Posts Tagged ‘WHO’

Creating Functional Healing Hospitals

November 8th, 2009

Why Healing Hospitals?  Transparency.  Human Dignity.  Patient Advocacy. All of these represent a new way of administering health care in this country.  Our industrialized model of care in the mirror image of factory-like settings is no longer acceptable, viable, or an alternative.  We, as a country, as a society –as a culture, need to step up and do what is right.  Love, kindness, nurturing, and a commitment to patient advocacy are the correct ways to interact with our patients.

healing_mosaicMany organizations who embrace the various human dignity monikers such as Planetree and Eden Alternative do so for marketing clout, for positive press, or for hoped-for financial gains.  Upon meeting some of these leaders, transparency becomes a very recognizable trait because they themselves are transparent –and not in the good  sense.  Rather, they are transparently “takers” in an environment that is much better served by “givers.”

For a country that is so obsessed with standardized tests, our healthcare delivery scores are abysmal, astonishing, and asinine. Not unlike our appetite for Biggie fast food meals and Biggie drinks, our appetite for beautiful trappings without substance, for corporate jets, for the power of millions and in some cases billions of dollars in reserves has resulted in a dysfunctional health delivery system that looks at patients as widgets.

Nicholas D. Kristof - NYT photo Nicholas D. Kristof  NYT photo

Nicholas Kristof, New York Times Op-Ed columnist has written another compelling article about the  U.S. health system, in which he quotes the latest World Health Organization figures. (Download the .pdf file.) According to the WHO report, the United States ranks 37th in infant mortality (partly because of many premature births) and 34th in maternal mortality. A child in the U.S. is two-and-a-half times as likely to die by age 5 as in Singapore or Sweden, and an American woman is 11 times as likely to die in childbirth as a woman in Ireland. He then quoted another study, a recent report by the Robert Wood Johnson Foundation and the Urban Institute that looked at how well 19 developed countries succeeded in avoiding “preventable deaths,” such as those where a disease could be cured or forestalled. The U.S. ranked in last place. Dead last.

He did find one health statistic that is strikingly above average: life expectancy for Americans who have already reached the age of 65. At that point, they can expect to live longer than the average in industrialized countries. That’s because Americans above age 65 actually have universal health care coverage: Medicare, he writes. Suddenly, a diverse population with pockets of poverty is no longer such a drawback.

Learning how to convert your hospital to the standards of  Healing Hospitals is not rocket science.  It is, however, not without tough decisions, aggressive doses of nonconformity, a passion and commitment to patient advocacy, and a strong desire to improve infection, readmission, restraint, and mortality rates.  It can be done, but it takes guts, a break from the conventional, unconventional wisdom, and a willingness to do what is not only right …but also what is very, very smart.

WHO Report – Primary Health Care: Now More Than Ever

View more documents from Nick Jacobs.

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Focus on the Positive

April 29th, 2009

Okay, who wants to be the first one to have written about a pandemic?  Unfortunately, I know way too much about this stuff.  Guess it’s that old hospital CEO mindset.  Prepare for the worst, and expect it.  Well, let’s all pray that this thing settles down before more people die.  My friend, Dr. Matt Masiello wrote an E-mail today that could probably help a lot of people.  A public health message with a level of calm urgency.

Dr. Matt MasielloBased on the cumulative experience of the scientific and health promotion/disease prevention staff at WRI, we began a more active approach in  preparedness then what had been recommended by WHO/CDC and the local EMS. We feel that with WHO now raising the alert level to 5 our actions were appropriate. May I suggest the following.

1.    Prepare and distribute a letter to parents asking them to keep their children home if they have a cough, fever, headache. If someone in the family has the same signs and symptoms the children should also stay home until  the illness by the family member is confirmed not to be Swine flu.

