Posts Tagged ‘Consulting’

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

October 25th, 2011

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

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

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

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

Dean Ornish at PopTech, Camden, Maine (2009)

 

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

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

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

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

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

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

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

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

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

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

Share

ACO’s or SSP’s: “Change or Die”

September 6th, 2011

Walk the Walk” author Alan Deutschman’s previous book kind of said it all in the title, “Change or Die.” In that book, Alan carefully lays out the statistical survivability matrix, and poses the question:

Alan Deutschman - Author of Change or Die and Walk the Walk - Nick Jacobs, HACHE - Healing Hospitals

Alan Deutschman

“What if you were given that choice? For real. What if it weren’t just the hyperbolic rhetoric that conflates corporate performance with life and death?…What if a well-informed, trusted authority figure said you had to make difficult and enduring changes in the way you think and act? If you didn’t, your time would end soon — a lot sooner than it had to. Could you change when change really mattered? When it mattered most? “

Then, he articulates the actual outcomes of studies. Talk about “tough love.”

“…The odds? You want the odds? Here are the odds that the experts are laying down, their scientifically studied odds: nine to one. That’s nine to one against you. How do you like those odds?”

So, as a nation, as healthcare leaders, as human beings in a country that is currently facing the realities of potential economic disintegration, we are faced with what can only be described as another enormous challenge: a financially unsustainable healthcare system. Regardless of your politics, regardless of your personal beliefs regarding the competency of the federal government and its ability or inability to fix anything, the law has been passed, the train is moving and it’s moving directly toward you and your hospital.

Over the past three years, we have repeatedly presented money-saving and money-making ideas to help begin to position your healthcare organization for the impending tsunami of change that has been launched. As a veteran of TQM, Six Sigma, Baldridge, and a half dozen other consultant-delivered “fixes,” I’m sure I can hear the words going round and round in your head, but, not unlike the clamor that arose from the HMO/PPO days of yesteryear, this ACO/SSP challenge has to be met and dealt with intelligently, and it has to be done in such a way as to not destroy your hospital or health system.

Let’s face it, we’re all pretty smart folks. We’ve all been in permanent white water for years, and the last thing that many of us want to take on is the ole captain of the ship without a rudder, during a hurricane while the lighthouses are being moved around on the shore.  But, once again, it’s here. It’s upon us, and we must deal with this challenge in an intelligent manner.

One possible alternative for smaller organizations is the SSP, a Shared Savings Program, the alternative put forth by CMS, the Center for Medicare and Medicaid Services, to a full-blown ACO, an Accountable Care Organization. Either way, however, SSP or ACO, the primary, overarching goal is to try to improve quality, decrease costs, and provide patient-centered care in a meaningful way. Not unlike the old HMO/PPO days, the effort requires infrastructure (and plenty of it…the average participant in the demonstrations spent about $1.7M on this one, single aspect of managing the healthcare new world order.)

What do you need? Well, you need 5,000 patients, to start. Then:

  1. Decide if you will use Medicare only or other patient groups.
  2. Determine the exact service area that you will target.  How many square miles?
  3. Decide which reimbursement model will work for your organization, i.e., an SSP that is more risk-based, or capitated.
  4. Figure out which provider groups will be involved.
  5. Examine IT reporting capabilities and process improvement methodologies.
  6. Identify patient-related strategies such as enhanced experience for the patients or faster throughput as well as reduction in errors.
  7. Then, dig deep into the organizational strategies for improvement.

Infographic: Medicare Margins - Nick Jacobs, FACHE - SunStone ConsultingLet’s face it. From 2001 until 2008, total Medicare inpatient margins for acute care hospitals have decreased every single year.  (Source: Journal of Healthcare Management)   Reimbursements have decreased while your bad debt has increased.  So, regardless of your tolerance for risk or change, cost control simply must become the culture of every healthcare organization in the United States. We have seen the variances in costs based on geography in this country and treble charges in one area as opposed to another will not go on into the future. Joel Allison, CEO of Baylor Health has stated that this movement is “All about…focusing on wellness, on prevention.” (Arnst, 2010)

We need our primary care docs, we need physician participation to a far greater degree than we currently have, and, at the same time, the physicians must be partners in the effort.  Employing physicians is also a critical element.

SunStone Management Resources can assist you in this effort on numerous levels, but the time to act is now!

