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Fracking, Beiber Fever…and Bedbugs

May 12th, 2011

Every once in a while, it’s important to write about things that are hot. (It keeps the blog numbers up.) Well, hydraulic fracking, Justin Beiber and bedbugs… yes, bedbugs are all very hot and in the news again. While the D’s and the R’s sort out the nuances of cutting $14 trillion or so from the U.S. federal budget over the next few centuries, we still have to deal with the day to day challenges of living on this planet. In Pennsylvania and New York at least, the hot news — according to the New York Times — is the radioactive water that is reportedly being forced from deep below the surface of the earth as a means of releasing natural gas reserves:

“The relatively new drilling method — known as high-volume horizontal hydraulic fracturing, or hydrofracking — carries significant environmental risks. It involves injecting huge amounts of water, mixed with sand and chemicals, at high pressures to break up rock formations and release the gas.”

“With hydrofracking, a well can produce over a million gallons of wastewater that is often laced with highly corrosive salts, carcinogens like benzene and radioactive elements like radium, all of which can occur naturally thousands of feet underground. Other carcinogenic materials can be added to the wastewater by the chemicals used in the hydrofracking itself.”

Of course, the essence of those two paragraphs will be the source of numerous heated discussions between environmentalists and the gas and oil lobbyists until this issue can be sorted out. In the meantime?  Well, that’s the question du jour.

On a lighter note, my five year old grandchild, Nina, is madly in love with Justin Beiber. She knows every lyric from every one of his songs and regularly either dances or does gymnastic flips to his music. On Saturday, she, her brother, sister and I worked to clean up their two car garage sized playroom. She turned on the Karaoke Machine and let it rip. We were all dancing and singing to the Bieb as we put the toys away, cleaned up the miniature kitchen, folded baby doll clothes and stacked their books.

Justin Bieber - photo credit: celebrity-gossip.net - Nick Jacobs FACHE - Healing HospitalsImagine my shock when one of my Google news alerts appeared spouting the fact that young Justin suddenly had become violently ill at one of his concerts in Manila, then quickly returned to the stage. He had been diagnosed with a bad chest infection prior to the show, but insisted on performing, having tweeted before the show, “Sick as a a dog… But the show must go on.” As a non-medical/non-science healthcare guy, the diagnosis made me a little curious, (remember, I’m a musician, too), but Yahoo Answers cleared things up for me with this patient testimonial: “I’ve spent so many years of my life convincing myself that I have emetophobia, because when I was about 11, I was sick from a chest infection and I threw up…” So, there you have it:  Justin is not the only person who gets sick from being sick. So, relax, Nina, he’s going to be okay.

Now, some additional disconcerting news. After having  personally survived a bedbug attack at a top-notch hotel in a major U.S. city last year,  I read with trepidation that it has recently been discovered that MRSA infection has now been associated with the scratching that comes after the bed bug bites.  This dangerous, antibiotic-resistant bacteria (usually acquired from hospital visits or things like high school wrestling mats), is a strain of the bacteria Staphylococcus aureus which is called Community Associated MRSA or CA-MRSA.  Because it is resistant to oxacillin, penicillin, amoxicillin and other antibiotics, it is not to be ignored.  My medical friends tell me that the best treatment for bed bug bites is to keep the area clean, use antibiotic ointments or gel and keep a close eye on the bite to ensure that it doesn’t become infected.

So, all of you frackers, Bieberbots and bedbug-dreaders …should have a sip of some Grey Goose or Courvoisier.  They’re not radioactive, may calm your fear of tossing your cookies, and would probably – in the right quantities – kill bedbugs…or at least make you stop caring if  they didn’t.  And, if you still want to learn more…well, there’s an app for that.

Bedbugs 101 mobile app - Nick Jacobs, FACHE - health 2.0 - healthcare

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Posted in Current Affairs, Healthcare

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Accountable Care Organizations

April 2nd, 2011

Avery Johnson of the Wall Street Journal wrote an excellent explanatory article this week about accountable care organizations – ACO’s. They’re a potential spin out from the Health Care Reform Act which are about to begin taking shape within the U.S. healthcare system.  The four hundred plus page proposal that was released this week is now being made available for comment, but those administrators and physicians who generally get the concept already are quietly pouring through the pages of this document to determine how it can become a part of their practices.

