Post-Conference Links and Information |
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The intent of the Chautauqua County Health Network, Inc. when planning the conference, Excellence in Health Care Delivery, was to provide an educational experience to interested parties and decision-makers about health care delivery and financing. A panel of experts in various areas of health care delivery and financing were acquired to present an array of information and perspectives to participants to meet this endeavor. The goal and objectives of the conference as outlined on the conference brochure were: |
Goal:
To bring clarity and a deeper understanding to the Chautauqua County decision makers and national health policy leaders on the issue of access to quality health care including the financial impact of that care and the plight of the uninsured.
Objectives:
For the purpose of meeting the requirements for qualifying attendance at the conference for continuing education credits for physicians and registered nurses, the objectives were further delineated to include:
The evaluation of the conference is based upon the conference goals and objectives, information conference participants included on evaluation tools completed and submitted as well as other related information.
Upon approval late in February by the Board of Directors to offer the conference, what usually requires at least a year to achieve was accomplished in record time with the collaborative efforts of the Board and Excellence in Health Care Task Force members, Network staff, Chautauqua Institution, Chautauqua County government and many others. The availability of experts desired to meet objectives and budgetary considerations resulted in constant modifications to the conference agenda. The unexpected notice of Senator Clinton's intention to visit and Chet Burrell's unanticipated conflict resulted in further juggling of the agenda. With focus on the desired objectives, sessions were offered to accomplish said objectives.
The evaluation tool design provided an opportunity for conference participants to rate how well the conference met the individuals' needs and answered their questions about health care financing and delivery as well as the educational value of each session. Additionally, the tool served to collect comments about the conference content, speakers, and format; suggestions for future program considerations; and information respective of inquires presented. In accordance with those completing and submitting the evaluation tool, the conveyed information assists in assessing the success of the conference and future planning.
Of the 122 registered for the conference, 118 attended both days, only one day or selected sessions. Fifty-two participants completed and submitted evaluations. Professions identified on the evaluation form included Administrators, of which 52% indicated that they were RNs and/or Nurse Practitioners; RNs; Public Officials; Other, of which 56% indicated they were educators; Unidentified; and MD/DOs. Table I below further identifies the number of each profession reporting and the number of those that evaluated each session.
| Table I: Evaluations Submitted by Profession and Per Session | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sessions:
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Overall SatisfactionNinety-two percent of those submitting evaluations rated their overall satisfaction for the conference. Of those, 80% indicated that the conference met their needs and answered their questions about health care financing and delivery, whereas 20% indicated it met their needs and answered questions satisfactorily and 0% poorly. Although 80% rated the conference very well, this rating per profession as illustrated in Chart 2 varied widely, 100% to 50%. |
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Educational Value of Sessions
Conference participants rated the educational value of each session on a scale of 5 to 1, where 5 represented the greatest value. As illustrated in Table I., a number evaluated individual sessions less than the total reporting. The variance appears to be due to attendance on only one day or for selected sessions.
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The range shown in Chart 4 is 5.0 to 3.7 where the physicians rated the session at 3.7 and public officials at 5.0. All others rated the session within 0.3 above or below the overall rating. |
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Ratings shown in Chart 5 range from 5.0 to 3.8. All professions rated the session close to the overall rating, except public officials. |
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Shown in Chart 6 all professions rated the session close to the overall rating of 4.8. |
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The educational ratings by professions in Chart 7 reveals a range from 4.5 to 3.1 with the majority between 4.0 and 3.5. |
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The educational rating by professions in Chart 8 reveals a range from 4.4 to 5.0 where administrators found the session less educational than all other professions. |
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As illustrated in Chart 9, all professions except for public officials rated the educational value within 0.2 points. |
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Chart 10 illustrates that the administrators, unidentified and physicians found the session to present similar educational value, whereas other professions fluctuated more from the overall rating. |
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The educational value of the session, as shown in Chart 11, differed broadly between professions with only those identified as other and unidentified finding similar value in the session. |
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Revealed in Chart 12, all but those identified as other rated the value of the session 4.6 or greater. |
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The educational value of the session, as shown in Chart 13, ranged from 4.0 to 5.0 where physicians found the session less educational than all other professions. |
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As shown in Chart 14, all professions except the unidentified and RNs rated the educational value in the range of 3.8 to 4.2 and within 0.2 of the overall rating of 4.0. The lowest rating of 3.3 was given by the unidentified and highest, 4.6, by the RNs. |
Comments and Inquiry Responses
Responses to requests for comments on the content, speakers and format, and other inquiries listed on the evaluation tool served to collect more information for assessing the event, determining educational wants and needs of those participating and planning for future action. Because the conference was attended by a wide representation of individuals/professions concerned about health care delivery, the replies from different professions help disclose not only common threads, but also issues specific to professions. Table III. summarizes by profession responses included on the form.
