Posts Tagged ‘Consulting’

Newer Entries »

On The Road Again

November 2nd, 2010

I’ve been living in hotels and airports lately speaking at and visiting Planetree hospitals in places like Colorado, Alaska and Iowa.  I’ve had some really fascinating and also some creepy experiences. For example, a few weeks ago, I was eaten by bed bugs in Denver. My legs looked like they were Thanksgiving dinner for someone. I was so freaked out from that experience that I threw away my suitcases and kept my clothes in the dryer until they could fit my granddaughter’s Ken doll.  I’m happy to report, however, that I’m bedbug free now. The down side? I really haven’t had a good night’s sleep in any hotel bed since then.

1919 Classic American Root Beer - Nick Jacobs - Healing Hospitals blogWhat else have I observed?  Last week, while traveling in Iowa, I learned about a drink called 1919.  I thought that it was a stronger version of a 7 & 7, but it turned out that it was root beer —Classic American Draft Root Beer.   Also, for the first time in years, I noticed that every table in almost every restaurant had Thousand Island salad dressing. Everyone seemed to like waffle fries, too; these are French fries that are cut to look like little waffles. By the end of the week, I was saying things like, “I’d like a salad with Thousand Island dressing, a plate of waffle fries, and a 1919.” (Sorry, Dr. Ornish. )

This hospital in Waverly, Iowa was incredible.  It was beautiful, warm, and filled with really friendly, competent employees.  Iowans also claim the honor of being the fourth windiest state in the union, but I think that notoriety only came after my speech.  They can claim Johnny Carson, Buffalo Bill Cody, Herbert Hoover, Ann Landers and John Wayne as theirs, too.  The very most interesting find?  The Quaker Oats factory is in Cedar Rapids.

The week before, while making a speech at Central Peninsula Hospital in Alaska, I noticed that everyone’s eyes had left both my presentation and me and were focusing on the scene that was taking place outside of the panoramic window behind me.   Imagine, gorgeous, snow capped mountains with glaciers tucked in between them feeding a glacier lake.   One of the employees explained to me that a seal had emerged with a halibut the size of a Volkswagen hood in its mouth while several bald eagles swooped down at the seal and grabbed bites of the halibut right out of its mouth.  It was like the Disney movie, “Seal Island,” or maybe it was like “The Muppets Kitchen?”  Anyway, it was fairly amazing to watch, and I was glad I was NOT the seal, but even more delighted that I was not the halibut.

Photo credit: http://www.alaska-bear-viewing.net

Photo credit: http://www.alaska-bear-viewing.net

After the meeting was over, two of the administrators in attendance were taking a small fishing boat to some island nearby, and then, were going hiking into the woods where they planned to go deer hunting among the bears. Read that line again; they were going deer hunting with the bears, the very big, grizzly bears.  The up side of that trip is that the deer there are very BIG. The down side is that the bears are bigger.  These guys explained to me that a lot of time, the bears decide to try to eat both the harvested deer and the non-harvested deer hunters.  It’s at times like that when being able to run faster than your hunting partner is probably important.

Where to next?  Pittsburgh for a panel for the American College of Healthcare Executives at Station Square, then a panel for the American Board of Integrative Holistic Medicine in San Diego, and finally, Fort Myers, Florida for work on a bio-tech center.

I’ve decided to carry a very large flashlight and a very small bottle of bourbon, with some sand.  I’m thinking that the bed bugs will get drunk and try to stone each other to death.

Share

9 comments »

Posted in Healthcare, Hospitals, Leadership

Tags:

$500 Billion From Where?

October 26th, 2010

In a recent conversation with a long time healthcare CEO, he made the following observation:

“There are about 2,750 pages to Obamacare.  I have no idea what the implications are of the first 2,700 pages, but I do know that at least 50 pages allude to the fact that $500B will be cut from hospital reimbursements in order to support the new legislation, and it’s also clear that these monies will be cut based upon quality.  Pay-for-performance will be the new catch phrase of the reimbursement world, and our peers are not ready for this stark reality.”

How does one move from a non-transparent system to one that allows anyone to log onto healthcare websites and search every detail relating to the success rates, scores, and capabilities of any given institution?  One very obvious “missing element” in hospital-related problems is the lack of dedication to getting to the “root cause” of most issues.  We are great at work arounds, but rarely take the time, energy, and have the cultural commitment to dig deeply enough to literally stop the root cause of the problem.  Is that why there are a reported 98,000 people killed by our facilities, and about an equal number injured each year?