Donald Berwick, MD, Administrator of the Centers for Medicare and Medicaid Services stated that ACOs were brought into effect with three major aims which are better care for individuals, better health for populations, and slower growth in costs through improvements in care.

Proposed Measures for ACO Quality-Performance Standards.

Scheduled to begin in January 2012, the primary goal of the ACO concept, not unlike other previous historical steps, such as PPO’s and HMO’s, is intended to extract about a billion dollars in costs from the existing Medicare system.  Theoretically, this model is not without merit.  Because most healthcare in the United States is still literally “a cottage industry,” simply having patient advocates help co-ordinate the care of those mega-users, the 18 Club of patients with nine physicians with whom they interact annually and nine different drugs that they take daily, should benefit tremendously.  If these patients can be directed to avoid those unneeded duplications, millions could be saved.

The government outlined rules for how doctors and hospitals can organize into new businesses to reduce Medicare costs and improve care are at the heart of the accountable-care organizations.  The new partnerships that could/should evolve from ACO’s would be aimed at controlling these costs.   They would be structured to coordinate care and their reward would be to share financially in savings with the government if they could come in lower than expected.  There is an alternative universe, however, where they would risk being penalized financially if they go over the anticipated costs.

There is no question that better synchronization of care could help to reduce both hospital readmissions and medical errors which in turn would produce Medicare savings.  In line with this, one of the primary reasons that ACOs might not work is that some of the largest health insurers in the country, including Humana, United Healthcare and Cigna, already have announced plans to form their own ACOs. Insurers say they can play an important role in ACOs because they track and collect data on patients, which is critical for coordinating care and reporting on the results.  As Jenny Gold quoted in her NPR report, “This could just be HMO in drag.” These partnerships of primary-care and specialists doctors with hospitals and clinics might help to produce a model that, although directed toward Medicare, could also have a positive impact on all of U.S. health-care.

Obviously, both hospitals and physicians are worried about ACO’s because they represent CHANGE, but it is common knowledge that if something is NOT DONE, our health care system will crash and burn.   Think of this, providers would get paid more for keeping their patients healthy and out of the hospital. What a concept.

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Posted in Healthcare, Hospital Administration, patient-centered care

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Sometimes it’s Better to Punch a Bear in the Face

March 27th, 2011

I’ve tried to avoid controversy, but since my reading audience has dropped by a few thousand readers after departing my previous CEO position a few years back, I doubt that this will cause me any more problems as a consultant than I’ve already caused by expressing my opinions in previous posts. So, for those of you who are still dependent upon me for financial support, I apologize.

This morning, I read an article in the Pittsburgh Post Gazette by John Hayes entitled “Meet Your Neighbors: The Bears,” about black bears living in Pennsylvania. The essence of the piece is that there are about 18,000 bears living among the 12,000,000 citizens of Pennsylvania, yet there are only about 1,200 bear-related complaints to authorities a year. The bigger issue, however, is that there have been no reported deaths caused by black bears. They don’t eat people.

During this same period of time, I read a post by my friend and fellow patient advocate, Dale Ann Micalizzi, referencing an article about the former president of Beth Israel Deaconess Medical Center (BIDMC) in Boston, Paul Levy,  another nontraditional hospital CEO who espouses transparency. “Admiting Harm Protects Patients” is the article appearing in today’s Las Vegas Sun. In my book, Taking the Hell out of Healthcare, which Paul graciously endorsed on the cover page, we talk about patient rights, patient advocacy, and the need to have someone with you during your hospital stay to ensure that you are not going to become a statistic. In today’s article, Paul is recognized for the work that he did with his blog — a blog which I encouraged him to write and to keep writing — in which he challenged the hospitals of Boston to reveal their mistakes, to stop keeping the infection rates and other problem statistics secret.

Because he was trained as an economist and a city planner, Paul Levy was considered an outsider by his peers when he took over the troubled Deaconess hospital, but as he quickly turned it around, he did so through the eyes of an outsider. In December 2006, he published his hospital’s monthly rates of infection associated with central-line catheters, which are inserted deep into the body to rapidly administer drugs or withdraw blood. These central line infections, which can be caused by nonsterile insertion of the catheter or not removing it soon enough, are preventable. The Centers for Disease Control and Prevention estimate 250,000 central-line infections occur annually, costing $25,000 each and claiming the lives of one in four infected patients.

