Posts Tagged ‘Hospitals’

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What’s Wrong With This Picture?

September 9th, 2010

American Healthcare Magazine - September 6, 2010 - Nick Jacobs, FACHE - HealingHospitals.comThe Modern Healthcare edition of September 6, 2010 has a cover headline that reads: “Passing the Buck,” and the descriptor goes on to explain that “Yet a new report says workers’ share of benefit costs is skyrocketing.”  The actual opening line of the article starts with “Workers are shouldering more of the costs of health coverage than ever before amid stagnant wages and a weak economy”…

A few weeks ago, I wrote about Patient Advocacy, a subject about which I am passionate. So, this blog is about patient and employee advocacy that also provides additional resources for hospitals to help them address the current economic challenges.

Every year when we looked at our medical insurance costs at my hospital, a politically incorrect friend would jokingly suggest that we begin an annual, required participation August Tennis Tournament for our high-utilization employees, but only after the temperatures reached at least 95 degrees.  “It would be a thinning of the herd,” he would jokingly say with an elf-like smile on his face.  We would then get serious and dig into a long list of creative ideas aimed at helping contain these costs so that we would not have to lower benefits or pass the charges on to the employees.

Included in these lists were some rather simple ideas such as offering, in a structured manner, the wellness options covered under our health insurance umbrella and generally rewarding our employees for taking better care of themselves.  We significantly reduced fees for the workout facility (1/3 of the regular cost ), provided personalized counseling from our dietitians, had a weight loss contest and gave rewards for taking classes on stress management, smoking cessation, diabetes control and exercise.

We offered psychological counseling for our employees who were suffering from stress related issues.  Our food service vendor, CURA, made sure that “no transfats” were a part of the hospital’s meals, that there were always low-fat vegetarian choices on every menu, that snacks were reasonable and that our vending machines had healthy choices. We also celebrated life and work on a regular basis.   We had cook-outs, off-stage break rooms, massage, aroma, Reiki, pet and music therapy.  We provided drum circles, non-denominational spiritual services and meditation classes; kick boxing, Pilates, pool therapy, and employee parties.

So, short of forced tennis matches, how else can we control these costs?  The following is a summary of a program that SunStone Consulting is currently offering with two other business partners, CBIZ and InforMed.

Over the past 6 years, the average annual health insurance cost increase for InforMed-supported patient advocacy programs has run at 4.5%, compared to the 10-12% trend for all employers.  In the case where a hospital with 1,500 employees is paying out about $10,000,000 a year for employee health insurance, a 5% savings over a three year period would generate $3.3 million in savings.  Let me repeat that:  By lowering those  premium increases by 5%, there would be over three million extra dollars available for hospital financial needs and co-pays and deductibles for the employees would not have to continue to escalate by 13 to 15% annually.

The Patient Advocate logo (California) - Nick Jacobs, FACHEThe care management “engagement” rate of all the major insurance companies is about 30%. That means that the insurance company-based “help programs” are about 1/3 effective in even reaching the employees.  This non-insurance company based program, however, has a 70% engagement rate of identified large claimants, more than double the insurance company’s rate, and with over 1 million employees in this program, they produce a 98% patient satisfaction rate.

By employing local, trained, patient advocacy nurses, paying physicians a monthly stipend out of the savings to help manage these patient/employees, and then helping those high utilization patients legitimately navigate through the nine to fifteen physicians with whom they interact on an annual basis, health systems are seeing tremendous savings.  (Kind of the Best of Managed Care scenario.)

These are clear, actionable items that will positively change a bottom line quickly and permanently without having to increase the financial burden on the employees.

Why not try it?  It works.

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Posted in Hospitals, Leadership, patient-centered care

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Moving Through Healthcare’s Version of the BP Oil Spill

May 27th, 2010

Who could have ever guessed that the United States of America would fall so far behind in education, childhood death statistics,  scientific research, manufacturing jobs, and even overall, general healthcare?  Yes, of course, we are still a wonderful, strong country with incredible resources, but somewhere along the line, the train seems to have jumped off the track just a little, or is that like being a little pregnant?  No one would ever have conceived that a spark plug would be worth more than GM stock, but that’s exactly what happened last year.  Or how about the fact that large investment banks responding to the mandate to increase home sales by spreading the risk internationally could have helped put this entire world on the verge of a national depression?

