CONTACTS 
0201 - University of Washington             206 764 2070
020101 - Mr. Clarence H. Braddock III, MD, MPH
020102 - Assistant Professor =206 764 2070
020103 - braddock@u.washington.edu
020104 - College of Medicine
020105 - Medicine, Adj Med History and Ethics
0202 - Kaiser Permanente - Shadelands       925 906 2200
020201 - Walnut Creek, CA
020202 - Ms. Jeanne Bradley; Site Coordinator =925 906 2204
020203 - Jeanne.Bradley@ncal.kaiperm.org
020204 - Administration Department

SUBJECTS
Medical Practice Requires Records
Medical Management Needs SDS
Bumbling TQM Cut Corners Faster Better Cheaper

0905 -    ..
0906 - Summary/Objective
0907 -
090701 - Follow up ref SDS 13 0000, ref SDS 12 0000.
090702 -
090703 - Received ref DRT 1 0001 from Clarence Braddock responding to my
090704 - letter, ref DIP 3 0001, on 991227, also, sent to Michael J. Barry, MD,
090705 - as shown in the record. ref SDS 13 2009
090706 -
090707 - Initially, Clarence has quite a signature block...
090708 -
090709 -
090710 -        Clarence H. Braddock III, MD, MPH
090711 -        Director, Bioethics Education Project
090712 -        Asst. Professor, Medicine, Medical History & Ethics, and Health Services,
090713 -        University of Washington
090714 -        and
090715 -        Director, Center for Education and Development
090716 -        VA Puget Sound Health Care System
090717 -        1660. S. Columbian Way Seattle, WA 98108
090718 -        ****************************************
090719 -        VA: Tue/Wed/Fri: VOICE:(206) 764-2070 FAX: (206) 764-2470
090720 -        UW: Mon/Thur:    VOICE:(206) 616-3605 FAX: (206) 685-7515
090721 -
090722 - ..
090723 - Clarence asks about progress working with Kaiser?
090724 -
090725 - Since Kaiser is not mentioned in the letter sent to Clarence, this
090726 - indicates he clicked around and discovered the effort to help Kaiser.
090727 -
090728 -    Kaiser is cited at a third level in the following way...
090729 -
090730 -    The remedy for information overload to enhance patience assistance,
090731 -    which is another form of a Communication Manager, cited in the
090732 -    letter to the doctors, ref DIP 3 8265, is linked to the letter on
090733 -    990924 explaining the High Cost of Medical Mistakes. ref DIP 2 2955
090734 -    That letter is linked to the record on 990625 citing the Kaiser
090735 -    Healthwise Manual calling for doctors and patients to use a ping
090736 -    pong method of feedback loops that help improve accuracy of
090737 -    understandings. ref SDS 2 0899
090738 -
090739 - This further supports value of SDS "intelligence" to help people find
090740 - information of interest to them.
090741 -
090742 - The letter to Clarence and Barry asked them to support two
090743 - initiatives...
090744 -
090745 -    1.  Enhance traditional patience assistance for proactive
090746 -        communication support of the doctor/patient partnership;
090747 -        ref DIP 2 2955; and
090748 -
090749 -    2.  Educate doctors and patients together about good communication
090750 -        practices. ref DIP 2 2601
090751 -
090752 - Neither Clarence nor Barry responded to these ideas until today.
090753 -
090754 - Sent ref DIT 1 0001 notifying that...
090755 -
090756 -         [On 000613 notified Sandy Klausner of this opportunity.
090757 -         ref SDS 20 0990
090758 -
090759 -         [On 000613 discussed with Steve Olsen, DDS. ref SDS 21 7905
090760 -
090761 -    1.  On 000113 Kaiser attempted a systemic improvement by assigning
090762 -        a Physician Leader to support communication between doctors and
090763 -        patients that could improve medical management, by carrying out
090764 -        requirements in Kaiser's Healthwise Handbook. ref SDS 15 5313
090765 -
090766 -        Solution to use Kaiser's web site was not supported by record
090767 -        of failed response on 991106. ref SDS 7 4505
090768 -
090769 -        Implementation is weak because focus is on making problems go
090770 -        away rather than investigating to develop improvements in work
090771 -        practice and tool sets to aid doctors and patients.
090772 -
090773 -        It conflicted with CEO Doctor Rober Pearl's report to members
090774 -        reviewed on 991028. ref SDS 5 0800
090775 -
090776 -    2.  On 000118 Kaiser administrator addressed medical management
090777 -        mistakes, ref SDS 16 3248, and on 000121 some effective action
090778 -        was taken, demonstrating the level of effort was not beyond the
090779 -        ability of doctors to perform. ref SDS 17 0863
090780 -
090781 -    3.  No action on systemic action as evidenced by two month delay in
090782 -        getting communication from doctors, which improves upon the 6
090783 -        month delay from the date Clarence was asked for help, until
090784 -        his letter today asking about progress.
090785 -
090786 -    4.  On 000121 Kaiser reported that computer will solve
090787 -        communication problems when it is rolled out in late 2000,
090788 -        early 2001. ref SDS 17 0783
090789 -
090790 -    5.  On 000211 example of medical management problems that need to
090791 -        be fixed is Dale Ames report. ref SDS 0 5538
090792 -
090793 -    6.  Cite cause of medical mistakes from letter, ref DIP 2 0001, on
090794 -        990924, ref SDS 4 0001, and solutions. ref DIP 2 5967
090795 -
090796 -        Team care reported on 990625, ref SDS 2 6970, needs a
090797 -        coordinator, and executive. ref DIT 1 1380
090798 -
090799 -    7.  Cite letter to Doug's team at SRI, ref DIP 4 0001, on 000317.
090800 -        ref SDS 18 0005
090801 -
090802 -    8.  Recommend support for Com Metrics, ref DIT 1 5395, reflecting
090803 -        recommendation on 000608 to support Sandy Klausner's project.
090804 -        ref SDS 19 3692
090805 -
090806 -
090807 -
090808 -
090809 -
090810 -
090811 -
090812 -
090813 -
090814 -