Engaging the Community and Health Care Providers to Help Prioritize the Allocation of Scarce Medical Resources
Mar 31, 2014
The H1N1 pandemic of 2009-2010 has resurfaced in the news lately. A recent article in The Lancet Respiratory Medicine finds that adult patients treated with drugs such as Tamiflu or Relenza (or similar) were half as likely to die compared to those who went untreated. These findings are indeed exciting, and assuming availability of the drugs, promising.
But what happens when lifesaving therapies or devices are in short supply? How do we make decisions to allocate scarce resources in a pandemic or other public health emergency? What kinds of ethical frameworks should be used to do so?
In partnership with the Johns Hopkins Berman Institute and University School of Medicine, and the Health System’s Office of Emergency Management, as well as the UPMC Center for Health Security, RESOLVE has managed a series of public engagement sessions to answer these complex questions. By engaging “lay” community members and health care providers, alike, this project seeks to collectively consider decision-making criteria for allocating ventilators in a pandemic flu. These discussions use a deliberative democracy model to probe views on different principles for allocating scarce medical resources.
The project’s principle investigator, Dr. Lee Daugherty Biddison, discusses the project in this Hopkins Medicine Magazine article by David Green
***Update 6/23/14*** Since the initial posting of this blog entry, the project was published in Annals of the American Thoracic Society. For more information, please see this abstract.
 Stella G Muthuri PhD, S. V.-B.-B. (2014). Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data. The Lancet Respiratory Medicine.
Nov 11, 2013
Since I’ll be posting blogs periodically on the RESOLVE website and elsewhere, I thought I should introduce myself. I recently became a RESOLVE volunteer after reading Amy Larkin’s book Environmental Debt: The Hidden Costs of a Changing Global Economy (Macmillan, 2013). Amy has been a tireless environmental activist who, in this well-documented analysis, clearly and powerfully illuminates the destructive impacts of business-as-usual, not only on the environment, but on our economy and ultimately on our way of life. Unlike many other screeds cautioning about ecological devastation, however, Environmental Debt delineates market-based and pragmatic solutions to some of our problems, not just for the future but many that are being implemented right now. RESOLVE, with whom Amy is affiliated as a strategic partner, has been a part of some of these solutions.
As I devoured her book, my feelings of hopelessness and helplessness about the mess we have made here on planet earth morphed into stirrings of optimism and excitement. Perhaps we can’t solve all of our problems with perfectly crafted solutions on the global and comprehensive scale required, but there are things that can be done as business and government and environmental groups work together. For example, large multi-nationals like McDonalds, Puma, Tiffany and Company, and Unilever have already taken steps to become more responsible environmental stewards. So perhaps all is not lost; and if so, I definitely want to be a part of the effort to make a difference.
Sure, I’ve done the typical things — recycle, change out incandescent light bulbs for fluorescents, purchase fuel efficient vehicles, turn down the thermostat, garden organically, etc. And my farm even showcases some unusual environmental initiatives, like prairie grasses and solar panels. But so much more is needed to preserve this orb that sustains us all. I can collect rain in recycled barrels, but that doesn’t begin to address the water challenges facing many parts of the globe. I can vote for candidates with a responsible environmental agenda, but the gridlock inWashingtoncan undermine the most committed legislators. Curtailing purchases, and buying from companies whose supply chains avoid workforce and environmental abuses, makes me feel better but leaves intact capitalism’s moral blinders.
As a psychologist, a profession from which I recently retired, when particularly intransigent situations arose, I would schedule extra sessions or seek a consultation or invite in family members to help move things forward. Failure was never an option I considered, even if on occasion results were not what I would have wished. We all need a sense of agency, of being able to make a difference, in our careers and in our personal and civic lives. With Mother Earth as the endangered client, thanks to Amy’s book I now recognize that here too despair does not have to play a role. With the exceptional promise of RESOLVE’s team operating in some of the most conflicted arenas of environmental decision-making, with their Solutions Network showcasing unusual and creative global initiatives to foster more responsible stewardship of human and natural resources, I have found a partnership that restores my hope that we can still avert disaster, and preserve the gifts of planet earth for our grandchildren and generations to come.
Stay tuned as I share more about RESOLVE’s work.
- Kathy Arcuri
Kathy Arcuri is a RESOLVE volunteer. She writes blog posts about RESOLVE’s work from her own perspective.
Nov 8, 2013
RESOLVE’s webinar on Joint Fact Finding (JFF) illustrated, through case examples and a hypothetical scenario, the usefulness of this consensus-building process for real-world problem-solving in conflicted arenas of energy development, like the relatively new momentum in hydraulic fracturing for natural gas extraction. Sixteen participants – representing industry, government, NGOs, and academia – learned about RESOLVE’s work from Stephen Courtney, Director of Collaborative Science; Paul De Morgan, Senior Mediator; and Dana Goodson, Senior Facilitator. The webinar was managed very efficiently by Adobe Connect, with its visual and auditory interactive format.
