Water Conservation

Moderated by Rick Badie

Apparently, our region’s water conservation efforts are paying off. The Metropolitan North Georgia Water Planning District’s long-range water demand forecast for 15 counties predicts we’ll use 25 percent less water in 2050 than was projected in 2009. In today’s lead column, the chairman of the water district governing board takes note of the potential decline. Elsewhere, a medical officer writes about the importance of quality time between a physician and his or her patients.

Conserving our water

By Boyd Austin

Residents have traded old, inefficient toilets — more than 100,000 at last count — for new models that use only a fraction as much water. Utilities have improved their ability to find and repair leaks, thanks to new tools such as sonar that help identify trouble spots. And “tiered” pricing, with rates that increase as the volume of water use rises, provides an incentive for consumers to conserve.

These are just a few of the conservation measures put in place across the region in the past 15 years under the leadership of the Metropolitan North Georgia Water Planning District.

These steps are making a dramatic difference. Metro Atlanta’s population has increased by about 1 million people since 2000. Yet during that time, total water withdrawals in the region decreased by 10 percent, while per-capita water use fell by more than 30 percent.

In 2009, the Metro Water District predicted the region would use 1.2 billion gallons of water per day by 2050. Recently, the district issued a revised forecast that lowers the region’s expected daily water use in 2050 to between 862 million and 898 million gallons – a 25 percent reduction, even as our region adds nearly 3 million residents.

Metro Atlanta currently uses about 560 million gallons a day. Two-thirds or more of this water is treated and returned to area river basins.

This significant progress didn’t occur by accident. The Metro Water District, created by the General Assembly in 2001, brings together 15 counties, 92 cities and more than 50 water utilities to implement strategies to protect water quality and ensure efficient water use.

Georgia’s 2010 Water Stewardship Act is also making a difference, with measures such as mandating low-flow toilets and shower heads in new construction.

Aside from conservation, metro Atlanta has made great strides in how it treats and returns water to the region’s lakes and streams.

Local water systems are investing in state-of-the-art water reclamation facilities to ensure water is recaptured, treated and returned to our river basins. For example, Gwinnett County has spent more than $1 billion to build a world-class water reclamation facility and pipeline that will return up to 60 million gallons per day of clean, clear water to Lake Lanier.

The bottom line: Metro Atlanta is a good steward of its water resources.

Plenty of water is available for our region. But careful planning and management remain crucial to ensure we have an adequate water supply, knowing periods of drought are inevitable.

The new Metro Water District forecast shows this water supply will carry us even further, partially because conservation and efficiency have taken hold across the region. This is good news for Atlanta and for downstream communities which, like the metro region, depend on this water for their economic vitality and quality of life.

So, what’s next? The recent water demand forecast will inform the Metro Water District’s long-range water plan, which is being updated for approval next year. For the first time, this plan will integrate strategies for water supply and conservation, wastewater and stormwater into a holistic plan.

It’s easy to take water supply and quality for granted. Indeed, we don’t usually think about water unless there’s a drought or water main break.

But every time you turn on the faucet or water the garden, remember water is critical to our region’s economic future, as important as transportation or education.

That’s why the Metro Water District and its member utilities are working diligently to make the decisions and investments necessary to ensure the region has a secure supply of abundant, clean water — for this generation and for years to come.

Dallas Mayor Boyd Austin is chairman of the Metropolitan North Georgia Water Planning District.

Doctors can help change patient experience

Steven Liu

Like many physicians, I pursued a career in medicine with the goal of improving peoples’ lives. It wasn’t until I completed my residency and started practicing as a hospitalist in Atlanta that I realized developing relationships with patients and improving their collective experience is often placed on the back burner.

From paperwork to the everyday pressures of releasing and admitting new patients, it became clear that building a strong patient-doctor relationship was growing more and more elusive. In my 20 years in medicine, not much has changed. In fact, today’s physicians face even more challenges and pressures that diminish the opportunities to spend quality time with patients.

Those issues are clouding patient safety. According to a recent survey on workloads cited by Medpage Today and authored by Johns Hopkins University, 40 percent of hospitalists said their typical inpatient load exceeded safe levels at least once a month; 36 percent reported having an unsafe workload at least weekly. Those excessive workloads lead to inadequate time with patients, which spur unnecessary tests, procedures, consultations and serious errors.

While hospitals are implementing quality initiatives and using technology to restrict lapses, it’s safe to say the focus on patient experience still needs resuscitating.

Misalignment continuously plagues the relationship between physicians and patients. Traditionally, physicians are paid on a fee-for-service model, with their performance in the area of patient satisfaction having little to no influence. Now the trajectory of health care is beginning to move toward quality of care with initiatives like the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey, giving patients more of a say. These survey results are publicly published, bringing more transparency and incentives for physicians to prioritize quality of care.

While feedback about the patient experience is important for hospitals and health care providers, patients should be a priority and included in the conversation about their care throughout hospital stays, not just at the very end. Moving toward a care-team model where hospitalists, nurses, primary care physicians and others work together and engage the patient throughout their stays can curb surprises, decrease chances of readmission and make any transition process seamless.

Additionally, it’s important to note any measure to further engage and satisfy patients should be monitored closely to determine its effectiveness. A number of hospitals implement processes with the right intentions, but those processes ultimately generate poor outcomes. For example, a hospital I once worked with instituted “stop lights” that would flash and blare when noise levels got past a certain point. However, this hospital, like most, was incredibly busy and the measure designed to keep noise levels down actually contributed to the problem.

Another more serious scenario is when physicians treat patients based on potential scoring in satisfaction surveys. Having what they’ll score in a satisfaction survey top of mind might make the decision between doing what’s popular with the patient and what’s best for the patient really challenging. Ultimately, satisfaction should never override quality of care.

There’s an art to balancing patient satisfaction. One thing in particular that gives Atlanta physicians an advantage is the number of health-care technology tools rooted and available here. Physicians in this area have greater access to innovations that aid in patient monitoring, communication and care coordination. Although Georgia, like many states, struggles with expanding its integrated health data delivery network known as a Health Information Exchange, the patient-focused technologies and services prevalent in the Atlanta market are moving the dial in the right direction.

The days when physicians could sit in a room with a patient for 30 to 45 minutes and develop a rapport with them has virtually disappeared, but some Atlanta companies find innovative ways to revive the patient experience. There’s a lot of hope for a more connected point-of-care treatment model that delivers a better collective patient experience and improved outcomes.

Dr. Steven Liu is founder and CMO of Atlanta-based Ingenious Med.


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