For years now I’ve written about the need to provide some type of safety valve for the uninsured, underinsured, and those struggling to make it from layoff at age 58 to Medicare at age 65.  Not unlike the Kennedy-Katzenbaum bill, (you know, that HIPAA bill that was just meant to provide health insurance portability), we have healthcare reform legislation.  The really challenging thing about this new bill is that it was primarily written by policy wonks fifty percent of whom will not be working in Washington D.C. in a few years, and worse than that, it will be interpreted by policy wonk lifers who will be there long after we are all dead.

So, the “Healthcare Oil Spill” has been addressed.  What will it mean?  What does it mean?  How will it impact all of us?  That remains to be seen.  The good news is that 30 million more people will finally have a safety net. The bad news is that there are still two wars going on that are draining our treasury.  There is still financial chaos among the countries lovingly referred to by the EU as the PIIGS (Portugal, Ireland, Italy, Greece, and Spain), and, along with this group,  spending in the United States  has been out of control for at least nine years.

What will happen is anyone’s guess.  How things will be interpreted is anyone’s guess.  How the law will be enforced is every one’s guess, but in  a recent round table discussion at the Mid-State HFMA meeting, we heard four CFOs discuss the challenges that they currently face and will continue to face as life becomes even more complex.  After that session, I’m thinking that lots of mud pushed in the head of the well might just be the cure!  Goodness knows there was enough mud thrown around during this last election cycle.  Maybe we could redirect it back to the source?  I do know for sure that one thing is clear: CHANGE is INEVITABLE, the train is back on the track, and it’s coming straight toward our physicians, hospitals, and nursing homes.

How do we cope with that change?  Make sure that every ounce of fat is cut from the system.  Take a look at the list below and contact SunStone Consulting for the next steps:

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Posted in Current Affairs, Future, Healthcare

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Healthcare Reform. . . It’s only just begun

March 10th, 2010

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

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

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

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

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

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

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

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

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Posted in Healthcare, Hospitals, Public Policy

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

March 1st, 2010

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

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

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

Warren E. Buffett

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

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

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

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

Blair House health summit, February, 2010

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

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

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

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

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

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Posted in Current Affairs, Healthcare, Hospitals

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Carrots or Sticks?

January 30th, 2010

When you do the math, you can rather quickly determine that, as the aging process continues with the Boomer generation, federal funding for health care and Social Security will become more and more scarce. At the same time, we have all read the sobering national statistics regarding unnecessary deaths from hospital missteps. The CMS (Center for Medicare and Medicaid Services) previously introduced a form of pay for performance, or –more accurately– no pay for performance, which has already caused a great deal of change in the American Healthcare System.

As is widely known by now, CMS has decided to literally stop paying for the treatment costs of preventable medical complications.  This actually may seem like an intelligent idea. This approach is referred to by some as visibility for good care, and there is no doubt that it will represent the beginning of a stampede from the third-party insurance payers to follow the CMS “Big Dog.”  In fact, several companies have already announced that they will not be reimbursing hospitals for similar errors, as well.  The truth of the matter, however, is that this step does not even begin to address the problem.

The problem is not about penalizing hospitals, it’s about creating an incentive system that is not disease and sickness based.  Until the pyramid is flipped, we will not see the necessary changes to halt this financial slide to economic oblivion.

Sanjay Saint, MD, MPH

About 9% of U.S. hospitals presently use daily reminders to help physicians remember which patients have urinary catheters in place.  According to the University of Michigan’s Sanjay Saint, a professor of internal medicine, about 74% of hospitals don’t keep tabs on how long the catheters are in place.  But the real issue is that about 98% of hospitals and physicians don’t completely address issues of wellness and prevention that can allow us to remain well until we die because there is little or no incentive to do so.

Logic would dictate that because financial reimbursements will be connected to these hospital-created mistakes, infections or injuries, someone will surely pay more attention to the current misses.  But what if the entire system was based on keeping people healthy?  What if all of our focus was on exercise, appropriate food consumption, and stress management?

Unfortunately – or fortunately, depending upon your perspective – the United States has become the most proficient country in the world when it comes to capitalism, and much of capitalism is based on manipulating people to get them to consume what will bring the financial success and rewards to the corporations.  If you doubt this, just go to Eastern Europe to see what is happening in an environment with unregulated tobacco advertising.  The circle has started all over again.