Several organizations have attempted to take on these issues, but few have gone beyond scratching the surface of the real problems.  As bundled payments become the norm, a commitment to getting the highest available reimbursement for procedures will take on a new meaning.  Imagine a great doctor in an under-performing medical center where his or her work is not rewarded equally to a peer in a stronger hospital, because that bundled reimbursement was lowered due to institutional medical imperfections. Charles Kenney in  The Best Practice, and Steven Spear in The High-Velocity Edge have both addressed some of the nuances of this new culture, this new world order, but for hospital administrators, physicians, and staff to “get their arms around it,”  there will need to be transformational shifts in the fundamental culture of the organization.

Leadership will be forced to accept personal responsibility for virtually everything that occurs in an organization.  Employees will need to be empowered to embrace shared values, and key targets such as patient and employee safety will need to be identified so that goals can be set that stop nothing short of a level of complete PERFECTION.

The healthcare establishment will also need to embrace transparency within their organizations, and that information must be shared with everyone.  Most importantly, it must include the human element.  What is the human impact of each and every error or mistake?  This point alone will represent a major cultural shift in the way we do business.

Truman's phrase "The Buck Stops Here" - F. Nicholas Jacobs, FACHE

Employees, physicians, and administrators will need to actually be taught to see risk, and be provided with data upon which actions may be taken.  Most importantly, however, problem solving must be encouraged and supported at every level of the organization.

How is this all possible?  I was recently on a speaking tour to several hospitals, and the bottom line at these facilities was that their leadership was “new age.”  They had worked diligently to decrease the hierarchy and to reduce and reorganize the roles of those in operations in order to support the fastest possible improvements.

The tsunami is coming, however slowly it may appear to be; it is approaching our healthcare shores, and quality – no, perfection, is the only means left for achieving success or, in many cases, is the only way to survive.  We must discipline ourselves to see problems and not simply try to work around them.  We must establish a problem solving culture.  We must set our goals and empower all of the players to do what is needed to solve these problems once and forever.  Harry Truman’s phrase, “The Buck Stops Here,” should become every CEO’s mantra, and the journey will finally begin, the journey to solve the myriad repeating problems in our current system.

Nick Jacobs, FACHE - HealingHospitals.com

Share

9 comments »

Posted in Healthcare, Hospitals, medical errors

Tags:

The Health Care Reality

May 15th, 2009

1979 was the year in Johnstown, Pennsylvania when I decided that it was time to leave teaching and transition into business.  For those of you who don’t remember that year, it was the beginning of some serious financial challenges for our country, but it was also two years after the Johnstown Flood of ’77, and there was an unemployment rate of 19.5% in Cambria County, PA.

1979 Rolling Stone cover Blues Brothers SNL Dan Ackroyd John BelushiIn 1980, when I accepted a job with a then bankrupt nonprofit organization in Somerset, PA, what had been a booming coal industry went into the skids. My house mortgage was about the same as the unemployment rate, 19%.  The job that I took was in the arts and Ronald Reagan was interested in cutting funding to the National Endowment for the Arts.

In 1985, my new job was with a tourism agency, and that was the year that then-PA Governor Casey cut funding to tourism.

In 1988, when I entered healthcare, it was clear that Johnstown could no longer support four hospitals, and the next decade and a half resulted in the closing of two (and almost three) of the four hospitals in that area.

Turn the clock forward to last October, when I announced my decision to become a healthcare consultant.  The stock market crashed, eight of every ten hospitals stopped, postponed, or scaled back needed capital projects, 58% of hospitals are now reporting  increases in uninsured patients using the emergency departments, 48% of hospitals have cut staff, and 80% have reported cutting expenses that include consultants.

As a consultant, the first thing I would tell anyone is that “No matter how bad things appear to be, you can do it.”

  • Our successes as a teacher continue to remain evident as former students ranging in age from 38 to 58 continue to remind me of great memories of our time together.
  • The arts organization became the largest and most successful rural arts organization east of the Mississippi.
  • The Convention Bureau went from almost closed to the fifth largest agency in the State, and most of you have tracked the successes that we experienced at Windber.

Not unlike the little engine that could, we focused on the positive, forgot about the negative, and never dealt with “Mr. In-between.”

roosevelt_action400

There are those who approach life cautiously, carefully, and very conservatively, and then there are those of us who drink from that same cup in big gulps and dream about how things could be rather than how they are.  There are those who are afraid of failure, and those of us who embrace failure because we know that it is getting us closer to more dramatic successes.

The only boundaries that we have are between our ears.

