Posts Tagged ‘Taking the Hell Out of Healthcare’

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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Finding the Cure…for Bullying

January 21st, 2011

No workplace bullying - Nick Jacobs - healinghospitals.comThis week, NBC’s Today Show featured another story about bullying. As I have have mentioned in previous posts here and elsewhere, I believe that bullying is the quintessential cancer on our lives in places of business, in the military, politics, and relationships of all types.  The good news – actually the very good news –  is that there has been some incredible work being performed on this topic through the efforts of Dr. Matt Masiello at my former place of employment, the Windber Research Institute in Windber, PA.  Grants through the Highmark Blue Cross Foundation of Pittsburgh have fueled this initial effort and the academic and quantitative analysis being done by Clemson University has documented this work.  I believe that this joint effort is a magnificent  example of what can be done to change the future course of events currently being controlled by bullies.

The Today Show story that I saw featured the Massachusetts school where, due to cyber-bullying, a young girl committed suicide last year.  Apparently, another girl is now having the same experience at the same school. With the help of programs like this comprehensive anti-bullying program, the former Secretary of Education from PA, Jerry Zahorchak, (now Superintendent of the Allentown PA school system), embraced the effort to quell and discourage this type of destructive behavior.  And the program, under the direction of Dr. Matt Masiello has successfully been introduced across the  entire State of PA. (Matt had started the Allegheny County’s Goods for Guns program in 1994, when he was the head of pediatric intensive care at Allegheny General Hospital. To date, this program is responsible for collecting more than 11,000 illegal guns from the streets of Pittsburgh.) Matt has had the same success with this anti-bullying program. Now, both Massachusetts and Maryland are looking into embracing this effort.

This anti-bullying program is based on a European program with which Dr. Masiello had become familiar.  This is a school system-wide effort that is very well documented and results in tremendous awareness and reduction of bullying at all grade levels.

The trainers bring a group of teachers and administrators together in the school system, and then “train the trainers” as to how this effort can become part of the philosophy of the school.  They start the training in the spring, typically launch the school wide effort in the fall and run it for at least a year. During that time, detailed records are kept measuring outcomes.

Matt Masiello, MD - Windber Research Institute - Nick Jacobs - Taking the Hell OUt of Healthcare

Matt Masiello, MD

Matt is a wonderful physician, a truly giving person and a saint of a man who is the only U.S. representative on the board of the World Health Organization’s Health Promoting Hospitals program. I hired him before I left Windber Research Institute, and he has worked tirelessly to address both this problem and the problems of childhood obesity.

The Olweus Bullying Prevention Program (Olweus.org on the web, @Olweus on Twitter) has impacted more than 400 school districts and 20% of all school-aged children in Pennsylvania. It has also had up to a 50% reduction in student reports of bullying …and bullying others.

For more information, please contact me or Dr. Matthew Masiello at the Windber Research Institute.

Michael & Marisa’s anti-bullying song – “The Same”

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So “Radical” Was the Correct Term?

April 8th, 2010
In 1987, my healthcare journey began in administration by asking the question, “Why are hospitals the way the are?”  It was a sincere inside/out question that had evolved from my having been a teacher, executive director of an arts organization, president of a convention and visitors bureau, and finally a PR/Marketing and Development professional in the world of healthcare.  By 1997, my ideas had been rejected so many times by so many traditional hospital administrators, who were either my bosses or my peers, that it felt like they would never come to fruition in a conservative field where change is sometimes seen as both life and job-threatening.
butterfly metamorphosis
In 1997, that all changed when Ernst and Young evaluated the hospital where my presidential appointment had just occurred and predicted the closure of that facility due to lack of population, lack of “financial depth” (a.k.a. cash), and a health system partner that successfully was eating our lunch each and every day. It was with that information in hand that I began the metamorphosis of this organization. The presentation to the board and medical staff was relatively simple:

“We can keep doing what we are doing, and then board the place up… or we can grow by changing  the way healthcare is delivered.”

No workplace bullying - Nick Jacobs - healtinghospitals.comLuckily for me, my board chairman at that time was a risk taker because, realistically, our backs were against the wall.  So, we began a journey of change.   We removed bullies from the workplace (both physicians and employees); created a homelike environment where you did not have to leave your dignity at the door;  added bread baking machines, popcorn machines in the lobby, decorative fountains, aroma therapy, massage, humor, music, and pet therapies.  We focused on Green, focused on Dignity for employees and patients; focused on providing a peaceful, loving, and Healing Environment; focused on Family Spaces; focused on Architecture; and focused on Quality of Care.  We began classes for our employees in Hospitality in Emotional Intelligence Quotient training and embraced ideas garnered from places like the Ritz Carlton, Disney, and Dale Carnegie.  Then we established an employee evaluation system that embraced these changes and rewarded our staff financially for their work.