As Dr. Courtney pointed out, science is often disputed or monopolized in complex, multi-party initiatives, creating stalemates. In the United States, such bottlenecks can result in regulatory agencies or the courts handing down decisions for action, perhaps after costly lobbying efforts and litigation. These top-down recommendations do not necessarily have buy-in from all participants and thus may be doomed to problematic implementation or even outright failure. JFF can make a huge difference in such cases, bringing divergent parties to consensus around the scientific or technical issues at stake. One example illustrated how a stalled project involving three government agencies moved from a ten-year standoff to resolution in seven months.
A very important aspect of the JFF process includes reaching out to all key stakeholders, large and small, and bringing them together for collaborative problem-solving on scientific or technical issues. This task force then defines the areas of disagreement amenable to JFF, determines how to find answers, jointly identifies experts who can conduct independent research if needed, and evaluates results in order to arrive at a roadmap for decision-making. RESOLVE, with their thirty-year history of conflict mediation and resolution, assures an unbiased approach to the team effort that is clear, orderly and respectful, and has buy-in from all participants. They also maintain a record of the proceedings and decisions, and ensure dissemination of these findings to all critical decision-makers, constituencies, and the public.
As a landowner in northeast Pennsylvania, living amidst the Marcellus shale gas play, I was very encouraged to hear about RESOLVE’s JFF resource and would encourage landowners, energy development companies, NGOs, and government regulatory agencies to consider this option if and when disputes arise around scientific or technical issues. Hydraulic fracturing for natural gas is fraught with uncertainties regarding environmental and health impacts, as well as complex financial and legal considerations. Landowners, as compared to large energy corporations, are not equally empowered as decision-makers and often operate in the dark, with a lack of transparency, scientific and technical understanding, and most importantly, trust, creating confusion about how to proceed. Therefore, it seems that all parties would be better served with a clear and consensual road map, so that the issues raised by this important bridge to energy independence and sustainability can be understood by all stakeholders, working together in a spirit of cooperation.
You can listen in to this informative webinar at http://www.resolv.org/site-collaborativescience/services/joint-fact-finding/#webinar.
- Kathy Arcuri, RESOLVE Volunteer
Kathy Arcuri is a RESOLVE volunteer. She writes blog posts on RESOLVE’s work from her own perspective.
Oct 25, 2013
A RESOLVE Webinar Illustrating the Usefulness of the Joint Fact Finding (JFF) Process for Energy Development
As a landowner in northeast Pennsylvania, I have tried to become informed about hydraulic fracturing for the capture of natural gas. My thirty-acre farm lies on the edge of the Marcellus shale deposits, in the bucolic Endless Mountains with rolling hills of field and woodland, trout-filled streams and spring-fed lakes, and state parks and gamelands enjoyed by visitors from around the world. This little piece of paradise needs to be protected from careless exploitation. However, as a conscientious citizen of the world, I would also like to see theUnited Statesmove toward a petroleum-neutralMiddle Eastpolicy and to a more sustainable energy agenda.
So how does a lay person make sense of all the conflicting data about this new technology? A joint fact finding (JFF) process, bringing together interested parties, would be useful not just for the big players in this emerging energy field, but for small stakeholders as well. Next Tuesday (October 29,12:00 – 1:30 PM Eastern), RESOLVE will host a webinar illustrating a consensus-based approach to such complex issues. Local and immediate concerns such as water and air quality impacts and noise and light pollution from drill sites and compressor stations could be properly addressed in this fashion and help to determine best policies and practices.
Whether you are a concerned citizen, NGO, government representative, or corporate stakeholder, a JFF approach may work for you.
If interested, please register for the webinar here.
- Kathy Arcuri, RESOLVE Volunteer
Kathy Arcuri is a RESOLVE volunteer. She writes blog posts on RESOLVE’s work from her own perspective.
Sep 5, 2013
RESOLVE has launched the Sustainability Standards Partnership (SSP) to help identify, improve and promote the most credible and effective voluntary sustainability standards and disclosure tools in the marketplace. The SSP is a forum where best-in-class standards organizations; forward-thinking business and institutional end-users; and credible experts from NGOs and academia work together to identify and protect the value of voluntary, market-based sustainability standards and disclosure tools.
“We see an urgent need for stakeholders across government, civil society and business who contributed extensively to the development of sustainability standards, to now confront growing complexity, costly inefficiencies for corporate and institutional end-users, and market confusion,” said Tim Warman, the partnership’s director. “In this pilot phase, we will develop a decision model to help differentiate and support uptake of high-bar standards and disclosure tools.”
Click here to see the full press release.
For more information on the Sustainability Standards Partnership, please visit www.standardspartnership.org.
