Archive for the ‘Healthcare’ category

Jacobs in Wonderland

April 16th, 2010

Back in 1969, a famous singer by the name of Peggy Lee came out with a song entitled, “Is That All There Is?”  She sang about her lifetime experiences of having her house burn down, having attended and then realizing that she hated the circus, and then being dumped by her boyfriend.  After each one of those experiences she would sing, “If that’s all there is my friends, then let’s keep dancing.  Let’s break out the booze and have a ball.”

This song could only be described as a “downbeat song of disillusionment.”  It probably contributed to the creation of most of the new antidepressant drugs that we have today.  Now that was  a wonderful contribution to society that evolved that even Peggy could never have foreseen.  So, for an optimist, one must dream that “from trials and tribulations good things may happen.”  Or, if you’re the head of a pharmaceutical company, you might say, “from depressing songs we can make billions of dollars.”  (It’s a joke …relax.)

Truthfully, we all spend time each day kicking away the many disappointments that come at us as we work our way through the myriad speed bumps that come up during our own personal journeys.  This week was a week of observation for me.  I spent time observing what is going right and what is going wrong at all levels: personal,  business, national, and international for friends, fellow employees, relatives, other loved ones, companies, and politicians.   During my periods of reflection it became clear to me once again that “change is inevitable.”  In fact, change is life and life is change.   Those who can embrace it, deal with it, and make the best of it seem to thrive.

Leland Kaiser - Healthcare Futurist - Nick Jacobs, FACHE - Healing HospitalsThe challenge for most of us seems to be that of being able to get ourselves into harmony with what we want. Some days we have good thoughts, then not-so-good thoughts, and then the next day good thoughts and so on.  It has become clear to me that we need to reach a permanent state of believing without any doubt in exactly what we want to have happen.  Then, not unlike those 10,000 hours that I practiced my trumpet, it a matter of sticking with it until you get better and better at creating your own destiny, designing your own future.  Because as Leland Kaiser has said over and over again, “The Future is a Design Function.”

Dr. Denis Waitley, a positive mental attitude psychologist for the U.S. Olympic team, often speaks of positive self talk, but more importantly, he speaks of taking positive action. If  you don’t like what is happening, work to change it, but first you need to dig deep down inside yourself and determine if it is because you are truly offended by what is happening or if it is just change itself that you resent or fear.  Positive energy is not a “Jacobs in Wonderland” phenomena.  Rather, it is the movement that brings good things to life.

So, embrace healthcare reform as you try to figure it out.  Embrace nuclear arms reduction.  Embrace the fact that you are stranded in Europe because of a volcanic cloud.  It’s all good, or at least we can make it all good.  As long as we have life, love, and a will to succeed, it’s all good.  And, Peggy, the answer is, “No, that’s not all there is.”

There is nothing more fulfilling than living a purpose driven life, than contributing to the betterment of mankind in some meaningful way.   As I work with the International Brain Research Foundation to help them find support to bring traumatic brain injury (TBI) patients out from what were previously believed to be deep, irreversible comas: as I work with the fine people in breast cancer research to spread their work internationally; as I work in Patient Advocacy, and in finding resources for hospitals and physicians to enable them to provide even more superior care, I can tell you that “That’s not all there is.”   In fact, it’s just the beginning.

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So “Radical” Was the Correct Term?

April 8th, 2010
In 1987, my healthcare journey began in administration by asking the question, “Why are hospitals the way the are?“  It was a sincere inside/out question that had evolved from my having been a teacher, executive director of an arts organization, president of a convention and visitors bureau, and finally a PR/Marketing and Development professional in the world of healthcare.  By 1997, my ideas had been rejected so many times by so many traditional hospital administrators, who were either my bosses or my peers, that it felt like they would never come to fruition in a conservative field where change is sometimes seen as both life and job-threatening.
butterfly metamorphosis
In 1997, that all changed when Ernst and Young evaluated the hospital where my presidential appointment had just occurred and predicted the closure of that facility due to lack of population, lack of “financial depth” (a.k.a. cash), and a health system partner that successfully was eating our lunch each and every day. It was with that information in hand that I began the metamorphosis of this organization. The presentation to the board and medical staff was relatively simple:

“We can keep doing what we are doing, and then board the place up… or we can grow by changing  the way healthcare is delivered.”

