Pioneering Ideas

Update: Positive Deviance & MRSA Reductions on NYT Lede Blog

Kevin Sack interviewed the CDC's John Jernigan about the effects of the Plexus Institute's positive deviance MRSA prevention partnership and wrote a post on the New York Times "Lede" blog.  Check it out and comment away, either there or on Pioneering Ideas.   

CDC: Positive Deviance Helps Reduce MRSA Infections

We've written several times before here on the blog about MRSA (methicillin-resistant Staphylococcus aureus) infections, their impact on lives and on hospitals, and the Pioneer-funded work of the Plexus Institute to explore "positive deviance" as a method to cut a hospital's MRSA infection rate. 

This past Saturday, at a special late-breaker session during the Society for Healthcare Epidemiology of America's 19th Annual Scientific Meeting, RWJF and Plexus announced the results of a study conducted by the Centers for Disease Control and Prevention (CDC) of whether the positive deviance approach does, in fact, work on MRSA.

We were thrilled to see that the answer is a resounding yes: significant reductions in MRSA incidence ranging from 26 to 62 percent at participating hospitals.  You can read more about the study and its results here.

And because a picture is worth a thousand words, you might also want to see how CBS News reported the story on Sunday night: 

Keeping an Eye on Prize Philanthropy

McKinsey & Company’s recent report on prize philanthropy is a useful overview of the field. Titled “And the winner is . . .capturing the promise of philanthropic prizes”, the report is available here. Kudos to McKinsey for conducting a broad scan of an important philanthropic tool, and to the John Templeton Foundation for initiating the idea, sponsoring the work and sharing it with the field.

Why is this report useful? It puts prizes in historical perspective and explores the reasons for the recent increase in their use. It combines a review of the scholarly literature with insights gleaned from the leading practitioners in the field. And it develops a set of categories that go beyond the useful, but limited, distinction between recognition prizes and inducement (or incentive) prizes. The report’s six prize archetypes point to important traits that anyone considering using prizes should carefully review.

 

I was particularly interested in this report because RWJF, and the Pioneer Portfolio in particular, has worked with many of the organizations featured in the report. We have worked with Changemakers on a number of competitions, and are continuing to do so. We worked with Hope Lab on the Ruckus Nation competition and with Idea Crossing on its Innovation Challenge for MBA students around the world. And we worked with the X Prize Foundation in its efforts to develop a health prize. These experiences influenced my thinking as I read the report, and prompt two suggestions for future work on prize philanthropy.

 

The first is to work towards a clearer sense of the boundaries of this field. Prize philanthropy, when viewed broadly (as this report did), covers a huge territory. This makes it difficult to distinguish from a whole host of other strategic (goal-oriented) philanthropic approaches. For example, the report lists four important lessons about how to create and deliver effective prizes (p. 35), but none of these lessons is unique to prize philanthropy; they apply to any type of strategic philanthropic activity.

Guest Bloggers: the Drug Box Meets the FDA

A few weeks ago, Al Shar told us about the work of Lisa Schwartz, Steve Woloshin and Gilbert Welch on a simpler way to communicate information about prescription drugs in direct-to-consumer advertising. Recently, the researchers met with the FDA to discuss their work, and then provided us with this report:

"The drug box was very positively received at the FDA's Risk Communication Advisory Committee meeting (February 27, 2009).  We described the history of the drug box (it was inspired by the FDA nutrition facts box), reviewed four studies demonstrating that consumers want, understand, and are influenced by drug efficacy and side-effect data, and summarized our pilot work to date with the FDA (funded by the RWJ Pioneer program).

We made the following recommendations to the committee:

1. FDA should start producing drug facts boxes as part of the review process for  new drugs now - either in a stand-alone form or as part of other CMI efforts.
2. Consumers want and understand data on drug efficacy and side-effects as presented in drug facts boxes.
3. No one is better positioned than FDA reviewers to write boxes.
4. Drug facts boxes are an effective way for FDA to ensure that it communicates what it knows about drugs to the public.

Following several hours of discussion, the committee voted unanimously that 'FDA should adopt the Drug Facts Box format as its standard' in communicating essential information about prescription drugs. While the vote was extremely gratifying for us, the committee's recommendations are not binding.  At this point we simply do not know how the FDA will respond.  And we may not know for some time:  many important policy decisions will be on hold until the new FDA Commissioner is named."

Our thanks to Lisa, Steve and Gilbert for this update.  We'll keep you posted on future developments.

Could a Virtual Nurse or Doctor Be Your Future Facebook Best Friend?

Microsoft and their partner Intel have an understandable interest in promoting new computing fields. So the recent reference to a Jetsons-style future with a virtual personal assistant, named Laura, coming out of Microsoft makes sense – Laura can tailor responses and decisions to your personal situation and visual presentation.

 

The challenge for Laura gaining a significant following in the long run may be the number of people any of us can have a meaningful relationship with. As estimated by the Anthropologist Robin Dunbar, humans can have about 150 connections in a stable social network. Recent analysis of Facebook data by Cameron Marlow reinforces the hypothesis, along with the observation that the number of friends a person frequently interacts with is typically quite small. At the upper end, when you go much beyond the 150, the cognitive limits of our species become a constraint. Now all this is far from precise, but the main point is that we do have limits, and preferences among possible types of friends. So what kind of person might make the list?

 

How about one that knows your health history, routine behaviors, and likes and dislikes. One who you can trust unconditionally, who could give you advice about how you could make your life more fulfilling, more healthful? In short, how about someone with the qualities that we often wish our nurses and doctors had? Could Laura be your future doctor or nurse and make it into your Dunbar 150? Might Laura be your best friend in 2020?