Share

Barcelona, VAT and Ambiance

August 18th, 2011

Last weekend, I traveled to Barcelona. How does one afford to spend a weekend in Barcelona in this economy with the dollar at $1.40 to one Euro, one might ask?  Points, my friends, points. When you travel enough, it’s possible to build up quite a few of these delightfully-useful but quickly-diminishing-in-value “perks,” and that’s how I got there.

Because it’s “Vacation time in Europe,” numerous hotels, restaurants, and tourist attractions offer nice packages for a reasonable number of points, and because I’d never been to Barcelona or anywhere in Spain for that matter, it seemed like a good plan. Albeit brief, my 4 day journey into yet another culture was almost worth the pain of traveling. Of course, if you remember my Serbia, Nigeria, Bosnia, Netherlands and Italy blog posts, you know that I’m all about “experiences.”

Barcelona - juice seller - Flickr Photo

Barcelona: juice seller at the Mercat de la Bouqueria - Flickr photo credit: Halvorson Photo

The longer I live, the more interested I am in how other people live. Many years ago, probably 20 or so, we had an exchange student, Monica, from Barcelona who used to stand in my family room, look out the window into the rolling fields and proclaim, “Nick, Nick, I am sooo bored.”  Truthfully, I was, too.

So, why Barcelona, VAT and the “A” word? I fell in love with the city. I loved the ambiance, the food, the wines, the architecture, and the people. Maybe it was the fact that there are two million souls living there, and I never felt uneasy even once. Unlike my last trip to Chicago, where I couldn’t sleep all night because of the continuing chorus of sirens from emergency vehicles, Barcelona’s street in front of our hotel erupted in the wail of those distinctive, European sirens only
about four times, from Friday until the following Monday.

Interior of La Sagrada Familia basilicaSome of the little things that captured my attention included the walk/don’t walk sign on the streets that actually allowed you enough time to cross at your leisure without being hit by an oncoming car. The people and cab drivers were polite and, most importantly, there was a feeling of helpfulness and respect in the shops, restaurants and architectural wonders.

Of course, by Sunday evening, we had visited nearly every architectural work of Antoni Gaudí, and toured and listened to a great concert at the inspiring Palau Música Catalana. Barcelona is today one of the world’s leading tourist, economic and cultural and sports centres, and this all contributes to its status as one of the world’s leading cities.

But what about the rest of the title of this blog post? Every time we purchased something material there, the VAT tax was applied, and when I asked someone to explain it, the answer was simple, “It’s how we pay for healthcare.” Consequently, when we walked the streets over that entire weekend, we saw a total of five beggars, and three of them had a Starbucks Cup to catch the falling Euros.

The other things that we saw everywhere were dumpster-style recycling binsBarcelona: color-coded recyclying bins. And not just any bins, either. Very fancy, clean, able-to-be-picked-up-mechanically bins, that were specifically color coded for every imaginable kind of recyclables. Not rocket science, but a comment on community pride, sustainability or climate change, perhaps.

So, we’ve taken care of the creation of a pleasant ambiance on numerous levels with extraordinary architecture, beautiful tree-lined streets, recycling, healthcare, low crime and compassion for fellow human beings. We didn’t see many Mercedes, but we also didn’t see much evidence of poverty, either. The beaches in town were public, and not controlled by exclusive beachfront hotels. Barcelona’s public transportation was a pleasure — clean, comfortable and efficient, with a train to Paris that delivers you there in about three hours…and the Tapas, wine and customer service were all simply amazing.

Nationally, Spain’s unemployment rate hit 21.3%, and they are listed as one of the PIIGS:  Portugal, Ireland, Italy, Greece and Spain…i.e., economically-unsound EU countries. In spite of these huge challenges,  Barcelona was a great city, a great experience, and a great setting with world class arts. So, should we charter an Airbus 380, load up our U.S. Congress, and fly them to Barcelona?

Nah, it wouldn’t help.

Hmm. Maybe we should fly them to Somalia?

Share

People and Ponies

June 26th, 2011

I’ve been periodically volunteering my weekend time to help establish an equestrian healing center where the horses help to heal the people. Although I’m not particularly connected to horses, I appreciate them and like to watch them run freely through the fields. It’s the people in this particular volunteer leadership group, however, who “make me tick.”

Over the last twenty or more years, I’ve had several opportunities to meet healers. Now, don’t get all “New Age-y” here and run out of the room screaming. These people are “pure of spirit,” and have no ulterior motives, except to help other people navigate through this sometimes relentlessly unforgiving maze that we call life. There are two doctors, an RN, two equestrian specialists and a couple of administrative types like me who simply believe that mankind is somewhat intellectually challenged, and not always capable of grasping anything that is not black and white or concrete and factual.

