Archive for the ‘Leadership’ category

TED and “me?”

March 20th, 2009

Okay, I’ll admit it. I’ve been obsessing over TED. If you aren’t sure what TED stands for, it is an abbreviation for (Technology, Entertainment, Design) and TED is an invitation-only event where the world’s leading thinkers and doers gather to find inspiration. It’s in California, of course.

While spending an absolutely delightful weekend a few months ago with several people who were creative, inventive, entrepreneurial, and fun, one of the most highly respected innovators in the world turned to me and said, “You should be on the agenda at TED.” You may wonder what qualifies one to be considered to be one of the most highly respected innovators in the world, but take my word for it, he is. He’s on the faculty of about eight universities, has offices in a couple of dozen countries, and is one of the most sought after creators of innovation anywhere.

Well, little did he know how much that comment meant to me. It shook me up, inspired me, and filled me with excitement. Why? Read that line above again, “an invitation-only event where the world’s leading thinkers and doers gather to find inspiration.” Okay, I’ve been called a futurist, a creative, a right-brained whatever, and several of the things that we’ve done over the years have literally rocked the house (like this blog), but . . . in the world? It always seemed to me that my primary claim to fame was my ability to keep trying when some people not only wanted us to fail, but would probably have like to have seen me personally run over by a cement truck. I was persistent.

I’m not sure where I would fall into that description of the world’s leading anything, but it surely was flattering to have someone of that caliber say that to me. It’s funny, because every time I begin to allow the little ghosts come out of the sewers to pull at my pants cuffs with their negativity, I simply smile and think about our collective accomplishments.

This week alone, our consulting practice has taken me to a publishing company to help their employees begin to create what they would like to have for their future; then to a chain of hotels in New York City where the owner fully comprehends the merits of wellness for his employees; to a biomedical informatics startup company specializing in neuroscience; a nonprofit music group struggling to re-invent itself; and finally to an executive recruitment firm seeking a new business niche.

So, back to TED. If you have ANY interest at all in what goes on there, what gets said there, who speaks there, you probably would be surprised, or not. People like Dr. Dean Ornish, Bono, Bill Gates, Jane Goodal, and former President Bill Clinton have spoken there, but so too has Dr. Alan Russell from the University of Pittsburgh and a hundred other people who have simply made a difference –with extraordinary results. The good news is that, should you have any interest in seeing and hearing any of these speakers, just go to TED Talks on the web, and they’re all there for your inspiration.

For example, in a presentation by Scott McCloud, the cartoonist and comic book artist, we heard: “Learn from everyone. Follow no one. Watch for patterns. And “Work like hell.” Stefen Sagmeister has made his mark by creating public art with sayings displayed in public places like, “Everybody thinks they’re right,” and “Money does not make me happy.” My favorite, however, is “Complaining is silly. Either act or forget it.”

Jill Tarter, astronomer and a world-renowned expert on extraterrestrial life made this comment, “If we are alone, it is an awful waste of space.”

Seriously, take a look at TED and its companion, TEDMED, dedicated exclusively to healthcare innovation. Maybe, in my dreams, I’ll be giving my speech on kindness in the workplace, my 18 minute presentation on life, love, and a kinder more co-operative future.

Hey, we all need a dream. And I, too, have a dream.

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How Do You Keep the Music Playing?

February 9th, 2009

When civilizations are evaluated, there are numerous indicators that are used to demonstrate their relevance, their contributions to the world, and their donations to the future. As a young musician, one of my college professors predicted that our culture would begin to decline as a military, economic, and artistic world power. He pointed toward what he described as primary indicators of this decay, and he saw the decline of music in our schools as one of those indicators.

Overall, this professor was more than concerned about the role of public education in the future of our country and once described our form of public education as an experiment that would eventually prove to be ineffective. He saw the effort as a misguided attempt to squeeze all different shapes, sizes, and types of personalities, intellects, and skills into a single classroom, which he called a “melting pot of mediocrity.”

That professor also used to teach us about the writings of Marshall McLuhan from the University of Toronto who indicated that television would change the manner in which we lived our lives. His book The Medium is the Message made us all begin to look at the influence of television on society.

