Peter Angood - Academia.edu (original) (raw)
Papers by Peter Angood
Critical Care Medicine, Sep 1, 2003
T he 36 members of the Robert Wood Johnson Foundation (RWJF)-sponsored Critical Care End-of-Life ... more T he 36 members of the Robert Wood Johnson Foundation (RWJF)-sponsored Critical Care End-of-Life Peer Workgroup, and the 15 nurse-physician teams from 15 of the intensive care units affiliated with this workgroup, have authored the results of an important study published by Dr. Clarke and colleagues (1) in this month’s issue of Critical Care Medicine. The RWJF is to be commended for sponsoring this type of topical healthcare research, and the study authors are to be congratulated for providing a strong start to a “field of research opportunity” within the discipline of critical care medicine. The formalization for end-of-life care (EOLC) strategies and evaluations in critical care is long overdue. This current study should prompt all of us involved with critical care to take a moment and reflect—why has it taken so long for this type of information to be critically reviewed, and why is it only now that we, as a committed group of medical professionals who routinely care for the dying, are finally beginning to focus some attention on one of the most important components of health care? We also should ask ourselves with stringent introspection whether we, as individual practitioners, have focused our efforts effectively enough for those patients with whom we become involved at the end of their lives. Before continuing with this article, please spend a couple of seconds right now to review your last few experiences with end-of-life patients in your intensive care unit (ICU)—and be honest! The end of a life is probably the most intensely personal and certainly one of the most powerful emotional periods in life that every human endures (yes, endures is the correct word). Fortunately, or unfortunately, no one person has the opportunity to preemptively predict or comprehend his or her individual reactions to this final stage of biological existence. This in itself is reason enough why trained professionals, from a variety of backgrounds, are obligated to prepare and provide the professional skills, environment, management processes, emotional support strategies, and evaluative structure to improve the overall quality of care for those managing through the end of a life. The end of a life in the critical care environment, however, can still potentially become an intensely public experience and, therefore, can become one of the most powerfully uncomfortable and inhumane experiences that any human will endure. This also is reason enough why intensivists and critical care professionals are obligated to do everything within their power and control to better manage EOLC for the benefit of their patients, the families or friends, and themselves. Perhaps as important, the institutions that manage EOLC in their critical care units are also obligated to provide the support, resources, and infrastructure to the ICU professionals so that the optimal level of care is provided at the end of a life. What, then, has been accomplished with the current study from this RWJF workgroup? The scientific strategy accomplished a detailed literature review from the English language regarding end-of-life issues in the acute care and ICU settings. The studies obtained from this comprehensive literature review then were subjected to an iterative process of consensus development by the authors (not a metaanalysis) to identify, develop, and refine several EOLC domains. Subsequently, quality indicators and a variety of behaviors or interventions were coupled within each of these identified EOLC domains using this same iterative process of consensus. The stated primary goal of the study was to address the documented deficiencies in EOLC for the ICU by identifying key EOLC domains and related quality indicators— developed through this consensus process. The secondary goal was to propose specific clinician and organizational behaviors or interventions that might improve EOLC quality indicators. The scientific results accomplished were that seven domains were identified as important to consider for EOLC in the ICU environment. These are patientand family-centered decision making, communication, continuity of care, emotional and practical support, symptom management and comfort care, spiritual support, and emotional and organizational support for ICU clinicians. Additionally, numerous (53) EOLC quality indicators were developed to populate these seven domains, and then another layer of information was similarly developed that provides examples ( 100) of clinician and/or organizational behaviors or interventions that could better address these quality indicators. These domains, quality indicators, and listing of behaviors or interventions are to be posted for complete review and consideration on the RWJF Web site (http://www.rwjf.org). Given the stated goals of the study, the workgroup did achieve its end points. The difficulty, however, is trying to decide if the developed domains, quality indicators, and examples of behaviors or interventions are…
Critical Care Medicine, Jun 1, 2000
Critical Care Medicine, Dec 1, 1999
The American Association for Physician Leadership (AAPL) is proud to now offer an information res... more The American Association for Physician Leadership (AAPL) is proud to now offer an information resource and journal entirely focused upon the evolving needs of physician and non-physician managers and leaders addressing the multitude of topics and issues related to healthcare administration, leadership, and management—the new Healthcare Administration Leadership and Management Journal (HALM Journal). Every other month, the HALM Journal will deliver indispensable and reliable results-oriented guidance for a healthcare industry moving toward inter-professional management and leadership that positively impacts patient care outcomes and population health.
