As I was moving some books around today, I noticed a paper that had fallen out of an old notebook. At the top of the page was the title Growth. Although the year does not stand out in my memory, the circumstances do. If a guess was involved, it would be ’05 or ’06, but no date was present. The situation was one of determining not only how to avoid laying people off because of necessary budget cuts, but how to grow the organization, so that all of the staff could remain employed and get their raises on an ongoing basis.
Of course, there were a list of issues relating to attracting physicians and patients. That “yada yada” list included traditional ideas like recruitment, increased marketing in a new clinic, new equipment for the breast center, expansion of the Emergency Department, performing more traditional surgical procedures, a higher-slice CT scanner, etc.
Then, there were the decidedly non-traditional ideas, like the addition of a data fusion center, increased uses of integrative medicine, a minimally-invasive bariatric center, expansion of the laboratory to include proteomic and genomic testing, management of donated tissue, and telemedicine were all there.
Looking back at that time in my CEO tenure, all of those ideas came to fruition, along with a 3T MRI with breast coil, and every one of these changes came with a certain amount of dissonance and conflict. When it all came down to it, however, the piece that worked the best – the area of concentration that yielded the most profound growth, – the ultimate, saving grace was that of producing a healing hospital.
On that same piece of paper was this note: “We must attract a heart-centered musician to work with the patients and their families.” We found that woman, Rachel, and along with her cohorts, Jean (who did aroma therapy, Reiki, and drumming), the music of healing and transition began. Later, physicians like Dr. Kelly brought flower essences and a half dozen other healing modalities. People were uplifted, reconnected, and relaxed. Through the use of therapeutic music, we gave the patient what they needed at the moment.
Each week, it will be my goal to give you a peek into the world of healing hospitals where people don’t come for an oil change, a new body part, or a shot of life, but rather a place where people go to heal. As a country our medical facilities have been lured into becoming factory-like for the sake of survival, but what we found was that the more humanness, the more loving, caring attitude, the more hope and help we could give in nurturing the body, mind, and soul, the better we did, the bigger we grew, and – most importantly – the happier our patients, their families, our physicians, and our employees became.
For the past several months, I have been searching for a new blog title. Nick’s Blog, NickJacobs.org, Ask a Hospital President, Taking the Hell out of Healthcare… none of them really told the story of my passion, my drive, my desire to change healthcare in a way that would be meaningful for every patient, every employee, and every physician. Finally, the idea of what exactly I believe in, try to strive for, and teach hit me: “Healing Hospitals.” Not only do I believe that we can make our hospitals healing places, I also believe that we can heal the hospitals themselves.
Nick Jacobs, FACHE – HealingHospitals.com
For too many years, the Socratic style of teaching our docs has basically made many of them as tough as professional football players. We have experienced “The Old Guard” in nursing, where, when new nurses come on board the older nurses are encouraged to “eat their young.” We also know that the over-utilization of overhead paging, blood tests in the middle of the night, loud staff members, et al lead to what can only be described as a tense environment.
For the past 20 plus years, we have advocated a kinder, gentler hospital environment. During that time we have introduced all types of non-traditional healing environments, integrative medicine, roving psychologists, drum circles, aroma, music, pet, and humor therapy as well as the elimination of bullies from the medical staff.
These are just a few of the very effective mechanism that can be introduced to create healing environments in hospitals. Healing gardens, labyrinyths, 24 hour visiting, double beds in the OB suites, and the beat goes on and on with decorative fountains, fireplaces, skylights, balconies, but most importantly dignity and respect amongst all staff and visitors toward patients. So, “Healing Hospital” has multiple meanings. Healing will take place more quickly, thoroughly, and meaningfully in these facilities, and the entire staff will be charged with the promotion of healing by creating an overall healing environment.
Well, I’m sure if you type in nickjacobs.org or even Ask a Hospital President.com you’ll still get to us, but remember that our overall goal, our direction, our mission, our passion, and our job is to help you to create healing environments where infection rates drop, as will lengths of stay, readmision, restraint and mortality rates. Call us at SunStone Consulting, LLC. 412-992-6197.
The warrior in the picture is my buddy and grandson, Jude. He is about to go to war for candy. It’s his Halloween costume, but a fitting example of a warrior, and one that works well for the topic of this blog post.