Dale Ann Micalizzi (L) and Paul F. Levy (R) - Healing Hospitals - F. Nicholas Jacobs, FACHEHe then challenged the other Boston hospitals to do the same. He was accused of self-aggrandizement, egomania, and numerous other witchcraft-like things, but the bottom line was that the number of infections went down, and they went down because the staff and employees wanted to do better and wanted them to go down.

What else happened at Beth Israel Deaconess?

• Hospital mortality of 2.5 percent, which translates to one fewer death per 40 intensive-care patients.

• Cases of ventilator-associated pneumonia, from 10-24  per month in early 2006, to zero in as many months by mid-2006.

• Total days patients spent on ventilators from 350-475 per month in early 2006 to approx. 300 by mid-2007.

• The length of an average intensive care stay from 2005 through 2009, the average stay was reduced by a day to about 3 1/2 days.

(See my previous post on outrageous claims at my prior place of employment.)

Well, in today’s article about the bears, I read that “when bear attacks occur they are generally very brief, and injuries can include scratches and bites.”  Here’s the part I had not anticipated from the bear conservation officer: “Fight back, don’t play dead.  Unlike other North American Bears, black bears don’t consider people to be food.  When it realizes what you are, or gets a painful punch in the face, it is likely to go away.” I believe it’s a useful metaphor.

If you or your organization would like to hear a CEO or two speak about patient advocacy (and way better healthcare), I’m sure I know a former teacher/musician and a former city planner who would welcome the invitation.

Patient advocacy is in your hands!

Health 2.0 Leadership (1 of 2) from Nick Jacobs, FACHE on Vimeo.

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Posted in Healthcare, Hospitals, patient-centered care

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Excerpts and Opinions on “What Makes a Hospital Great?”

March 17th, 2011

Dr. Pauline W. Chen’s March 17th New York Times article answers the question, “What Makes a Hospital Great?” In this article, Dr. Chen finds:

Dr. Pauline W. Chen - surgeon & New York Times contributor - Nick Jacobs, FACHE

Pauline W. Chen, MD | Blog: paulinechen.typepad.com

“Hospitals have long vied for the greatest clinical reputation. Recent efforts to increase public accountability by publishing hospital results have added a statistical dimension to this battle of the health care titans. Information from most hospitals on mortality rates, readmissions and patient satisfaction is readily available on the Internet. A quick click of the green ‘compare’ button on the ‘Hospital Compare’ Web site operated by the Department of Health and Human Services gives any potential patient, or competitor, side-by-side lists of statistics from rival institutions that leaves little to the imagination. The upside of such transparency is that hospitals all over the country are eager to improve their patient outcomes. The downside is that no one really knows how.”

I’ve written often about the failed promise of technology alone, and this is reaffirmed in Dr. Chen’s findings:

“…hospitals have made huge investments in the latest and greatest in clinical care — efficient electronic medical records systems, ‘superstar’ physicians and world-class rehabilitation services. Nonetheless, large discrepancies persist between the highest and lowest-performing institutions, even with one of the starkest of the available statistics: patient deaths from heart attacks.”

As she asks why this is,  the answers have become relatively clear from a study that was released in the Annals of Internal Medicine this very week. This research indicated that it was not the expensive equipment, the evidence-based protocols, or the beautiful Ritz Carlton-like buildings. It was, instead, the culture of the organization.

Hosptials in both the top and bottom five  percent in heart attack mortality rates were queried by the study team. One hundred fifty interviews with administrators, doctors and other health care workers found that the key to good (or bad) care was “a cohesive organizational vision that focused on communication and support of all efforts to improve care.”

Elizabeth H. Bradley, Phd, Yale School of Public Health

Elizabeth H. Bradley, Phd, Yale Global Health Leadership Institute

“It’s how people communicate, the level of support and the organizational culture that trump any single intervention or any single strategy that hospitals frequently adopt,” said Elizabeth H. Bradley, Senior Author and Faculty Director of Yale University’s Global Health Leadership Institute.

