Archive for October, 2011

People You Need (and People You Don’t)

October 31st, 2011

Tom Atchison - http://atchisontom.com/ - Nick Jacobs, FACHEA few weeks ago, I mentioned that I was in Santa Fe, NM for an ACHE educational training course. Since then, I’ve been thinking a lot about some of the things that were said there by Master Instructor, Dr. Tom Atchison, Ed.D. (a/k/a, Yoda), the President and founder of Atchison Consulting Group. In fact, a few of the tidbits that he offered have been wedged in my brain to the point of obsession. It took me 40+ years to learn some of this, and now I am dying to share it. If you are a boss, a manager, or an employee, it applies equally to everybody, and the information has been valid for as long as mankind has roamed this earth.  So, thanks to Dr. Tom, I can finally articulate it.

SSCS…yep, that’s it. SSCS. If you know what these letters stood for, you can stop reading now, but let me explain. In any group of workers, volunteers, employees, leaders, there are four very distinctive types of people:

Stars

There are the stars, and we all know the stars. No, not the “I’m going to get paid a million dollars to pose for a magazine” or for “selling the rights to my make-believe wedding” kind of stars. Rather, these are the bust your butt, be on the right seat in the bus, make it happen, hard working, cooperative, dedicated stars. They’re the people who lead the way and make things happen.

Skeptics

The next group of employees is the skeptics. Skeptics are generally really good people, sometimes slightly below the star category because they question everything in a meaningful, truth-seeking manner. The only problem with the skeptics is that they take a lot more energy than the stars. You must keep them informed, up to speed and appeased. Once they do get it, they are on board and make things happen in a big and important way. It’s just a little harder to get them there.

Cynics

Next we have the cynics. These people are insincere, and they are motivated by self-interest. They question everything, but more importantly, they dis everything, don’t cooperate and try to block every idea, action or activity. They are the ones who work behind the scenes to make sure that things don‘t get done, that people don’t cooperate and then openly criticize each and every idea no matter how sound the concept may be.

Slugs

Finally, there are the slugs. Usually they are nice enough people, but on a scale from one to ten with the stars being a ten, the slugs are exactly what they sound like. In fact, in reference to printing, the word slug came from traditional hot-metal printing where a strip of type metal is used for spacing that is less than type-high, hence a slug to fill in SPACE! They are space-fillers.

So, here’s what leaders who were present at this workshop were told. The cynics suck your life out of you by continuously challenging and undermining everything, and the slugs add no value to the organization. The problem with stars is that they are often taken for granted, or passed over because they are consistently amazing, and because we spend so much time dealing with the cynics and redoing everything the slugs don’t do.

His solution? Fire ‘em. (The slugs and cynics, that is.) Now if that seems a little harsh, maybe it’s because we all know and love both slugs and cynics. Unless you’re a tenured professor or the boss’s kid, it’s really tough to stay in a job where you do these sluggish and cynical things over and over again. Of course, if you fall into either of those categories, you could change!

Final advice? Be kind and nice and wonderful to the stars and the skeptics, and spend time explaining everything to the skeptics so that they embrace the concepts and dreams and vision and move forward with the rest of the team. Oh, yeah, and help the slugs and cynics find work, especially if you can find them work with a competitor because they will be the gift that keeps on giving cause they’ll probably be cynics and slugs for the next place, too, and all of those disgruntled patients and customers will come to you!

The new Brad Pitt film, Moneyball offers some object lessons here…

“We’re building a baseball team, here. We’re not looking for Fabio. We’ve got to think differently!”

“Who’s ‘Fabio?'”

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Steve, Dean and Nick: Be “Insanely Great.”

October 25th, 2011

Steve Jobs - HealingHospitals.com - Nick Jacobs, FACHE
During this time of economic uncertainty, the recent loss of creative, innovative leaders like Steve Jobs and Dr. Lee Lipsenthal adds to a collective national and personal concern over what seems like a serious lack of truly inventive and ethical leadership. Who will represent the next wave of 50-something leaders, and how will their personal characters influence upcoming generations?