When I first saw this picture, it reminded me of my peers who are out there in the day to day fight trying to work their way through the current financial crisis. Then the picture reminded me of a much bigger and more threatening challenge. Last week’s New Yorker ran an article entitled “The Catastrophist” by Elizabeth Kolbert. It was about another type of warrior, James Hensen, Director of NASA’s Goddard Institute for Space Studies. He is fighting for our children and their children’s future. He is the top scientist for NASA who successfully made early recommendations about chlorofluorocarbons creating holes in the Ozone, and was instrumental in getting the world to ban them and stop the holes in the atmosphere from progressing.
For the last several years, he has been fighting a personal war to get the world to take the steps necessary to stop global warming before it is too late. At a recent rally in New Hampshire, he described our situation as a one in which, “climate history is being run in reverse and at high speed, like a cassette tape on rewind. Carbon dioxide is being pumped into the air some ten thousand times faster than natural weathering processes can remove it.”
The world has not yet responded to his and the majority of scientists discoveries, but he fights on for his grandchildren while the pundits say it is all hype and without substance. “The world goes through cycles,” they say, “and this is just another cycle.”
Then, I read a comprehensive article by Malcolm Gladwell in this week’s New Yorker magazine (I know, I know – It’s New York) …entitled “Offensive Play.” Mr. Gladwell examined the realities of professional football, boxing, NASCAR, and the world of fighting dogs that can only be described as painfully chilling. In this treatise, he examined the frequency and degree of damage that professional football players endure from multiple head injuries. In fact, it was not limited to professional football players, but players of all levels.
Pittsburgh Steelers Quarterback Ben Roethlisberger after sustaining a concussion – Tom E. Puskar/Associated Press
He met with scientists who have studied the autopsied brains of these men, men who have made their living as modern day gladiators and warriors. Men who, as he described it, “had game.” No matter the degree of injury, they were ready and driven to get back in and play. He likened this attitude to Marines and young doctors and asked the question “If you have people who are willing to march over a cliff for you, you cannot march them close to the edge of the cliff?’
In this analysis, he gave the example of a veteran football player who might be exposed to 18,000 head hits during a ten year period. He also provided example after example of famous NFL players who had tragic endings to their lives because of these injuries. These were often times great player who became abusive toward loved ones or lost their personal direction in life and committed suicide.
These “modern day gladiators,” not unlike boxers, have some degree of information regarding the potential risks that they face. But, also like boxers, about 22% of whom end up with dementia, they will most likely continue to do this work as long as we are willing to pay them millions in order to observe their physical prowess.
NASCAR, on the other hand, has worked year after year to improve survivability of their drivers from even horriffic accidents. NASCAR can make their sport relatively safe, but football has a much greater challenge because helmets don’t really stop the impact of hitting your head at 80 miles or more an hour, the equivalent of going through an automobile windshield at that speed. Yet a NASCAR driver escaped injury in a head on collision of 180 miles an hour last year.
Maybe the idea of having “game” is not limited to football, or soldiering, or medicine. If you look at the level of stress that many executives endure with the blessing and even pressure to do so from their bosses, their stakeholders, and their stockholders, the same type of moral question seems to surface. Kevlar gas tanks keep Grand Prix automobiles from exploding. What keeps modern day gladiators from exploding? Clearly, it is not more Yang.
I’m just the reporter, and this reporter is going to borrow my grandson’s battle gear as I fight on through the economic downturn. By the way, my new book, You Hold Em. I’ll Bite Em. should be out next month. Talk about the result of a head injury. We played without pads or helmets!
Those who have worked with me know that I have been unequivocally one of the most loyal supporters of the PlanetreePhilosophy of care in the world.
My former place of employment was the third Planetree hospital in the country, after Planetree’s headquarters moved to Griffin (Derby, CT.) We were the first Planetree hospital in Pennsylvania, and that hospital, Windber Medical Center, is now one of the top ten Planetree-designated sites internationally. After having served on the Board of Directors of Planetree for nearly eight years, having written literally dozens of blog posts and articles about Planetree, having taught numerous online seminars for them, contributed a chapter to their latest book, and served on the Planetree Speaker’s Bureau for half a dozen years, I’m back once again with a presentation this Tuesday at the Planetree 2009 conference. It’s called: Take Care of Your Employees and They Will Take Care of Your Patients.
Although I was encouraged to retire from the board in order to give newer members their opportunity to participate, and am no longer a part of the Speaker’s Bureau, with no formal ties to the organization anymore, I want to assure you that my experience, passion, and commitment to humanizing healthcare, transparency, creating a nurturing environment for patients and their families could not be stronger.