No workplace bullying - Nick Jacobs - healtinghospitals.comLuckily for me, my board chairman at that time was a risk taker because, realistically, our backs were against the wall.  So, we began a journey of change.   We removed bullies from the workplace (both physicians and employees); created a homelike environment where you did not have to leave your dignity at the door;  added bread baking machines, popcorn machines in the lobby, decorative fountains, aroma therapy, massage, humor, music, and pet therapies.  We focused on Green, focused on Dignity for employees and patients; focused on providing a peaceful, loving, and Healing Environment; focused on Family Spaces; focused on Architecture; and focused on Quality of Care.  We began classes for our employees in Hospitality in Emotional Intelligence Quotient training and embraced ideas garnered from places like the Ritz Carlton, Disney, and Dale Carnegie.  Then we established an employee evaluation system that embraced these changes and rewarded our staff financially for their work.

Loved ones were encouraged to stay 24/7 as visiting hours were opened to them, double beds were placed in the OB suites, a wellness/prevention/and integrative health facility was built to embrace not only traditional therapies but to an entire gamut of alternatives.  A senior citizen center was condominiumized and made available to the Area Agency on Aging.  We had patients help us design a new Palliative Care Unit, Breast Care Center, and Fitness facility, then finally we added a world class International Research Institute.

That was 1997 through 2008.  It appears from the posting below that the world is beginning to consider some of these ideas, but lo, these many years later, they are still being referred to as “radical.”  Well, if any of you are interested in how to do what we did which tripled our organizational budget in size and doubled our workforce,  just give me a call at 412-992-6197, to participate in this program.

Obviously, Windber, Pennsylvania was where this movement all started.   Let’s make sure that it doesn’t stop.  After all, it’s not what people like.  It’s what people LOVE.

Henry Ford Health System - Nick Jacobs, FACHE - HealingHospitals.com

Henry Ford Health System Goes Radical: Creating the Hospital of the Future

DETROIT – Looking to shake up your industry, transform your medical center, and recharge your organization?

A two-day educational symposium, “Going Radical: Creating the Hospital of the Future,” may hold the key to revitalization. It will be held May 25 – 27.

Henry Ford Health System President and CEO Nancy Schlichting will share her radical, but practical strategies for success at the symposium, tapping into the wisdom of her top executives in an interactive session on the profound lessons learned during their tenure.

It was Schlichting’s brainstorm to hire a CEO for Henry Ford West Bloomfield Hospital from outside the healthcare industry. Her choice was Gerard van Grinsven, a former executive of the Ritz-Carlton hotel chain, and an expert in service excellence.

Henry Ford West Bloomfield staff will discuss its successes in differentiating itself from the competition by:

• Constructing prototype rooms for planning and community input.

• Incorporating green features in the architecture and construction.

• Building all private patient rooms, including in the emergency department.

• Emphasizing wellness and healthy living.

• Combining traditional clinical care with complementary therapies.

• Creating a unique brand and inspiring staff to think differently.

• Including family space in each patient room, including intensive care.

• Implementing a new kind of food culture in health care.

• Putting a focus on the special concerns of the elderly.

Entrepreneur Bill Taylor, co-author of Mavericks at Work and co-founder of Fast Company magazine, will be the keynote speaker. His ideas have helped shape the global conversation about how business works and “why the most original minds in business win”. His next book, Practically Radical, to be published this fall, explores how to unleash big change in difficult times.

During break-out sessions Henry Ford staff will share lessons learned while juggling the building of the $360-million West Bloomfield hospital and the $300 million renovation of Henry Ford Hospital in Detroit.

Tours of Henry Ford West Bloomfield Hospital will include a visit to the Emergency Department, wellness center, and an inpatient room. At Henry Ford Hospital, participants will tour the Center for Simulation, Education and Research – one of the largest facilities of its kind in the Midwest that provides hands-on training with medical mannequins.

Symposium sessions include:

• Creating a Culture of High Performance
• Facility Innovations Through the Eyes of the Patient
• The Best of Both Worlds: Clinical Excellence Meets Integrative Medicine
• Transforming Hospital Food
• Radical Outreach: Relationship Building to Win Over the Community and Recruit Staff
• Thriving in Detroit: A Blueprint for Transforming Your Hospital System and The Physician Perspective

each and every day.  It was with that information in hand that I began the metamorphasis of this organization.  The presentation to the board and medical staff was relatively simple, “We can keep doing what we are doing, and then board the place up, or we can change the way healthcare is delivered and grow.”
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What’s Still Missing?