Surely, with all of the things that we purport to believe in religiously, it seems incomprehensible to me that we, as a group, have problems giving it up to the fact that our brains, our spirits and our hearts don’t or can’t play a larger role than that assigned to us by our Primary Care Physicians or our big Pharma companies. For the most part, we believe in an after-life, we believe in miracles, we believe in goodness, but we have problems understanding how an Autistic kid on a loving, nurturing horse can be helped. It’s because there have not been enough control groups, double blind studies or scientific documentations to support the theory, and typically those scientific theories are only scientific law until they are proven wrong, and that has happened plenty of times.

The freedom of having been a nonmedical, nonclinical, nonscientific healthcare CEO was that “I really didn’t care what made people get better; just so they got better.” Consequently, if a golden retriever licking your hand or a clown bopping you with a sponge hammer, a violinist, a massage therapist, an acupuncturist, a flower essence or aroma therapy specialist, a reiki master or a visit from your grandchild helped you, it was all good to me. Pick your passion and start to heal.

The only real way to describe this philosophy was “Open” because that’s what it was and is. One of the amazing aspects of the collection of healers that have gathered to lay the groundwork to make this amazing dream operational is that they also believe that there is much more to healing than a pill or seven pills, and they are more than willing to be open to the spirit of healing.

Of course, one of the problems with this type of work is that you have to “let go” to allow things to happen, and if you are too into the discipline of concrete and only proven science, you will not let enough of your guard down to see what can happen. The problem is that we’ve all heard about the quacks who almost religiously rip off naïve people with magic elixirs or spiritual interventions like Whoopi Goldberg called forth in the beginning of the movie “Ghosts,” but our collection of healers is filled with people who are sincere, well-trained, highly-credentialed and, believe it or not, open to understanding what may otherwise be ignored by the scientists or the traditional establishment.

So, on we roll in search of others who believe that there may be ways to help people that have not been used for several decades or centuries where the brain leads itself into healing or where the switch that turned the gene on inappropriately can be coerced into reversing that physically destructive non-decision. Life is a journey, and when I look back at all of the people who were helped because of things that sometimes make no sense to anyone else, my only response is “Yeah, that’s right.” It can happen, and with the help of other believers it will happen.

Share

Treating People With Dignity

June 9th, 2011

As part of my continuing series of anti-bullying blog posts, this week’s post was inspired by a WDUQ/NPR interview of the authors of a book entitled: Unleashing the Power of Unconditional Respect: Transforming Law Enforcement and Police Training. It was written by Jack Colwell, a police veteran and trainer, and Chip Huth, who heads a SWAT team for the Kansas City, Missouri Police Department. The interview was inspired by the Pittsburgh police beating of CAPA (Creative and Performing Arts) student Jordan Miles, a who hadn’t done anything wrong. The interviewer stated that this beating, and the subsequent ruling regarding its legality, has seriously eroded the support of law-abiding citizens in the African American community and beyond toward the Pittsburgh Police.

CAPA student Jordan Miles and his mother, Terez

CAPA student Jordan Miles and his mother, Terez | Photo credit: Justin Merriman, Pittsburgh Tribune-Review

Why, in a healthcare blog, would I select this topic? It is my firm belief that treating people with respect and dignity, regardless of the situation, leads to a more harmonious environment. Chip Huth, one of the two authors interviewed by WDUQ,  commented that the he believes that the Kansas City police force’s policy of holding meetings that allow community members to express their points of view and to feel understood may open them up to understanding the police point of view. He went on to say that “after a SWAT raid…when the situation is secure, his teams sit down with the suspects and explain the terms of the search warrant, answer questions, advise of rights, etc.” Convicted felons heading off to jail have told him how much they respect the way his team treated their families.

So, read between the lines. It’s not any different from healthcare work when it comes to “Treating People With Respect and Dignity.” It is what it is, and that care and treatment must transcend all races, colors and creeds. More importantly, it crosses all professions. By analogy, think of us as the SWAT (caregiving) team. We break into your life and scare you. It’s a well known fact that those individuals who are most often sued in healthcare are those with the weakest interpersonal skills  and worst “bedside manner.” They are often mean, curt or simply uncaring in their attitude and responses. Or else they make sure that they just don’t communicate at all with the family or patient.