One hope that I have for the future is Dr. Dean Ornish, a man who has been a personal friend, mentor and physician to both Mr. Jobs and Dr. Lipsenthal. To describe Dr. Ornish as a man of character, knowledge and creative medical vision would be akin to calling Winston Churchill a “good dinner speaker.”

Dr. Ornish and I have a long history of friendship, respect and support for each other’s work. Years ago, wanting to avoid being a heart surgery patient, I began to explore alternatives to legacy procedures and regimens. And, not unlike Steve Jobs, whose initial interest was also to avoid having his body violated by surgery, my research led me to the work of a young Dr. Dean Ornish. As soon as I learned more about his extraordinary program for coronary artery disease reversal, it was a simple decision to invest my own personal funds in one of his intensive workshops, held near his home in California.

Dean Ornish at PopTech (2009) - Camden, Maine - Nick Jacobs, FACHE - HealingHospitals.com

Dean Ornish at PopTech, Camden, Maine (2009)

 

As providence would have it, my own work resulted in what became a steady stream of research grants, and my subsequent personal decision to include Dr. Ornish in our appropriations for the next half-dozen years at the hospital and research institute where I previously served as President and CEO. Each year, I fought to have at least one million dollars invested in the Preventative Medicine Research Institute in California so that Drs. Ornish and Lipsenthal could continue to move forward in their research, as well.

Once, Dr. Ornish asked me, “Nick, what do you really want from our work together?” Without a moment’s hesitation, I replied, “Dean, I want to lose the question mark after the name of the town, ‘Windber.’  Whenever I tell people where we’re based,  they usually respond, ‘Windber?’…’You mean Windber, PA… the old coal mining town?'” Some history here: I had been hired by the board of rural 102-bed, acute care hospital in that historic, rural community to either radically turn it around, or shut it down. For me, the latter option was never a consideration.

Among the many transformational changes we made as part of the turnaround was to be among the first hospitals — and most probably the first rural hospital — in America to implement Dr. Ornish’s evidence-based program that arrests (and can even reverse) the effects of coronary artery disease. The results — with patients of broadly diverse ethnic backgrounds — were so successful, that we were asked to present to the World Congress on Cardiology in Belgrade, Serbia in 2007 on our outcomes and research discoveries, garnered from our experience implementing the Ornish program.

We were also instrumental in introducing the program at other sites for Highmark Blue Cross, as well as a host of other innovations and reforms at our own hospital; from live music playing, to fountains, delicious, nutritious food, cooked by classically-trained chefs, 24-hour family visitation and… wait for it… pajama bottoms for the comfort, dignity and modesty of our patients.

The goal: an environment entirely dedicated to the healing of body, mind and spirit.

The result: among other verified successes, one of the lowest hospital acquired (i.e., nosocomial) infection rates – less than 1%) in the U.S., where the national average is around 9%.

And, yes, we were profitable. Consistently profitable, quarter over quarter.

On one flight in a private plane with my board chairman and me from Cincinnati, Dr. Ornish and I had mutually planned to spend some “quality time” together – collaborating, planning and just trading stories about our experiences. Instead, he wound up honoring an emergent commitment as a personal health advisor and consultant to the leader of an Asian nation, and spent the majority of our flight in direct, one-on-one communication with this person. Awesome? That’s just the kind of guy he is.

My personal hope is that Dean Ornish will take up the mantle for both Jobs and Lipsenthal, as he takes his wellness programs to new levels through mobile apps and enterprise solutions using  iPhones and other mobile devices, and iPads and other tablets, making innovative use of social media technology. (Talk to my friend Mike Russell about that.) My further hope is that  Dr. Ornish’s success as an agent of influence and change will continue to be used in a powerful way, to not only help improve the health of the world, but to continue to positively influence public policy in the United States, as well.