McLuhan described the fact that in visual space we used to think of things as continuous and connected. In either the auditory senses or the sense of touch, there are only resonances. There is no real continuity in our other senses. The fact that we have become the visual wo/man, through television, and that visual orientation has produced a collage that is neither continuous nor connected, has resulted in the reality that even our visual perceptions have lost their continuity.

It is well-known that music nurtures both the right and left sides of the brain, and that those who study music have intellectual opportunities that literally may not exist for those who don’t. The challenge is not just one of music as entertainment, but music as part of our intellectual training. So the question is, as in the James Ingram song lyric, “How do we keep the music playing?”

Young music teacher Nick Jacobs meets musical hero Maynard Ferguson What does this all mean? In 1972, my professor indicated that we were leaning toward a different type of society that would learn, participate, and act in a different way. One of his greatest fears though was that, due to this lack of continuous connection, those who would take charge of our educational systems would not recognize the importance of music as part of education and that music would begin to be downgraded, minimized, and even dropped from public education. Thus reading, writing, arithmetic, and the arts became reading, writing, and test scores.

If we look at the dramatic decline in participation in music education over the past 30 years, he was not far from wrong. The answer to the question of how this has impacted us as a society may not be totally clear for a few decades, but as we look across the overall educational landscape and see these chasms of deprivation from exposure to the arts that already exist, it seems relatively obvious that we have and will pay the price for ignoring those subjective, intellectually stimulating programs that spawn creativity and lead to new and better ways to form our futures.

Remember, from science fiction comes science, from dreams come creations, and from fertile minds come our professional careers. The high-quality drama teacher, vocal instructor, or orchestra director who helped many of us find our way to where we are today is many times not employed anymore, and last week we saw the arts cut once again from the stimulus package. In 1987, I read that more physicians had studied music as a discipline than any other single concentration in both high school and undergraduate work. Will tomorrow’s physicians be nurtured by music, and if not, at what cost to society?

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Like Deep Sea Fishing

February 2nd, 2009

Being a little older or just more chronologically mature makes this new life of consulting somewhat like snorkeling or even deep sea fishing for me. It’s a whole new world out there. If the total culmination of all of my experiences were listed on an 8½” x11″ sheet of paper in order of interest, category, and complexity, it would have to be written in 4 pt. type.

When it comes to prioritizing, cataloging, and quantifying my consulting practice desires, skills, knowledge base or just interests, this gets somewhat crazy at times.

For example: Planetree and the Samueli Institute have both captured my imagination and, I’m sure that over the years, I’ve captured theirs as well. Optimal Healing and Patient Centered Environments are my forte, my passion, and my love.

Do you know all about Web 2.0 …or 3.0, as some are calling it now? I’ve presented all over the United States and been featured on podcasts and webinars for years. How should you use Twitter, YouTube, and other streaming video platforms, Facebook, Blogs, Podcasts, Webinars, and other new technologies to move your business forward, to publicize your specialities, and to get your company’s name out there?

The actual science of microbiology is NOT necessarily one of my passions or deep skill sets, but running a research institute for nearly a dozen years that specialized in proteomics, genomics, biomedical informatics, and histopathology while interacting with the Department of Defense and Military medicine community certainly is a skill base developed through massive amounts of tears, sweat, and blood (my own). This information alone should be something that someone needs to know about on a regular basis.

The world of small and rural hospitals you say? My goodness, name someone who has had more “edgerunning” experience in this area than I have, and I’ll personally send them flowers. The growth, nurturing, care and feeding of a hospital that is smaller than 100 beds takes special stamina and a very positive mental outlook, because limited resources require unlimited creativity.

Economic Development through technology, healthcare, small businesses, and even tourism seems to have been a recurring theme in my world for decades. Jobs, Jobs, Jobs.

How about OC-48 dark fiber, telemedicine, teleradiology, telepharmacy, telecritical care, and teledermatology? Been there, done most of that, and have been working with groups and contacts who can add electronic medical records, disaster recovery/business continuity, data fusion centers, and other areas of specialty to your needs.

Interested in being an all-GE shop? Going completely digital? Having a 3T MRI with a breast coil? How about mobile PET/CT or the latest in mammography, and data repository technology? Okay, I’m not an expert, but I sure do have some interesting knowledge and amazing contacts here, and when it comes to breast care centers, we constructed one of the finest in the world.

