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Mayo Clinic

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Mayo clinic
MAYO CLINIC
The Mayo Clinic was founded over 150 years ago. It has been a pioneer for group practice creation, community service, quality improvement initiatives, health informatics, and health care technology.
Group Practice Creation Impacts Mayo Clinic's Growth
Dr. William J. Mayo justified the concept of a group practice in a speech he delivered in 1910. He took the view that it would be foolish for a single practitioner to assume he or she had sufficient knowledge of medicine. He maintained that it is in the best interest of the patient to have practitioners join forces and coordinate care (Mayo Foundation for Medical Education and Research [MFMER], n.d.-a.) Patients realized the benefits of a team of medical experts, so patients travelled long distances for diagnosis and treatment. The Mayo Clinic website states that the "group practice concept that the Mayo family originated has influenced the structure and function of medical practice throughout the world" (MFMER, n.d.-b). According to the website, the Mayo Clinic has grown from three physicians (father and two sons) to over 55,000 staff at locations in the Midwest, Arizona, and Florida. The Mayo Clinic is most famous for its implementation of an "integrated, multi-specialty, group practice" (MFMER, n.d.-c).
Mayo Clinic Community Service Reflects Mission and Values
According to the Mayo Foundation for Medical Education and Research (n.d.), Mayo Clinic's mission is to "provide the best care to every patient through integrated clinical practice, education and research." The Mayo Clinic's values involve positive and forward looking statements regarding respect, compassion, integrity, healing, teamwork, excellence, innovation, and stewardship (MFMER, n.d.-d).
The Mayo brothers set the precedent for their future staff in visiting other hospitals around the world to discover new, innovative surgical services to the community. Mayo physicians and researchers developed "low anterior resection for colon and rectal cancer, endoscopic injection of esophageal varices, and advances in resection of the stomach for cancer," as well as " the first open-heart surgery in 1955," "the first total hip replacement in 1969," and "the early use of robotic laparoscopic surgery in 2002" (Mayo Foundation for Medical Education and Research, 2014e). Innovative surgical instruments, developed by May Clinic staff, include "the Balfour retractor, the Mayo stand, the Mayo scissors, the Adson pickups, the Harrington Behrens, and the Adson-Beckman retractors" (MFMER, n.d.-e).
The value of compassion was modeled early on by Dr. William Mayo who would anonymously pay the cost of a private room for patients he thought needed privacy. Demonstrating compassion, Mayo Clinic staff would occasionally help organize weddings and birthdays for patients hospitalized just before their special occasions. According to Berry & Seltman, on a sadder note, Mayo Clinic staff would sometimes hold memorial services for out-of-town patients who died at the hospital (as cited in Paul, 2011, p. 41).
Other demonstrations on the link between the Mayo Clinic’s values and community service are as follows. Exemplifying stewardship, the Mayo Clinic expanded their facilities to serve the communities of Jacksonville, FL, and Scottsdale, AZ, in addition to their Rochester, Minnesota community (Paul, 2011, p.42). A variety of minority community outreach and education programs, such as cancer prevention, prenatal education, and healthy brain aging further demonstrate the value of stewardship (MFMER, n.d.-f). Showing respect for those in the community with low incomes, the Mayo Clinic provided, in 2009, $58 million of free health care (MFMER, 2010, p.31).
Central to their mission of using research to improve patient care, during World War II, the Mayo Clinic donated the services of its aero medical research unit to the United States military. Aviation medicine advancements such as the anti-blackout suit and the Mayo-1 (M-1) maneuver enabled pilots to cope with greater gravity or "G" forces (MFMER, n.d.-g).
Mayo Clinic Promotes Quality Improvement Initiatives
Since the interest of the patient is of paramount importance to the Mayo Clinic, quality improvement initiatives are all about the patient's experience, from the initial phone call to the final visit (MFMER, n.d.-h). A multitude of healthcare quality measures places the Mayo Clinic at or near the top of those rankings. Among its accolades are U.S. News Best Hospitals Honor Roll, UHC Quality Leadership Award, Leapfrog Top Hospital, Leapfrog recognition for patient safety, Magnet recognition for its Minneapolis nursing program, and the American College of Surgeons National Surgical Quality Improvement Program's commendation for exemplary outcomes (MFMER, n.d.-i).
