#reflecting team

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Tom Andersen zum 90. Geburtstag

Tom Andersen (2.5.1936-15.5.2007) Heute würde Tom Andersen, der am 15.5.2007 im Alter von 70 Jahren tödlich verunglückt ist, 90 Jahre alt. Eine Gelegenheit, an ihn zu erinnern. Sein Konzept des reflecting Teams inspiriert auch heute noch die klinische Arbeit vieler Therapeuten. Ein Artikel von Anna Sidis und Kollegen von der University of Wollongong in Australien zeigt, wie lebendig sein Denken…

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The Art of Reflection

The Art of Reflection

Tom Andersen

Heute vor 10 Jahren verunglückte Tom Andersen bei einem Spaziergang mit seinem Hund tödlich. Im systemischen Feld war er einer der wichtigen Pioniere, seine Arbeit mit dem reflecting team hat Eingang in unzählige Anwendungsbereiche gefunden und viele Menschen inspiriert, die beruflich mit anderen Menschen arbeiten. Zahllose Arbeiten haben sich mit diesem Ansatz beschäftigt, aber die…

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Tom Andersen (2.5.1936-15.5.2007) Heute würde Tom Andersen (Foto: psicoterapiaintegrativa.com) seinen 80. Geburtstag feiern. 2007 ist er wenige Tage nach seinem 71.

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Evidence-based support for transparency in medical records

Family therapists have been in favor of radical transparency for a couple of decades now. In training contexts, we used to sit behind one-way mirrors and strategize about how to fix families. At its worst, this practice led to openly derisive talk about family members and oracular advice from the mysterious supervisor and team whose faces were never seen. All this changed when Tom Anderson decided to come out from behind the mirror and have team discussions in front of the families who had come for help. The practice caught on rapidly, and our field soon learned the power and joy of transparency.

Even before the development of "reflecting teams," it had beeen my practice to write my notes as if the people whose lives they recorded were reading over my shoulder. This just seemed proper to me. I have always, even when working in systems that made it difficult for people to obtain copies of their records, treated records as if they belonged immediately and directly to the people they were about. This makes me more respectful and careful with my internal language. It leads me to think about people in less pathologizing ways.

Now there is empirical support for these practices.

A few years ago, Tom Delbanco and Jan Walker pitched us with a simple idea: Patients should routinely be able to see the notes that physicians write about them.  Now it’s true that we all have the legal right to see these notes, but obtaining them is anything but routine. The process involves phone calls, faxes (sic), duplicating fees and all sorts of other demoralizing steps. The net result is that reviewing your doctor’s notes about you is a rare experience.

Tom and Jan said that the physicians with whom they had spoken about this idea were split. Some were interested, some were resigned: They recognized that transparency was an increasingly powerful wave and that the world seemed to be heading this way, and the others thought they were crazy―notes were for documentation and communication among doctors and were never intended for patients.  The arguments were of a religious quality―they were about belief and values.  The obvious solution was to test the idea and let data help sort it out.  Today, with the publication of the study results in the Annals of Internal Medicine, that debate is now illuminated.

One hundred and five primary care doctors, more than 19,000 patients and 12-months of testing at three sites has brought us to some striking findings: Patients overwhelmingly support open notes; they report significant benefits from it; and doctors reported that the effects on their practice have been minor.

Some Key Findings:

60-78% of patients (depending on the study location) reported that they took their medications better.

86-89% of patients said that open notes would be an important factor in choosing a provider or a health plan.

99% percent of patients wanted to continue with open notes.

OpenNotes: The Results Are In

By Stephen J. Downs at http://thehealthcareblog.com