It’s 5:33 PM on New Year’s Eve.  For some reason New Year’s Eve has become a significant contributor to some landmark memories for me, memories that will always be with me.  Maybe it’s because the day represents such finality.  Starting tomorrow, for example, 2009 better be the number that you write on the forms, checks, and documents because 2008 will be gone, gone, gone. 

One vivid and unique New Year’s Eve memory occurred back in 1985.  After making payroll 24 times a year for 59 consecutive months, success or failure all boiled down to the last day of December.  Truthfully, for the first time in five years, there was not enough cash to compete the payroll.  As I was closing down the office and preparing to leave for the night, the main door of the building opened and footsteps could be heard coming through the gallery.  My mind went immediately to the dark side.  Is someone coming here to rob or kill me?  Let’s be candid, this was a rural arts center, for goodness sake on New Year’s Eve.  Who in their right mind would be coming into the gallery five minutes before closing? 

As it turned out, the footsteps were coming from a donor who was there to present me with a check.  That check came to exactly the amount of money needed to complete payroll.  My immediate response was that the universe had, once again, taken care of the problem, but later, the concept of almost not making payroll put me over the edge and sent me on a job search for something that was just a little more secure. 

For two years after my father died, pneumonia became my New Year’s Eve visitor.  My kids were two years old and five months old, and my chest cold had gotten worse and worse until finally, the doc said, “It’s pneumonia.”  So, 1975 and 1976 were my pneumonia years.  The most memorable part of those two years was that pneumonia boy got to stay at home with the kids while the rest of the world partied.

Finally, the New Year’s Eve of Y2K holds a prominent spot in my brain as well.  The team of IT specialists, finance personnel, maintenance, and administrative leaders all gathered in the conference room to ensure that the the world would not come to an end.  Some of you have read the story before, but just as the ball began to drop on Times Square, one of our computer jocks accidentally leaned up against the light switch and all of the lights went off simultaneously.  A wave of palpable fear swept through the room until one of the team members said, “Hey, the television isn’t off; we’re okay.”

Well, today was my last day of work as a hospital administrator and research institute executive, but the puropse of this New Year’s Eve blog is not to tell you about my pneumonia, about light switches going off, or even about making payroll.  It is to let you know that, in spite of the title and career change, we’re doing okay.  So, Happy New Year to all, and remember, the only bad New Year is no New Year.

For those of you who might have any interest in this topic, read on . . . for the rest of you, have a great holiday. 

With seven working days remaining until the name of this blog should be officially changed to Ask a Former Hospital President.com, I’d like to just make a short list of the areas in which I have been and will be working as the International Director for SunStone Consulting.

1.  Patient Centered Care. . . It is clear that this area of expertise will be my first and foremost focus, my passion.  How can any hospital succeed in this arena?  How do you become not only patient but also employee centered in such a significant way that your HCAHPS scores improve, your infection rates will go down, your length of stay will decrease, and the bottom line will improve significantly?  That’s the story that is burning inside me.  So far my new job has included significant keynote speeches, visits to hospitals seeking this guidance, and plenty of blogs and articles.  With organizations like Planetree, the Samueli Institute, and American Healthcare Solutions seeking to spread this word, this topic should consume a great portion of my time.

2.  Patient Advocacy. . . When the day is done, and my time is over, it is my very deep desire to have helped to change healthcare significantly, and patient advocacy is a very clear key to the success of this goal.  My book “Taking the Hell Out of Healthcare” was the first step toward telling the advocacy story. 

3.  Being Green . . . No matter what the pundits say, the world will only become a better place if we all work toward a common goal, to reduce the carbon footprint.  The investments made in this arena will result in a multi-fold financial and philosophical payback to any organization seeking to explore a green philosophy.  We have agreed to do Beta work in this area, and believe that every hospital will benefit financially from this initiative.  Pittsburgh Gateways is leading this initiative, and it is my commitment to work with them to bring to my CEO peers not only the how to but also the financial benefits that will make this work possible.

4.  Being Digital. . . As my current position comes to a close, we can openly declare that we will be completely digital before the end of the fiscal year.  One of our tasks has been to bring groups of hospitals together through fiber connections for work on tele-mental health, tele-pharmacy, and disaster recovery.  These are only three of the myriad of initiatives that fiber connectivity will permit.  Corathers Consulting will be working with me to help introduce various aspects of this somewhat complex initiative to hospitals throughout the United States.