Green? Wanna be green? Well, unlike Kermit’s song, it can be easy being green, and one of my current assignments involves everything green for schools, churches, and, most importantly, hospitals. How to get there, how to save, and most importantly, how to MAKE money from going green is currently something that we understand.

The Dean Ornish Coronary Artery Disease Reversal Program that we established is one of the best in the country, and we know how to set them up, run them, and help them prosper.

What about the World Health Organization? Work in the Netherlands, Croatia, Bosnia, Serbia, Montenegro, England, Italy, Greece, and even Africa interests me deeply, and my contact lists from those areas are very long indeed.

Construction? How to afford it? Alternatives to traditional methodologies, traditional financing, and Planetree design? Yep, we have that knowledge base, too.

Of course, there are things that you probably haven’t even considered: Wellness or EQ education, Patient Centered Care models, employee centered care to get you to patient centered care, the use of Markeking to grow your organization and to protect your position, and don’t forget: board relations, strategic planning, employee education, and, of course, nutrition.

Now, add to that this list of skills that SunStone brings to our table as well: the CDM, charge process, Compliance, Documentation Accuracy, Inpatient Coding and Compliance, Outpatient Charge Process Analysis, Outpatient Billing Maintenance, Pharmacy Revenue Cycle, Pricing, Recovery Audit Contractor Readiness, Reimbursement and Financial Analysis, Revenue Cycle, Transfer DRG’s and Workers’ Compensation Recovery.

IF YOU NEED US… Remember:

F. Nicholas Jacobs, FACHE
International Director
SunStone Consulting, LLC
1411 Grandview Avenue,
Suite. 803
Pittsburgh, PA 15211
nickjacobs@sunstoneconsulting.com

Home Office: 412-381-3136
Mobile: 412-992-6197
Fax: 866-381-0219

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Never Look Back

January 21st, 2009

Never look back.

That should be the motto of every outgoing president. You did the best that you could. You did what you thought was right. You gave it your all, but when the power changes, when the new world order takes shape, and when you fly off to your new life, it will be forever evident that what you did will not be what your predecessor will do. It will not be what you fought for, believed in, or worked so hard to accomplish. So, never look back; George W., Bill, George, Jimmy or Nick. It was what it was; it is what it is, and you can’t change either the past or the future. You can only go on with your life.

With the changing of the guard this week in Washington D.C., the entire process was very moving to me. Things that are being proposed seem so obvious, so clear, so amazingly right, but they too will most probably be disassembled almost before the door is closed on our next president’s final helicopter ride. The only worst situation would be if all of President Obama’s former loyal leaders would stay behind and make those disassemble decisions on the next inauguration day.

In the raw emotion of abstract observation, it dawned on me that, my time as a president is over, too and that change will happen as it is permitted to happen by the leadership left behind. It also became clear to me that my role should now be one of elder statesman not that of interfering has been.

We built this city on rock ‘n roll” is a song that plays over and over in my head. In our case, we received international recognition because of the uniqueness of the institutional soul that evolved there. It was an open, progressive environment, but, more importantly, it was an environment filled with positive energy.

My role now as elder statesman is to offer advice only if asked, to realize that my time is indeed over as a president, and to help those who believe in what we once created to do the same for their organizations.

It is not to attempt to stop motion, no matter which direction it is flowing, but this part is damn hard, and I don’t have a library to focus on building.

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Make Sure That You are on the Right Side of the Paradigm Shift

January 15th, 2009

The word paradigm provides a cerebral representation of a model that, throughout our lives has remained relatively constant. Transformational changes in the manner in which we travel, how we communicate, and even in the ways that we are educated have simultaneously produced significant shifts in those models as well. In the early 90′s, we were informed that the information being transferred to us would only be viable and, in fact, would be very nearly invalid within about 18 months or so after ingestion.

Those parameters of informational decay continue to diminish exponentially as we immerse ourselves in 24-hour instant access to changing data, innovative discoveries, and altering states of acceptance of ideologies that were once believed to be infinite in their substance. Science is only valid until the next discovery.

The archetypical model of high-tech health care that was believed to be our “Star Trek” salvation from the ills of our parents, and their parents is currently being exposed as an artificial promise that has failed to deliver healing. Each decade our technologists have produced new; more sophisticated, and higher priced equipment with promises of earlier detection. Unfortunately cures have not been part of the equation. The additional technology has simply produced additional questions.

