Creating Functional Healing Hospitals

November 8th, 2009 by Nick Jacobs Leave a reply »

Why Healing Hospitals?  Transparency.  Human Dignity.  Patient Advocacy. All of these represent a new way of administering health care in this country.  Our industrialized model of care in the mirror image of factory-like settings is no longer acceptable, viable, or an alternative.  We, as a country, as a society –as a culture, need to step up and do what is right.  Love, kindness, nurturing, and a commitment to patient advocacy are the correct ways to interact with our patients.

healing_mosaicMany organizations who embrace the various human dignity monikers such as Planetree and Eden Alternative do so for marketing clout, for positive press, or for hoped-for financial gains.  Upon meeting some of these leaders, transparency becomes a very recognizable trait because they themselves are transparent –and not in the good  sense.  Rather, they are transparently “takers” in an environment that is much better served by “givers.”

For a country that is so obsessed with standardized tests, our healthcare delivery scores are abysmal, astonishing, and asinine. Not unlike our appetite for Biggie fast food meals and Biggie drinks, our appetite for beautiful trappings without substance, for corporate jets, for the power of millions and in some cases billions of dollars in reserves has resulted in a dysfunctional health delivery system that looks at patients as widgets.

Nicholas D. Kristof - NYT photo Nicholas D. Kristof  NYT photo

Nicholas Kristof, New York Times Op-Ed columnist has written another compelling article about the  U.S. health system, in which he quotes the latest World Health Organization figures. (Download the .pdf file.) According to the WHO report, the United States ranks 37th in infant mortality (partly because of many premature births) and 34th in maternal mortality. A child in the U.S. is two-and-a-half times as likely to die by age 5 as in Singapore or Sweden, and an American woman is 11 times as likely to die in childbirth as a woman in Ireland. He then quoted another study, a recent report by the Robert Wood Johnson Foundation and the Urban Institute that looked at how well 19 developed countries succeeded in avoiding “preventable deaths,” such as those where a disease could be cured or forestalled. The U.S. ranked in last place. Dead last.

He did find one health statistic that is strikingly above average: life expectancy for Americans who have already reached the age of 65. At that point, they can expect to live longer than the average in industrialized countries. That’s because Americans above age 65 actually have universal health care coverage: Medicare, he writes. Suddenly, a diverse population with pockets of poverty is no longer such a drawback.

Learning how to convert your hospital to the standards of  Healing Hospitals is not rocket science.  It is, however, not without tough decisions, aggressive doses of nonconformity, a passion and commitment to patient advocacy, and a strong desire to improve infection, readmission, restraint, and mortality rates.  It can be done, but it takes guts, a break from the conventional, unconventional wisdom, and a willingness to do what is not only right …but also what is very, very smart.

WHO Report – Primary Health Care: Now More Than Ever

View more documents from Nick Jacobs.

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10 comments

  1. Joel says:

    I will begin to think thoughts like these might be able to make some difference when they start talking about reducing the crime rate in medicine and start talking about giving the victims of unfriendly practices someplace to go for help. As long as we speak as though calls for passion and commitment to patient advocacy are going to magically eradicate the darkest sides of medicine, as long as we do not even acknowledge the darkest side of medicine, we are talking only about what it makes us feel good to talk about, not what actually will help.

  2. Nick Jacobs says:

    Joel,

    After 22 years in hospital administration, I’ve seen it all, and when you embrace a movement like the one I’m proposing, the bullies, the creeps, and the negative people drop out because they don’t know how to function in an environment that is transparent, caring, and open. I feel your pain, and agree that, in every part of any BUSINESS there is a dark side lurking, but I’m not doing this to “make me feel good.” I’m doing it because I’ve done it, I’ve seen it, and I’ve lived it. It works. 10% of the staff and 10% of the docs moved on because the environment did not embrace their behavior. They went to the competitors and are the gift that keeps on giving.

  3. Joel says:

    So there simply is no need for systems to help patients who are victims of unfriendly acts? You are demonstrating the unrecognized subjectivity of health care professionals. You have not seen it. You never can. No one is going to victimize you because you could do something about it. You never will see the worst side of medicine. And when a patient tries to tell you about it, you just don’t believe it. That is the response of all people in medicine when victims of unfriendly acts present themselves. Those victims cannot even get diagnosed or treated, let alone get justice. No one in medicine believes them. So no one in medicine thinks that there is a crime rate in medicine or that anything needs to be done to protect victims of crimes in medicine because in the subjective view of health care professionals, they don’t see any crimes. And that is one of the reasons why the rates of unnecessary death and injury in medicine have not come down with “commitments to patient safety.” People in medicine think they are objective and all-seeing and dismiss the most fundamental problems in medicine as not being problems.

  4. Nick Jacobs says:

    Joel,

    I believe you should look for another blog to vent your frutrations. I admitted to you to having seen what you describe. I, myself have been the victim of some of these medical treatments, and, even as a hosptial CEO have advised people to seek legal counsel to “right what has been wronged.” I don’t appreciate you painting me with the same broad brush that you use for “all hospital administrator types.” You don’t know me, and don’t know what I have done and how hard I have fought as a patient advocate. Read, “Taking the Hell out of Healthcare.” I have seen CRIMES. I have worked to remove physicians, nurses, and other professionals from practicing in our facilities. altogether. I do believe that there is a crime rate in medicine just like there is in law and education. I am not like Alan Greenspan who said, “I can’t believe the greed.” Well, I can, and I”ve seen it. Some of the unnecessary deaths are from human mistakes, some are from stupid decisions, and some are from people doing things “for the money.” I do not think that I am all-seeing and do not dismiss the most fundamental problems as being problems. Thanks for your opinion.

  5. If the idea of living in an increasingly crowded country doesn’t put you in a celebratory mood, consider this: The dramatic rise in population over the last century has been accompanied by an even more phenomenal rise in life expectancy.When the U.S. population reached 100 million in 1915, the average lifespan was 54 years. When we hit 200 million in 1967, it was around 70.Today, the average lifespan of someone living in the U.S. is just months shy of 78, and there is little reason to think that we won’t continue to push the life expectancy envelope.

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