Physician leadership journal, Jan 8, 2023
SoundPractice podcast host Mike Sacopulos has spoken with luminaries who shed light on the need t... more SoundPractice podcast host Mike Sacopulos has spoken with luminaries who shed light on the need to provide physicians with business training and leadership skills for the betterment of healthcare delivery. In celebration of the 100th episode, here are some highlights of their conversations. Peter Angood, MD, president and CEO of the AAPL, provides expert commentary.
Physician leadership journal, Nov 8, 2022
Helping others get better, stay healthy, or navigate difficult periods in their lives is at the c... more Helping others get better, stay healthy, or navigate difficult periods in their lives is at the core of being a physician. Medical training and practice provide positive influences for individuals under our care. Leadership education and experience can expand those positive influences beyond individuals to a larger scale of health system improvement. Embracing leadership, informally or within formal roles, can lead to a self-fulfilling prophecy of significant positive change and improvement in our industry.
Physician leadership journal, Sep 8, 2022
All physicians are leaders at some level, and as such, all must continue to lead through and mana... more All physicians are leaders at some level, and as such, all must continue to lead through and manage the transitions and transformations required to improve the complex healthcare industry. But this can come at a costly price unless they simultaneously embark on personal transitions and transformation as well.
World Journal of Surgery, Nov 1, 2001
The Information Age has made profound changes in society and is slowly entering the healthcare fi... more The Information Age has made profound changes in society and is slowly entering the healthcare field. Some of the most important areas are telemedicine, the Internet, and the world wide web (www). Millions of physicians, healthcare providers, and patients are accessing the web daily for patient information, consultation, and distant learning. Telemedicine is beginning to enter the mainstream of health care after decades of demonstration projects. There are many issues which have been raised, such as access to the information, the security of the information, and the quality of the content on the web. While telemedicine is beginning to Hower, there are numerous barriers that prevent its rapid implementation, such as licensure, reimbursement, liability, quality of service, and technical issues. In spite of the numerous challenges, telemedicine over the Internet was practiced in one of the most remote areas of the world--Mt. Everest--demonstrating that it is possible to utilize all the latest healthcare telecommunications tools in even the most extreme of settings.
Physician leadership journal, May 8, 2022
We all know the burnout phenomenon in healthcare is rampant and seemingly expanding. While burnou... more We all know the burnout phenomenon in healthcare is rampant and seemingly expanding. While burnout encompasses an important set of issues, daily opportunities remain to find ways to express kindness and demonstrate goodness toward others. Finding gratitude can also be refreshing when integrated into our daily routines. Collectively, these actions will nourish our spirits while we wrestle the burnout rates.
Physician leadership journal, May 8, 2023
Materials management in health care, Feb 1, 2008
Physician leadership journal, Jan 8, 2023
Medical training and practice are markedly different from leadership education and experience, re... more Medical training and practice are markedly different from leadership education and experience, requiring a completely different intellectual path of learning and knowledge processing. When embracing leadership, recognizing this dichotomy is critical for success in creating the positive changes sorely needed in healthcare.
PubMed, Jun 15, 2016
Physician leadership is increasingly recognized as pivotal for improved change in health care. Mu... more Physician leadership is increasingly recognized as pivotal for improved change in health care. Multi-professional care teams, education and leadership are evolving trends that are important for health care's future.