Not so many years ago, I was taken to task by a group of physicians who were upset because I had written an article about those docs “who make rounds before the families are present and the patient is awake.” The good docs were indignant — and in some cases rightfully so — because they were communicators, but the “bullies” that I targeted, who were not patient centered, came at me from all directions: letters, phone calls, and attempts to have me censured by my hospital’s board. It really reminded me of the often-paraphrased Shakespearean line, “methinks he doth  protest too much.” If they were truly “caregivers,” and not technical health scientists, they would want to communicate with the patients and their families, to answer their questions, to help them understand what is happening (or about to happen) to them, and they would be sensitive so as to ensure that the fears being expressed by those involved were ameliorated about as well as could be expected under the circumstances.

If the SWAT team can kick in your door, throw in flash grenades, tie your hands behind your back, and arrest you, but take the time to heat the baby’s milk and explain to everyone involved what exactly is going on and what to expect, there will be a marked difference in response from those who are being impacted by their work. A hospital does not attain 98 or 99% patient satisfaction scores by ignoring patients and their families, treating the employees and administrators like they are minions and ignoring the kindness and respect that should be part of their jobs.

Respect - Nick Jacobs, FACHE - healthcare - anti-bullying - Healing Hospitals

Okay, I’m done. Like Aretha Franklin sang, “R-E-S-P-E-C-T / Find out what it means to me.” Look up the Jordan Miles story online, or better still, buy the Unleashing the Power of Unconditional Respect book and see what can happen when you treat people with dignity.

Share

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.

Share

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.

You read it here first!

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!”

Share

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.

Share

Wikileaks and Transparency

December 9th, 2010

LONDON (Dec. 8th) —Held without bail in Wandsworth prison, Julian Assange has been deprived of his trusty laptop, so the WikiLeaks founder can’t supply an inside scoop on life behind bars. But if the pro-transparency campaigner could leak just one word about conditions in Britain’s biggest jail, he would probably settle for “cramped.”   (via AOL NEWS)

Wikileaks' Julian Assange at TED - Nick Jacobs, FACHE

At my last CEO position, there were about 650 employees on the hospital side and another 50 at the research institute, but in the position that I held as the Chief Communications officer immediately before that,  there were over 4,500 employees.  Any one of those employees could  potentially have become PFC Bradley Manning.  Manning is the young man being accused of leaking millions of pieces of information to Assange’s Wikileaks. Every disgruntled, well-intentioned and sometimes naive employee who either had an “axe to grind” or who simply embraced a philosophy of openness would have potentially presented a major problem to any organization that was built around secrecy at all costs.

In my 20+ years as a hospital administrator, there were hundreds no, thousands of incidents that could have been “leaked” to family, friends and the media regarding incidents that may or may not have been problematic.  My memory goes immediately to an online discussion forum where the death of Congressman John P. Murtha was being dissected by a group of Bethesda Residents;  specifically, young U.S. Navy physicians who were venting and expressing their fears regarding their “being held responsible for the death of this powerful Congressman.”  The amazing thing to me was the it was a running dialogue that was, yes, online. The discussion topic thread was etitled Did we kill Congressman Murtha? The anonymous user names went through case-by-case analysis of other undeserving patients who did not emerge with their lives from surgeries at the hospital over the previous weeks and months.  These were individuals who, according to their estimations, should have. Imagine my shock when I came upon the casual page which, at minimum represented a potential HIPAA violation.

Well, it’s all about transparency, my friends, and this movement is only the beginning.  Unlike Kevorkian’s efforts which were almost single-handed, this is a movement, a viral, well-funded, philosophical movement that feels like “Damn the torpedoes, full speed ahead.” And it’s “coming to a theater near you.”   Not unlike the content of the sensitive documents that have been appearing online recently where peoples’ lives are at stake,  hospitals and physician offices face many of the same realities every day.  How many people, like PFC Manning, may not be truly insane or wish to destroy the government, but simply believe that their assistance in exposing the truth will “set us free?

Transparent Butterfly - Nick Jacobs, FACHE - Healing HospitalsAs business leaders not many decades ago, we were urged to treat every e-mail and every comment as if it was being reported by Mike Wallace on 60 Minutes.  Of course, not many of us did, nor could we stick to that difficult rule of communicating, but think of the potential ramifications if Mr. Wallace had been as potentially ever-present as Mr. Assange.