In the old carrot-and-stick arrangement, there will be plenty of hits.  Wouldn’t it have been interesting, though, to reward hospitals where mistakes are almost nonexistent so that the less successful medical centers might line up to learn from them, or to reward docs and hospitals for helping to keep people healthy all the time. Carrots work, too, and with much less grief.

Carrots and (Celery) Sticks

What’s the old line?  “We’re going to beat the troops until morale improves.”

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Posted in Boomers, medical errors, Wellness

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Healing Hospitals and Healing People

January 18th, 2010

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

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

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

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

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

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

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

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

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

Healing Hospitals: Doctor on hillside with laptop

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Posted in Healthcare, Hospitals, Leadership

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Communicating in 2010

January 11th, 2010

This blog post is dedicated to “getting the word out” about your Healing Hospitals. So, let’s start at the beginning.  Actually, let’s start at my beginning.

In 1969, business communication consisted largely of yellow legal tablets, Bic pens, daily reminder calendars, newsletters that were pasted-up by hand, then run off on the mimeograph or ditto machine, and an occasional public meeting for the employees.

I remember one hospital whose philosophy was “We’re the biggest and the best, and if you don’t come here, you’re stupid and will probably die.”  Their CEO was totally against press releases, advertising, or public outreach of any kind. He would say, “If they don’t know us well enough from our work, we need to do better work.”

News coverage was pretty simple at that time, too.  You sent your news release to the local paper(s), local radio, and, if available, local television stations.  Grand slam home runs in communications in that era would consist of a story that hit the wires or made either the New York Times or Wall Street Journal. Not unlike scenes from Ozzie and Harriet or Leave it to Beaver, things were formal and “normal.”

The interesting thing about today’s world, is that just the description of  “how to communicate” from a business perspective would take thousands of words.  Without beating all of those digital horses to death, we now have hundreds of television cable choices, Satellite radio, dozens of specialty publications, 24 hour/real-time web-based everything, and so much spin that even the late S.I. Hiyakawa would be flabbergasted.

So, the question becomes, “What’s the ticket?”  “How do we get the word out about our work, our facility, our philosophy?”  To that end, it is important to understand that the entire vision of healing hospitals is a wholesome, caring, loving, nurturing philosophy that is profoundly newsworthy. How do you capture the hearts and minds of current patients, their families, their neighbors, and their neighbor’s neighbors?   Interestingly enough, the first approach and my initial recommendation is education for your employees.

Many employees have not yet made the connection between this type of unique care and publicity.  Obviously, not unlike the old CEO quoted above, it is the power of “word of mouth” that can carry the day locally, but –not unlike my last CEO experience, if there is not enough population to produce growth, then you need to reach beyond the local geographic boarders. By doing so, we tripled in size over a decade of population decline.

There is an old saying that “anyone who is 50 miles from home can become an expert.” For the most part, most people are not aware of your quality care, your commitment to humankind, your nurturing attitude even 30 miles away.  Consequently, media is the key.  What I have found is that national media can bring a halo of credibility to an organization that years of local media could never bring.  Unfortunately, unless you have done something wrong or a meteor drops onto your grounds, national media is not that easy to attract.

We were fortunate in that we had the Wall Street Journal, USA Today (four times), the New York Times, the Today Show, the Philadelphia Inquirer, Oncology International, Forbes, Fortune, and several stories in Reuters releases and at least three placed with the Associated Press that were picked up internationally.  How did we do it you might ask?  We often times did it by linking local stories to national topics. It takes creativity, persistence, and a strong desire.

You need to do news releases to just about everyone. Pick topics that are timely, informative, and have a unique angle, and then work at it constantly.  The other way that we promoted our organizations was through social media and Web 2.0.   My original blog, Nick’s Blog at the time – started in 2005, now HealingHospitals.com (i.e., this blog), was the first hospital CEO blog in the world, and that brought a tremendous amount of new traffic to our organization.  We also became active on You Tube, Twitter, and Facebook long before many others in (and outside) the healthcare community accepted these phenomena.

Bottom line?  It can be done cost-effectively with great success, and we’re here to help.