Loved ones were encouraged to stay 24/7 as visiting hours were opened to them, double beds were placed in the OB suites, a wellness/prevention/and integrative health facility was built to embrace not only traditional therapies but to an entire gamut of alternatives.  A senior citizen center was condominiumized and made available to the Area Agency on Aging.  We had patients help us design a new Palliative Care Unit, Breast Care Center, and Fitness facility, then finally we added a world class International Research Institute.

That was 1997 through 2008.  It appears from the posting below that the world is beginning to consider some of these ideas, but lo, these many years later, they are still being referred to as “radical.”  Well, if any of you are interested in how to do what we did which tripled our organizational budget in size and doubled our workforce,  just give me a call at 412-992-6197, to participate in this program.

Obviously, Windber, Pennsylvania was where this movement all started.   Let’s make sure that it doesn’t stop.  After all, it’s not what people like.  It’s what people LOVE.

Henry Ford Health System - Nick Jacobs, FACHE - HealingHospitals.com

Henry Ford Health System Goes Radical: Creating the Hospital of the Future

DETROIT – Looking to shake up your industry, transform your medical center, and recharge your organization?

A two-day educational symposium, “Going Radical: Creating the Hospital of the Future,” may hold the key to revitalization. It will be held May 25 – 27.

Henry Ford Health System President and CEO Nancy Schlichting will share her radical, but practical strategies for success at the symposium, tapping into the wisdom of her top executives in an interactive session on the profound lessons learned during their tenure.

It was Schlichting’s brainstorm to hire a CEO for Henry Ford West Bloomfield Hospital from outside the healthcare industry. Her choice was Gerard van Grinsven, a former executive of the Ritz-Carlton hotel chain, and an expert in service excellence.

Henry Ford West Bloomfield staff will discuss its successes in differentiating itself from the competition by:

• Constructing prototype rooms for planning and community input.

• Incorporating green features in the architecture and construction.

• Building all private patient rooms, including in the emergency department.

• Emphasizing wellness and healthy living.

• Combining traditional clinical care with complementary therapies.

• Creating a unique brand and inspiring staff to think differently.

• Including family space in each patient room, including intensive care.

• Implementing a new kind of food culture in health care.

• Putting a focus on the special concerns of the elderly.

Entrepreneur Bill Taylor, co-author of Mavericks at Work and co-founder of Fast Company magazine, will be the keynote speaker. His ideas have helped shape the global conversation about how business works and “why the most original minds in business win”. His next book, Practically Radical, to be published this fall, explores how to unleash big change in difficult times.

During break-out sessions Henry Ford staff will share lessons learned while juggling the building of the $360-million West Bloomfield hospital and the $300 million renovation of Henry Ford Hospital in Detroit.

Tours of Henry Ford West Bloomfield Hospital will include a visit to the Emergency Department, wellness center, and an inpatient room. At Henry Ford Hospital, participants will tour the Center for Simulation, Education and Research – one of the largest facilities of its kind in the Midwest that provides hands-on training with medical mannequins.

Symposium sessions include:

• Creating a Culture of High Performance
• Facility Innovations Through the Eyes of the Patient
• The Best of Both Worlds: Clinical Excellence Meets Integrative Medicine
• Transforming Hospital Food
• Radical Outreach: Relationship Building to Win Over the Community and Recruit Staff
• Thriving in Detroit: A Blueprint for Transforming Your Hospital System and The Physician Perspective

each and every day.  It was with that information in hand that I began the metamorphasis of this organization.  The presentation to the board and medical staff was relatively simple, “We can keep doing what we are doing, and then board the place up, or we can change the way healthcare is delivered and grow.”
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As Close to Home As You Can Get

October 15th, 2008

Yesterday afternoon the realities of humanism, mortality, and fear attempted to take me out for about the one millionth time in my life. A phone call came from a loved one casually explaining that the doctor had potentially discovered a problem that needed further examination. When the office called for an appointment to have the scan done, they were told that it would be approximately a week before there was an opening in the schedule.

As an insider, I knew that a certain number of slots were held each day for emergency or unscheduled procedures. Not unlike the hotel that holds back a room or two from the 1-800 reservation list, just in case a preferred guest or luminary comes through the doors, flexibility is something that hospitals have to embrace at some level.

Taking the Hell out of Healthcare by Nick JacobsOnce again, as an insider, a call to the department resulted in an immediate invitation to come in for the test the very next day.

My route to health care management was a particularly unique and circuitous route, and it left me asking the question, “why does it have to be this way?” I’ve personally done everything that I can to make it humane, patient centered, and sensitive.

If you or your loved one wants to know the inside story on how hospitals work, take a look at my new book, “Taking the Hell out of Healthcare.” It really can help. It is a simple “how to” book aimed at the everyday person who is having to deal with this complex and sometimes difficult world of health care.

My passion and personal commitment has always been to patient advocacy, transparency, and human kindness. Find out how to make the system work for you.

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