So, it wasn’t the affiliation with an academic medical center, whether patients were wealthy or indigent, bed size, or rural vs. urban settings that mattered in hospital mortality rates. Rather, it was the way that patient care issues were challenged that made the difference. The physicians and leaders at top-performing hospitals aggressively go after errors. They acknowledge them, and do not criticize each other. Instead, they work together to identify the sources of problems, and to fix them.

One of the most telling findings in this study was that relationships inside the hospital are primary, and the physicians and staff must be committed to making things work. Dr. Bradley said. “It isn’t expensive and it isn’t rocket science, but it requires a real commitment from everyone.”

So, the next time that you select a hospital, look up its statistics, and I guarantee you that you will be surprised. When it comes to outcomes, to nurturing or even competent care, the biggest is not always the best.

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Posted in Healthcare, Hospital, patient-centered care

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It’s Not Just About the Passion

February 20th, 2011

Get up at 3:00 AM, get to the airport at four, fly out at five, arrive in Austin, Texas at 10:20 AM, wait until 1:30 PM to meet three other board members, rent a car and drive to the retreat center. Check–in, have a quick dinner and go to the first evening board meeting; in bed by 11:30 PM, up at 6:30AM and meetings on Saturday until 11:00 PM. Next day: Up at 6:30 AM, meet until 10:30 AM, drive to the airport and fly home through multiple cities; arrive at around 8:00 PM. That was my weekend. Why? Because I am the only non-physician member of the American Board of Integrative Holistic Medicine. More specifically, I am the not-so-token former hospital administrator, and that’s how much ABIHM cares about spreading the word.

This is my third year as a board member, and during that time, it has been my genuine pleasure to watch this amazing group of caring, integrative/holistic physicians build what is fast becoming the most important element in the U.S. healthcare reform movement. Most of them may not be seeing this the same way that I am (i.e., as not only life but also economic saviors), but it is absolutely a fact that their way of providing care is the only hope that we have in this country to contain health care costs and improve the quality of life in America.

As physicians, this group of humble yet brilliant men and women are true giants in their respective fields of endeavor, be it Family Practice, Internal Medicine, OB/GYN, or Psychiatry. They are “top docs” in combining traditional practice with integrative and holistic medicine. They come from prominent medical schools, and some eve teach residents at these schools. Some are in private practice and still others are working for large, prestigious health systems. They have literally written many of the books on integrative and holistic medicine, but the most important thing that I can tell you is that they are all unbelievably positive people; kind, caring, nurturing, thoughtful human beings who are “in it for all the right reasons.” No kidding. All of them.

Why am I so enthusiastic about these folks? They truly practice what they preach. Spending even 50 hours with them revives the soul and confirms my beliefs that every one of these holistic modalities can contribute to our well-being. I’ve heard their stories about the power of meditation, of vigor restored by appropriate diet and things like simple yoga stretching and walking. They casually discuss case after case of people who have been cured or healed of what would otherwise be considered debilitating maladies simply by altering a diet; cutting out the processed foods and sugars, walking a little every day and finding anywhere from 20 to 40 minutes a day to just step back and focus on themselves, their hopes, dreams and positive outcomes through internal journeys of self-exploration and meditation.

So, where do we go from here?

If you’re a doctor, look them up on the web at integrativeholisticdoctors.org, attend their seminars and workshops, meet them, learn about their peer mentoring program, embrace them and their 1200 Diplomates, and, most importantly, get on board. Each and every one of these gifted, inspired physicians has one thing in common: they love their work; they love to go to work, and their patients and staff love to work with them. If for no other reason, look them up for yourself.

If you’re a patient, don’t settle for less. Search their website at and find physicians near you who are certified in Integrative Holistic medicine. Get off those medicine cabinets full of pills, start taking care of yourself, and begin to live the life that you and your loved ones deserve. It’s the only way. The promise of technology has not cured us. The skill of steel from our gifted surgeons has not prevented the malady from impacting us in the first place, and, finally, the pain and suffering keeps going on and on in our lives.

The solution? Find an ABIHM doctor and start the change today.

