My cousin who is a Public Health nurse, with a MD husband, told me about this wonderful thing going on in the Cherokee Nation since they pulled out of the Indian Health Service and started their own. Public health is the seventh Domain of a civilized society. Without national sovereignty, they could never do this. They wouldn't be allowed. The article is from last year but the things I hear are amazing.
REH February 6, 2012 <http://muskogeephoenix.com/local/x2009902799/Cherokee-health-services-under go-revamp> Cherokee health services undergo revamp Changes going into effect more quickly than norm By Wendy Burton <http://muskogeephoenix.com/> Phoenix Staff Writer - Cherokee Nation Health Services is stripping away red tape and applying better practices to improve patient care with 28 projects. Some of the projects affect every aspect of patient care, and others affect the way the hospital conducts common procedures. Perhaps the biggest change is in refilling prescriptions - Cherokee Nation Health Services can now refill prescriptions in less than a day. Before the change, patients waited an average of four days to pick up a refill. To Jonathon Merrell, the performance improvement officer for Cherokee Nation W.W. Hastings Hospital, what's more incredible is that all the changes through the 28 projects, which began last year, are being put into effect in 12 to 15 weeks. Typically, such big changes take at least two years, he said. "Cherokee Nation health leadership had this vision to create a world-class health system, so they sent myself and one of our physicians, Dr. John Kreuger, to the Institute for Healthcare Improvement in Cambridge, Massachusetts," Merrell said. Kreuger completed a year-long medical fellowship at IHI, and Merrell attended off and on for 10 months. "It was a big deal," Merrell said. "Cherokee Nation Health Services was already working to improve patient care and services through the Improving Patient Care program with the Indian Health Service." Many of the CN's health services have seen improvements through that program, and Hastings is following its lead, Merrell said. The 28 projects affect more than just Hastings. The Cherokee Nation has been working on improvements at all of its health clinics. A project at the Stilwell dental clinic improved patient scheduling and increased access to services, Merrell said. And all Cherokee Nation health facilities are now using a new sterilization process created by team members from the Salina clinic, Quality Improvement at the Cherokee Nation and the Performance Improvement Program at Hastings. "There were no problems before, but we wanted to create sterilization processes that would exceed our patients' expectations," Merrell said. "The processes that we developed will probably be adopted as a best model by the IHI and shared worldwide. They improve quality and decrease costs because we eliminated defects from the process." All Cherokee Nation health centers also are focusing more on patient communication and overall health through another project in which screening has been turned into a structured process, he said. Every patient is now screened for domestic abuse problems, depression, and the like, Merrell said. "The more we are able to communicate with and screen patients for these issues, the better we can treat them and prevent long-term health consequences," he said. Among the 22 projects already completed are a redesign of the information technology help desk to help staff become more efficient, improvements in surgical care processes and improvements for treatment of diabetic patients. The first wave of the 28 projects began in March 2011 and the second wave began in October, Merrell said. Feedback from patients and staff has been very positive, he said. "The patients like to be involved in this. The staff are enjoying being involved in the improvements and they're bringing ideas for change, too," he said. "They like seeing the improvements overall in the system." Cherokee Nation Health Services is proud of the changes. "Just like the hospital and clinic employees, this administration is committed to ensuring access to first-rate health care for all its citizens," said Principal Chief Bill John Baker. "Efficiencies like those created by the refill center at Three Rivers are further proof of that continued dedication." Cherokee Nation health facilities see more than 700,000 patients a year. The system typically fills about 1.25 million prescriptions a year. Merrell said the Cherokee Nation is meeting its health care goals at an incredible speed. "The Cherokee Nation about five years ago developed a 50-year plan, and to date, they've achieved 20 years of the plan as of right now," he said. Reach Wendy Burton at (918) 684-2926 or <mailto:[email protected]> [email protected].
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