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Listen and Learn
Patient survey data can be valuable in planning quality improvement initiatives, but only if health care providers understand how to use this information effectively, finds a Fund-supported analysis published in Quality & Safety in Health Care. In talking with medical professionals involved in a Minnesota quality improvement collaborative, former Harkness Fellow Elizabeth Davies, Ph.D., and Harvard Medical School's Paul D. Cleary, Ph.D., uncovered numerous barriers to using patient survey data, including the competing pressures created by financial priorities, skeptical or defensive attitudes of staff, and delays between data collection and feedback. The authors say that in the end, surveys alone aren't enough—rather, health care organizations must develop cultures that support patient-centered care.

Let Patients Designate Their Race
Collecting information on patients' race and ethnicity is a necessary step toward eliminating health disparities. While most patients support this policy, some experience discomfort when asked for this information, and their attitudes might discourage providers from collecting it. A Fund-supported study in the Journal of General Internal Medicine concludes that this can be avoided by clearly explaining up front the reasons for asking. Patient interviews conducted by Northwestern University's David W. Baker, M.D., and colleagues also revealed that many patients who were initially uncomfortable with reporting this information to a clerk said they would feel more comfortable providing it to a nurse or doctor instead.

More Child Development Data, Please
Promoting children's overall development is increasingly a focus of pediatric providers and policymakers. To aid their efforts, researchers at Child Trends reviewed 26 national data sources on kids' social, emotional, intellectual, and physical well-being and made recommendations for future data collection. Their report, Studying and Tracking Early Child Development from a Health Perspective, calls for more information on the characteristics of children's neighborhoods; the addition of developmental screening assessments to the National Health and Nutrition Examination Survey; and the inclusion of more details on the content of developmental screening and well-child visits in longitudinal studies.

Medicare at Middle Age
Medicare has successfully met the two central goals its founders envisioned in 1965: protecting elderly and disabled Americans from burdensome medical bills and ensuring they get the health care they need. Up next for the program are the twin challenges of rapidly rising health care costs and the impending retirement of the baby boom generation. In an essay published in Health Care Financing Review, Fund president Karen Davis and Senior Program Officer Sara R. Collins say that addressing both will require new strategies for improving health system efficiency and quality while maintaining affordable access for enrollees.

New Harkness Fellows Chosen
Harkness Fellowships in Health Care Policy provide promising health care policy researchers, clinicians, managers, public health officials, and journalists in the Australia, Germany, New Zealand, and the United Kingdom with a unique opportunity to spend up to 12 months in the United States. Just recently, the Fund announced the recipients of 2006–07 Harkness Fellowships. They are:

Vidhya Alakeson, M.Sc. (United Kingdom)
Senior Research Fellow/Social Market Foundation
Project: The Role of Out-of-School-Hours Activities in Improving Health-Related Behaviors Among Teenagers

Mark Booth, M.A. (New Zealand)
Manager, Strategic Funding, Therapeutic and Social Policy/New Zealand Ministry of Health
Project: Analysis of the Health Care Policy Responses to Population Aging in New Zealand and the U.S.

Shirley Bowen, B.M., M.M., FRACP (Australia)
Executive Director of Population Health and Ambulatory Care/North Metropolitan Area Health Service, Western Australia
Project: An Evaluation of Chronic Disease Management Programs in the U.S. with an Emphasis on Cost-Effectiveness and Evidence of Improvement in Health Outcomes

Bruce Guthrie, Ph.D., MRCGP, MRCP (United Kingdom)
Honorary Clinical Senior Lecturer/University of Dundee
Project: Implementing Systematic Chronic Disease Management in Organizations Serving Diverse Populations: Lessons from Comparative U.S. and U.K. Case Studies

Robbie Foy, M.B.Ch.B., Ph.D. (United Kingdom)
Clinical Senior Lecturer in Primary Care/University of Newcastle upon Tyne
Project: Mapping Quality Improvement: A Comparative Study of U.S. and U.K. Health Care Organizations

Richard Hamblin (United Kingdom)
(Harkness/Health Foundation Fellow)
Head of Analytic Support/Healthcare Commission
Project: Using Information to Improve Health Care and Decision Making for Chronically Ill Patients

Katharina Janus, Ph.D. (Germany)
Research Fellow/School of Public Health, Hannover Medical School
Project: The Effects of Financial and Non-Financial Incentives on Physician Job Satisfaction and Quality of Car: A U.S./German Comparison

Ruth Lopert, M.B.B.S. (Australia)
Principal Advisor, Pharmaceutical Policy Taskforce/Australian Government Department of Health and Ageing
Project: Comparing Cost, Coverage and Access to Pharmaceuticals Under Australian and U.S. Policy Frameworks

Anatole Menon-Johansson, M.B.B.S., Ph.D. (United Kingdom)
(Harkness/Health Foundation Fellow)
Specialist Registrar/Chelsea and Westminster Healthcare
Project: Identifying Barriers to Effective Treatment for HIV/AIDS Patients

Carly Muller, B.Podiatry, M.P.H. (Australia)
Senior Policy Advisor/Victorian Department of Human Services
Project: An Evaluation of Proactive Telephone Disease Management Services

Jonas Schreyogg, Ph.D. (Germany)
Senior Lecturer/Berlin University of Technology
Project: Comparing the Costs of Health Service Delivery Between the U.S. and Europe for 10 Procedures

Mihi Ratima, Ph.D. (New Zealand)
Associate Professor of Maori Health/Auckland University of Technology
Project: The Characteristics of Effective Health Care Policy to Reduce Ethnic Disparities in Access to Health Care

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