The American Board of Integrative Holistic Medicine (ABIHM) is pleased to announce an additional opportunity to take the 11th Annual Board Certification Examination, on-site at the conclusion of the iMOSAIC Conference in Minneapolis, MN.  Please take a moment to review the iMOSAIC conference schedule at www.imosaicconference.com, where you will see an impressive program of faculty and topics!

Date: Sunday, April 10th, 2011 at 1:30 PM. Sign in between 1:00-1:30 (preregistration required).

Location: Minneapolis Convention Center, Room 208 AB

Duration: 5 hours allotted; at least 50% of candidates finish by 2.5-3 hours

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Posted in Healthcare, Integrative Health, Wellness

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Medical Homes – Defining What Patients Want

February 13th, 2011

The definition of a medical home can be confusing to those who have not been dedicated students of this terminology. As the medical home concept has been added to the healthcare landscape of  the U.S., many uninformed healthcare professionals look at each other and shrug as if they seem to expect to see villages being built with work-out facilities and critical care equipment as part of the accoutrements. Instead, the concept of the medical home (also known as the Patient Centered Medical Home – PCMH) refers to patient-centered care, a phrase that we and Planetree have been using for over thirty years.

Imagine a physician’s office or clinic where the patient’s records are reviewed prior to each visit to ensure that the necessary immunizations, tests and wellness milestones are in place and accounted for on a consistent basis. If that stretched your imagination, consider a medical support staff that communicates by secure e-mail and phone to organize the patient’s care. Add to that an electronic medical record system that tracks the patients, their tests and prescriptions. That is just the beginning of what a medical home could be and do.

One of the companies with which SunStone Management Resources is working goes so far as to add nurse- patient advocates to the mix and then assigns them to help sort through the morass of decisions every person faces with significant co-morbidity risk factors. This system not only helps the patient, it holds down costs by giving people a stable, well-coordinated patient centered medical experience. As an advocate, I believe that it will be key to stopping the loss of billions of dollars in unnecessary treatment costs that conversely leaves millions of our citizens without appropriate medical care.

These outcomes can only be achieved by developing years-long, longitudinal relationship with the primary care provider and their team, and with patient advocate nurses who are assigned to work with those teams to help sort out the redundant tests and medications that often evolve from interacting with as many as nine different specialists each year. This number of hands usually results in at least 15 office or clinic visits and countless unnecessary tests. Imagine how great it would be to have someone who can lead the patients more efficiently through this journey.

In a recent edition of Modern Healthcare, Andis Robeznieks wrote an article entitled “In Search of Medical Homes.” Interestingly, it described the evolving requirements from the National Committee for Quality Assurance for medical home standards. Some of you may remember that this journey began officially in 2008. Of course, the Joint Commission and the Accreditation Association for Ambulatory Health Care were also in on the act as they began that same journey. The question posed by these organizations centers around the unique qualities of a patient-centered medical home.

Somava Stout, MD - Cambridge Medical Associates - Nick Jacobs, FACHE

Somava Stout, MD

Even though, as the article pointed out, the NCQA was experiencing success from their medical home practices business line, patients weren’t experiencing that same feeling of success, attention or comfort. According to Mr. Robeznieks this fact was eagerly confirmed by the patients as they filled out their patient satisfaction scores. The piece went on to outline the latest and greatest revisions to the NCQA standards which included, heaven forbid, a stronger voice from the patients. My favorite quote from the article was from Dr. Somava Stout, Vice President of Patient–Centered Medical Home Development for the Cambridge Health Alliance: “One of the things we do over and over again in healthcare is we don’t remember to include the patient as a partner in designing the (personal ) healthcare system.”

In summary, medical homes would provide patient-centered care that results in reduced visits to specialists and allows less expensive primary care doctors to care for the majority of people’s health care needs. This in turn would result in higher quality outcomes with greater patient satisfaction and more funds to take care of the under insured.

Sounds like a plan.

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Veratherm

February 3rd, 2011

For the past 25-plus years, my personal commitments, both intellectually and emotionally, have been directed toward helping to make positive changes in the healthcare system worldwide. It’s been my great pleasure to have had the opportunity to connect with such organizations as Planetree, and to work with them to enhance and promote their philosophy of integrative medicine and human touch. We have watched them grow from three to more than 600 affiliated hospitals. It has also been exciting to have had the chance to work with organizations like the American Board of Integrative Holistic Medicine (ABIHM), a truly transformational healing organization. Their laser-focused goal is to reach more and more physicians worldwide to assist them in becoming certified in the techniques of holistic and integrative healing arts.