From these four areas of expertise, dozens of additional projects, services, and opportunities will also be made available like arrows in a quiver.  We will continue to promote our knowledge regarding the use of genomics in the hospital setting.  We are also working with groups to introduce other services through our peers and partners that will help hospital CEO’s in their journey to fortify and grow their organizations.  Areas such as strategic facilities plans, construction and finance alternatives, physician strategic plans, physician office work, legal partnerships, food purveyors, insurance services, benefits management, case management, fund raising, marketing, as well as literally dozens of other growth and infrastructure opportunities will be on this menu.

SunStone is also working with me on the most important aspect of these initiatives and that is to help hospitals, practices, and senior leaders find the money to initiate every aspect of the programs needed to thrive.  Be it DRG Transfers, Workmen’s Comp initiatives, RAC preparation, and a myriad of other financial initiatives that will result in finding or reclaiming money, SunStone has that expertise to bring to these initiatives as well.   

So, as Bob Hope said so many times, “Thanks for the Memories,” and thanks to everyone who has helped me through this very emotional transition.  Please don’t forget to “Ask A Hospital President.com” after the new year begins because being busy is my goal and helping you is my passion.

After nearly a dozen years, I attended my last board meeting as President/CEO of this hospital yesterday. I believe that I have missed only one meeting in all of those years. As I retire from the day to day operational aspects of health care and move into the next chapter of my life, it seems like a good time for reflection.

Looking back at the previous twenty plus years, my heart is filled with wonderful memories and the support of many friends, and it is also filled with the challenges and hurts that are almost always a part of senior leadership. A mentor once told me that, “The wind blows hard at the top of the pole.” I’ll never forget another suggestion that came to me from one of my former bosses when I informed him that I was thinking about becoming a hospital president. He said, “If you think you want to run a hospital, make sure you go somewhere where it is the only game in town, in the county, and preferably in the region.” Well, obviously, that was one more piece of advice that went by the wayside. We landed in a place where there were four hospitals all using the same media.

Having started as a musician and band and orchestra director, I have never moved very far from my education roots. It has always been about open communications, respect, dignity, encouragement, a spirit of co-operation, and positive mental attitude for me and those around me. In many ways, being a dad and a teacher was the best practice anyone could have had for running a hospital. Even though one of my favorite sayings was “I don’t want to be anyone’s parent here,” it seemed that there were numerous situations that were similar to the same types of issues that were regularly part of any family’s interactions.

Health care, however, is changing rather dramatically. As our economy and the Boomers both begin to shake, health care has to seek its own level. Will it be directed more toward wellness and prevention? Will it be rationed? (Rationing, of course, would indicated that everyone would get some of what is being offered. You know, similar to sugar rationing in World War II. They just wouldn’t get as much. The reality of our current system is that some get everything and others get NOTHING. Consequently, rationing may not be a great description of this process.)

My new charge is to help hospitals find their niche’, to help them find money and most importantly to find stability by becoming patient centered. We will be attempting to provide hospitals with the knowledge gained from over twenty years of experimentation into areas that had not been popular before we explored them. We will be helping hospitals to become patient-centered, digital, and green to name a few.

Some day, all of this will make sense to those of you who doubt. It was interesting when my career path went from teaching, to arts management, to tourism, to health care. The skeptics deeply questioned the transitions, but it all made sense. As I went from one discipline to the next, it all merged together in a meaningful way in health care management.

Now, we are launching into one more area of expertise, but this time, we have 40 years of experience, and deep knowledge regarding not only life, but marketing, communications, Web 2.0, patient centered care, construction, carbon credits, ambiance, Planetree, Optimal Healing Environments, employee centered care, recruitment, data mining, proteomic and genomic research, wellness centers, hospice, behaviorial modification, food services, fund raising, integrative medicine, and digital radiology equipment. So, if anyone needs a motivational speaker, some advice on OC48 lines, 3TMRI breast coils, micro turbines, public relations campaigns, or anything from the list above, remember me. My web address contact information will be nickjacobs@sunstoneconsulting.com.