"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Friday, November 21, 2014

Five Years

This week, we celebrate the five-year anniversary of the opening of the new hospital.  It is truly remarkable as to how fast those five years have gone and how great the facility has held up.  The amount of attention that was paid to the planning, the design, the construction, the move and the opening was simply amazing.  That hard work has paid off many times over.  Aside from issues with the elevators early on, we have been free of incidents related to the construction and subsequent installation of many new systems and technology throughout the hospital campus.  

We were so fortunate to have such a committed and dedicated staff five years ago; many who are still with us today.  These people perform exceptionally in their jobs and allow us to remain ahead of many hospitals with our technological and care delivery advances.  

Over the last five years, we have been recognized by the NY Times, the American Hospital Association, the Maryland Hospital Association, the Governor of Maryland, the Maryland's Health Secretary, just to name a few.  In December, WMHS and the nine other TPR hospitals will receive the American Hospital Association's Living the Vision Award.  

Since the opening to the new hospital, we have been doing some amazing things in changing how we deliver care and ensuring that the health system continues to be viable in an ever-changing health care environment.

Wednesday, November 19, 2014

Legislative Priorities for Health Care

Yesterday was a day well spent in Hagerstown.  Joe Ross, my counterpart at Meritus, hosted a forum for elected officials from across western Maryland, from Garrett County to Carroll County.  There was great attendance from delegates, senators, county commissioners and the aides to Senators Cardin and Mikulski as well as Congressman Delaney.  

The CEOs from the five counties presented on a variety of related topics and Carmela Coyle, President of the Maryland Hospital Association, gave the keynote presentation.  The four CEOs from Allegany, Washington, Frederick and Carroll Counties presented on today's successes and challenges related to health care reform, transitioning to value-based care delivery in our hospitals, and newly formed partnerships for healthier communities.  We also heard from the Garrett CEO, who gave a presentation on his many successes since arriving in January 2014 at Garrett Memorial, one of the state's smallest and most isolated hospitals.  Lynn Rushing, the CEO at Brook Lane, gave a wonderful presentation on behavioral health issues and challenges and Dr. Ted Howe, the Medical Director for the Williamsport Retirement Village, gave an enlightening presentation on new partnerships for improved resident outcomes.  

It was a great opportunity to provide our elected officials with information about how health care is changing and remind them that we need their support as we continue to evolve under the new Medicare Waiver for Maryland.  Again, time well spent.

Monday, November 17, 2014

Medical Malpractice

I was in Charleston, SC, last week for a meeting and, coincidently, my son-in-law's inpatient stay for his last chemotherapy treatment.  As a side, he was successfully discharged on Saturday morning and will hopefully never have to return to the "Cancer Floor" at MUSC.

On Friday evening after visiting Terrell in the hospital, Pamela and I needed to have dinner.  Terrell and Jessica suggested Fig, supposedly "THE" restaurant in Charleston and Charleston has many fabulous places to eat.  They suggested that we see if we could get two seats at the bar since there is a long lead time to get a reservation for a table.  So, we did and we were successful.  Shortly after we arrived, a gentleman arrived by himself and sat next to me at the bar.  He seemed like a nice guy and we started talking about food and travel and exchanged some recommendations of our favorite restaurants in Charleston and other cities.  

As our conversation continued, I asked what he did for a living and he said that he was an attorney.  A short time later, I asked what type of law did he practice?  He responded that he was a medical malpractice attorney. I jokingly yelled to the bartender, "Check please!" He then asked what I did; I told him and we laughed.  It was a fascinating conversation as he told me that medical liability is by far the most interesting and challenging law to practice and that it also pays very well (don't I know it).  

I was able to tell him about our approach at WMHS after we learn that harm to a patient has occurred.  I explained that we inform the patient of our error; apologize; meet with the family; provide the necessary support to all who are involved, including the caregivers; maintain open communications; waive all related fees and, when appropriate, offer financial support.  Our approach is to get out in front of the harm that we caused as soon as we verify that it has occurred and assess the situation to ensure that it doesn't recur. During our subsequent conversation, my new friend gave me the impression that, thankfully for him, most hospitals and physicians don't take that same approach.  


It was an interesting evening to say the least, from the build-your-own Manhattan menu, to the food that was so different and unique, to the best bartender by whom I have ever been served, to my new friend.  An interesting as well as enjoyable evening, especially when I can talk about the very progressive approaches that we are taking at WMHS.

