Posts Tagged ‘planetrussell’

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.”

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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?

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The Smurfs and Culture

July 29th, 2011

The other day, I was imagining a conversation between our U.S. elected officials about the Smurfs.  On one side of the aisle, the rhetoric would go something like this: “I believe that Poppa Smurf  represents Karl Marx. He is not the leader of the Smurfs but an equal who is admired by the others for his age and wisdom.”  Then they might say, “And Brainy Smurf represents Trotsky, as he is the only one who comes close to matching Papa’s intellect.  He wears round glasses, is often isolated, ridiculed for being too professorial and is even ejected from the village for his ideas.”

Photo Credit: AP/Richard Drew

Furthermore they might add, “The smurfs don’t have private property, have adopted a collective-style economy and no individual Smurf is represented as either superior or inferior to others.” Someone would yell out, “They probably even have healthcare for everyone!” Consequently, the conclusion from one side of the aisle would be that the Smurfs are Socialists and are destroying the fabric of our society.

Then the other side might say something like: “Gargamel represents capitalism and embodies all the negative attributes associated with that economic system, such as greed, ruthlessness and the pursuit of personal gratification.”  “Gargamel is the quintessential symbol of Wall Street and will take his billions in tax cuts but never create even one job,” this side would say. At the same time, they might surmise that, “Azrael represents the worker in the ruthless, free-market state that is Gargamel’s house, and his union must be busted!”  Their final conclusion would be that, “The wealthy are taking all of our money and destroying the middle class.”

Is it any wonder we can’t get a debt ceiling bill?

One of my last professional trumpet playing jobs, “Smurfs on Ice,” was nearly 25 years ago. So, Brainy, Jokey, Grouchy, Greedy, and Stinky were all part of my early years, and now they are coming back, but the world is not the same!  So, be careful Smurfettes. Don’t invest in the market, real estate or dot.coms.  Try to avoid those outrageous credit card interest rates.  Don’t, whatever you do, don’t believe what the heads of the big banks and insurance companies are saying, and, for goodness sakes, buy gold, or maybe buy precious blue stuff.

When I was a kid, I was on journey to learn. So, when my dad bought me a box of vocabulary words and helped me learn ten new words every night, it wasn’t because he wanted us to grow up and be rich.  To him, the most important thing that he could do for his children was to make sure that they got an education.  He was all about the awareness that comes from exposure to information.

It started for me as a simple challenge to read the Bobbsey Twins books, and then the Hardy Boys, and from there, works by Mark Twain, Shakespeare, Dickens, Poe, Roth, Hemmingway and Tolstoy. Going through life without all of these friends would have been an empty and lonely journey. I’ll never forget when my brother, a young teacher at the time, introduced me to his classical record collection.  Yes, I was a trumpet player, but when I discovered Mahler, Beethoven, Mozart, Bach, Wagner, Brahms, Handel, Stravinsky, Chopin, Mendelssohn, Berlioz, Bartok and Sibelius, my life was changed forever.  Between the written word and the music, the mysteries, joys, challenges and humanness that is life became more apparent to me every day.

We have migrated away from anything but basic education and our favorite pastimes are video games, celebrity magazines and reality TV shows. Maybe that’s why we seem to have lost our way in this country.  We no longer embrace a culture of open mindedness, understanding and compromise.  Is it any wonder our U.S. Representatives can’t work together?  Maybe they are simply unenlightened…Maybe they all need to spend some time with the Smurfs and read a few blue books.

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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.

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