Table Discussion Session
The final session of the conference, Table Discussions and Summaries, offered participants the opportunity to consider information delivered in prior sessions, bring forth issues, concerns, opinions and such related to their chosen table discussion topic, discuss points generated and establish priorities associated with the topic. The process presented a forum for different and like professionals to collaborate about specific topics and bring forth priorities for future deliberation and/or action. Of the ten topics for discussion, Rural Challenges; Community Initiatives; The Medicaid Crisis; Medicare for the Future; National Reform; Provider Issues (Hospital & Physician Challenges); Business/Provider Partnerships; Politics and Health Reform; Prevention: The Key to Excellence; and Comparative Health Systems, two topics, Business/Provider Partnerships and Medicare for the Future, were eliminated due to lack of interest.
The facilitator and process guidance provided served to achieve uniformity in process, recording of discussions, and identification of priorities. Comprehensive and summary documentation for each table are available in hard copy or within the CD production of the conference, however for this evaluation only an abbreviated report is disclosed (see Table Discussions). The educational value rating of this session as illustrated in Chart 3 demonstrates that its significance was comparable to the majority of other sessions. This session differed from all others in that the outcomes emerged from the participant's direct involvement. By community representative consensus priorities emerged.
Summary and Conclusions
Eighty percent of the participants evaluated the conference very well and 20% satisfactory. All of the conference evaluators claimed that it met their needs and answered their questions regarding health care financing and delivery. The educational values of all sessions ranged between 3.8 and 4.8, so it seems warranted to conclude that the intent and objectives of the conference were successfully accomplished. It seems realistic to conclude that the conference goal: to bring clarity and a deeper understanding to the Chautauqua County decision makers and national health policy leaders on the issue of access to quality health care including the financial impact of that care and the plight of the uninsured, at best, was indirectly attained because most of the conference attendees were the constituents of the aforementioned. However, it is warranted to conclude that the potential for accomplishing the conference goal reaches beyond the conference through those in attendance, and, additionally, if highlighted issues and priorities generated from the table discussion session are acted upon.
Also, it seems justified to conclude that participants, in general, appreciated the mix and quality of speakers, but that some had points of concern. Additionally, comments provided appear to focus on moving forward to address issues, learning more about other health care delivery and financial systems, reimbursement, recruitment/staffing and political dynamics. Furthermore, based on comments in Table ll. and fact that the results of the table discussion session reflects the positions of parties interested in the health care system, it is recommend that the table discussion results and evaluation tool comments be assessed and incorporated into future planning of educational events and/or development of action plans.
| Table II: Summarization of Participants' Comments per Evaluation Question |
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| ADMINISTRATORS |
| Comment on content, speakers and format |
| It was a nice mixture of speakers from various backgrounds and from different perspectives; makes you stop and think! Facilitator very unclear on purpose and process. Broad scope of knowledge in presenters. Excellent mix of speakers and topics. |
| What - if any lingering question(s) do you have about the issues discussed at this program? |
| Where do we go from here? Why can't we (the USA) follow the Canadian process re: a drug formulary - there is no shortage or delay in availability of such products in Canada, the prices are 50% lower and products meet needs of patients. Congress needs to focus on this. How will changes be paid for? Will CCHN overview and publish discussions in the Post-Journal? No mention of faith-based response to health issues, i.e. mental health, substance abuse, etc. What is the cost Impact of "gang" and antisocial behavior in communities, non-drug related? How do we get our arms around the issues? |
| What is the single most important step that needs to be taken to improve health care in Chautauqua County? |
| Including state, Could all the insurers at least Medicaid and Medicare get together and create a formulary, negotiating with pharm. companies to lower medication costs? Coordination of care, especially for indigent. Don't drop the ball - we need leadership and fearlessness! Recruitment of health care professionals. Incentivize, motivate and educate for wellness and preventive measures and care! Raise Medicare rates to comparable areas of the U. S. Raise commercial insurance reimbursement in order to enable fees/salaries for physicians and nurses that are competitive and work for us not against our recruitment as the existing case. On-going dialogue - opportunities to begin working on those items that can be improved without huge sums of money. Change from sick system to prevention system. Provider cooperation and coordination. Cohesion and consumer saving government, providers and taxpayer on issues and direction. Agenda/or action. |
| What is the single most important step that needs to be taken to improve health care in the nation? |