Because the future is a design function. Let me close this blog post with the ending from my commencement address to the graduate students of St. Francis University (with the help once again of Dr. Leland Kaiser):

  • Nothing has to be the way it is.
  • We can invent (or prevent) our future, because all limitations are self imposed.
  • We can empower ourselves to create a new world.
  • Reframe any limitations to become opportunities because…
  • Tremendous limitations breed success. They open doors.

So, as we design our future, remember that we should not work to create what people will like, but instead work to create what people will love!

…and we will know success beyond our wildest dreams.

Share

7 comments »

Posted in Healthcare, Hospital Administration, Leadership, Public Policy

Tags:

Healing and the Mind Revisited

April 8th, 2009

I’m working in Chicago right now, feeling a little overwhelmed by a phone call that I had from one of my very dearest friends about his impending future, about my son-in-law in Baghdad and his family who are living without him at home, and also about the challenges that we individually and collectively face both nationally and internationally during this time of economic crisis and overall unrest. During the midst of my thoughtful contemplation, I received an E-mail from a very dear friend, Savery, with a link to open. I was so moved by it that I decided to post the link on Facebook.

Almost immediately after it went out, my friend, Dr. Dean Ornish, sent me this follow up link from Bill Moyer’s show. For those of you who don’t know this about me, the Bill Moyers series, “Healing and the Mind” was my inspiration for the Planetree Philosophy that we implemented at Windber all those years ago. For some reason, he and I keep intersecting, and here we are again.

So, thanks, Savery, Dean, and Bill, but most of all, thanks to the amazing man who created this wonderful experience that you are all about to have.

Share

4 comments »

Posted in Healthcare, Leadership, Music, patient-centered care

Tags:

NickJacobs.org???

April 2nd, 2009

Let me open this blog with a little housekeeping chore. Because I’ve retired from being a hospital president (Yes, they replaced me with two great people, count ’em, two.) , I’d like to change the name of this thing. It’s not that I’ve established a P-Diddy-type Twitter following where 100,000 human beings are waiting with baited breath to see what my next move will be, it just doesn’t seem right to keep calling myself a hospital president. We know who reads this thing, and we are grateful to our loyal, talented, and brilliant followers. We also know that we can link the old blog names to get you here. So, regardless of what you typed, or what gets Googled, our genius social media maven & webmaster, Michael Russell, can help to bring you home to this site.

Okay, so as a transformational advisor, a broker of sorts, most people with whom we have consulted have described me as a person who can fix things that are broken before they actually break. Maybe we should call it the “Break it if it’s not already fixed” blog. I’d love it if it was a name that would generate millions of hits and companies would fight to advertise on it.

My first thought was to use nickjacobs in the title because there is a Nick Jacobs on Facebook who teaches Aboriginal people in Australia, and he seems popular. There is another Nick Jacobs who is a professional organist, and one who is an athlete. There’s a Nick Jacobs who is a consultant and another a paramedic in London, one who had a blog who is a yachtsman, there’s my son, the commercial real estate broker, and finally, there’s a Nick Jacobs who does pornographic movies who is not my son. Actually, that Nick Jacobs’ followers would probably be the most disappointed by this blog.

Since the .com version of nick jacobs was already taken by some guy in England, we captured nickjacobs.org, and that will work for right now.

If you have any ideas, however, that you think would really rock the blogspere, let us know and we’ll check with our domain registrar to see if it is available. In fact, if you are the winner of a Name Nick’s Blog Contest, I’d be happy to consult for free BY PHONE for at least one hour of brainstorming with you about the topic of your choice: music, healthcare, proteomics, teaching, PR/Marketing, the travel business, or even physician recruitment.

Remember, Hospital Impact is already taken, and, because my last three consulting jobs have been with a newspaper, a nonprofit arts oragnization, and a chain of hotels, we don’t want to think too restrictively. Gotta earn a little money, too.

When we ran the breast center, we found that the website got more hits than anyone could imagine. The problem was that the readers were mostly thirteen-year-old boys who probably weren’t too interested in running a hospital. After Miss America had visited us, the hits went up exponentially when those two searches were combined. Somehow, I don’t think that Nick Jacobs’ Breast Center for Miss America would probably get me the type of following I’m currently hoping to attract. On the other hand?

A very good friend recently asked me to write a brief bio about what my new life is like, and it struck me that it is very much like my old life but without any restrictions. This is what I wrote:

While teaching junior high school instrumental music in the early 1970’s, Nick Jacobs made an extraordinary discovery. He learned that, by empowering his students and surrounding them with positive influences, he no longer was providing a service or even an experience for them.

What this entirely unique teaching style resulted in was a method for helping to transform students. By providing with both passion and commitment the tools needed by them to undertake their journey, his involvement with the students became a means of dramatically helping them to make whatever positive life changes they were seeking.

