelihood of a mother having a caesarean ? The correlation between the hospital and the c section rate. Exploring an article authored by Dr Shah-  “In the United States it appears that about half the cesareans we do may be avoidable in hindsight. Getting to perfect may be hard but there is tremendous room for improvement.”  What might be some of the red flags that you see in hindsight that may have been avoidable? Are hospitals are always the safest place to give birth? What we can learn from other countries who have created a supportive system to offer home birth. The role of midwives in US birth. About Dr Shah: Dr. Neel Shah, MD, MPP is an Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, and Director of the Delivery Decisions Initiative at Harvard’s Ariadne Labs. As an obstetrician-gynecologist at Beth Israel Deaconess Medical Center in Boston, Dr. Shah cares for patients during critical life moments that range from surgery to primary care to childbirth. As a scientist and social entrepreneur, he is a globally recognized expert in designing, testing, and spreading solutions that improve healthcare. Dr. Shah is listed among the “40 smartest people in health care” by the Becker’s Hospital Review, and has been profiled by the New York Times, CNN, and other outlets. He is senior author of the book Understanding Value-Based Healthcare (McGraw-Hill), which Don Berwick has called “an instant classic” and Atul Gawande called “a masterful primer for all clinicians.” Prior to joining the Harvard faculty, Dr. Shah founded Costs of Care, a global NGO that curates insights from clinicians to help delivery systems provide better care. In 2017, Dr. Shah co-founded the March for Moms Association, a coalition of 20 leading organizations, to increase public and private investment in the wellbeing of mothers. Follow Dr. Shah on Twitter: @Neel_Shah on in Learn more about your ad choices. Visit megaphone.fm/adchoices

I've wanted to do this interview for a long, long time.Atul Gawande is a surgeon at Brigham and Women’s Hospital. He's a professor in the Department of Health Policy and Management at the Harvard School of Public Health. He is executive director of Ariadne Labs, a joint center for health systems innovation, and chairman of Lifebox, a nonprofit organization making surgery safer globally. He's a New Yorker writer. He's the author of some of my favorite books, including Better: A Surgeon's Notes on Performance and The Checklist Manifesto. He's a MacArthur Genius. Atul Gawande makes me feel like a slow, boring, unproductive person. What makes it worse is that he's a helluva nice guy, too. And he knows more new music than I do. There haven't been many conversations on this podcast I've looked forward to more, or enjoyed as much. Among many other things, we talked about:- How Atul makes time to do all of the writing, large-scale research, and surgery he does- His time working in Congress and in the White House- His writing process and how it’s evolved since his early days writing for Slate- Why he hates writing and likes being edited (and why I am the exact opposite)- His thoughts on ignorance, ineptitude, why we fail at things, and what hand washing has to do with it- How effective Medicaid coverage is in improving health outcomes- The ways we need to more effectively deliver existing knowledge and technology rather than always focusing on the next big discovery- What he thinks we’ve learned so far from Obamacare- How Rivers Cuomo from Weezer has applied lessons from Atul’s writing to his music- His work with the Clintons, Jim Cooper, and Al Gore and thoughts on their private versus public personas- How all the different parts of his life — the writing, the surgery, the policy work — come together into one single engine for actually making change- What new albums he thinks everyone should listen toAnd so much more. Talking to Atul was a real pleasure. I hope you enjoy it too. Learn more about your ad choices. Visit megaphone.fm/adchoices

Neel Shah is an assistant professor of obstetrics and gynecology at Harvard Medical School and Beth Israel Deaconess Medical Center and associate faculty at Ariadne Labs for Health Systems Innovation. Stephen Morrissey, the interviewer, is the Managing Editor of the Journal. N. Shah. A NICE Delivery - The Cross-Atlantic Divide over Treatment Intensity in Childbirth. N Engl J Med 2015;372:2181-3.

Atul Gawande and Will Self speak about what matters in the end. In his book Being Mortal author Atul Gawande tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its ending Atul Gawande is a staff writer for The New Yorker, and author of four books. He is Executive Director of Ariadne Labs, a joint center for health systems innovation. He practices general and endocrine surgery at Brigham and Women’s Hospital. He's interviewed by best selling author and novelist Will Self about his book Being Mortal. 5x15 brings together five outstanding individuals to tell of their lives, passions and inspirations. There are only two rules - no scripts and only 15 minutes each. Learn more about 5x15 events: 5x15stories.com Twitter: www.twitter.com/5x15stories Facebook: www.facebook.com/5x15stories Instagram: www.instagram.com/5x15stories