As we delve into the diva world of science, we find many reasons why significant progress has not been made, mostly related to a lack of continuity in the incentive systems. But, because of these failures to heal, we also may now be able to discern another reality that will truly contribute to the new world order of medicine.

Dr. Lee Hood, M.D., Ph.D

Lee Hood, M.D., Ph.D

Dr. Lee Hood, infamous for his work in the creation of the equipment used by our present day scientists, launched a school of thought that has been generally accepted in the scientific community, Systems Biology. Dr. Wayne Jonas has pursued with passion his work in Systems Wellness. Both of these edge-running thinkers are also working to contribute to a medical degree at a leading university that will be entitled Systems Medicine.

The uniqueness of this type of thinking is not the newness of it. It is, in fact, a melding of the old and the new, the oldest and the newest approaches to healing. What Drs. Hood and Jonas separately yet collectively are advocating is an approach to illness that embraces the complexities of genomics and proteomics and allows that knowledge to be firmly wrapped in a swaddling of information that, in many cases, has been with us since indigenous man walked the earth, an Optimal Healing Environment.

Wayne B. Jonas, M.D.

Wayne B. Jonas, M.D.

We have all been inundated by the mythical promise of cures from fraudulent presenters, and the result of those untested, unproven, and unfounded promises has created a culture of distrust, cynicism, and fear that thwarts the reemergence of those healing practices that represented not only viable alternatives, but, in many cases, the only alternatives that were available to our societies less than eighty years ago. As we more clearly understand that the human body is a comprehensive system that interacts within itself on a myriad of levels, we also can begin to understand why individual responses to certain types of healing modalities also produce very different results, i.e., Systems Healing.

The philosophies, beliefs, and practices of the American Board of Integrative Holistic Medicine, a major group of practitioners who have come together to provide not only education, training, and additional resources to physicians in general, have also come together to ensure that those Systems Healing practices that were pushed aside for the promise of high tech and high chemistry are reintroduced to medicine and healing in an appropriate and informed manners. Their work is not new to mankind, to medicine, or to healing, but it is a reemergence of those long proven, highly embraced modalities that promote and support health and wellness, the new paradigm?

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Two Guys Medical Center

January 9th, 2009

Back in the early nineties, two of my peers replicated the pro forma and business plan of an offer made by a for profit hospital system that was interested in buying a specific medical center. They then presented it to a religious order and ended up buying a hospital which many of us began to refer to as “Two Guys Medical Center.” The difference was that, unlike the religious order, they were interested in it for some personal financial gain, the American way. Once the cash flow turned into a trickle, they found their way clear of ownership with heavy golden parachutes from the organization that bought the hospital, and it became the gift that kept on giving. All in all I’m sure that it was a very lucrative series of events that, after their or my death would make for a great fiction novel.

As I prepared for my departure from my previous employer, the entire issue of identifying someone to continue to carry the torch of leadership weighed heavily on my mind. Succession planning, if you will, was never far from my thoughts. With that in mind, I looked into the region and found, well, two guys. These two guys were very different from the previous two mentioned. They were committed to the good of mankind on so many levels that no one could question their personal intentions. Over a year later, the reality of their futures does not lie firmly in my hands when succession is discussed, but they certainly are two people to watch as the region’s health systems continue to morph medically.

Only four short years ago, Tom Kurtz, one of my two recruits, was working diligently every day in every way to ensure that four heart stents was an inadequate number for my chest. It had been his job at the competitor to literally master my strategic plan and to replicate it at an even higher level. He found federal, state, and local funds to begin a neuro-science center, research in post polio syndrome, work in anesthesia that would be converted to the battlefield, and, in his spare time to build and promote a Tech Park for the City of Johnstown.

We were usually friendly, but fierce competitors. He honestly has never told me the entire story of his journey with his former employer’s leadership, but I’m sure it would fill about ten of these blog posts. Tom was a master at political nuance and learned quite a bit about grants from the Department of Defense. He not only knew where to find them, he learned how to get the monies delivered to the projects for which he was responsible. Tom is progressive, aggressive, and knowledgeable about both the need to find sustainability on the research side and growth on the hospital side. When it comes to the “vision thing,” Tom embraced that as well. He’s not one of those cant-see-the-forest-for-the-trees guys. In fact, he is just the opposite of that. He sees the big picture and quickly embraces just exactly how things can be in the future with a little guts and a lot of persistence.