April 3rd, 2010
We are on a not-so-merry-go-round which, even after health care reform, continues to promote a system of illness incentives  that are improperly reimbursed, improperly addressed, and inappropriately segmented. We continue to consider body parts as if they are not connected to or a component of the whole.
Wellness Wheel - Image credit: Marquette University

Tort reform still has virtually no teeth.  This causes physicians to practice sometimes over-the-top medicine in self-defense. When will it be time to begin to throw the switch and teach patients what we already know so well; that wellness, wholeness, and health can change the quality of our lives completely? Our medical schools need to embrace wellness and prevention as a path to health. Not unlike indigenous man, it is time that we begin to realize that our brains do have something to do with our bodies.  We live in a commodity driven society which does not always promote the best, most healthful food, even miminal exercise, stress management, or self-nurturing. Instead, because of those quarterly reports to the stockholders, these companies promote what is the most lucrative and often the easiest to sell.

Oprah.com - Health and Wellness - Nick Jacobs -  HealingHospitals.comWe know that drinking a soft drink with 10 teaspoons of sugar is not healthful. We clearly understand that quadruple cheese anything might eventually catch up with us, or that Uncle Buck’s 72 oz. steak can’t really be good for our arteries. Fried and buttered everything, a total lack of exercise, and more stress than anyone can ever dream of will not extend our lives

One night a few weeks ago I couldn’t sleep, and at 3:00 AM, I looked up and saw an apparition… Oprah. There she was, talking about food. The person she was interviewing said, “Oprah, in the 1960’s, our food cost us 18% of our annual income. ” Maybe that’s why there weren’t more restaurants at that time. Families were stretched just eating at home. He went on to say that, “In the 60’s, healthcare costs us 9% of our income.”  Finally he said, “Now healthcare costs us 18% of our income, and food costs us 9%.”

So, that’s the trade off. We can buy good, farmer’s market-type healthy, organic food and have low healthcare costs, or we can buy manufactured, additive filled food, and pay more for our healthcare.  How much further down this cul de sac must we go as a country before we begin to realize the path to health and wellness or longevity?

Health and Wellness - Nick Jacobs - HealingHospitals.com

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So, it passed. Now what?

March 22nd, 2010

The very essence of the fabric of our society has changed today and forever.  The questions that arise from the passage of health care  reform are endless in number and the answers will be both evolutionary and revolutionary.  Not unlike those dark or bright days following the passage of Medicare back in the 60′s, the naysayers are predicting the end of the United States and those individuals who will be positively impacted are finally able to sleep through the night without feeling the steady stream of their own tears flowing across their cheeks because they either couldn’t get care or couldn’t afford to pay for the care.

It is more than a cultural change, it is a humanity change.  The key to both, however, is the word change. Those who have wonderful, sustainable, well-financed lives with adequate health insurance are concerned that their hard-earned dollars will go to support an inefficient welfare sate.  Interestingly, many of these people clearly may benefit tremendously by these changes, but  they are unsure as to what that change will represent to them personally.

When Medicare passed, those who did not or could not embrace it quickly enough did have significant life changes.  On the other hand, those who could ended up doing better than they could have ever dreamed.  The same was true of the managed care movement of a dozen years ago. The real question here seems to be one of  “The Greater Good.”  Will it be worth it to help our fellow man?

The bigger issue in my mind is the question of our ability to shift from sickness to wellness care. Wellness and prevention, Tort Reform, Big Insurance, Big Pharma, were all part of the dance.  What will their involvement be in this new healthcare plan?  My insurance friends are predicting the end of their world. Will it be the end or just a different model?

What do we need to do to make it work?  We need to end two wars, decrease the DoD spending accordingly, and monitor those who abuse the system.  We still need Tort Reform. We need to reimburse our physicians for counseling their patients about wellness and prevention as well as for end of  life choices and options.

Telemedicine technology

In a recent article in the Harvard Business Review by Gardiner Morse, The Ten Innovations that will Transform Medicine, we see a stimulating list of opportunities that could make this all work better:

1. Evidence Based Decision Making
2. Payment Innovation (based on outcomes and volumes)
3.  Patient Portals for access to personal health information
4.  Behaviorial Economics
5.  Protocols that work for specific treatments
6. Accountable Care
7. Regenerative Medicine (incl. adult stem cells)
8. Virtual Visits  (telemedicine)
9.  Genetics
10.  Robotics

Regardless of your personal view of healthcare reform, it was clear that the system has been broken for a very long time, and whatever religion or spiritual belief you embrace, it has to be supportive of an effort that will potentially stop destroying the lives of others due to either a lack of available healthcare or a lack of finances.  Stay Tuned.