2.    Place a small table with sanitizer bottles at the entrance ways of the school buildings.

3.    Encourage staff to carry on their person the small hand sanitizers.

4.     Instruct your teachers to review with the students advice on handwashing and use of the sanitizers. Teachers should remind students throughout the day of the importance of handwashing as well as keeping their hands away from their face and the importance of coughing into their sleeves. Wash/sanitize hands afterwards. I would encourage formal, scheduled trips to the BR to wash hands and when ever necessary.

5.    Place the attached sign in key locations and encourage staff and familes to take them and post at home as a reminder. Wash hands prior to and returning from work/school/play.

6.    Get plenty of rest, eat well and exercise.

7.    Open windows for better movement of air, when and if possible.

8.    Minimize social gatherings. The canceling of social events may come as  a formal recommendation via the CDC in the very near future.

Matt

So, that’s the official word from the United States’ representative to the World Health Organization.

Now, onto life.  Last night we completed a list of services that we are helping to provide to hospitals, schools, hotels, newspapers,  businesses and anyone else that might be interested.  Rather than list each business individually, let me list their services, products, and work, and, if you’re interested, give me a call.

  • Technology Solutions for Government
  • Sophisticated market research
  • Physician billing/Pre-certification and approval of payments for doc offices.
  • Telemedicine and medical device marketing analysis and launch
  • Food Services for hospitals and long term care centers
  • Education Programs and Leadership Solutions
  • Continuing Medical Education for physicans and nurses
  • State and Federal Lobbyists and Business Development Experts
  • Personal Healthcare and Corporate Wellness
  • Crisis Response Communications
  • Construction solutions (REIT)
  • HR and House Wide Quality System for Job Descriptions
  • Translation services (Contract pending)
  • Specialized Cancer Laboratory Services
  • Removal and disposal of hazardous waste, a green company
  • Economic Development and ECAP green initiative
  • The Doctors’ Doctor – Physician office mergers, acquisitions and general business operations consulting, and Hospital Physician strategic planning

Obviously, each line represents a company that we represent, and even more obviously, SunStone Consulting is your answer for all of the financial challenges that hospitals face.

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A Different Kind of Saturday Night Fever for Some

April 25th, 2009

In August 2006, I was inspired to write a disconcerting blog post regarding the potential outbreak of the avian flu.  It was a disturbing post not only because it contained potentially negative statistical mortality outcomes on an international basis, but also because, as a relative insider, it was clear to me that we were not ready at all for this type of pandemic.

Churchgoers in Mexico City | Photo Credit: AP

Churchgoers in Mexico City Sunday | Photo Credit: AP

With new grandbaby Zoey safely here on earth less than a week ago as the youngest member of the family,  today’s opening story of a potential influenza pandemic made my blood run cold.  The rate and speed with which this type of pandemic could overtake our world is almost immeasurable, and, having flown from San Francisco, to San Diego, to Richmond to Pittsburgh in the last week, it was clear that,  if I had been a carrier, literally hundreds of people could have been infected simply by my presence.

Those who are realists or pragmatists will simply say, it is Mother Nature’s way of “thinning the herd,” but herd thinning in our case is something that is uncomfortable, especially in such a random way.  During the pandemic of 1917/1918, mass graves were dug not ten miles from my home, and undertakers were not even permitted to prepare the bodies for burial.

My previous blog focused on the avian virus, but this morphed virus that appeared in Mexico, not China, not the Far East as originally predicted, is a combination of human, swine, and avian viruses.  No one has ever seen or found cures for this type of radical new flu yet.


View H1N1 Swine Flu in a larger map

The World Health Organization came out today with only a level three warning, but when they described this level of warning, they indicated that it was simply because they did not yet have enough information to take it to level six.  There are confirmed cases in San Antonio, San Diego, and one report even indicated that New York had two cases, and over 68 are known dead in Mexico.  Fever, sore throat, coughing, nausea, body aches, headaches, chills and fever are some of the symptoms presenting with this flu that can result in pneumonia and respiratory failure.

Mexico City closed it schools on Friday, and more such initiatives are expected as this powerful force of nature begins to take on a life of its own.