Promoting quality improvement means monitoring and measuring both positive and negative patient experiences. Mayo Clinic was among the first hospitals to monitor unanticipated outcomes. They would then devise preventive steps to minimize an adverse event happening again. The Mayo Clinic excels at quality control because of their organizational culture. They are not only committed to internal review and to prevent adverse events, but their goal is "to contribute to preventing errors in the wider medical community by training our future health care providers and sharing improvements that could be used to prevent errors” (MFMER, n.d.-j).
Other quality improvement initiatives include the following. Avatar International conducts weekly surveys of Mayo Clinic patients to judge the quality of their visit and seek suggestions for better quality. Based on survey results, individual Mayo Clinic departments develop quality improvement initiatives (MFMER, n.d.-k). The Surgical Care Improvement Project specifies measures to be performed before, during, and after surgery to reduce the occurrence of complications such as surgical site infection, adverse cardiac events, deep vein thrombosis, and postoperative pneumonia. Other efforts to improve quality are the development of new order sets, according to the latest evidence-based medicine, as well as electronic health record reminders for individualized care measures MFMER, n.d.-l).
Health Informatics Impact
Mayo Clinic's Dr. Henry Plummer pioneered the concept, in 1907, of having all of a patient's medical information, outpatient and inpatient, in a single file aligned with a single identification number, stored in a central place. Three years later, Dr. Plummer developed a diagnostic index, to assist in clinical data research. Keeping track of patient charts using bar codes started at Mayo Clinic in 1975. Having an all-inclusive health record impacts healthcare by enabling just-in-time evaluations and sooner scheduling of surgery (MFMER, 2002, p. 16). By the 1990's, the Mayo Clinic began converting paper medical records into electronic ones. The advantages were instant access to patient information, simultaneous access by multiple physicians, and consultative access by physicians in remote locations, faster laboratory results, and faster scheduling of surgery (Paul, 2011, p. 43).
Genetic information provides doctors a more detailed understanding of a patient, enabling better treatment decisions. Mayo Clinic's Center for Individualized Medicine (CIM) started inputting genetic information in a small number of patient's electronic medical records. According to Gianrico Farrugia, M.D., director of the CIM, "Eventually, every patient at Mayo will have this information embedded in their medical record. It's the intersection of genomics, computerized learning and physicians" (MFMER, n.d.-m).
Emerging Technology Support
Pharmacogenomics uses an individual's genetic makeup to find the most appropriate drug in the most appropriate dose. It enables doctors to predict drug reactions for a specific patient before they occur. For the past three decades, Richard Weinshilboum, M.D., director of the Pharmacogenomics Program, has helped the Mayo Clinic lead the field in applying an individual's genetic makeup to an individualized drug treatment for breast cancer, prostate cancer, and cardiovascular disease (MFMER, n.d.-n).
Antibiotics indiscriminately kill communities of bacteria, called microbiomes, some of which make patients sick, while others keep them healthy. Mayo Clinic researchers, such as Heidi Nelson, M.D., director of the Microbiome Program, are investigating ways, using genomic sequencing, to propagate the healthy micobiome of a patient using particular probiotics, delivered through pill or suppository for intestinal infections (MFMER, n.d.-o).
One emerging technology to treat people with Parkinson's disease is deep brain stimulation (DBS). Electrodes planted within the brain create small pulses that promote the release of chemicals which affect neurons. Kendall Lee, M.D., PhD., leads Mayo Clinics's Neural Engineering Lab in designing a remote DBS system that wirelessly gauges the brain chemicals and uses feedback to create the stimulation needed. Using DBS therapy, patients with memory loss, spinal cord injuries, and psychiatric disorders, have a greater chance of progress using this emerging tool to understand what's happing in the brain (MFMER, n.d.-p).
