Category Archives: Communities

Safety Culture

1) Watch the video: “Building a psychologically safe workplace” (TED talk by Amy Edmonson).

GOAL: Develop awareness of psychological safety and its importance in teamwork.

Optional After class:

IHI Online Open School Modules – http://app.ihi.org/lms/home.aspx

Supplementary activity to provide greater detail and context for the material covered in lecture. Recommended for students pursing certificate in quality and safety.
GOAL: Improve understanding of culture of safety by providing additional examples.
- PS 104 lessons 2-3
- PS 202 Lesson 2

The Medical Safety Net

After Class:

GOAL for this reading: Provide additional data regarding community health centers, populations served, and funding received.

Instructions: Read the “Executive Summary” of “Community Health Centers: Recent Growth and the Role of the ACA” after class in preparation for community experience.

https://www.kff.org/medicaid/issue-brief/community-health-centers-recent-growth-and-the-role-of-the-aca/
- NOTE: the longer “Issue Brief” contains additional details but is not required reading

Optional video:

Out in the Rural – a documentary of the origin of community health centers – https://vimeo.com/9307557

Optional additional references:

For Washington students:
- https://www.kff.org/health-reform/fact-sheet/the-washington-state-health-care-landscape/ (section on “Safety Net”)
HRSA list of community health centers by state:
- https://www.hrsa.gov/about/news/2013-tables/outreach-and-enrollment/index.html
“Health Reform and the Changing Safety Net in the United States”:
- https://catalyst.nejm.org/health-reform-changing-safety-net/
American College of Emergency Physicians website “EMTALA”:
- https://www.acep.org/news-media-top-banner/emtala/#sm.000006qekiwgfhcsjrd3cbqrat032

Community Violence: ACEs, Resilience, and Trauma Informed Care

Watch Nadine Burke Harris’s TED talk that introduces key concepts about Adverse Childhood Experiences and how they impact health.

Read about how one community is addressing violence (PDF) and adverse childhood experiences.

Optional: For students who want to see how the idea was started – Read the original ACE Study, Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults.

Ethical Values, Obligations and Virtues in Communities

1) Review Ethics Key Terms

GOAL: Develop a preliminary grasp of these approaches/concepts and how they are different from ethical approaches/concepts covered thus far in the course.

Review these key ethics terms before turning to the video and reading:

2) Watch video of Carol Gilligan on Moral Development and Care Ethics.

GOAL: Understand the basics of care ethics and how it might apply to the clinical setting.

Consider what is different about the approach that Gilligan is suggesting (i.e. a relational or Care Ethics based approach) from what you typically think of in terms of your ethical obligations as physicians.

3) Read Baby Aaron and the Elders by Ellen Wright Clayton and Eric Kodish 

GOAL: Start to employ these two approaches (communitarianism and care ethics) to a complex case of refusal of life sustaining treatment (LST).

Consider what you learned from Gilligan’s video and the above ethics key terms.

How is a communitarian approach being employed by Aaron’s family?
How could a communitarian approach guide the response of the medical provider?
What would be the primary goal(s) in a Care Ethics based approach to this case? Be specific.
How might a Care Ethics approach guide your particular response to baby Aaron’s family? What would it avoid?

Social Ecological Model

McLeroy, Bibeau, Steckler and Glanz are generally credited with creating the social ecological model of care. A quick Google search for the social ecological model will reinforce how widely it has been adopted. There are numerous community, state, national and international organizations that utilize this model in their programs.

Think back to your session in immersion on the social history. How often do you think beyond the individual and interpersonal factors that influence you and your patients health?

Image result for social ecological model uw

From CDC Colorectal Cancer Control Program (CRCCP)