Harkness Project Title: Use of Effective Cardiac Medications After Myocardial Infarction: A Comparison of Ambulatory Care for Medicare Beneficiaries in Fee-for-Service and Managed Care
Mentors: John Ayanian, M.D. and Barbara J. McNeil, M.D., Ph.D.
Placement: Harvard Medical School
Biography at time of Harkness Fellowship: Mary Seddon, a 1998-99 Commonwealth Fund Harkness Fellow in Health Care Policy, is a physician and fellow of the Royal Australasian College of Physicians. Prior to accepting her Harkness Fellowship, Dr. Seddon was a research fellow at New Zealand’s National Heart Foundation (NHF). Her work for the NHF involved a critical appraisal of the evidence for the NHF national nutritional guidelines, as well as assisting in the development and dissemination of guidelines for the management of heart failure. She recently completed her master's of public health degree. The thesis for this degree, included an overview of the rationing of health care, the various approaches to rationing, and the ethical implications of these. The focus was on the recently introduced priority scoring system for Coronary Artery Bypass Graft (CABG) surgery that is used in New Zealand to ration access. Her current research interest focuses on methods of measuring quality of care, and ensuring quality in the face of funding constraints. She received a medical degree from Otago Medical School, Otago University. She is also currently completing a Masters of Public Health.
Project: Seddon aimed to examine the quality of ambulatory care provided to patients after myocardial infarction, with reference to the use of effective cardiac therapies and the avoidance of ineffective medications, by type of insurance (traditional fee-for-service versus HMO) and by region. She drew data from the Cooperative Cardiovascular Project and a General Accounting Office survey on a sample of fee-for-service and HMO patients who had been recently hospitalized for myocardial infarction.
Career Activity Since Fellowship
- Clinical Director Quality Improvement Unit, Counties Manukau District Health Board, 2007
- Head of Quality Improvement, Medicine and Acute Care, Middlemore Hospital, 2001
- Senior Lecturer in Quality Improvement, School of Population Health, Auckland University, 2001
- Ken Newell Prize in Public Health (top examination candidate), 2001
- Director, Clinical Quality Improvement Program, Middlemore Hospital, Auckland, New Zealand, 2000
Current Position: Clinical Director of Quality Improvement Unit, Counties-Manukau District Health Board, Middlemore Hospital. (Updated 1/2014)
E-Mail: [email protected]
Selected Publications
Seddon ME, Hocking CJ, Mead P, Simpson C. “Aiming for zero: decreasing central line associated bacteraemia in the intensive care unit.” N Z Med J. 2011 Jul 29;124(1339):9-21.
Seddon ME, Hay D. “Task Manager: an innovative approach to improving hospital communication after hours.” N Z Med J. 2010 Oct 15;123(1324):57-66.
Willcox S, Seddon M, Dunn S, Edwards RT, Pearse J, Tu JV. “Measuring and Reducing Waiting Times: Cross-National Comparison Of Strategies,” Health Affairs 2007 26(4): 1078-1087.
Seddon, M.E., Marshall, M.N., Campbell, S.M., Roland, M.O. “Systematic review of studies of quality of clinical care in general practice in the United Kingdom, Australia and New Zealand.” Quality in Health Care. 2001; 10(3):152-158.
Seddon ME, Ayanian JZ, Landrum MB, Cleary PD, Peterson EA, Gahart MT, McNeil BJ. “Quality of Ambulatory Care after Myocardial Infarction for Medicare Patients by Type of Insurance and Region” American Journal of Medicine July 2001; 3: 24-32.
Seddon ME. “Managed Care in America: Lessons for New Zealand” New Zealand Medical Journal 2000; 113(1114):318-21.