Since my transition from formally running hospitals full time, I have immersed myself deeply into the world of helping hospitals through my consulting practice to achieve the patient, employee, and family satisfaction ratings that ensure top scores in HCHAPS which, in turn, will result in increased business, increased revenue, and increased growth for any organization.
Nick Jacobs, FACHE
I am including one of my lastest articles on Integrative Health written for Hospital News. Remember, if I can help, just call, e-mail or or comment:
Integrative Medicine
Massage, Flower Essences, Spiritual Healing, Drumming, Reiki, Acupuncture, Music, Aroma, Humor, Pet, and Art Therapy; all of these healing practices were formerly referred to as Alternative or Complementary Medicine. They deserve, however, to be referred to as Integrative Medicine. Because, when we integrate these various disciplines with other contemporary healing methodologies, the results can be amazing.
As a hospital CEO, it brought me great satisfaction to introduce all of these treatments to the healing environment of the hospital. Many times they came amid intense resistance from both the medical staff, and some members of leadership. In fact, after nearly 10 years of offering comprehensive exposure to Integrative Medicine, we still had a smattering of nonbelievers. The only thing questionable about these therapies for a healthcare administrator is that the typical insurance companies don’t cover the costs of all of them and cash payments come into play.
The number of patients coming to our facility had tripled through the emergency room alone as did the overall budget of the entire organization during that time period. Those “Forest for the Trees” practical leaders still could not bring themselves to give credit to one of the major contributing factors involved in that surge of the hospital’s popularity. Yes, of course, we also encouraged 24 hour, seven day a week visiting, had guest beds in many patient’s rooms, and served meals to the families on the medical floor where their loved one was a patient. Did all of this combine to the create a healing environment? Of course it did, but Integrative Medicine was the heart and soul of the difference.
Their skepticism seems to fit into the cycle of questioning the validity of wellness and prevention, two comprehensively established methodologies for improving general health and well-being, proven over centuries of unofficial clinical trials. Wellness and Prevention works, but because the insurance companies have not yet fully embraced these philosophies, then some still say that they are not valid. Treating sickness can be as comprehensive as ensuring wellness. For whatever reason, some of our medical and administrative leaders often confuse reimbursements with healing, and forget to add new patients and additional income from related disciplines like PT and OT to the equation.
As a nonmedical, nonscientist, it was easy for me to understand why the various integrative arts worked so well for our patients and their families. From the old song, “All You Need is Love,” you could easily enjoy the looks on the faces of those patients and family members who used these treatments to receive sorely needed relief from whatever pain or loneliness they were experiencing. It doesn’t matter if you’re eighty minutes or eighty years old; touch, nurturing, and love all remain critical in our lives. Have you seen the statistics on how much better people do with pets than without, or how many babies died in orphanages due to the “failure to thrive?”
None of these ancient arts were created because the scientific method produced FDA approved results in trials of 200,000 or more. They evolved into centuries old healing arts because they provided relief and help in a time when leeches, bleedings, and a lack of hand washing were the accepted medical treatments. The tribal shaman, medicine man, healers, and other spiritual leaders all knew what the subtle and not so subtle impact of their work meant to their fellow human beings.
We have casually observed the use of these healing modalities on patients who have experienced restored feelings to otherwise numb feet.
We have seen them relieved from debilitating back pain, healed from hopeless wounds, saved from surgeries due to the opening of blocked intestines through acupuncture. We have observed psychological breakthroughs from drumming that had never been reached by traditional therapy. Truthfully, I didn’t care exactly what made our patients better, just that they were better, and the results were dramatic, with an infection rate of 1% or less, a 3.4 day length of stay, a low readmission rate, and the lowest mortality rate for adjusted morbidity in the region.
F. Nicholas “Nick” Jacobs, FACHE, is Senior Partner at (SMR) Senior Management Resources, LLC. In that capacity he provides transformative, strategic solutions to companies, organizations and individuals. He has decades of experience in hospital management, with an acknowledged reputation for innovation and consumer-centered leadership.
Throughout his career, Mr. Jacobs has developed a reputation for innovative leadership that focuses on effective delivery of service that puts the patient’s needs and concerns first. He speaks extensively on this topic and has spoken for the American College of Healthcare Executives, American Hospital Association, and the World Health Organization numerous times.
These are just a few of the very effective mechanism that can be introduced to create 