What is my formula for success?  It’s always been the same.  Be as transparent as you can possibly be. Seems simple, but try it sometime. Don’t break the law. Don’t give out information that is inappropriate as in personally destructive regarding individuals, but be as open about your operation as you can possibly be.  Encourage an environment of openness when it comes to issues, mistakes, etc. and the frustration levels will go down, down, down…sometimes to the point of having employees telling you, “I wish I didn’t know so much.  Life was easier when I was in the dark.”  That’s when you’ll know you are beginning to provide a truly transparent business environment.

Share

Is Saint Vincent’s Just the Beginning?

November 9th, 2010

In an article in New York magazine by Mark Levine entitled, “St. Vincent’s Is the Lehman Brothers of Hospitals,” we are taken on an extremely in-depth and comprehensive review of the sickness and death of one of New York City’s oldest hospitals. It is not my intent to re-create or completely paraphrase this incredible article, but only to select a few of the most poignant facts that literally jumped off the pages and painted a reality for me that was not restricted to the hospitals of New York City.

Photo Credit: Associated Press via WSJ.com

A worker removes signage from now-closed St. Vincent's Hospital.



Mr. Levine’s research revealed that “In 2008, local hospitals spent $3 billion more delivering care than they took in.” He also found that New York hospitals carried twice as much debt in relation to net assets as hospitals around the country, and that, — this is no surprise, as various New York City hospitals close, “the health of low-income and minority residents will be most affected.”

In this commentary, he listed a myriad reasons why these facts represent reality. Included is the $600 per square foot construction costs, outrageous malpractice premiums that are double the national average, 15% higher staffing levels than in other areas, CEO salaries that in some cases have reached nearly $10M per year, daunting demographic challenges, a lack of private physicians living in most communities, lengths of stay that, once again, are at least a day longer than other U.S. hospitals, the 1.4 million New Yorkers who have no health insurance, decreasing Medicaid rates, and a private insurance network that makes considerably more on its New York hospitals than is the case in other geographic areas.

Interestingly enough, as we forged our way through this comprehensive history of how the City system has devolved over the past thirty or so years, we were taken on a journey that is not unfamiliar to many of us in hospital administration. As government swung from socialized (as Mr. Levine states…with a small “s”) medicine to shock-therapy free market, to increased costs in competition, physician recruitment, technology build-up (a build-up that he referred appropriately to as the “medical arms race“), and more movement toward outpatient care, it is very clear that New York City’s hospitals crisis is just one view of a dysfunctional healthcare system that is clearly on a path that could eventually lead to collapse for not only the system, but also for the economy of the country as well.

New York City’s hospitals crisis is just one view of a dysfunctional healthcare system that is clearly on a path that could eventually lead to collapse for not only the system, but also for the economy of the country as well.

This paragraph is one of the most telling paragraphs in the article, “The way forward seems perfectly, if brutally, clear. With private insurers under pressure to cover more patients yet not hike premiums, with federal and state governments facing record deficits, and in a local industry climate with free-market survivalism, many New York (substitute U.S.) hospitals won’t be able to generate sufficient revenue to restore themselves to financial health.”

Image Credit: gothamgazette.com - Nick Jacobs, FACHE - HealingHospitals.com

Interestingly enough, the conclusions reached regarding survival embrace numerous ways of doing business that were not entirely foreign to many hospitals. Included were such concepts as: moving more toward outpatient care in less expensive locations, more follow-up care to keep patients from returning, reduction of unnecessary testing, employment of and profit sharing with physicians, and additional methods of dealing with “the tyranny of insurance companies.

Steps such as measuring nursing hours, housekeepers per square foot, food service people per meals delivered, and embracing the entire model of industrial efficiency were all suggested contributors to the bottom line.

Mr. Levine also granted partial sainthood to a profoundly bullying management style of one CEO who cut services that didn’t make profits, eliminated catering to the poor and “told doctors where to go.”

All of this plays perfectly into the story that I had lived and am currently telling across these United States and beyond; that dignity, prevention and wellness, attention to human and humane detail, the removal of autocratic leadership, and patient and employee-centered care — all enveloped in a spirit of entrepreneurship — can prevail.

That integrative and holistic medicine practices will contribute to taking us out of the current crisis and into a health care delivery system that will be the design for this century and beyond. Of course, we need malpractice reform; we need more control over big pharma and most importantly, we need to provide some type of safety net for those without coverage, but the path to survival is not simply one of a “business model.” It is a path to a humane model, a creative model that embraces people, embraces wellness, embraces humanness in creative, meaningful ways.

Perhaps hospitals are not being killed, but rather are committing slow suicide by following their “Calf Paths” from the past.

Share