Dr. Matt Masiello

Then came Matt. Dr. Matt Masiello has been a friend for over a decade. He represents almost everything that I embrace philosophically. Matt is a gentle and kind man who fully comprehends the value of treating human beings like human beings. A background as a pediatrician has enabled him to understand compassion, and after having been in charge of intensive care for years, he has also learned of the heartbreak that this profession can bring. Dr. Matt captured my attention a year or so ago when, like me, he got involved with the World Health Organization. This time, however, he went way beyond my wildest dreams and has literally been appointed the U.S. representative for the WHO.

When my short history on this planet is finally written, let it be said that Matt and Tom have had a tremendous impact on our community, our region, and now our world as special attention is given to breast cancer research, and as health and wellness, prevention and anti-bullying programs are nurtured, cultivated, and grown by these two men. No, it’s not “Two Guys Medical Center,” but it sure is a medical center that has been positively impacted by two guys. Keep up the good work, Matt and Tom. This region needs you.

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More on Leadership…

December 12th, 2008

Nick Jacobs, FACHE author of Taking the Hell Out of Healthcare

One imperative for any leader is a positive mental attitude. We must work tirelessly on believing in ourselves, and then we must work constantly to reinforce that belief with positive self-talk. If we embrace that concept that we can, there’s a very good chance that we indeed can. If, on the other hand, we believe that we won’t, we probably won’t. This single belief can initiate all forward movement. Winners in life constantly encourage themselves to think that I can, I will, and I am, and they don’t focus on the past —the should have, would have, or can’t do’s are gone forever. We can never make a better past for ourselves.

Last year, one of our employees attended a non-traditional educational seminar whose primary focus was directed toward the analysis of different personality types. When the employee returned, I asked, “What did you learn?” Their response was, “I learned that the primary function of people with my personality type is to pee on your cornflakes, to rain on your parade, and to frustrate your every creative idea, because that’s just what we do.”

Hence the opening paragraph of this piece. We are in difficult economic times, and the general counsel from our advisors is more often going to be to take no risks. If they are doing their jobs, we will be inundated with reasons why we should be against almost everything. In fact, words like growth, expansion, and opportunity all seem to be put away as this storm cellar mentality prevails. They will argue that they are saving their organizations by “shrinking to greatness” while opportunity after opportunity slips away.

One of my favorite visuals of this mind set comes from the 1990 movie Ghost where the people were helped to find their place in eternity by little demons that came out of the sewer grates to drag their souls into Hell. As leaders, we are surrounded every day by people who see their job as one of hard, cold, black and white facts. There are the extremists who spend their days spreading pessimism, fear, gloom, and negative energy; looking at the down side as they constantly undermine not only growth, but the attitudes that foster growth. The blacker the sky, the deeper the reinforcement of their concerns, and the more intense the corporate paralysis becomes throughout the organization.

Positive Mental Attitude Psychologist, Denis Waitley helped to change my life when he lectured on this topic nearly 30 years ago. He had been the U.S. Olympic athletes’ psychologist. Dr. Waitley taught us to learn from the past, set vivid, detailed goals for the future, and live in the only moment of time over which you have any control: now. He always spoke about the reality that life is inherently risky and that there is only one big risk you should avoid at all costs, and that is the risk of doing nothing.

Don’t get me wrong, conservative thinkers are important in the balancing act of leadership, but they must never be given the power to control all aspects of an organization. It is a recipe for disaster. The result will be stagnancy and eventually, business failure. There must be a means to carefully look at what they have to say, to evaluate the risks outlined, and then to make a decision based upon the prudent person process, but, having said that, remember that leadership is not a gutless proposition.

If you are not interested in some sleepless nights, tension filled meetings, or numerous failures, don’t get into the game. As Waitley says, the winner’s edge is not in a gifted birth, a high IQ, or in talent. The winner’s edge is all in the attitude, not aptitude. Attitude is the criterion for success. There are two primary choices in life: to accept conditions as they exist, or accept the responsibility for changing them.

A leader’s world is not always black and white.

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Something’s Gotta Give, Something’s Gotta Give, Something’s Gotta Give!