| Did we hear any solutions today? Realign the system. Making the health care system less complex. Raise Medicare rates to comparable areas of the U. S. Raise commercial insurance reimbursement in order to enable fees/salaries for physicians and nurses that are competitive and work for us not against our recruitment as the existing case. Make one payor source for healthcare. Patient accountability for their health. Health care as a human right. Pt. POS payment - decrease cost of insurance by reducing profit allowed by companies. Determined by States. Catastrophic insurance only. Leadership and honesty in approach to look for basic health care for all. |
| Suggestions for future programs, e.g., topics, speakers, time, place, duration, etc. |
| Too much talk about national and universal health care without specific discussions on how it would work or what the healthcare costs would rise to? Put affiliations on nametags or provide list of participants for networking purposes. Okay to slow down/more questions. Great line up! Wonderful accommodations. Thank you. |
| REGISTERED NURSES |
| Comment on content, speakers and format |
| It was unfortunate the organizers added a political speaker to the agenda. Had I known Senator Clinton was speaker I may have chosen not to pay the tuition cost. These problems and solutions need to be apolitical. |
| What - if any lingering question(s) do you have about the issues discussed at this program? |
| Where to now? How is health care going to be reimbursed in the future? |
| What is the single most important step that needs to be taken to improve health care in Chautauqua County? |
| Universal health care. Increase focus on prevention. Staffing to increase patient education. |
| What is the single most important step that needs to be taken to improve health care in the nation? |
| Universal health care. Less control of the insurance companies on practices. |
| Suggestions for future programs, e.g., topics, speakers, time, place, duration, etc. |
| Same thing next year. |
| PUBLIC OFFICIALS |
| Comment on content, speakers and format |
| Outstanding. Large data dump - need CD and time to integrate thinking on this. |
| What - if any lingering question(s) do you have about the issues discussed at this program? |
| Enhanced interest in building partnerships in our county to effect healthcare reform. |
| What is the single most important step that needs to be taken to improve health care in Chautauqua County? |
| Continue work done by task force. Get others involved in specific issue areas. Move some solutions forward ASAP. |
| What is the single most important step that needs to be taken to improve health care in the nation? |
| I don't have a set plan or even after today a clear sense of solutions. Behavorial change model-Social marketing. |
| Suggestions for future programs, e.g., topics, speakers, time, place, duration, etc. |
| Behavorial Science/healthcare topic. Speakers from academia and practice. Time, place, duration similar to this conference. Excellent program conference. |
| MD/DOs |
| Comment on content, speakers and format |
| Excellent Program. Too long-first day.
I felt Dr. Chin's presentation, although sensational, was presented out of context. When certain statistics were presented, certain of his numbers, especially his death rate from medication errors were presented without any clinical contextual side which makes the numbers alarming; but what he didn't say was more important and very relevant. I have seen his act before: he's bright, well educated and speaks well, but his little insight into the day to day practice of medicine, even though he is an MD. This intigates the relevance of his talk. Should avoid political statements. |
| What - if any lingering question(s) do you have about the issues discussed at this program? |
| Addressing quality and consistency of care delivered. Where do we go from here? Political inaction.
Too many. Recruitment of physicians to rural communities is obviously difficult. With financial and time. |
| What is the single most important step that needs to be taken to improve health care in Chautauqua County? |
| Get everyone covered with affordable and decent health care.
Advance directives. Prevention Co-align all parties. We need to continue to look for local solutions to our health care issues while trying to sidestep many of the broader issues that affect our health system nationally. Small changes for reimbursement |
| What is the single most important step that needs to be taken to improve health care in the nation? |
| Get everyone covered with affordable and decent health care.
Universal Health Care. Prevention Take the politics out of health care. Eliminate third party. |
| Suggestions for future programs, e.g., topics, speakers, time, place, duration, etc. |
| Get HMOs and MSNY to participate in next meeting.
Excellent overall. Perhaps make conference a biannual event. |
| OTHER |
| Comment on content, speakers and format |
| Very difficult to hear in dining room. Very good discussion group. Very interesting speakers - especially Friday. Would have liked podium higher than, floor -made it hard to hear and see speakers. The setting and hotel staff were awesome. Based on the 5 objectives in the brochure, these speakers have accomplished these objectives. Most Thursday speakers painted a bleak picture. Friday's speakers and a few of Thursday's speakers gave valid ideas to try. Lecture format was most informative. So much political discussion was not expected. However, I was enlightened on the symbiotic relationship between politics and economics with healthcare delivery. We talked about financing issues, but did not discuss viable solutions at length.