It was during that early period in his career that he also discovered that this formula could work to positively change lives in almost any aspect of living as he ran an arts organization, a convention bureau, and finally a hospital and research institute.

Since that time he has dedicated his personal work to helping others make their lives better, and that is exactly what he is doing in his position as an international executive consultant with SunStone Consulting, LLC.

Maybe that will give you something to chew on? Okay, something on which to chew.

SunStone Consulting. With more than 20 years experience in executive hospital leadership, Nick has an acknowledged reputation for innovation and patient-centered care approaches to health and healing.

Share

91 comments »

Posted in Boomers, Breast Care, Communication, Current Affairs, Development, Healthcare, Healthcare Marketing, Hospital, Hospital Administration, Hospital Blog, Hospitals, Integrative Health, Leadership, marketing, Medicare, Medicine, Music, Music Education, Nutrition, patient-centered care, Public Relations, Uncategorized, Wellness

Tags:

The Marketing Enigma

February 15th, 2009

As the economy continues to present its myriad of challenges nationwide, hospital executives are embracing a variety of cost-cutting measures at a very high rate of implementation. Delays or discontinuation of capital projects, employee layoffs, and a variety of other broad-based measures are currently dominating the healthcare environment.

Departments without direct patient contact are usually perceived to be the easier layers to peel in these expense reduction activities. Areas such as marketing, community, and public relations often become prime targets as they are significantly scaled back or even disbanded.

Historically, hospitals have implemented fluctuating sequences from one extreme to another as they have decreased and increased marketing department sizes and budgets through the various economic cycles. Unmistakably, in challenging economic times, marketing is nearly always more important than ever. Without knowledge concerning the various services available, the patients will not be aware of the nuances of each and how they could impact their health and wellness.

Having said this, however, many hospital executives are not experts in this area, and consequently, they simply move in lockstep with those individuals who see these programs as non-patient expense centers that merely drain the organization of its valuable resources even further.

BusinessDictionary.com aptly describes marketing as the management process through which goods and services move from concept to customer. As a philosophy, it is based on thinking about the business in terms of the customer, or in healthcare, patient needs and their satisfaction. As a practice, it consists of the coordination of four elements:

  • identification, selection, and development of a product
  • determination of its cost
  • selection of a distribution channel to reach the patient, and…
  • development and implementation of a promotional strategy designed to reach these goals

In order to avoid erroneous decisions that could lead to disastrous business consequences for the organization, marketing evaluations might be performed by professional marketing assessment companies specializing in this arena. Some of these firms can provide this service in economically viable risk-reward agreements that do not further complicate the financial challenges being addressed. They specialize in the evaluation of services that detail which marketing functions need to be continued and which functions should be restructured, and/or outsourced. The goal of these marketing evaluation firms is to:

  • help preserve the existing positive effects created by marketing
  • build better marketing practices, and…
  • cut the unnecessary associated costs

In two decades of observing the yo-yo phenomena described above, we have worked with numerous individuals and firms along the way, but none have been more valuable than the firms that specialize specifically in this area of marketing department analysis.

Firms that provide this specific service can be found through the American Association of Healthcare Consultants, The American Marketing Association, and the Society for Professional Marketing Services.

In our work, however, we have found at least one company that has continuously provided the necessary analytic and evaluation components required to complete this sensitive task. Corathers Health Consulting is a unique organization because it utilizes luminaries and unique specialty consultants through a team approach for most of their highly customized projects. What we observed when we worked with Corathers was that their distinguished consultation supplied an unparalleled differentiating factor over the other consulting companies with whom we had previously worked, but they are one of many such firms.

Regardless of the organization chosen, the concept is the key, and that is that you owe it to yourself and to your organization to understand exactly what can or should be eliminated or outsourced before the cuts are irreversibly implemented. The future of your organization may lie directly under that hatchet, and once the decision has been made, reverse is a costly gear to find on a very bumpy road of lost business, missing publicity, and absent advertising. The answer lies in cutting wisely and appropriately as you attempt to keep patients informed and to grow your business.

Linking a patient-Centered Approach to Quality Improvement & HCAPS

Nick Jacobs, FACHE addresses the 2008 Healthcare CEO Summit, co-sponsored by the Picker Institute and Planetree. Chicago, IL USA – Fall, 2008

Share

10 comments »

Posted in Healthcare, Healthcare Marketing, Hospital Administration, Hospitals

Tags:

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

Share

11 comments »

Posted in Healthcare, Hospital, Leadership

Tags:

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

Share

23 comments »

Posted in Healthcare, Hospitals, Leadership, Partnerships

Tags: