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Margy Wienbar, MS, has dedicated more than 25 years to improving health and health care in New Mexico, with a particular interest in investigating the underlying causes of poor health and mitigating these causes through systematic approaches including effective data utilization, policy development and a focus on the social determinants of health. Led and collaborated on complex quality improvement projects for various parts of the health care system including health plans and the state’s Medicare quality improvement organization. Directed a six-county region from 2005-12 that encompassed more than 50 percent of the state’s population and oversaw the administration for 17 local public health offices and the related programs. Serves as the Executive Director for HealthInsight New Mexico, where she has primary responsibility for health care quality improvement projects with a primary focus on improving the quality of care for Medicare beneficiaries.

HealthInsight: A Top Workplace in New Mexico

Albuquerque Journal Top Work Place

Each year the Albuquerque Journal offers the opportunity for businesses to be considered for inclusion among the state's "Top Workplaces." This opportunity is offered throughout the country and HealthInsight Utah has been recognized before as well. This year and previously in 2013, HealthInsight New Mexico was named a Top Workplace.

Our journey began with an employee first nominating the organization to be considered, which was gratifying in itself. Following the nomination, management has to agree to support the nomination by allowing employees to participate in a survey. Employee responses are what determine an organization's success in the process.

The survey focuses on characteristics of an organization that are related to organizational health and employee engagement.

Among the strengths that emerged from our survey data were that employees believe they are part of something meaningful and that they feel enabled to work to their full potential. Those are powerful statements.

When I'm asked about what's important to me about where I work, the first thing I talk about is that the organization is mission driven. It's heavily focused on improving health status and health care in the locations we serve. New Mexico probably faces some of the greatest challenges, and every day I see staff dedicated to that mission because they feel they are part of something important.

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Dreaming of What Can Be

Woman looking up

Each year at this time, I begin humming a tune in my head by song writer Bob Franke: "Thanksgiving Eve." The simple and inspiring lyrics begin with:

It's so easy to dream of the days gone by
So hard to think of the times to come

Nostalgia for "days gone by" is part of the human condition. It helps us appreciate and commemorate the past and, hopefully, to learn and to grow. The trick is to not become stuck in this place. As my horoscope recently reminded me, fear of the unknown is part of a journey, but it shouldn't become a parking lot. This is true of our work in the health care environment. Things are changing-fast-and we can be part of crafting the journey if we can use our uncertainty to propel us forward and dream of what can be.

The song's chorus continues:

What can you do with your days
But work and hope
Let your dreams bind your work to your play

What a glorious notion: that the work you do helps fulfill your dreams. At HealthInsight we have hope for a health care system that delivers on its intrinsic promise of care. Care for those in need, who are frightened and troubled, who worry if they can continue to work and be who they have always been as they face illness and treatment in a complicated system. I see the dedication in those I work with who advocate every day for a system that puts the patient first, that delivers the safest and best quality care at a fair cost, and that contributes to individual and community well-being.

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The Upstream Parable: What’s High School Graduation Got to do With it?

Classroom desks

I come from a background in public health where the upstream parable is often used to discuss the importance of prevention. The parable goes something like this:

A medical professor and his student are walking together along a river. As they walk, they discover a drowning man. The student immediately jumps in to save him. Farther along, a woman is drowning. Again, the student jumps in while the medical professor stands and watches. They continue walking and encounter two more people drowning in the river. Once again, the student dives in to save the people, and he barely survives with his own life. The professor just continues walking along the river.

Exhausted and infuriated, the student confronts the professor and asks, "Why didn't you help me? Those people were dying, and I barely made it out alive!" The professor keeps walking and says, "I'm going upstream to see why all these people are falling in the river."

Soon enough, the professor and student come across a bridge. People need the bridge to get to their farmlands across the river, but they are falling into the river because the bridge is in poor condition. The professor sets to work repairing the bridge.

Last October, the HealthInsight Management Corporation Board of Directors, and the respective Boards in each state, voted on a series of True North Measures to guide the work of the organization. The boards selected high school graduation rates as a True North Measure. This is an example of an upstream measure as there is a clear association between educational attainment and future success and health status.

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Bright and Hot: Spotting Success

Report Card

What do you do when your child comes home with a report card? Do you celebrate the A's or do you narrow in on the F's? If you're like most people, you probably narrow in on the F's. It is common for our rational brains to focus on problem areas, and problem solving in health care is no different.

In their book, "Switch: How to Change Things When Change is Hard," Dan and Chip Heath promote an idea called "bright spots." The idea is to look for instances of success in order to learn what is working so it can be applied to areas that are struggling. The report card is an example from their book. The Heaths contend that during times of great change, there will never be a perfect report card. However, there will be successes. In the example, the A is a bright spot, a success. Parents may zero in on the F, but what can they learn from the A that can help improve the F? And, how does this apply to health care?

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New Mexicans Step Up for Health Care Value

New Mexico Coalition for Healthcare Value Logo

HealthInsight New Mexico joined nine other stakeholders in New Mexico as founding members of the New Mexico Coalition for Healthcare Value, a new not-for-profit organization that includes private and public employers, health care providers, insurers, and one of the state's largest retiree health care organizations. The focus of this organization is to provide a neutral forum to discuss ways to improve value and transparency in health care in the state.

The coalition was formed as a result of the momentum generated by the Robert Wood Johnson Foundation's Aligning Forces for Quality (AF4Q) grant that had been operating in New Mexico over the past six years. Employers in New Mexico were interested in sustaining the efforts of the AF4Q initiative and were a driving force behind forming the new organization.

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Sustaining Change: The Role of the Coach

Chalkboard

It's that time of year again: about three weeks after New Year's when the commitment to this year's resolutions begins to fade. All the fitness centers in the country understand this phenomenon. Many gyms see a significant spike in memberships in early January that often help contribute to their bottom line—people who pay, go diligently for a few weeks, then quit going by mid-February. A report in Prevention magazine highlighted that Gold's Gym reported the greatest drop off in attendance on February 18.

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Sales vs. Service: Which Leads to Health Care Engagement?

Collaborate

There's a great deal of discussion about engagement in the health care arena: community, provider and consumer. In this context "engagement" is defined as "emotional involvement or commitment." In Facebook terms, it means providing a comment or sharing a post with others, not merely a "Like" click.

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Breaking Free of Restraints

iStock 000004386083MediumEliminating the use of physical restraints in skilled nursing facilities is associated with improvement in residents’ quality of life, greater independence and functional capacity, use of fewer antipsychotic medications, less skin break down, and fewer serious injuries due to falls.

For nearly ten years, HealthInsight has worked with nursing facilities in Nevada, New Mexico and Utah to improve the lives of nursing facility residents through activities aimed at reducing the use of physical restraints.

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It’s 2 a.m. Saturday: Who do you call with a question about your medicines?

iStock 000000622142MediumWe’ve all been there: it’s the middle of the night and we’re unsure about an aspect of a medication:

  • What exactly is the appropriate dosage?
  • What should I do about a missed dose?
  • Should the medicine be taken with food or not?
  • Is a symptom I’m having a side effect of a new medicine?

Unanswered questions like these can contribute to injuries caused by medicines and unnecessary hospital visits.

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