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Posted in Healthcare Marketing, Hospitals, Public Relations

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It’s Been (Quite) a Year…

December 19th, 2009

Last year at this time, as word of the global economic meltdown was beginning to take hold, we saw the beginning of a decline in all aspects of purchasing, including the  optional surgeries and tests in our hospitals.  At the same time, as a member of several volunteer boards, we began to see declines in ticket sales that went as high as 20%.  Later, we met with restaurateurs who indicated that their business was down between 10 and 20%, an amount that proved to be terminal for numerous marginal companies.

obama_health_costs

As the year proceeded, we saw  hospitals make extensive cutbacks in employee  education, travel, and marketing.  This trend became the norm in the industry.  The healthcare-related industries that seemed to hurt the most were those involved in construction and new equipment acquisition.  One type of firm that did well was financial consulting groups, like SunStone Consulting, LLC , organizations that specialized in finding money that hospitals had already earned, but had either not been staffed deeply enough to pursue or that did not know the processes necessary to generate these funds.

For those of us in administrative consulting, the year has been interesting.  Decision makers stepped back a little and waited to see where Obamacare was heading, to collect more cash in a society where “cash was definitely king,” and to cut back on new initiatives until things had settled down economically.  These leaders watched the markets, looked at investment activities, counted revenue versus expense results, and generally became more conservative in their leadership approaches.

What’s on the horizon:  There is an old saying that “He who looks into a crystal ball to predict the future will get crystal in his eye,” that is not far from truth.  Are we completely out of the woods?  Not by a long shot.  Will there be additional taxes, additional expenditures that are not budgeted nationally?  Yes, most assuredly, there will be, but are we certainly seeing more positive signs in virtually every economic indicator that would predict at least a somewhat more optimistic overall outlook.

Wall Street Journal: Pointing to renewed signs that the global slump is bottoming out, the International Monetary Fund on Wednesday upgraded its outlook for 2010 while slightly trimming this year’s forecast.

The overleveraged global financial system continues to cast a shadow over the economic outlook, however, and the fund urged policymakers not to become complacent about recent market improvements.

“Financial conditions have improved, as unprecedented policy intervention has reduced the risk of systemic collapse and expectations of economic recovery have risen,” the IMF said in its updating its outlook for the world economy and financial system. “Nonetheless, vulnerabilities remain and complacency…

100_on-iceSo, if we embrace those little rays of hope as a means of restarting the economic engines, if we visualize a better future for all of us, if we focus on the positive, at the very least we most likely will find a better parking space at the Mall!

Happy Holidays and here’s knowing that 2010 will be a better year for everyone.  (It wouldn’t take much!)

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Posted in Current Affairs, Healthcare, Hospitals, marketing

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Thanksgiving and CHANGE…

November 21st, 2009

One of the sometimes-challenging realities of Thanksgiving is that it forces us to look into the microscope of our personal time here on earth and acknowledge the change that will always be a part of our humanity.  This week I received a phone call that should never have been necessary “in my lifetime.”  One of my former employees passed away. For those of you who have some knowledge of my past, you might scratch your head in confusion regarding my deep consternation and pain from the loss of one person, because there were literally thousands of employees with whom I have worked over the years. But, for the others of you who know me well, you will clearly understand.

When I became the president of my former hospital, the waves of change had touched on it shores only briefly as it had attempted to avoid being consumed by neighboring health systems.  Because of this challenge of competition, we were given the authority to “try some new things” to attempt to preserve the facility as a community hospital.  To say that the road ahead was laced with hazards would be a serious understatement, but we did  navigate those sometimes treacherous waters successfully.

Carolyn "Winnie" Horner (1961-2009)As my tenure began in this difficult environment, a few people stepped forward who “got it.”  Winnie Horner was one of those people.  She “got it” from our first presentation about our dreams and plans.  Winnie was literally one of a handful of people who was willing to put herself out there to help the hospital establish new dreams, new ideals, new goals, and new caring philosophies.

Because a concept seems easier to embrace if it can be identified with others, we became a Planetree Hospital, the third in the United States and the first in Pennsylvania.  It was our goal to become a Healing Hospital.  It helped to jump start us into a new world of compassionate, healing, loving care that literally gave new life to the organization and helped it to remain not only open but also to succeed in ways that could never have been imagined.