How can you avoid getting this flu?  Wash your hands, stay away from infected people, cover your nose and mouth.

In children, emergency warning signs that need urgent medical attention include:

  • Fast breathing or trouble breathing
  • Bluish skin color
  • Not drinking enough fluids
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and worse cough
  • Fever with a rash

In adults, emergency warning signs that need urgent medical attention include:

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting

Let’s all hope that this never gets any worse than it did in the 1976/77 cycle when only a very few people died at that time…mortality rate was low with swine, but this is swine, avian and  human combination.

Tonight, say a little prayer.

Also by Nick Jacobs:

Are We Ready for the Avian Flu?
Hospital Impact
August 8th, 2006

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Two Guys Medical Center

January 9th, 2009

Back in the early nineties, two of my peers replicated the pro forma and business plan of an offer made by a for profit hospital system that was interested in buying a specific medical center. They then presented it to a religious order and ended up buying a hospital which many of us began to refer to as “Two Guys Medical Center.” The difference was that, unlike the religious order, they were interested in it for some personal financial gain, the American way. Once the cash flow turned into a trickle, they found their way clear of ownership with heavy golden parachutes from the organization that bought the hospital, and it became the gift that kept on giving. All in all I’m sure that it was a very lucrative series of events that, after their or my death would make for a great fiction novel.

As I prepared for my departure from my previous employer, the entire issue of identifying someone to continue to carry the torch of leadership weighed heavily on my mind. Succession planning, if you will, was never far from my thoughts. With that in mind, I looked into the region and found, well, two guys. These two guys were very different from the previous two mentioned. They were committed to the good of mankind on so many levels that no one could question their personal intentions. Over a year later, the reality of their futures does not lie firmly in my hands when succession is discussed, but they certainly are two people to watch as the region’s health systems continue to morph medically.

Only four short years ago, Tom Kurtz, one of my two recruits, was working diligently every day in every way to ensure that four heart stents was an inadequate number for my chest. It had been his job at the competitor to literally master my strategic plan and to replicate it at an even higher level. He found federal, state, and local funds to begin a neuro-science center, research in post polio syndrome, work in anesthesia that would be converted to the battlefield, and, in his spare time to build and promote a Tech Park for the City of Johnstown.

We were usually friendly, but fierce competitors. He honestly has never told me the entire story of his journey with his former employer’s leadership, but I’m sure it would fill about ten of these blog posts. Tom was a master at political nuance and learned quite a bit about grants from the Department of Defense. He not only knew where to find them, he learned how to get the monies delivered to the projects for which he was responsible. Tom is progressive, aggressive, and knowledgeable about both the need to find sustainability on the research side and growth on the hospital side. When it comes to the “vision thing,” Tom embraced that as well. He’s not one of those cant-see-the-forest-for-the-trees guys. In fact, he is just the opposite of that. He sees the big picture and quickly embraces just exactly how things can be in the future with a little guts and a lot of persistence.

Dr. Matt Masiello

Then came Matt. Dr. Matt Masiello has been a friend for over a decade. He represents almost everything that I embrace philosophically. Matt is a gentle and kind man who fully comprehends the value of treating human beings like human beings. A background as a pediatrician has enabled him to understand compassion, and after having been in charge of intensive care for years, he has also learned of the heartbreak that this profession can bring. Dr. Matt captured my attention a year or so ago when, like me, he got involved with the World Health Organization. This time, however, he went way beyond my wildest dreams and has literally been appointed the U.S. representative for the WHO.

When my short history on this planet is finally written, let it be said that Matt and Tom have had a tremendous impact on our community, our region, and now our world as special attention is given to breast cancer research, and as health and wellness, prevention and anti-bullying programs are nurtured, cultivated, and grown by these two men. No, it’s not “Two Guys Medical Center,” but it sure is a medical center that has been positively impacted by two guys. Keep up the good work, Matt and Tom. This region needs you.

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