Patrick Quinlan, M.D., CEO of Ochsner Health System, New Orleans, will leave his post on Sept. 1 to head the organization's Center for Community Wellness and Health Policy to take on an equally important challenge. He'll lay out a strategy for managing population health and engaging staff, area students, congregations and businesses in embracing healthy lifestyles.
Interviewed by Bob Kehoe
What are the Center for Community Wellness and Health Policy's goals?
Quinlan: We want the Center to highlight what will be required for us as a community, state and as a nation to achieve our health goals. When we talk about the aspirations in health care reform, we're a nation in great medical need. While it's good to focus on care delivery and expense, the real goal should be to reduce the disease load of the entire population. It's heartening to know that at least half the disease in this country is avoidable if we can change through lifestyle choices.
What particular challenges face your community?
Quinlan: They are the same factors that drive the disease load throughout the country and all are avoidable to the degree that behaviors can be changed — addiction to smoking, the growing obesity epidemic and the activity levels that are required for a particular person's situation.
We know that if the population is going to have a higher total disease load — as can be expected as our population ages and as the obesity epidemic becomes more evident and as smoking goes unchecked — we will end up with a subpopulation that is particularly sick and expensive to treat. We're promoting the idea that if we tackle the lifestyle choice problem with the same vigor that we did, say, in putting a man on the moon, we could have a very different future for health care.
How will you manage population health?
Quinlan: We have engaged in a number of initiatives around lifestyle choices to promote the health of our employees and their families. We offer incentives to stop smoking, including steep discounts on insurance premiums. We cover visits for smoking cessation and offer generic prices even for proprietary drugs for smoking cessation. This is also a smoke-free campus.
How do you engage staff in this effort?
Quinlan: This is an institutional effort. We believe in going back to basics. It's easy to get lost in the symptoms and take your eye off the root cause. Lifestyle is the root cause of half of this. If we all engaged in behavioral change we would free up so many resources that we could take beautiful care of people who had diseases of chance, make our country proud and have money left over to deal with social issues. That's the thought that we share with our group because there is a high road on this health care debate. There is a way out if we lead by example, so let's start with ourselves.
What are some of the Center's early initiatives?
Quinlan: Our Change the Kids program starts with a simple idea that by focusing on children, we can change the future. Children can be powerful change agents within their families if they're fully armed with the right information. They often have youthful zeal and can see with clarity what adults don't because we're so habituated by our behaviors.
We took two fairly typical schools with a fair number of children at risk. We want to help them help themselves and have students drive the process. We've also created advisory councils in collaboration with parents and teachers that were authorized by law but never enacted. In the process, we've seen lots of anecdotal change within this group. We've sponsored a fitness grant for the schools in Jefferson parish so we can get baseline data and see how much progress we've made.
How are you educating children?
Quinlan: We sponsor school-based clinics to have someone in place all the time who works with children at risk. We hope to prevent children from migrating to the 1 percent, 5 percent or 15 percent of the population who generate the most costs. We're also taking a broad approach to their activity level at school, what they eat and how to educate them so they in turn educate others.
During Health Week, students worked with each other to reinforce what they'd been taught about calorie counting, food contents, reading labels, understanding the role of exercise in both burning calories and promoting health. We hope they become as schooled in this area as they are in their formal education. One of our next steps is engaging churches because quite often that is where you have a group of people who are open to change, who are dedicated to doing the right thing and who recognize we're all fallible.
The final piece is the least developed, but we've started a partnership with a grocery chain that we're calling Choose Healthy. We provide "shelf talkers" that give information to shoppers in this target-rich environment where people are thinking about what they want to eat when they're hungry. It's sort of, "Buy this; don't buy that." The ideal would be to integrate food purchases into medical records to give willing participants more insight into what they think vs. what they do to educate at the moment of decision.
What changes have you instituted on your campus?
Quinlan: We try to make it easy to do the right thing and hard to do the wrong thing, and we reward those who do the right thing. We've changed our eating environment — from vending machine selections to what's offered in the cafeteria. We've eliminated the fryer, for example. We offer "smart meals" that are nutritionally balanced and appropriate. They cost more to make than our selling price and we encourage people to take them home. We hope that if we can get them used to eating better foods here, this will carry over to home as well.
We also have Virgin Health Miles where we give people discounts on their health insurance if they agree to work in a partnership. We're self-insured so we're able to help people in that regard. We also have a pedometer program and regular weight and blood pressure checks at stations so staff can tackle it all at once because your body works as a system. Last year, collectively, we lost 33,000 pounds. The year before, we lost about 30,000 pounds.
This is working in concert. If we can get people to significantly increase their physical activity, change their eating environment and help people to stop smoking, then we've done what we can to tackle the big three issues. No one person, organization or government can do all of this, but what if all hospitals did as a start? That represents a large number of people and would make a difference at many levels.