Critical Care Medicine, Sep 1, 2003
T he 36 members of the Robert Wood Johnson Foundation (RWJF)-sponsored Critical Care End-of-Life ... more T he 36 members of the Robert Wood Johnson Foundation (RWJF)-sponsored Critical Care End-of-Life Peer Workgroup, and the 15 nurse-physician teams from 15 of the intensive care units affiliated with this workgroup, have authored the results of an important study published by Dr. Clarke and colleagues (1) in this month’s issue of Critical Care Medicine. The RWJF is to be commended for sponsoring this type of topical healthcare research, and the study authors are to be congratulated for providing a strong start to a “field of research opportunity” within the discipline of critical care medicine. The formalization for end-of-life care (EOLC) strategies and evaluations in critical care is long overdue. This current study should prompt all of us involved with critical care to take a moment and reflect—why has it taken so long for this type of information to be critically reviewed, and why is it only now that we, as a committed group of medical professionals who routinely care for the dying, are finally beginning to focus some attention on one of the most important components of health care? We also should ask ourselves with stringent introspection whether we, as individual practitioners, have focused our efforts effectively enough for those patients with whom we become involved at the end of their lives. Before continuing with this article, please spend a couple of seconds right now to review your last few experiences with end-of-life patients in your intensive care unit (ICU)—and be honest! The end of a life is probably the most intensely personal and certainly one of the most powerful emotional periods in life that every human endures (yes, endures is the correct word). Fortunately, or unfortunately, no one person has the opportunity to preemptively predict or comprehend his or her individual reactions to this final stage of biological existence. This in itself is reason enough why trained professionals, from a variety of backgrounds, are obligated to prepare and provide the professional skills, environment, management processes, emotional support strategies, and evaluative structure to improve the overall quality of care for those managing through the end of a life. The end of a life in the critical care environment, however, can still potentially become an intensely public experience and, therefore, can become one of the most powerfully uncomfortable and inhumane experiences that any human will endure. This also is reason enough why intensivists and critical care professionals are obligated to do everything within their power and control to better manage EOLC for the benefit of their patients, the families or friends, and themselves. Perhaps as important, the institutions that manage EOLC in their critical care units are also obligated to provide the support, resources, and infrastructure to the ICU professionals so that the optimal level of care is provided at the end of a life. What, then, has been accomplished with the current study from this RWJF workgroup? The scientific strategy accomplished a detailed literature review from the English language regarding end-of-life issues in the acute care and ICU settings. The studies obtained from this comprehensive literature review then were subjected to an iterative process of consensus development by the authors (not a metaanalysis) to identify, develop, and refine several EOLC domains. Subsequently, quality indicators and a variety of behaviors or interventions were coupled within each of these identified EOLC domains using this same iterative process of consensus. The stated primary goal of the study was to address the documented deficiencies in EOLC for the ICU by identifying key EOLC domains and related quality indicators— developed through this consensus process. The secondary goal was to propose specific clinician and organizational behaviors or interventions that might improve EOLC quality indicators. The scientific results accomplished were that seven domains were identified as important to consider for EOLC in the ICU environment. These are patientand family-centered decision making, communication, continuity of care, emotional and practical support, symptom management and comfort care, spiritual support, and emotional and organizational support for ICU clinicians. Additionally, numerous (53) EOLC quality indicators were developed to populate these seven domains, and then another layer of information was similarly developed that provides examples ( 100) of clinician and/or organizational behaviors or interventions that could better address these quality indicators. These domains, quality indicators, and listing of behaviors or interventions are to be posted for complete review and consideration on the RWJF Web site (http://www.rwjf.org). Given the stated goals of the study, the workgroup did achieve its end points. The difficulty, however, is trying to decide if the developed domains, quality indicators, and examples of behaviors or interventions are…
Critical Care Medicine, Jun 1, 2000
Critical Care Medicine, Dec 1, 1999
The American Association for Physician Leadership (AAPL) is proud to now offer an information res... more The American Association for Physician Leadership (AAPL) is proud to now offer an information resource and journal entirely focused upon the evolving needs of physician and non-physician managers and leaders addressing the multitude of topics and issues related to healthcare administration, leadership, and management—the new Healthcare Administration Leadership and Management Journal (HALM Journal). Every other month, the HALM Journal will deliver indispensable and reliable results-oriented guidance for a healthcare industry moving toward inter-professional management and leadership that positively impacts patient care outcomes and population health.
