When groups decided to attend the Breakthrough Series Collaborative on Improving Care for Patients with Advanced Heart and Lung Disease, they generally sought to improve direct patient care by doing things such as reducing emergency room admissions and teaching patients to monitor symptoms. Some members of the team from Mercy Medical Center-North Iowa and Hospice of North Iowa decided that political action was also essential to improving care.
Tana Olson, R.N. a quality improvement educator for the Hospice of North Iowa said the Breakthrough Series inspired her to introduce a resolution to the Republican party in her community of Cerro Gordo County. "Attending the collaborative, listening to Joanne [Lynn] speak, and being motivated to change [led to my decision]. You can sit and whine about it, or you can do something."
Her colleague, Jane Brokel, R.N. an executive director of the Care Management Institute at Mercy Medical Center, also decided to do something by introducing a resolution at her county's caucus meeting, where it was approved. The resolution reads simply:
"Whereas very sick and frail elderly persons often require medications for day to day well-being, including medications to prevent terrible symptoms, and whereas these medications are quite costly and are required at a time in life when resources are thin, or limited to social security benefits, Be it resolved that at least those medications needed by persons with serious and complex illness should be made part of the Medicare benefit."
According to Brokel, it is likely to make the cut and become part of Iowa's Democratic Party platform. From there, she hopes it will make its way to the national platform.
"Typically, Democrats believe that individuals should have a voice in government, therefore, when a resolution is brought forward, it usually goes forward, unless it is completely against party principles," Brokel said.
"I want legislators in the state to start speaking about this issue--along with Congress and others," she added.
Brokel explained that her work with patients and case managers inspired her to introduce the resolution; she has been active in the party for many years. "I was motivated by patient needs, which I was very aware of. I work with case managers and spend a lot of time with patients who have chronic diseases. The issue of paying for medications is a real problem--sometimes it's a choice between medicine and food."
Olson found the process more difficult than she had anticipated, primarily because her resolution included a controversial increase in prescription coverage, which would have resulted from increasing the amount of time patients can spend in hospice from the current six months to two years. To her disappointment, the resolution was not accepted during the district convention, although it had been passed at the county level.
"When [my resolution] came up for a vote, I had a chance to address the entire county delegation," she said. "That gave me a chance to address them about end-of-life issues, and to tell them we need a mechanism for appropriate end-of-life care. And the people voted for it."
Olson noted that the Republican district platform was very conservative. “Very little was on there for health care reform or Medicare reform. I'm a little disappointed in the system here for the Republican platform. I feel that if changes take place, we will need them going directly to the legislature from citizens.”
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