Mapping Healthcare : Healthcare improvement lessons from around the world

33. The Rural Community Pharmacy: A Lifeline on Catalina Island

In rural counties most pharmacies are independently owned. When these rural pharmacies close, they don’t just leave a gap in healthcare, they affect a region's economy. Because who wants to move to a town where you can’t get a prescription filled for 40 miles? Hear the audio story that I created at the Transom Story Workshop on Catalina Island about Sue Ponce, the sole pharmacist on Catalina Island’s only drug store for three decades. When I arrived at the workshop I thought I was there to learn some audio technical skills. What I didn’t expect was to also rethink how stories work and their place in healthcare. References: * Berenbrok LA, Tang S, Gabriel N, et al. Access to community pharmacies: A nationwide geographic information systems cross-sectional analysis.J Am Pharm Assoc. 2022;62(6):1816-1822.e2. * Catalano G, Khan MMM, Chatzipanagiotou OP, Pawlik TM. Pharmacy Accessibility and Social Vulnerability.JAMA Netw Open. 2024;7(8):e2429755. doi:10.1001/jamanetworkopen.2024.29755. * DiStefano MJ, Chen NC, Asche CV, Anderson KE, Mattingly II TJ.“The crux of the community”: A qualitative focus group study of the impact of community pharmacy closures in Colorado and Utah.J Am Pharm Assoc. 2026;66:102940. doi:10.1016/j.japh.2025.102940. * Gravlee E, Ramachandran S, Qato D.Critical Access Pharmacy Designations Could Strengthen Access. Health Affairs Forefront. December 19, 2025. doi:10.1377/forefront.20251216.325474. * Kono M, Deller S. Rural Pharmacies an Overlooked Piece of the Rural Health Care Milieu.Choices. 2023;34(4). * Luchen GG, Hall KK, Hough KR. The Role of Community Pharmacists in Patient Safety.PSNet. October 25, 2021. Accessed May 7, 2026. https://psnet.ahrq.gov/perspective/role-community-pharmacists-patient-safety [https://psnet.ahrq.gov/perspective/role-community-pharmacists-patient-safety]. * Moodley S. Rethinking Community Pharmacy: A Path To A Sustainable Model.Health [http://Model.Health] Affairs Forefront. July 28, 2025. doi:10.1377/forefront.20250724.565622.

32. What Matters to You: A Simple Question That Transforms Care in Switzerland

In healthcare, we’re trained to move fast, to diagnose, treat, and fix. But what happens when we slow down just enough to ask a different question: What matters to you? In this episode, we reflect on how one simple question can transform not just clinical decisions, but relationships, trust, and meaning for patients, families, and clinicians. Christian von Plessen shares what happens when we stop asking “What’s the matter?” and start asking “What matters to you?”. Whether you're wearing a stethoscope or the hospital gown, this seemingly simple question is a reminder of why connection matters. References: * von Plessen C, Vasserot K, Bonnevie L, Coelho V, Dell'Eva E, Piazza V, Staines A. “What matters to you ?” From campaign to daily practice. Rev Med Suisse. 2025 Jun 4;21(921):1192-1196. French. doi: 10.53738/REVMED.2025.21.921.47318. * Barry MJ, Edgman-Levitan S. Shared decision making — the pinnacle of patient-centered care. N Engl J Med. 2012;366(9):780-781. doi:10.1056/NEJMp1109283. * Staines A, Laroussi-Libeault L, Coelho V, Pomey MP. “What matters to you?”: a powerful question to unlocking partnership in care. Int J Qual Health Care. 2025;37(1):mzaf007. doi:10.1093/intqhc/mzaf007. * Barry M. Ask “what matters to you?” when it matters most. Institute for Healthcare Improvement Blog. September 17, 2019. Accessed April 11, 2026. * Janerka C, Hooper AR, Sanders B, Gallagher O. How has ‘what matters to you’ been used for patient care? A scoping review. Health Expect. 2025;28:e14300. doi:10.1111/hex.14300. * Kebede S. Ask patients “what matters to you?” rather than “what’s the matter?”. BMJ. 2016;354:i4045. doi:10.1136/bmj.i4045.

