Brittany Stollar, 2015 GHLI Fellow
During the week-long Forum, I was surprised to realize how little I really knew about health care systems outside of the U.S. I knew our health care expenditure per capita was much higher than most other countries, but never truly understand to what degree and that we spend more than $2000 beyond that of our closest competitor while still having health outcomes consistently below the average of our peers. I was also shocked by how partisan the Affordable Care Act has been. Unlike in the UK, there is no agreement between the parties on any of the issues raised within the ACA.
Coming from a country that has practiced universal health care coverage since 1948, the UK delegates struggled to understand our political conflict over the ACA. I found myself struggling to understand as well. I hadn’t realized that I’d grown accustomed to debates over the basic human right of available, accessible, affordable, and acceptable health care. While the delegates learned about how to improve the NHS by looking at our system, I learned how we could improve our system by looking at the NHS. During this week, the concept of national agreement on universal health care became less of a myth and more of a feasible possibility.
Modupeore Shenbanjo, 2015 GHLI UK Fellow
Before becoming a graduate student at Yale, I worked as a research assistant in adolescent medicine where I observed multidisciplinary teams caring for patients struggling with eating disorders, drug addictions and teen pregnancy. I often heard in my classes at Yale about how the National Health Services (NHS) provides equitable health care at the point of service. And, now I’m able to see firsthand how the East and North Hertfordshire NHS Trust ensures that no one “falls through the cracks” of health care.
In my role as a GHLI Fellow, I have been able to interact with the trust management, divisional directors, general managers, service coordinators as well as consulting physicians to assess surgical theatre efficiency such as investigating reasons for late start times for the first patient of day and blockages to quick turnovers in between patients.
Through various conversations within the trust, it is evident that not only health professionals, but also the general public are proud of their health system and are determined to ensure they continue to meet the expectations of their citizens.
While observing a surgical procedure, I was impressed at how nurses as well as clinical support workers ensured that each surgery had all the necessary equipment and anticipated possible complications. I also noted that even in a specialty as busy as surgery, senior staff members understood the value of good management and leadership to ensure the needs of each staff member is met and to ensure they create an environment that continues to support learning.
I have been able to utilize my past research skills, as well as my knowledge gained from my courses in order to collaborate with consultants and investigate the root causes leading to surgical starts and cancelations. It’s been an exciting, informative journey thus far.
Although the weather is typically grey and overcast, the people have been warm and cheerful. It is an inspiring group of people to work with, and it makes it very easy to wake up, be motivated and want to contribute-to and improve their community! “Cheers!”
Joan Rhee, 2014 GHLI Intern
Last week, Yale welcomed United Kingdom National Health Service visitors for the International Health and Social Care Leadership Programme (IHSCLP). The IHSCLP is a partnership between GHLI, the South Essex Partnership Trust, and Health Education East of England. Participants learn different problem solving strategies and explore public health issues in their respective home institutions for nine months, eventually presenting their final findings to Yale faculty. I had the amazing opportunity at GHLI to help organize this program and attend it as part of my internship here this summer.
The delegates’ visit was filled with lectures from Yale faculty on various issues as well as field assignment presentations from program participants. We also visited local healthcare facilities, which promoted an enriching exchange of ideas between health management experts from the UK and US. After learning details about the Affordable Care Act, delegates were visibly dazed by the scope of our problems. They asked if I thought there was hope for the American health care system, and I said I honestly wasn’t sure.
During the celebratory final dinner on Thursday night, I was asked again–do I think there is hope? I reflected on everything I learned this week through conversations, lectures, and the delegate presentations showing how each participant had managed to make a difference, ranging from better budgeting for specialized services to improving efficiency in acute hospitals. I DO have hope.
Despite my having much to learn, this internship has shown me that the American healthcare system is on an upward trend and there is a continuous desire to improve. The experience of working on IHSCLP has solidified my desire to work in global health, and I am extremely thankful for the opportunity and learning this internship has brought me.
In July the Global Health Leadership Institute hosted the International Health and Social Care Leadership Programme, a partnership between GHLI and the South Essex Partnership University NHS Foundation Trust (SEPT). SEPT provides health care services to U.K. communities and has a partnership with GHLI to strengthen the capacity of health and social care leaders. The 18 delegates worked with GHLI on field assignments tackling public health issues, and presented their final assignments at the conference. Delegates also heard lectures from Yale faculty and visited health care facilities in and around New Haven.
GHLI faculty director, Elizabeth Bradley, Ph.D., provided a history on health care systems in the U.S. including community health care centers and health maintenance organizations. Dr. Bradley highlighted the physician-led Geisinger Health System in Pennsylvania as a model of high quality integrated health care services. She ended her presentation with a charge to delegates to continue brainstorming ways in which health care systems can be improved.
Site visits to health care facilities are a key part of this program. Delegates visited the Smilow Cancer Hospital, Yale-New Haven Psychiatric Hospital, Connecticut Valley Hospital and the Cornell Scott Hill-Health Center. Following the site visits, delegates shared their experiences. They were impressed by the investment several of the facilities made in their employees, from their interview stage to ongoing reinforcement for employees throughout their careers. “We struggle to get staff feedback and retain employees for any length of time,” said one delegate. “The investment in employees we observed set up a strong system for employee engagement and long-term retention and that is something we can do better.” Delegates also noted that the U.K. seemed to be better at long-term follow-up with patients after they left a hospital. This type of follow-up helps them rate the quality of care, which is something they felt could be improved in U.S. hospitals.
The SEPT delegates said they felt re-energized to tackle challenges they face as health care leaders and plan to continue working together.
Nina Gumkowski, GHLI Intern