Measles has been allowed to make a comeback largely because many parents choose not to have their children vaccinated. Those unfortunate choices jeopardize not only the children of those parents, but very young children of other parents and vulnerable persons who are unable to be vaccinated. In Wisconsin, those choices are permitted by a law providing exemption from vaccination requirements simply based on “personal conviction”.
Despite overwhelming scientific evidence to the contrary, many of these parents subscribe to the notion that vaccines cause autism. Disturbingly, President Trump appears to agree, and he may be considering an anti-vaccine advocate to chair a task force to address the subject. Fortunately, countering that notion is a recently-released bipartisan Congressional letter of vaccine support.
We have a long and cherished history in this country of protecting the rights of individuals, including the freedom to make personal choices. But we also have a long and cherished history acknowledging the rare circumstances where the health of the community takes precedence over the rights of individuals. Over 100 years ago, the U.S. Supreme Court decided in a vaccination case involving smallpox that there are “restraints to which every person is necessarily subject for the common good. On any other basis, organized society could not exist with safety to its members.”
We have enjoyed healthy lives, free from dreaded infectious diseases, because individuals and families historically took it upon themselves to be vaccinated. If they failed to do so, communities and states required vaccination in the interest of everyone’s health. We need to remember where we’ve been. It is bad public policy to permit parents to jeopardize the health of their children and other vulnerable persons in the community by permitting an exemption based on “personal conviction.” As individuals and communities, we need to acknowledge our collective responsibility for everyone’s health and insist that the state Legislature roll back the harmful “personal conviction” exemption law, joining the majority of states disallowing such an exemption.
Wisconsin Statutes Section 252.04: http://docs.legis.wisconsin.gov/statutes/statutes/252/04
Anti-Vaccine Activist Says Trump Wants Him to Lead Panel on Immunization Safety, New York Times, January 10, 2017:
Congressional Group Gives Bipartisan Support to Vaccine Safety, WebMD Health Day News, February 21, 2017:
Jacobson v. Massachusetts, 197 U.S. 11 (1905):
State Law & Vaccine Requirements, National Vaccine Information Center: http://www.nvic.org/vaccine-laws/state-vaccine-requirements.aspx
At the final Tribal Accreditation and Quality Forum of 2016, Michelle Myers, from the Oneida Nation Comprehensive Health Division, introduced us to a wonderful tool used to teach basic quality improvement and team building skills called "Bus Crash." Some of you may have seen variations of this tool, but this version uses an assortment of Mr. Potato Head dolls to inject a healthy dose of laughter and fun into QI.
At the beginning of the exercise our group was divided into four teams and given the following scenario:
"Four buses are traveling to an event. Each bus has 14 Potato Head family members. An unfortunate accident occurs and all four buses crash. EMS arrives to the accident scene to find only potato parts scattered inside each bus. Fortunately the bus contains a record of each member-photos prior to the crash. The potato parts and photos are scooped into bags and each bag is sent to a different hospital. It is your job to save as many lives as possible."
After reading the scenario and setting out some basic ground rules, each team member was assigned an area of responsibility: 2 surgeons, who were only allowed to assemble, 3 assistants, who were only allowed to prep potato parts for assembly, and 2 inspectors, who verified that each Potato Head family member was assembled correctly. Then, each medical team was given 7 minutes to save as many Potato Head family members as possible. At the end of 7 minutes, each team reported their results and discussed what might be done differently during the next round. Then, each team repeated the process two additional times, incorporating changes based on their experiences during the previous round(s). When all was said and done, each team reported lessons learned on QI and team building.
This exercise forced each team to think strategically and work together to improve their processes, and many Potato Head family member lives were saved as a result. Not only did our group learn valuable quality improvement principles, but we had a bus load of fun doing so!
So, if you or your department is looking for a fun and valuable learning tool, please reach out and we can help you build your own "Bus Crash" kit!
Special Thanks to Michelle Myers, Community Health Nursing Supervisor, Oneida Comprehensive Health Division, and Judy Tupper, DHEd, CHES, CPPS, Muskie School of Public Service.
About the Author, Dustin Young - Vice President, Gray Horse Strategies, LLC.
Dustin Young is the Manager for Gray Horse Strategies. He provides consulting services, project management and support, multimedia project development and website administration. Prior to joining Gray Horse Strategies, Dustin served as Manger for the Institute for Wisconsin's Health, Inc., and as an AmericorpsVISTA for the Wisconsin Department of Public Instruction. Dustin graduated from Marquette University in 2008 with a degree in International Affairs and is an ASQ Certified Quality Improvement Associate. Dustin is on the Board of Directors of the Wisconsin Public Health Association and Drive Clear, a Madison, Wisconsin based non-profit organization dedicated to helping the victims of drunk and impaired driving accidents.