Stem cell research is providing regenerative treatments for reconstructive surgery, tendinitis and osteonecrosis. The Regenerative Medicine Biotrust (RMB) at Mayo Clinic helps researchers better gather samples, evaluate cells, and distribute results. According to Dennis Wigle, M.D., PhD., director of the RMB, "the biotrust puts Mayo at the cutting edge in investigating how fast we can make new technologies, apply new technologies and do it for real clinical care. This will advance regenerative solutions for our patients (MFMER, n.d.-q).
References
Mayo Foundation for Medical Education and Research (2002). Mayo Clinic model of care. Retrieved from http://www.mayo.edu/pmts/mc4200-mc4299/mc4270.pdf
Mayo Foundation for Medical Education and Research. (2010). Mayo Clinic 2009 annual report. Retrieved from http://www.mayoclinic.org/documents/mc0710-2009-pdf/doc-20078776
Mayo Foundation for Medical Education and Research. (n.d.-a). Concept of group practice of medicine. Retrieved from http://www.mayoclinic.org/tradition-heritage/group-practice.html
Mayo Foundation for Medical Education and Research (n.d.-b). Mayo Clinic history. Retrieved from http://www.mayoclinic.org/about-mayo-clinic/history
Mayo Foundation for Medical Education and Research (n.d.-c). Frequently asked questions. Retrieved from http://150years.mayoclinic.org/history/history-faq.php
Mayo Foundation for Medical Education and Research (n.d.-d). Mission and values. Retrieved from http://www.mayoclinic.org/about-mayo-clinic/mission-values
Mayo Foundation for Medical Education and Research (n.d.-e). History of surgery. Retrieved from http://www.mayoclinic.org/departments-centers/surgery/overview/history
Mayo Foundation for Medical Education and Research (n.d.-f). Minority health and wellness. Retrieved from http://www.mayoclinic.org/patient-visitor-guide/minority-health-wellness/services
Mayo Foundation for Medical Education and Research (n.d.-g). History of community involvement. Retrieved from http://www.mayoclinic.org/about-mayo-clinic/commitment-to-community/history
Mayo Foundation for Medical Education and Research (n.d.-h). Quality and Mayo Clinic. Retrieved http://www.mayoclinic.org/about-mayo-clinic/quality
Mayo Foundation for Medical Education and Research (n.d.-i). Top ranked more often. Retrieved http://www.mayoclinic.org/about-mayo-clinic/quality/rankings
Mayo Foundation for Medical Education and Research (n.d.-j). Event reporting. Retrieved http://www.mayoclinic.org/about-mayo-clinic/quality/event-reporting
Mayo Foundation for Medical Education and Research (n.d.-k). Patient satisfaction. Retrieved http://www.mayoclinic.org/about-mayo-clinic/quality/quality-measures/patient-satisfaction
Mayo Foundation for Medical Education and Research (n.d.-l). Surgical Care Improvement project. Retrieved http://www.mayoclinic.org/about-mayo-clinic/quality/quality-measures/surgical-care-improvement-project
Mayo Foundation for Medical Education and Research (n.d.-m). Finding the right drug. Retrieved http://www.mayoclinic.org/giving-to-mayo-clinic/life-changing-gifts/finding-right-drug
Mayo Foundation for Medical Education and Research (n.d.-n). Our symbiotic selves. Retrieved http://www.mayoclinic.org/giving-to-mayo-clinic/life-changing-gifts/our-symbiotic-selves
Mayo Foundation for Medical Education and Research (n.d.-o). Gaining control. Retrieved http://www.mayoclinic.org/giving-to-mayo-clinic/life-changing-gifts/gaining-control
Mayo Foundation for Medical Education and Research (n.d.-p). The biotrust. Retrieved http://www.mayoclinic.org/giving-to-mayo-clinic/life-changing-gifts/biotrust
Paul, B. A. (2011). Searching for the soul of American medicine (Paper 114).

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