Newsweek cover - Dr. Dean Ornish - Healing Hospitals - Nick Jacobs, FACHEDean Ornish has long been recognized as a leader, a man of character and a visionary, but with the loss of two of his closest friends, the pressure to perform grows exponentially greater. So, my best to you Dr. Ornish. Thanks for your confidence in my work. Keep the faith, and keep up the good fight to make a phenomenal difference in this world, thinking in insightful new ways and never resting on your laurels. As your friend  Steve Jobs famously said at his Stanford commencement address, “Stay hungry. Stay foolish”…but especially the phrase he immortalized early in his career: be “insanely great.”

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Going “Rogue” – An Open Letter to Healthcare CEOs

October 17th, 2011

For the past three years, I have had a chance to dig heavily into the future, and I’m pretty convinced that the old saying, “Necessity is the mother of invention,” has never been more true than in today’s healthcare environment.  What was a given before in healthcare management may no longer be so in the future, and since most hospitals only Chief Innovation Officer is the President him or herself, their tasks of visualizing, understanding, deciding and directing the future of the organization will be shifting even more heavily from quantitative deciding-and-directing to the more qualitative visualizing-and-understanding side of this leadership equation.

Although I understand the reluctance of most CEO’s to be on the bleeding edge of creativity, my experiences at my former positions can significantly reduce or mitigate the majority of risk from any decision regarding innovation.

Our new competitive environment has an insatiable appetite for information, access and connectivity and it’s a well known fact that a periodic injection of chaos fosters creativity and forces your co-workers to leverage technology.   Because most organizations already have an environment that is built on trust and collaboration, injecting a little creativity can put their CEOs in more of a position to be the orchestrator and the inspirer.

That Used to be Us That Used to be Us is the new book by Thomas Friedman and Michael Mandelbaum in which they analyze four specific challenges Americans face as a nation—globalization, the revolution in information technology, the nation’s chronic deficits, and our pattern of excessive energy consumption—and spell out what they believe needs to be done to sustain the American dream, and achieve true supremacy based on innovation and excellence.

As an innovator and futurist,  several sections of this book captured my imagination and brought closure to a myriad of beliefs that I have instinctively embraced over the past few decades.  When my responsibilities revolved around the CEO position, I always saw my job as being a contributor to an environment where creative decisions were embraced allowed to happen and then those innovators were rewarded and inspired to keep going.

As the co-founder of a Research Institute, one issue that continually resonates with me is that  “We don’t have enough ‘rogue’ CEO’s in healthcare administration to take risks so that the rest can benefit from both their successes and knowledge.”

Well, fortunately, I’m your guy.

For the last several years I have been out there implementing unusual things, and many of these disruptive ideas are coming to pass in a big way.  I was the first hospital CEO to blog, starting in 2005 (HealingHospitals.com), was an early Planetree board member, created the first breast cancer research center dedicated to the Department of Defense, and filled my hospital with Integrative Medicine, hotel amenities, and music.

Below, I’ve listed thirteen new examples of areas of innovation, in which we’ve been working for the past three years, as well as numerous ways to pay for these initiatives.

 Thirteen Examples of Disruptive Technologies and Practices That Hospitals Need to Understand 

  1. Robotic algorithmic software that improves emergency room flow by 37 to 50 percent.
  2. Financial transaction software that reduces electronic transfer fees exponentially (25% of health care income is from electronic transfers.)
  3. Utilization of nurses and actuaries as patient advocates to significantly reduce your employee health costs.
  4. Preventative medicine reimbursements that can double a physician’s income and add bottom line profits to hospitals.
  5. Treble growth potential of your organization through adding Integrative Medicine
  6. Diabetic retinopathy telemedicine for Family and Internal Medicine docs.
  7. Proteomic and genomic testing creating new “hospital income.”
  8. Peritoneal lavage that extends Stage 4 cancer patients from three months to five years or more.
  9. Bone scaffolding that supports bone growth and virtually eliminates bone infection.
  10. Special bandages that protect and stem cell cocktail sprays that heal burn wounds
  11.  Access to a cancer consortium that allows small and medium hospitals to become Certified Cancer Centers
  12. Hospitals paid “not to play” during an energy crisis as a back-up to the power grid.
  13. Green hazardous waste disposal costing 25% less than traditional methods

If you’d like to learn more about any adopting any of the concepts above, or receive a leadership presentation that will enable your staff to see the opportunities (rather than just the threats) in our current, uncertain environment, here’s where to find me.