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Healthcare Reform. . . It’s only just begun

March 10th, 2010

This week’s Bloomberg Business Week magazine featured a phenomenal and very personal story of healthcare that actually captures many of the challenges around healthcare reform.  The author, Amanda Bennett, takes us on a journey that she has titled, “Lessons of a $618,616 Death.“  The true title, however, should have been, “How Do You Put A Price on 17 Months?”  In this article, Ms. Bennett takes us on the step-by-step, blow-by-blow journey that ended with her husband’s death.  She and a friend painfully reconstructed every page of his medical records, every dollar paid by her insurance companies, and every charge made by the various doctors and hospitals that treated him during the last years of his life.

Business Week end-of-life issue - Nick Jacobs - healinghospitals.com
Amanda Bennett and Terence Foley

She showed 1.) the grand total of charges, $618,616, 2.) the actual monies paid by the insurance companies to the hospitals after contractual negotiations, $254,176, and 3.) the total paid by her family, $9,468. In the article, she described the 30% overhead/administration costs, the costs of experimental drugs inside and outside of trials, and the 4,750 pages of medical records that were amassed during this time. For those of us who have “spent our time” trying to live within, cope with, and better understand America’s healthcare system, there were no surprises.  For those of us who have watched a loved one take this cancer journey with all of its mysterious unknowns, there were also no surprises. Ms. Bennett’s quote, “The system has a strong bias toward action,” was, I believe, the most poignant in the entire piece.

A few weeks ago, I had lunch with a very healthcare-savvy individual who, when I jokingly referred to death panels, almost came across the table at me.  She did not believe it was funny.  To say that she was passionate would miss the point.  Only the day before, I had spoken with another very intelligent healthcare reform advocate who indicated that the entire concept of death panels emanated from a payment code that reimbursed physicians for simply (or in some cases finally) talking to patients about their alternatives.  I had heard other explanations, but neither mattered.  What matters is that, in many instances, we are not discussing appropriate alternatives or revealing the quality-of-life issues often overlooked before beginning long courses of experimental drugs, or oncology drugs that may not have any positive impact on the health outcome of the individual.

Interestingly, Ms. Bennett did indicate that for all of the time, money, and pain invested in this journey, no one could confirm that her husband’s life was actually extended by these medical experiences.

Someone once described America’s healthcare system to me like this:  You walk into Nordstrom, order several three-thousand-dollar suits, a dozen shirts and some handmade, silk Italian ties, then turn to the person beside you and say to the clerk, ‘”He is paying for this.”  Our heroine Ms. Bennett did mention the fact that her husband would probably have questioned the use of all of these funds in this manner and the relationship that these expenditures might have had on all of the other people in the world who might have been helped by these dollars.

Taking the Hell Out of Healthcare by Nick JacobsWhen healthcare reform is discussed, it is personal.  It is also deep, and it is costly, but the bottom line always comes back to this: “How do you put a price on 17 months?”  In my book Taking the Hell out of Healthcare, I discuss the journey that my father and our neighbor took together over about a 17 month period.  Both diagnosed with lung cancer, my father decided to go for it all.  He had surgery, chemo, radiation, more radiation, and more chemo.  My neighbor, a man without significant health insurance coverage, decided to spend his time with his family.  They both died on the same day.  My father died in a cold, tertiary care hospital where no clergy was present, his family members were not all able to be there with him, and it was over.  In contrast, our neighbor died peacefully in his home, surrounded by his entire family.

Ms. Bennett did say that she was glad that she was not a bureaucrat having to deal with these issues.  Frankly, I wish that she was!

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Gotta Love This Guy (Oh, yeah, and this is an editorial comment)

March 1st, 2010

As we begin to emerge from the bottom of a V-shaped recession, we all pray that it does not evolve into a W-shaped recession. Having been a witness for the majority of this economic challenge rather than an officer in charge, I’ve observed several significant issues that have impacted the hospital industry.  They have included the downgrading of bonds, a serious lack of access to capital financing, cutbacks in elective surgeries and elective donations to our health care foundations,  All of which has resulted in a deep degree of uncertainty as to when  all of this will be over.

V, L, W, U or L-shaped recovery vs. recession

The fact that many of the economic practices that got us into this mess have still not been discontinued or are being reshaped into the newest version of the scam du jour does not bring peace of mind to the vast majority of us, a deeply concerned citizenry.  Add to that the billions and now trillions that we are committed to repay over the next several generations, and one has to wonder about the ability of our current political system to respond appropriately to these challenges.