Speakers: When I saw the list of speakers for the Chautauqua Conference entitled "Excellence in Health Care Delivery" (Dahl, D. Conference to explore health care solutions. The Post Journal ((Jamestown, NY)). 22 March 2003). I recognized among them significant players in my career as a medical school professor over the last 25 years. This was an opportunity to see them as "real human beings" (as Dan Morhaim put it) rather than just as authors of letters and subjects of newspaper articles. Content: The information provided by each speaker was painfully accurate and informed. I consider myself well-informed about current medical news. I did not learn anything new, but, importantly, I learned that the speakers know the details of my concerns and share them. Format: I deliberately select academic conventions where speakers are limited to 12-minute presentations followed by 3 minutes of pointed questions. This provides no time for fawning introductions (despite the printed biographies) and fatiguing jokes which I experienced at the Chautauqua Conference. The hurried arrivals and departures of the speakers emphasize a defect in American public life today: there is little time for contemplation and reasoning among significant players in medicine and politics. |
| What - if any lingering question(s) do you have about the issues discussed at this program? |
| What to do? How to improve the situation? How can we, locally, move contrary to national movements? How can we as a community, take meaningful steps to success? Would have been very interesting to hear from HMO. Interesting huh? How can we stop/change the insurance industry and pharmaceutical industry from controlling healthcare and choices for both care givers and those in need of medical services? "Pay for better performance "who determines it"? Is it just about procedures or does it include patient "talktime"/"bedside manner". How do you fix a defective ship? What are the details about the CCHN Healthcare model? We spoke of the innovativeness of the program, but not in any detail. More on best practice from best nations. Implementation of ideas and transferring information to needed people.
I have none because the presentations were so remarkably comprehensive. |
| What is the single most important step that needs to be taken to improve health care in Chautauqua County? |
| Improve the economic and educational situations. Keep our productive youth here. Further integration of community resources. Healthcare reform legislation. Too many self-serving and competing agencies. We each individually responsible for change. This seems like the only effective way for change. A return to personal ethics, to be and do the best I can, would achieve much. Drs. Chin, Morhaim and Dunham gave some concrete opportunities for helping! Small steps by steps have the less. Will those that were listening do what they came to hear? Continuation of the CCHN program to evaluate the benefit to the county - for county benefit and possible nationwide influence. Focus on a few items that are do-able, initiate them and move on. |
| What is the single most important step that needs to be taken to improve health care in the nation? |
| I wish, I knew? Healthcare reform legislation. Universal coverage. Clinton had no business at our supposedly non-political seminar. Insurance and pharmaceutical industries let go of their profits and provide more appropriate services that are more cost effective for everyone. We each individually responsible for change. This seems like the only effective way for change. A return to personal ethics, to be and do the best I can, would achieve much. Drs. Chin, Morhaim and Dunham gave some concrete opportunities for helping! Small steps by steps have the less. Will those that were listening do what they came to hear? Further focus on the uninsured and underinsured. Universal healthcare - federally funded. Focus on a few items that are do-able, initiate them and move on. Every country needs a National Health Service with a rapid information system to deal with infectious disease epidemics. Local action cannot proceed without presidential leadership. Since the conference was announced in March, four Democratic Presidential candidates for the 2004 election have announced specific health platforms. The importance of this was emphasized by Senator Hillary Clinton’s presence at the Chautauqua Conference. (I was affected by her nostalgia about her August 1992 visit to Chautauqua with Presidential Candidate Bill Clinton and Senator Pat Moynihan. My now-deceased father had attended that rally, and his remembered comments are vivid in my mind.) |
| Suggestions for future programs, e.g., topics, speakers, time, place, duration, etc. |
| Would have been very interesting to hear from HMO. Interesting huh? Exploration of healthcare delivery and quality from different perspectives (e.g. physicians working for hospitals, with HMO/PPO, free clinic, etc.). Continue.
Consider Williams, R.S., Willard, H.F., and Snyderman, R. Personalized health planning (Editorial). Science, 25 April 2003, 300, 549. See also www.dukemednews.org/news/top_story.php for the same information. The writers are respectively Dean of Medicine, Genome Institute Director, and Health Affairs Chancellor at Duke University. The late May meeting in Chautauqua finds the institution in all its botanical glory. |
| UNIDENTIFIED |
| Comment on content, speakers and format |
| Great! |
| What - if any lingering question(s) do you have about the issues discussed at this program? |
| Solutions? More on best practice from other nations, other states, and other communities. |
| What is the single most important step that needs to be taken to improve health care in Chautauqua County? |
| What is the single most important step that needs to be taken to improve health care in the nation? |
| Universal healthcare system federally coordinated and funded. |
| Suggestions for future programs, e.g., topics, speakers, time, place, duration, etc. |
| More real life examples, solutions, and action plans. |
Post-Conference Links and Information |