31. A Voice from the Village: Primary Care in Rural Ireland

Today we’re in a place where everybody knows your name, but also where the nearest specialist may be a three hour drive away. In a city, your physician is someone you may see a couple of times a year. In a rural area you see them in the grocery store or at the Friday night football game. This creates a whole new level of social connection. John Brennan tells us about his experience providing primary care to people in County Kilkenny, Ireland. Join us as we explore the rugged landscape of rural healthcare and hear why this lifeline that depends heavily on committed primary care physicians, is becoming increasingly fragile. References: * Arredondo K, Bay K, Witte L, et al. Rural practice made attractive: a scoping review of rural primary care physician recruitment and retention incentives. J Gen Intern Med. Published online January 26, 2026. doi:10.1007/s11606-026-10218-8. * Kaboli P, Blaine A, Mares J, Fortney J, Ono S, O’Shea AMJ. Health care access from the rural perspective: a narrative review. J Rural Health. 2026;42:e70119. doi:10.1111/jrh.70119. * Maganty A, Byrnes ME, Hamm M, et al. Barriers to rural health care from the provider perspective. Rural Remote Health. 2023;23(2):7769. doi:10.22605/RRH7769. * Huffstetler AN, Greiner A, Kempski A, Park J, Filippi MK, Langa M. Closing the Distance in Rural Primary Care: Primary Care Collaborative 2025 Evidence Report. Washington, DC: Primary Care Collaborative/Robert Graham Center; 2025. * Serchen J, Johnson D, Cline K, et al. Improving health and health care in rural communities: a position paper from the American College of Physicians. Ann Intern Med. 2025;178:701-704. doi:10.7326/ANNALS-24-03577.

30. Smart Risks in High-Stakes Health Systems from the Netherlands

Healthcare faces urgent challenges. Rising complexity, widening inequities, burned-out clinical teams, and health systems stretched to their limits. But what if the biggest risk is playing it safe? Behind every breakthrough in healthcare, there is a moment when someone chose to take a thoughtful, informed risk. Ellen Joan van Vliet tells us how to question the status quo, experiment responsibly, and push forward when it matters most. Hear what it really takes to make smart bets that improve patient care, strengthen communities, and accelerate meaningful change – one intelligent risk at a time. References: * Edmondson AC. Learning from failure in health care: frequent opportunities, pervasive barriers. BMJ Qual Saf. 2004;13(Suppl 2):ii3‑ii9. doi:10.1136/qshc.2003.009597 * Macrae C, Vincent C. Learning from failure: the need for independent safety investigation in healthcare. J R Soc Med. 2014;107(11):439‑443. doi:10.1177/0141076814555939 * Hibbert PD, Stewart S, Wiles LK, et al. Improving patient safety governance and systems through learning from successes and failures: qualitative surveys and interviews with international experts. Int J Qual Health Care. 2023;35(4):mzad088. doi:10.1093/intqhc/mzad088 * Bates DW, Singh H. Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety. Health Aff (Millwood). 2018;37(11):1736‑1743. doi:10.1377/hlthaff.2018.0738 * Ramar K, Oxentenko AS, Dowdy SC. Transforming health care through quality and safety. Mayo Clin Proc. 2025;100(8):1385‑1401. doi:10.1016/j.mayocp.2025.03.021

29. Improving Clinical Environments for Nurses from South Africa

About 40% of nurses say they plan to leave nursing in the next five years because of unmanageable stress, workload, and understaffing. There are scales to measure the health of a workplace that look at staffing, leadership support, nurse-physician relationships, participation in hospital affairs, and the quality of care delivered. Sabelile Tenza tells us about her research on the relationship between nurses' practice environments and the quality and safety of healthcare. Hear how we can create clinical environments where nurses don’t just survive their 12-hour shifts, but where they are empowered to thrive. References: * Leary KB, Lee M, Mossburg S. Patient Safety Amid Nursing Workforce Challenges. PSNet. April 24, 2024. * Chiminelli-Tomás V, Tutte-Vallarino V, Ferreira-Umpiérrez A, Hernández-Morante JJ, Reche-García C. Impact of Nursing Practice Environments in Work Engagement and Burnout: A Systematic Review. Healthcare. 2025;13(7):779. * Leone S, Rosato I, Poli E, Canova C, Danielis M. Factors Related to Turnover Intention Among OR Nurses: A Systematic Review. AORN J. 2025;121(5) * Mabona JF, Van Rooyen DRM, Ten Ham-Baloyi W. Best practice recommendations for healthy work environments for nurses: An integrative literature review. Health SA Gesondheid. 2022;27:a1788. * Martinez E, Cartwright T, McKenzie L, Faulkner B. Cultivating Healthy Work Environments Through the Lens of Nursing’s Code of Ethics. Nursing Administration Quarterly. 2026;50:25–30.