Along with these high-touch organizations, I’ve also been privy to advancements and discoveries made within the research field. As a former hospital CEO, and Founder of a medical research institute, I have been exposed to both the peaks of promise created by medical technology and the valleys of disappointment that have evolved from those unfilled expectations generated by the promises of that same technology.

Veratherm - ThermalTherapeutic Systems, Inc. - Nick Jacobs, FACHE

The subject matter to be addressed in this next blog segment is not a false promise. This particular medical device, the VERATHERM™ system was designed, patented and FDA-cleared as a portable hyperthermic perfusion system. There are two other FDA-cleared devices that have been used for this procedure – one which has been retrofitted and the other is somewhat outdated. There are also experimental-type devices that have been pieced together for use in some research facilities and academic medical centers, but they are not FDA-cleared and cannot be marketed.

What VERATHERM™ does provide is a very real opportunity for surgeons and perfusionists to not only standardize hyperthermic perfusion in the treatment of cancer but, potentially, to help to significantly extend the lives of those patients touched by these surgeons and the use of this technology. Most recently, I have had an opportunity to not only see this medical device but also to work with the extremely passionate individual who is in charge, Raymond Vennare, CEO of Thermal Therapeutic Systems, Inc. Raymond has helped to develop and bring to market this compact and mobile perfusion system that, I believe, will contribute to helping literally hundreds of thousands of people worldwide. In my exploration of hyperthermic perfusion, however, I have discovered that only a tiny fraction of those patients who could be helped by the technique that is enabled through the use of this device have any idea that it even exists. Hence, the reason for this blog. VERATHERM™ not only does exist, but the procedure performed by these surgeons and perfusionists can also have a dramatic impact on certain types of cancers.

Please understand that my interest in hyperthermic perfusion in the treatment of cancer revolves around a commitment to those individuals – people like my father, and Raymond’s father, mother and brother who, because products like this were not available, were all lost prematurely due to different types of devastating cancers.

How does this work? After complex surgery for the removal of the tumors in specific body cavities, such cancers as the colon, appendix, stomach, lung and even some types of metastatic breast cancer, the appropriate fluids can be heated in order to perform an intraperitoneal or intrathoractic lavage. These heated fluids then are circulated through the impacted body cavity as needed to help eradicate any remaining cancer cells. Sensors and probes built directly into the VERATHERM™ Console and Disposable Kit efficiently monitor temperature, pressure and flow of heated and unheated sterile solutions while protecting the patient, physician and profusionist.

Let me close by saying one more time that, due to the procedure enabled by this medical device, the lives of many patients have been extended by as much as three-to- five years. It’s not technically impossible to do, but, as a patient, you have to know about it to request it, and only a handful of cancer centers in the entire country have begun to even look at the creative re-use of profusion equipment for non-traditional surgical lavages such as this.

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The Parable of the Starfish

One morning an elderly man was walking on a nearly deserted beach. He came upon a boy surrounded by thousands and thousands of starfish. As eagerly as he could, the youngster was picking them up and throwing them back into the ocean. Puzzled, the older man looked at the young boy and asked, “Little boy, what are you doing?” The youth responded without looking up, “I’m trying to save these starfish, sir.” The old man chuckled aloud, and queried, “Son, there are thousands of starfish and only one of you. What difference can you make? Holding a starfish in his hand, the boy turned to the man and, gently tossing the starfish into the water, said, “It will make a difference to that one!”

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Along the Way…Things Became Very Interesting

January 31st, 2011

Two years ago I began this new journey, but not until a few months ago did my work in consulting really begin to take shape in a way that could never have been predicted.

As the challenges of our present economic times have become increasingly daunting, my personal and professional journey has become even more dedicated to innovation and creativity. One goal has been to provide new alternatives to past practices that will create value for patients. This means making a contribution to saving and transforming lives, while producing cost savings and financial stability, and developing new markets to enable provider growth in their missions.