November 1st, 2008

My Facebook friend, Anne Zieger, editor of Fierce Health Finance, wrote a compelling piece the other day regarding the potential demise of hundreds of hospitals. Her prediction is based upon some very valid financial realities, and we are witnessing them locally as well as nationally. Not unlike the little banks in our area that seemed to have been insulated from Wall Street’s collapse, some of these national problems seem to be washing over some of the smaller hospitals with relatively minimal damage. Yes, many of us have seen as much as a 10% decrease in elective, outpatient procedures.

In fact, while visiting a really upscale mall for a photo session with my two year old granddaughter, Lucy, an employee engaged me in a conversation about the rotten economy. About five minutes into the conversation, she indicated that there are currently 150 stores in the chain for which she works, and that only five percent of them made budget last month. Portrait pictures must fall into the category of a luxury as their business is severely impacted by this economy. More directly, however, she indicated that she needed stitches removed the other day, and that, “she did it herself” rather than spend the $20 co-pay.

So, are we seeing decreases in important tests? Are we seeing patients avoiding emergency room visits? Are we seeing patients cutting their prescriptions in half? Yes, to all of these questions. Anne, however, seemed to be talking about the “big boys,” where their millions or billions in investments have recently tanked. If you are so big that your income from running the hospital is not a major source of protection, and your income from your investments is propping you up, then the problems begin to manifest themselves exponentially.

“Some hospitals are responding by digging into their investment income more deeply than usual, using it to finance capital projects, or even meet operational needs. Others are issuing bonds with the scary codicil that they’ll buy them back if finicky investors want to dump them,” states Zieger in her column.

She further goes on to explain that “both of these situations put a huge squeeze on hospitals’ long-term viability. One robs from their long-term assets to solve medium-term problems, while the other puts the hospitals at risk of being bled dry by investors who get spooked.”

Well, wouldn’t ya know? Yes, we are seeing a few challenges due to decreased electives, but not because we were living off of our investments. The other good news is that, because we froze our fixed pensions several years ago, we are seeing very little impact upon them from the huge drop in those investments as well. Unlike many of our larger peers, neither of these issues is similar. Between the drops in the market, the loss of pension funds, the decrease in electives, and the down-grading of their viability by the bond markets, their challenges look galactic in size compared to ours.

Sometimes smaller is just safer.

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A Note From Nick Jacobs

October 24th, 2008

A Note from Nick Jacobs

On October 23, it was my honor and privilege to speak at the PATIENT-CENTERED CARE CEO CONFERENCE in Chicago with some very impressive CEO’s and Leaders. My topic was “Linking a Patient-Centered Approach to Quality Improvement and HCAHPS,” but my deeper theme was “Leadership with a Heart – Developing Love and Respect in the Workplace by Nurturing Staff, Physicians, and Patients.” For those of you who were able to attend, thank you for your kind words of encouragement and support.

As was explained during my introduction, I have made the very difficult decision to leave Windber Medical Center, but I leave with a commitment to spread the word both nationally and internationally about the journey to Patient Centered Care and how to achieve it.

Obviously, it is a risky time to attempt to begin this endeavor, but, because no time is ever completely safe, it was my decision to reach out to my peers and friends to offer my commitment to work with you with that same passion to help you achieve your goals regarding this effort.

Because Sunstone Consulting is an organization that has specialized in finding additional financial support for hospitals, we can bring you not only the formula for Patient Centered Care, but also the needed additional financial support to achieve your goals in this area.

Although I will not officially complete my assignment at WMC until December 31st of this year, my current schedule permits me two days per week to begin to develop new relationships with my friends and peers. Should you have interest in contacting us for a visit to Windber, or if you would just like to make inquiry regarding engaging us for work at your facility, please feel free to either respond to this letter by E-mail or to call me at the following contact address below.

Once again, thank you for the privilege of working with you on such a significant topic.

Warmest Regards,

Nick Jacobs

Nick Jacobs FACHE - Author of Taking the Hell Out of Healthcare

Nick Jacobs

F. Nicholas Jacobs, FACHE
International Director
SunStone Consulting, LLC
1411 Grandview Avenue Apt. 803
Pittsburgh, PA 15211
nickjacobs@sunstoneconsulting.com
jacobsfn@aol.com
Mobile: 412-992-6197
Fax: 866-381-0219

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In Their Own Words: Patients, staff and physicians on their experiences at Nick’s Planetree hospital

October 5th, 2008

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