Physician leadership journal, Jan 8, 2023
SoundPractice podcast host Mike Sacopulos has spoken with luminaries who shed light on the need t... more SoundPractice podcast host Mike Sacopulos has spoken with luminaries who shed light on the need to provide physicians with business training and leadership skills for the betterment of healthcare delivery. In celebration of the 100th episode, here are some highlights of their conversations. Peter Angood, MD, president and CEO of the AAPL, provides expert commentary.
Physician leadership journal, Nov 8, 2022
Helping others get better, stay healthy, or navigate difficult periods in their lives is at the c... more Helping others get better, stay healthy, or navigate difficult periods in their lives is at the core of being a physician. Medical training and practice provide positive influences for individuals under our care. Leadership education and experience can expand those positive influences beyond individuals to a larger scale of health system improvement. Embracing leadership, informally or within formal roles, can lead to a self-fulfilling prophecy of significant positive change and improvement in our industry.
Physician leadership journal, Sep 8, 2022
All physicians are leaders at some level, and as such, all must continue to lead through and mana... more All physicians are leaders at some level, and as such, all must continue to lead through and manage the transitions and transformations required to improve the complex healthcare industry. But this can come at a costly price unless they simultaneously embark on personal transitions and transformation as well.
World Journal of Surgery, Nov 1, 2001
The Information Age has made profound changes in society and is slowly entering the healthcare fi... more The Information Age has made profound changes in society and is slowly entering the healthcare field. Some of the most important areas are telemedicine, the Internet, and the world wide web (www). Millions of physicians, healthcare providers, and patients are accessing the web daily for patient information, consultation, and distant learning. Telemedicine is beginning to enter the mainstream of health care after decades of demonstration projects. There are many issues which have been raised, such as access to the information, the security of the information, and the quality of the content on the web. While telemedicine is beginning to Hower, there are numerous barriers that prevent its rapid implementation, such as licensure, reimbursement, liability, quality of service, and technical issues. In spite of the numerous challenges, telemedicine over the Internet was practiced in one of the most remote areas of the world--Mt. Everest--demonstrating that it is possible to utilize all the latest healthcare telecommunications tools in even the most extreme of settings.
Physician leadership journal, May 8, 2022
We all know the burnout phenomenon in healthcare is rampant and seemingly expanding. While burnou... more We all know the burnout phenomenon in healthcare is rampant and seemingly expanding. While burnout encompasses an important set of issues, daily opportunities remain to find ways to express kindness and demonstrate goodness toward others. Finding gratitude can also be refreshing when integrated into our daily routines. Collectively, these actions will nourish our spirits while we wrestle the burnout rates.
Physician leadership journal, May 8, 2023
Materials management in health care, Feb 1, 2008
Physician leadership journal, Jan 8, 2023
Medical training and practice are markedly different from leadership education and experience, re... more Medical training and practice are markedly different from leadership education and experience, requiring a completely different intellectual path of learning and knowledge processing. When embracing leadership, recognizing this dichotomy is critical for success in creating the positive changes sorely needed in healthcare.
PubMed, Jun 15, 2016
Physician leadership is increasingly recognized as pivotal for improved change in health care. Mu... more Physician leadership is increasingly recognized as pivotal for improved change in health care. Multi-professional care teams, education and leadership are evolving trends that are important for health care's future.