Why Are Hospitals The Way They Are? from Nick Jacobs, FACHE on Vimeo.

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Look, Up In The Sky…

October 7th, 2011

I have to admit that the 12-credit, continuing education course I signed up for was not supposed to be fun. In fact, I fully expected it to be two full days of classroom work, in a room with no windows, followed by exactly zero recreation time. I knew it would include a working breakfast, working lunch and a couple of bathroom breaks. I’ve done this before in places like Hawaii, Fort Lauderdale, Cape Cod; you name it. And,  because of my work schedule, I usually fly in, take (or teach) the course, sleep in some no-nonsense business hotel, then head home the following day. What have I been thinking about for all of these years?

Vintage New Mexico Postcard - Nick Jacobs, FACHE - HealingHospitals.comWhen I arrived in Albuquerque, New Mexico on Sunday and went to the rental car agency desk for my trip to Santa Fe, I should have guessed that something big was going on that week. The service representative told me that she could not rent me the compact car that I had ordered, but, in fact, had to rent me one of those black Secret Service type RV’s that hold eight people, a few rocket launchers and a small quad, but she’d cut me a break on the price. When I asked her about gas mileage, she put her head down and said something like, “Drill, Baby, drill.”  The helpful young lady informed me that the Albuquerque International Balloon Festival was taking place throughout the week, and there were virtually no rooms and very few rental cars available anywhere in the area.

Because I had run a visitors bureau in the 80’s, I had seen pictures of hundreds of hot air balloons floating over New Mexico and knew there was such an event, but didn’t realize it was, you know, this week.

My course was being offered by an organization called the American College of Healthcare Executives; the recipient of many thousands of my dollars over the last 25 years.  You see, they provide you with a credential that some hospital CEO’s have, and even when you’ve stopped running hospitals, it is important to keep paying them and taking courses in order to maintain the credential until at least six months after your death.

Albuquerque Baloon Festival - Humpty DumptyOne of the unusual things about this credential is that it is spelled FACHE.  My former assistant once asked me why I signed my name as Nick Jacobs, FACHE, but she pronounced it “fake.”  It actually means Fellow in the American College of Healthcare Executives, but, really, her pronunciation was more fun…and a great conversation starter, too.

The rain started during my 5:00 AM trip to Santa Fe and continued for two days.  So, because the balloons always fly very early in the morning, I never saw even one of them, but on my way to the airport this morning in the shuttle, I overheard a man and his wife discussing “the cow.” He went on and on about how big “the cow” was. It never dawned on me that he was talking about a cow balloon.  Finally, when he said, “Those were the biggest set of udders I’d ever seen,” I had to interrupt and question this discussion.  At that point he explained to me that the basket was in front of the udders, but I still didn’t get it until he laughed and said, “Heck, man, it was a hot air balloon the size of the Astrodome.”  Hence, the title of this post.

I’m glad New Mexico, the Land of Enchantment, isn’t wine country. Could you imagine finishing that 22nd sample of some great vintage, walking outside and seeing that colossal, airborne cow coming at you?

The course was great, the hotels were clean, and the people were nice, but missing that cow has me really upset.  I mean, how many chances do you have in your lifetime to see 600 hot air balloons flying overhead?  How many days in a lifetime provide a person with that type of visual opportunity?

It’s time to stop and smell some roses. From now on, I’m only going to go to courses that end at noon.

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