From left: Susan Chapman, Nancy Dudley, Christine Ritchie (photo by Elisabeth Fall)
August 2014 • By Andrew Schwartz

As a manager for many years in Stanford’s Aging Adult Services programNancy Dudley had far too many patients who were at risk of falling through the cracks in a health care system ill prepared to deal with them. Typically, these patients were older adults living with comorbid conditions, including chronic illnesses once considered fatal.

“I’d be called in when they were being readmitted to the emergency room (ER). A lot of them had received specialty care and then lost contact with their primary care physician or even specialty physician [after discharge],” she says. “There were a lot of gaps in coordinating their care.”

A nurse with master’s degrees in nursing administration and gerontology, Dudley knew her patients’ unmet needs went beyond specific diagnoses to what were often stubborn symptoms that drove them to the ER, mental health challenges and “big picture” questions about how they wanted to live and die. She began to believe that the system needed to adapt if it was to help her patients achieve a quality of life that would justify the medical miracles prolonging their lives.


The Dean's Blog | David Vlahov

The World Health Organization reported that as of August 11, 2014, the number of cases attributed to Ebola virus disease (EVD) in four West African countries stood at 1,848, with 1,013 deaths. More than 145 health care workers who have provided care to Ebola patients have also become infected, with 80 deaths so far.... The virulence of the disease, some misunderstanding of how it is transmitted and a failure to have proper protections in place in some health care settings have caused alarm among those charged with treating EVD’s victims. Those fears recall memories of when I was an infection control nurse in Baltimore, caring for patients with AIDS early in the HIV epidemic.

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Mothers Across Borders – Immigrant mothers – driven by poverty to leave their children behind and come to the US to provide their families with better lives – wrestle with the mental health challenges their choices engender. Rosa Maria Sternberg’s work brings their struggles to light and helps the mothers and health care providers address the challenges.
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Improving Partnerships to Make Family-Centered Care Work for Children with Special Health Care Needs – Fragmented systems and services affect the quality of care for children with complex, chronic health needs. Overcoming the fragmentation requires partnerships among families, providers and various support organizations.
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Reframing the Tobacco Story – For over a century, the tobacco industry's narrative about cigarettes has been a major contributor to more than 100 million deaths worldwide. In the 34th annual Helen Nahm Research Lecture, UCSF’s Ruth Malone described how she and her tobacco control colleagues are reshaping that narrative.