Warren E. Buffett

Warren Buffett’s annual letter to Berkshire Hathaway shareholders criticized Wall Street executives and board members in a way that most of us would liked to have expressed, but which only Buffet could articulate. This is because his comments are clearly supported by his business acumen and investment skills.  He broadsided the leadership of Wall Street for failing to control risk and for avoiding  what very clearly should have been the “severe” consequences of these failures.  He chastised the bankers in particular for designing and implementing their own industry’s doom and then piling the losses onto investors, while they themselves have managed to maintain lavish lifestyles.

“It has not been shareholders who have botched the operations of some of our country’s largest financial institutions,” Buffett wrote. “Yet they have borne the burden, with 90% or more of the value of their holdings wiped out in most cases of failure. Collectively, they have lost more than $500 billion in just the four largest financial fiascos of the last two years. To say these owners have been ‘bailed-out’ is to make a mockery of the term.”

“The CEOs and directors of the failed companies, however, have largely gone unscathed…Their fortunes may have been diminished by the disasters they oversaw, but they still live in grand style. It is the behavior of these CEOs and directors that needs to be changed: If their institutions and the country are harmed by their recklessness, they should pay a heavy price – one not reimbursable by the companies they’ve damaged nor by insurance.”

With his sentiments firmly ensconced in my mind, I have to wonder about the current rounds of outrageous health insurance increases perpetrated upon the customers of many of our largest and most profitable insurance companies.  As a hospital CEO, I learned very early on that no matter how low we held our charges, those savings would not be passed on to the patients because the middle man controlled this aspect of the “business.”  Incentives are completely upside down in the system at many levels, and the political commitment to truly work toward meaningful change seems not only misguided but also seriously uninformed.

Blair House health summit, February, 2010

Bottom line?  We need to be heard.  We need to work toward systems that make sense: protection from catastrophic financial situations brought on by major illnesses or accidents, primary care that truly helps the patient manage their health challenges at a reasonable cost, and a complete change from a sickness-based to a wellness-based reimbursement system that is not dependent upon the insurance companies for the decision making proposition.

Sometimes right is truly black and white, and until we embrace palliative care, incentivize individuals for taking care of themselves, and deal with tort reform, progress will be only a delusion.

U.S. Health Care Reform Timeline: 1910-2010

U.S. Health Care Reform Interactive Timeline: 1910-2010

Click image above to view full-size, interactive timeline. (Will open in a new web browser window.)

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Inflationary Indices

February 19th, 2010

As the pulse is still an indicator of health in human beings and other animals, health care-related inflationary indices can be a measure of economic health, growth, and change in our business.  After perusing nearly six pages of single-spaced inflationary projections in an Amerinet-produced report, two jumped out at me, the two highest.  One was more significant than the other, but both tell their own story.

Photo credit: Eric Zamora - University of Florida IFAS

Ice-covered Orange Tree Photo credit: Eric Zamora - University of Florida IFAS

The first was coffee/juice, and the projected costs for these two items are up 10 percent. At first my curiosity was piqued by this, but then I saw the explanation further over on the page.  It said that these increases were based on the recent freezes in Florida, which will have a significant impact on juice pricing.  I guess that makes sense.  The trees and oranges froze and were ruined, but it was interesting to me that every other orange-growing country in the world hadn’t jumped into the market and taken advantage of this shortage situation.

The even more difficult quandary created by this coffee/juice category, however, was that the coffee wasn’t explained.  Surely, everyone knows by looking at a world map in Starbucks that coffee comes from places that are not Florida. Maybe it’s just a “calf path” item. You know, some ancient, primeval calf made a trail in the woods named “coffee/juice” and we still follow that path today.

I’m sure that many of you are now wondering what the second category is, the second highest predicted commodity increase for health care, and, honestly, I can’t wait to tell you.  Why am I excited about this one?  It’s because, you see, it is a NIGYSOG (Now I’ve Got You, You Son of a Gun) moment.  For nearly five years, I’ve been predicting some very obvious changes that are about to sweep through the healthcare delivery system.  Our blogs, newspaper columns, and speeches have all directed you toward these changes, and over and over, the vast majority of healthcare management professionals have either ignored or rejected these pronouncements; sometimes out of fear and sometimes out of a “wake me when it gets here” mindset.  Honestly, when it comes to prognosticating, it made me feel like Punxsutawney Phil.  (Oh, and what was that advertisement I read today?  “You have just survived the worst snow storm in this area in the past 100 years.”)