For previous RESOLVE work on this issue, see the multi-stakeholder 2012 report Toward Sustainability: The Roles and Limitations of Certification.
- Dana Goodson, Senior Facilitator
Sep 3, 2013
The Association for Conflict Resolution (ACR) has just selected RESOLVE Senior Advisor John Jostes to receive the 2013 Sharon M. Pickett Award for Environmental Protection through Conflict Resolution. The award recognizes “significant and important” contributions to environmental protection for a project or over the length of one’s career.
John deserves this award and the recognition it brings. He has helped stakeholders work through such dicey issues as sharing water and protecting species, and beyond conservation to issues like homelessness. As a Senior Advisor to RESOLVE, John focuses on water and climate.
Check out the award announcement here.
Jul 30, 2013
Five years ago, when Motorola Solutions and other tech companies started to work proactively to address the issue of so called “conflict minerals” – tin, tantalum, tungsten, and gold – some said solutions like this were unrealistic or unlikely to have meaningful impacts. The argument went something like this—“How can companies reach into their supply chains and have an impact in DRC when they don’t even know which minerals are in their components?” Five years later, Motorola Solutions’ Corporate VP and Chief Procurement Officer Rich Valin is speaking about the positive impact efforts like Solutions for Hope have produced to encourage peace and development in the DRC.
RESOLVE hosts several other efforts working on this issue, including the Public-Private Alliance for Responsible Minerals Trade, the Conflict-Free Tin Initiative, and the Conflict Free Smelter Early Adopters Fund. Click here to learn more about RESOLVE’s early supply chain mapping research and resulting report.
May 20, 2013
- 1. Strategic Assessment and Planning
If you need a new strategic plan or want to assess opportunities to find new pathways and new partners.
- 2. Facilitation and Meeting Training (Including Integrating Technology)
We’ve all participated in poorly planned and executed meetings that cost both time and money. RESOLVE trains staff (and/or stakeholders) to improve their meeting planning and facilitation skills. We emphasize pre-meeting planning, in-the-room skills, and post meeting follow-through. We offer basic, advanced, and expert training.
- 3. The Use of Science in Decision Making
Science and technical information is often politicized when there is a dispute or uncertainty at a site or policy level. RESOLVE has deep experience with processes that use science to build trust and support effective decision making. We can train your staff or provide direct support to design and/or implement an engagement process that utilizes science.
- 4. Leadership Coaching & Change/Transition Management
Support for new leaders, and during periods of change, is essential to success.
- 5. Leading, Supporting (or Fixing) Coalitions
RESOLVE can manage/facilitate coalitions, provide member training, or help put a coalition back on track.
- 6. Negotiation Support and Training
We can help you plan to win and train you or provide support during negotiations.
- 7. Collaborative Technology—The best tools and training to integrate them seamlessly into meetings.
May 2, 2013
The World Economic Forum council on responsible natural resource management has zeroed in on the issue of how to unlock value with regard to mineral development. For three years, Steve and the rest of the council has focused on a program called the Responsible Minerals Development Initiative (RMDI). The RMDI has new findings to report. This is timely given the essential role that mining can play in development and the conflicts we are experiencing in many regions including Latin America and Africa. With support from the Boston Consulting Group, the WEF prepared a report (Mineral Value Management—A Multidimensional View of Value Creation from Mining) and tool that underscores the critical role of dialogue and communication to support development. See the press release and the report for more information.
Here’s Steve’s comment on the RMDI program: “’Financial value is important, but it is not the only measure,’ said Stephen D’Esposito, an advisor on the project and president of RESOLVE, a nonprofit organization that promotes collaborative resolution of public issues. ‘Anything that matters to stakeholders and affects their view of mining—be it a new road development that benefits local businesses or impacts on traditional cultures—needs to be included.’”
In addition to our participation in policy development as part of the World Economic Forum and RMDI, you’ll find RESOLVE in communities grappling with these and similar issues.
May 1, 2013
This press release, an announcement of the new Conflict Free Sourcing Initiative (CFSI), is evidence of the progress that’s been made by electronics companies and other manufacturers and retailers on the issue of supply chain transparency and “conflict free’ sourcing of tin, tantalum, tungsten and gold from DRC and the surrounding countries. What’s notable is the extent to which tool, strategies and programs have been shared across industry sectors. In the release, you see links to the automotive industry, department and big box stores and others.
NGOs like Enough, PACT, PAC and others have played a key role.
When RESOLVE first began working on this issue over four years ago, ideas, strategies and relationships — particularly those that extend across sectors — were in short supply (see the 2011 Responsible Mineral Development Report).
Today, the CFSI is complemented by a number of linked initiatives to support in-region capacity building (e.g., PPA) and “conflict free” sources (like Solutions for Hope and Conflict Free Tin Initiative).