Olympic National Park, Port Angeles, WA - Nick Jacobs, FACHE - Healing Hospitals - SunStone Consulting

The driving force behind my exploration began with asking how we can begin to control those out of control expenses that are currently blurring the lines between continued care for our population, and rationing or elimination of services?  But, the answer(s) must enable us to continue to add healing opportunities for our patients at every turn.

Because my creative energies have always been focused on producing more ways to generate new monies for whatever organizations I have personally represented,  it seemed somewhat foreign to me to spend more time on fiscal issues than creative alternatives.  However, with literally millions of Baby Boomers coming of age each year, it was obvious that our entire culture is at risk both fiscally and socially. Consequently, after listening carefully to my peers, several opportunities presented themselves that would address all levels of these concerns.

Through the combination of their proprietary software and dozens of years of combined knowledge in the healthcare finance field, SunStone Consulting, LLC, spends each and every working day addressing the challenges of finding monies that should already have been captured by hospitals and physician practices, while also creating new opportunities that have heretofore not been explored. That’s where SunStone Management Resources comes into play.

SunStone Consulting - Nick Jacobs, FACHE

We have identified new companies, new entrepreneurs and new creatives who can not only improve healthcare, but also significantly improve the bottom line of those organizations willing to embrace their programs. One such company with whom we are partnering can increase Emergency Room productivity by as much as 35 to 50%.  They can also help do the same for cancer centers and operating rooms. They utilize robotic systems that communicate patient needs and simultaneously seek out the appropriate medical services required as soon as the patient is triaged. The patient’s condition and potential requirements are communicated to every individual who will or should have contact with them throughout their hospital stay.

We have also identified what I refer to as “no brainer” opportunities. By making otherwise locked fiscal percentages  a commodity, even small and medium sized organizations can save huge dollar amounts. How? By changing out only the electronic reading devices used hospital-wide. This simple change has resulted in huge fiscal savings for clients.

Add to examples like those above the introduction of  a new invention that, in the right hands, can help to extend some types of Stage 3B and Stage IV cancer patients’ lives from months to years through a relatively simple post-surgical procedure. Also consider the invention of new materials that would support bone growth, while virtually eliminating the need for casts or even slings. Imagine a series of protocols that have brought over 40 people out of deep, irreversible comas. Then, on a completely different path, consider having access to  the cumulative knowledge garnered from over a hundred million dollar investment in breast cancer care.  (This is about to be made available to small and medium sized hospitals across the world.)

These are but a sampling of  just some of the opportunities currently driving my passion in this new healthcare world order.

You may want to make a simple inquiry into what’s behind the innovative, practical, and incredible creations of the brilliant people doing this work.  It’s not just so many words on a page.  It is the future, and the future for you and your organization could be now.

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Posted in Boomers, Healthcare, Hospital Administration

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Finding the Cure…for Bullying

January 21st, 2011

No workplace bullying - Nick Jacobs - healinghospitals.comThis week, NBC’s Today Show featured another story about bullying. As I have have mentioned in previous posts here and elsewhere, I believe that bullying is the quintessential cancer on our lives in places of business, in the military, politics, and relationships of all types.  The good news – actually the very good news –  is that there has been some incredible work being performed on this topic through the efforts of Dr. Matt Masiello at my former place of employment, the Windber Research Institute in Windber, PA.  Grants through the Highmark Blue Cross Foundation of Pittsburgh have fueled this initial effort and the academic and quantitative analysis being done by Clemson University has documented this work.  I believe that this joint effort is a magnificent  example of what can be done to change the future course of events currently being controlled by bullies.

The Today Show story that I saw featured the Massachusetts school where, due to cyber-bullying, a young girl committed suicide last year.  Apparently, another girl is now having the same experience at the same school. With the help of programs like this comprehensive anti-bullying program, the former Secretary of Education from PA, Jerry Zahorchak, (now Superintendent of the Allentown PA school system), embraced the effort to quell and discourage this type of destructive behavior.  And the program, under the direction of Dr. Matt Masiello has successfully been introduced across the  entire State of PA. (Matt had started the Allegheny County’s Goods for Guns program in 1994, when he was the head of pediatric intensive care at Allegheny General Hospital. To date, this program is responsible for collecting more than 11,000 illegal guns from the streets of Pittsburgh.) Matt has had the same success with this anti-bullying program. Now, both Massachusetts and Maryland are looking into embracing this effort.