The second most highly inflationary bell ringer from the Amerinet report is one that spot-on supports our predictions completely.  (Drum roll, please.)  It is biotech products.  The prediction is that the cost of biotech products will increase an average of about nine percent.  Upon examining the comment section beside this category, the following sentence appears:  “Increased demand will drive these price increases.”

Windber Research Institute - Image by PlanetRussell.net

Many of you may still be scratching your collective heads in wonderment.  “What are ‘biotech products,’ and why should I care about them?,” you may be asking.  Let’s take a quick historic look at life in the biotech lane.  In 2001, when we co-founded a research institute that had specialty areas in biomedical informatics, tissue banking, proteomics, and genomics, it cost approximately $100,000,000 (that’s 100 million) to map ONE human genome. This year, that number will fall to below $500. If you take that ratio of product-to-cost and project it forward, it doesn’t take too much imagination to conclude that not so many years or months from now, your physician will potentially have (or want to have) access to your molecular profile.  It will provide insights into your personal health that were heretofore unavailable, even unimaginable.

Once issues involving insurance coverage, confidentiality, and ethics are resolved satisfactorily, these tests will become a routine part of your annual physical.  Complete Blood Counts, lipid profiles, prostate or breast testing, and genomic and proteomic analysis will provide your caregiver with answers that make the practice of medicine until now seem hit-or-miss by comparison.

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Healing Hospitals and Healing People

January 18th, 2010

The origin of the name of this blog, HealingHospitals.com came from decades of seeking a better way to transition an old model to a more meaningful, experiential approach to caring for people.  This would actually provide transformational experiences for the patients and their families in a more interactive and participatory way.  (HealingHospitals was named a top 50 hospital administration blog.)

In a recent conversation with a clinical psychologist, I learned that we generally become our habits or, in fact, our habits become us. Accordingly, to change, to grow, to transition and to flourish, we have to work very hard at changing those habits that are not benefiting us personally: over indulgence, negativity, low self-esteem, or whatever the issue(s) may be.

How does this apply to an organization?  Every organization that I have ever experienced has a distinct personality and, in its own way, habits, as well.  Sometimes the personality of the organization is imposed by its leaders, but usually there are layers and layers of practice that have become part of the culture of that organization; practices –for better or worse– that have accumulated over time.

My observations of numerous hospitals have also provided me with an understanding of the myriad of habits that no longer make sense in today’s world; habits still being embraced that literally produce negative results, and are not only insensitive to the needs of both the staff and the patients, but also are many times intellectually and emotionally caustic to all participants.  We’ve written several times about the disparaging nature of the “parent-to-child” management styles prevailing in many hospitals amongst staff, physicians, and administrators, but this is just the proverbial tip of this particular iceberg.

Senior woman patient in hospital hallwayMany hospitals are wonderful examples of business models that flourished during the Industrial Revolution.  Employees still swipe time cards into time clocks, bells and pagers go off all day and all night; professionals poke and prod patients without any explanation.  How many times have you observed the 84-year-old being wheeled into a cold, uncarpeted hallway, parked near a wall with nothing to see, nothing to do, and no one to talk to for long stretches of time while waiting for tests about which he or she knows very little?

In many hospitals patients are referred to by staff members by their  body parts: the kidney in 101, the heart in 543, the stroke in 300.  It is also common that the procedures administered are at the total convenience of the staff and docs without much consideration for the patient.  Numerous hospitals still ask loved ones to leave promptly at 8:00 PM each night, and many times bad news is delivered via the phone.

Consequently, the blog name, HealingHospitals.com which may seem almost like an oxymoron, is intended to help us all to create environments for healing. For the most part, we can probably agree that it would be great if hospitals were places where you could go to begin that healing process.  We might even agree that it would be wonderful if we could be nurtured there, to be helped to find the road to recovery through healing, and even more dramatically, to have a transformational experience that would help us break or modify those habits that keep bringing us back.

It would also be fantastic if, at the end of life, our loved ones could be admitted to control pain, or if the family could have respite.  More importantly, it would be amazing if relationships could be healed before the transition to the other side.

In the late eighties, when I entered healthcare administration, it was my passion to make hospitals more like hotels and spas. But, most importantly, it was all about making the hospitals healing places where patients would have a chance to change their lives in a meaningful way; mentally, physically, and spiritually, via a transformational center of caring.  Let me certify that we did just that, and it is going on to this day. The point is that “you can, too.”

Healing Hospitals: Doctor on hillside with laptop

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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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