Winnie not only “got on board,” for a long time she became the engineer of that train.  Her passion, her kind ways, her belief in spirituality, her amazing  voice, and her commitment to change was always obvious and appreciated.  She was a leader, a champion, the Joan of Arc of this effort, and I loved her for this.

Unfortunately, she will not get to read this because, at 48 years of age, she died this week.  Unbeknownst to her, she had been working with pneumonia, but, like Winnie always did, she kept giving of herself.  Who would have ever thought that it would have had this ending, and her three beautiful children are now without their mom this Thanksgiving.

So today, I write to you, Winnie.  You were a very important part of the soul of Windber Medical Center, and your presence will always be felt, but your absence will be felt even more deeply.

For me, Thanksgiving has always been a time of change, starting at a very young age as grandparents, uncles, aunts, and parents passed on.  The empty chairs at the table were always indicative of our own mortality, and the loss of those we love, be it permanent or just because of the sometimes-messy circumstances that are a part of living,  is a reality that we all must deal with throughout our time here on Earth.

thanksgiving_table_white

It’s ironic that, as commercial as our country has become, the tradition of Thanksgiving has remained virtually untouched in the essence of its meaning.  If you are alone for Thanksgiving, or with a cast of dozens, take a moment to reflect upon your life and your gifts.  Understand that nothing is permanent, and that, like Winnie Horner, we all have a chance to make a difference in thousands of lives, a positive, forever difference.

This year, Winnie and her passionate partners were able to achieve something that has only happened a handful of times in the world.  Through their work, Windber became a Planetree Designated Hospital, a model of care in the Planetree philosophy, my final Windber dream.  Thank you, Winnie, and if any of you don’t believe that you can make a difference, a real difference, take a page out of “Winnie’s Book.”  She was one of the best.

Planetree banner

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Posted in Healthcare, Hospital, Leadership

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Another Day, Another “A”

November 12th, 2009

Straight-A Report Card One of my many college roommates, Mark, graduated with a perfect, straight-A GPA.  In those days the grade point average indicating perfection was a 4.0.  He worked harder than anyone I had ever known, and hardly took even a few minute break from studying.  For all intents and purposes, he had virtually NO social life, and, except for the occasional pinochle game and a coke-and-pizza break between study sessions, Mark was 100 percent committed to perfection in his grades.  As he became more and more sure of himself over the years, he would walk into our apartment and yell out, “Another day, another A!” and mean just that.

One of the greatest challenges of my life has been finding those measuring sticks that quantify our accomplishments.  In fact, the quest to solve just that ongoing problem has caused me plenty of sleepless nights.  I know, for example, that the infrastructure established for our research institute was so singularly unique, so perfect, so incredible that it should  become an international model.  In fact, when the National Cancer Institute evaluated just one aspect of the  institute, they indicated that the tissue repository was “The Only Platinum Quality Tissue Repository in the United States.”

As my time away from the hospital and research institute quickly approaches twelve months, my passion for the accomplishments that we experienced there has become even more clear to me, but where is Judge Simon when you need him?  How do you grade them?  Worse yet, how does one convince his former peers that the design that grew out of the ideas that became the philosophy of our hospital should be treasured as a new way to achieve perfection on multiple levels? …Another Day.  Another A.

fierce_hospital_innovators

Having an infection rate that never went above 1 percent; an extremely low length of stay (3.2 days); low readmission rates, low restraint rates, unbelievably low litigation rates that almost didn’t register on the charts at all.

If your CFO is reading this, simply add the following to each one of those accomplishments . . . $$$.  How does a small hospital in Western PA with one major health care plan produce a bottom line in excess of $2M?  More importantly, why wouldn’t every hospital administrator want to adopt these approaches?

So what’s the “secret sauce?” We did this by working endlessly to create a truly healing environment, not to be confused with simply doing our jobs well . . . that was a given. We all had to do our jobs well, AND create an environment that fostered a healing atmosphere.

People actually got a chance to begin the healing process.  By eliminating overhead paging, permitting loved ones to stay over with 24 hour visiting, as well as pet, aroma, music, and humor  therapies, integrative medicine, kindness, a commitment to nurturing, patient centered care and a total commitment to the creation of an optimal healing environment, we began to see outcomes that were previously thought to be literally unthinkable.

Another day.  Another A.

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