This anti-bullying program is based on a European program with which Dr. Masiello had become familiar.  This is a school system-wide effort that is very well documented and results in tremendous awareness and reduction of bullying at all grade levels.

The trainers bring a group of teachers and administrators together in the school system, and then “train the trainers” as to how this effort can become part of the philosophy of the school.  They start the training in the spring, typically launch the school wide effort in the fall and run it for at least a year. During that time, detailed records are kept measuring outcomes.

Matt Masiello, MD - Windber Research Institute - Nick Jacobs - Taking the Hell OUt of Healthcare

Matt Masiello, MD

Matt is a wonderful physician, a truly giving person and a saint of a man who is the only U.S. representative on the board of the World Health Organization’s Health Promoting Hospitals program. I hired him before I left Windber Research Institute, and he has worked tirelessly to address both this problem and the problems of childhood obesity.

The Olweus Bullying Prevention Program (Olweus.org on the web, @Olweus on Twitter) has impacted more than 400 school districts and 20% of all school-aged children in Pennsylvania. It has also had up to a 50% reduction in student reports of bullying …and bullying others.

For more information, please contact me or Dr. Matthew Masiello at the Windber Research Institute.

Michael & Marisa’s anti-bullying song – “The Same”

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Making Sense of Tucson

January 11th, 2011

It was 1991 when one of  my professors at Carnegie Mellon University began discussing health policy in the United States.  He told us about Arizona, where the state government had decided to stop paying for transplants.  Then he went on to explain that desperate families were moving from Arizona to Pittsburgh, just so they could establish residency in Pennsylvania, and their loved one could receive a transplant.

At around that same time, an outspoken politician from Colorado, former Governor Richard Lamm, who ran for President of the United States on the Reform Party, described the travesty of Medicare vs. Medicaid.   He described the older generation as committing “generational murder” because, even though many times there was no hope  for their survival, for extending their life or for having any quality to their life, we, as a nation, spend 60% of our Medicare dollars on the last  30 or so days of life.  He advocated being honest and allowing people to decide if they wanted palliative care.

What he also pointed out was that, as a country, we continue to have one of the highest infant mortality rates in the industrial world. The reason, he theorized, was because the seniors voted and the young mothers didn’t and no politician would dare vote against that senior coalition.  (This is not about death panels, it is about honesty in healthcare. It is about transparency and explaining the facts to the families so that they could make rational decisions.) None of his words were well received, but nevertheless, they were filled with candor and embraced very difficult ethical views.

Giffords Tucson tragedy - Nick Jacobs, FACHE - Healing Hospitals

The bottom line?  It is a very sad situation when we have to, in effect, sentence people to death at any age because resources are not available to save them, but this is emphatically not about rationing of care, because rationing infers giving everyone a little less.  This is about making a government decision to take away everything. So, this is about making rational  resource allocation, not based upon the number of votes needed to get re-elected, but based on the value of a life at any and all ages.

Finally, the elephant in the room?  Those people killed and wounded in Arizona were killed and wounded because of a man who is most likely mentally ill.  We, as a country, must begin to address this mental health issue with parity, with commitment and without judgment.  No family is without some member who is suffering from some mental health issue, but  this discussion is still ignored, hidden or buried.

So, when the pundits ask if it is about the rhetoric? We don’t know. When they ask if it is about the availability of weapons and ammunition?  The answer seems to fall under that same category. BUT, when the question is properly directed toward mental health?  The answer seems to be absolutely, yes without a doubt.

During this time of reflection, let’s get serious about the very real and very big challenges that this nation faces. We must, as a nation, take these challenges head-on and deal with “problem solving,” and if this Congress does not begin to take action and begin to solve problems, then we must vote again in May and November to continue to make our voices heard.

Unless we can begin to talk with each other with dignity and respect, we will not make progress.  Until we begin to respect the other person’s point of view and understand that debates are healthy again, we will not make progress. Our leaders need to debate, but at the end of that debate, it is essential that they walk out of the room together and agree that they are all here to do a job, and that job is to solve problems.

My heart goes out to all of those families who were impacted by this awful tragedy.

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