Archive for December, 2009

Staying Humanly Grounded and Healthcare Reform

December 26th, 2009

Each year I put up the tree and begin to believe that it is magic. The room feels and looks warmer. Often, I’ve considered leaving it up all year as a symbol of joy, love, and happiness, but when I returned home last evening it hit me that it was not the tree as much as it was the carefully wrapped packages beneath it. Once they were gone, the room seemed void of its magic.

It hit me that those packages represented anticipation, love, and sharing in ways that truly touch your soul. Those acts of love represent the essence of that entire experience, price or cost don’t really matter.  It’s the giving.

Healing Hospitals: little girl in hospital bed with caring doctorI try to end every night by reading CarePages from a local children’s hospital website; stories of young children that have many times reached the end of effective treatment and are waiting to meet their destiny decades before their time might have been.  The outpouring of the deep, soulful hurt that their parents, siblings, and grandparents are experiencing from this journey is always profoundly moving to me.  In many of these instances, the only gifts that we have left to give them are our  love and support.  That, however, is not the case for the majority of our fellow men in this country.

It won’t be long until the final product of the healthcare reform effort will appear.  We all know by now that it will be a patchwork quilt of sometimes horrendous compromise.  We can also count on the fact that the negative rhetoric will reach decibel levels typically heard only when standing in close proximity to a jet engine.  The pundits will parade up and down the isles of righteousness, and they will be spouting off their theories regarding what should have happened.  At the end of the day, however, when we approach our bathroom and bedroom mirrors for that last inevitable look, we must all dig into our humanity and ask one very real question: “Will it be better for the uninsured than it had previously?”

As a former hospital CEO, it became evident to me in the first six months of my administrative training that only those without insurance were destroyed by the system.  Only those who were not under Medicaid or an other insurance were hit with the awful burden of paying for everything at the full, retail price.  The fallout was clear.  Due to the risk of having to pay full costs to the hospital, they either were too frightened to go for treatment until it was too late, or they lost what little they had; their homes, their savings, and their possessions.

In a country with such unbelievable abundance, where not just the number but also the quality of the cars, clothes, and even pets that we own are held up as barometers of success, we have often allowed our fellow man to suffer and die for economic reasons.

That fact is no more obvious than at any children’s hospital in Pennsylvania, where you’ll see parents from conservative states where childhood transplantation surgeries were always denied, so as to avoid increased taxes.  You’ll see these parents waiting in line to establish residency here so that they can at least have a chance to save their child’s life.

Healing Hospitals: Mother kisses son in hospital bed

Regardless of your politics, regardless of the dysfunctional (mal-)functioning of our government, in which some of our representatives and senators have taken us to the brink of collapse due to their inability to co-operate; regardless of these issues, we are looking at the beginning of health care reform.  I just pray that we don’t revert to the inhuman practices of our recent past.

It’s time for a human win.

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It’s Been (Quite) a Year…

December 19th, 2009

Last year at this time, as word of the global economic meltdown was beginning to take hold, we saw the beginning of a decline in all aspects of purchasing, including the  optional surgeries and tests in our hospitals.  At the same time, as a member of several volunteer boards, we began to see declines in ticket sales that went as high as 20%.  Later, we met with restaurateurs who indicated that their business was down between 10 and 20%, an amount that proved to be terminal for numerous marginal companies.

obama_health_costs

As the year proceeded, we saw  hospitals make extensive cutbacks in employee  education, travel, and marketing.  This trend became the norm in the industry.  The healthcare-related industries that seemed to hurt the most were those involved in construction and new equipment acquisition.  One type of firm that did well was financial consulting groups, like SunStone Consulting, LLC , organizations that specialized in finding money that hospitals had already earned, but had either not been staffed deeply enough to pursue or that did not know the processes necessary to generate these funds.

For those of us in administrative consulting, the year has been interesting.  Decision makers stepped back a little and waited to see where Obamacare was heading, to collect more cash in a society where “cash was definitely king,” and to cut back on new initiatives until things had settled down economically.  These leaders watched the markets, looked at investment activities, counted revenue versus expense results, and generally became more conservative in their leadership approaches.

What’s on the horizon:  There is an old saying that “He who looks into a crystal ball to predict the future will get crystal in his eye,” that is not far from truth.  Are we completely out of the woods?  Not by a long shot.  Will there be additional taxes, additional expenditures that are not budgeted nationally?  Yes, most assuredly, there will be, but are we certainly seeing more positive signs in virtually every economic indicator that would predict at least a somewhat more optimistic overall outlook.

Wall Street Journal: Pointing to renewed signs that the global slump is bottoming out, the International Monetary Fund on Wednesday upgraded its outlook for 2010 while slightly trimming this year’s forecast.

The overleveraged global financial system continues to cast a shadow over the economic outlook, however, and the fund urged policymakers not to become complacent about recent market improvements.

“Financial conditions have improved, as unprecedented policy intervention has reduced the risk of systemic collapse and expectations of economic recovery have risen,” the IMF said in its updating its outlook for the world economy and financial system. “Nonetheless, vulnerabilities remain and complacency…

100_on-iceSo, if we embrace those little rays of hope as a means of restarting the economic engines, if we visualize a better future for all of us, if we focus on the positive, at the very least we most likely will find a better parking space at the Mall!

Happy Holidays and here’s knowing that 2010 will be a better year for everyone.  (It wouldn’t take much!)

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There are (at Least) Ten Reindeer

December 13th, 2009

{Taking a business blogging break this week for a little holiday fun.}

This holiday thing is intense. I was reading the other day that people started really getting into celebrating Christmas around 354 A.D. So, we made it from 354 until about 1954 before things really became so commercial. It took 1600 years for capitalism to take hold, but when it did, WOW! I’m not exactly sure what a Christmas recession looks like in other countries, but in the United States, we seem to still buy everything; we just try to get it on sale.

So, in the spirit of holiday capitalism, I went to the mall today with three of the little kids; the six, four, and almost two year old.  We went there to see Santa Claus, or, as their mom called him, “The Big Cheese.” When she called Santa that, there was a three kid pause, and finally, the four year old said, “Cheese?” Who is the “Big Cheese?” “Santa,” her mom said, “Santa Claus is the Big Cheese.” Nina said, “Why is he cheese? I thought he was Santa.” By then mom realized that it was not good to confuse little kids about elves, magical people, and such because it was already confusing enough.

Photo Credit: AP

Photo Credit: AP

The day’s plan was simple: get their picture taken with Santa. We needed Annie Sullivan, Helen Keller’s teacher to pull off that miracle. The oldest one with two missing front teeth, played with everything in the garage before agreeing to be strapped into his seat, and the baby somehow flipped the lining of her seat and buried the belt latches. Only the four year old, who was wearing her Christmas dress, sliver dancing shoes, and holiday hair ribbon climbed into her seat and said, “Let’s go see Santa.” Not unlike her three year old cousin, Lucy, who spent hours under the Christmas tree staring mesmerized up into the lights and decorations, Nina was completely into it all.

When we arrived at Santa’s workshop, we watched a string of tiny kids panicking on the ole boy’s lap. The two year old was no different. Nothing helped. Squeaking reindeer toys, binkies and funny faces, were all in vain as she screamed in the arms of this strange, red suited man. After the trauma, we bought their Christmas picture. It had one terrified baby and two older kids looking off into space as if a hypnotic alien was on top of the camera. It could have been a scene from “Transformers 2: Revenge of the Fallen.”

During lunch we discovered that Santa had known exactly what the middle child wanted for Christmas, and that he had even discussed the particulars with her in detail.  The magic continued. It was also during this meal that  we had a very serious reindeer discussion. The boy’s mother looked at me and said, “Ask your grandson to name the reindeer that pull Santa’s sleigh.” So, I did just that. To which he replied, “Well, Poppa, you see, there’s Dasher and Dancer and Prancer and Vixen, Comet, Cupid, Donner and Blitzen plus Rudolph and Olive.” “Olive?,” I said out loud. “Yes,” he replied strongly, “Olive the other reindeer …used to laugh and call him names.” The absolute truth about the reindeer is that Dunder and Blixem, Dutch words for Thunder and Lightning, had their names changed to Donner and Blitzen several years ago for better song rhyming. (Another list of reindeer names that I saw included: Fireboy, Leroy, Pablo and Clarice, so Olive worked for me.)

In fact, this week I got another E-mail describing a third grader who was reading a story in class when he yelled out, “Mr. Markle, what’s a frickin’ elephant?” The teacher walked quickly over to the student’s desk to assure him that he was incorrect when he saw that the boy was reading a story about an “A-frican elephant.”? He was obviously Hooked on Phonics. So, “Ho, Ho, Ho, Merry Christmas to all and to all a good night.”

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“Extraordinary claims require extraordinary evidence.”

December 3rd, 2009

“Extraordinary claims require extraordinary evidence.”
CosmosCarl Sagan (1934-1996)

healing_mural420

Over the last several years, we have made extraordinary claims in our blogs, our speeches, and our consulting.  We have made claims that have been questioned, sometimes scoffed at, and generally ignored by the masses who believe that their way is the only way.  It is almost as if these claims are so seemingly “out there,” that many believe they could not possibly be true.

  • less than 1% infection rates
  • lowest restraint rates
  • lowest re-admission rates
  • lowest mortality rates
  • 99% patient approval rates
  • 97% employee approval rates

In hindsight,  should we have just kept these claims “under the basket” because too many believe they look too good to be true?

When we claimed a bottom line that was over $2.5 M in a hospital with fewer beds than an average wing of most hospitals, you could see the frowns of disbelief on the faces of financial officers.  When we claimed those approval rates, the CEO’s of other hospitals simply smiled and probably thought to themselves, “…maybe in your little hospital, but NEVER in mine.”

eldercare_nurse5_445

Now that I am no longer affiliated with my previous employer, let me throw down the gauntlet to you.  It is my complete and sincere belief that these results, with your total support and endorsement, can happen in your facilities. It is my further belief that I can help deliver those results for you, so that instead of laying people off, you too can double or triple in size. I believe that you can take your everyday challenges and turn them into unbelievable successes.  How?  Take the pages from my book on hospital management.  (The one that’s not published yet, but firmly planted in my heart and head.) In the interim, get yourself a copy of my first healthcare book that has been published, Taking the Hell Out of Healthcare.

  • If you are a genuinely kind person, that will show through in your management style.  Kindness is not weakness.
  • If you care about your staff, they will care about not only you but also about your patients.
  • If you treat people with dignity at all levels of the organization, your organizational culture can change.
  • If you help the 10 percent or so of your employees, physicians, and others who do not support this philosophy to find work at neighboring institutions, they will be the gift that keeps on giving as they run rampant over patients at those hospitals and drive those patients to your doors.

These are not difficult assignments.  They require only that you stick to your resolve, that you always try to do what is right, and that you do not stop until all of the necessary changes have been made.  Healing organizations start with YOU.  Healing organizations embrace their human resources.  They embrace patient families.  They DO NOT function like cold, corporate America.  They function like patient-centered America.  Kindness in the workplace is not a gimmick, not a fleeting idea, not a once or twice a year thing, it is a complete commitment to a change in culture that reaches out to patients, employees, and medical staff.

doctor_welcome220The cost?  In the big picture, the cost is not even a consideration. Your investment now is less  than you can imagine, as your facilities grow, expand, and thrive. Besides:

What does it cost to be nice?

What does it cost to be civil?

What does it cost to be kind?

Healing Hospitals are a way of life.  Make sure that your hospital becomes just that, a place for healing.

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