Wednesday, November 12, 2014

The Last One

As many of you are aware, my son-in-law Terrell has been battling cancer, specifically high- grade osteosarcoma since February.  It just so happens that, truly by coincidence, I am in Charleston, SC, this week with Pamela for a meeting.  Charleston is where Jessica and Terrell live and where Terrell is receiving his treatment.  

We were able to arrive a day early, so yesterday Pamela and I had the privilege to take Terrell to the Medical College of South Carolina to be admitted for his LAST round of chemotherapy.  He will be hospitalized from Tuesday into the weekend, provided all goes well.  

Going into this last round of chemotherapy, he has had well over 60 inpatient treatments with various chemotherapy drugs and each hospital stay lasting anywhere from 4 to 13 days.  In addition, he had his right knee replaced, along with part of his femur, in June.  In addition to his hospital admissions, he has endured physical therapy several times each week since June, doctor visits and numerous procedures and tests since his diagnosis.  He has literally spent over a third of this year hospitalized.  

Through this ordeal, both Terrell and Jessica have truly become my heroes.  What they have endured since February and how they have handled it has been amazing.  Their faith, their resiliency, their endurance, and their ability to cope under such challenging circumstances have been remarkable. Their lives have been filled with ups and downs throughout the year, but normalcy returns next week.  

I want to thank everyone for their thoughts, their prayers and their concern.  People have been amazing, from the friend who organized meals almost every night since Terrell's diagnosis to the Greek Orthodox neighbor who provided anointing oil and holy water prior to each hospitalization, to the neighbors who watched Sammy (their dog), to their friends and relatives who have traveled from all over the country to visit throughout their ordeal.  The kindness and generosity have been overwhelming.  To think that both Jessica and Terrell have lived in Charleston, SC, for less than four years and to have such an outpouring of love, concern and friendship.  Both Jessica and Terrell, along with Pamela and I, have been truly blessed to have such wonderful people in our lives.  Please accept a most heartfelt thank you!


Friday, November 7, 2014

The Analysis and Implications of Maryland's Election Results

Yesterday, Nancy Adams, COO and CNE at WMHS, and I participated in a statewide conference call sponsored by the Maryland Hospital Association on the election results from Tuesday and what they mean for Maryland hospitals. Some of the background from the experts on the call was as follows: 

The outcome of the gubernatorial race was unexpected and based on the anti-tax trends against President Obama and Governor O'Malley, as well as an anti-incumbency trend.  Registered democrats in Maryland hold a two to one advantage over Republicans and Lt. Gov. Brown outspent Gov. Elect Hogan by a 4 to 1 margin ($19 million to $5 million), making the results that much more stunning.  

There were 1.6 million votes cast in total, which were less than what was cast in 2002 when Gov. Erhlich won (1.7 million votes).  Lt. Gov Brown lost by 75,000 votes to Gov. Elect Hogan.  There has been a steady decline in voter turnout, yet there has been an increase in registered voters in Maryland over the years.  Lt. Gov Brown won in Prince Georges, Montgomery and Charles Counties and Baltimore City but by a significantly lower margin than Governor O'Malley did four years ago.  Even Howard County, the home county of Ken Ulman, Lt. Gov Brown's running mate who was also the County Executive, was won by Gov. Elect Hogan by more than 5000 votes.  According to the experts, the 2012 redistricting based on the 2010 census that was done by the O'Malley Administration to strengthen Democratic districts didn't work to Lt. Gov Brown's advantage.

In the Maryland General Assembly, there are 57 new House members (seven new Republicans for a total of 50 Republicans out of 141) and 11 new Senators (two of which are Republicans for a total of 14 out of 47).

There will also be an overhaul of cabinet secretaries.  We are likely to see previous appointees from the Erhlich Administration since Gov. Elect Hogan served as Gov. Erhlich's appointment's secretary.  

For Maryland hospitals the message will not change based the election results.  We will continue to focus on preserving the Medicare waiver; reduce and eventually eliminate the Medicaid Assessment (tax) on hospitals; pursue medical liability (tort) reform and get State support for an increase in Behavioral Health services statewide.  MHA encouraged hospitals to build relationships with the newly elected House and Senate members in our districts and to appropriately educate them on issues facing WMHS as well as hospitals throughout Maryland.

Tuesday, November 4, 2014

Flu Shot News

Good news related to the flu shot in Maryland.  I learned yesterday that because of the Ebola scare, influenza vaccinations are up 30% so far this year.  Now it could be that the Ebola scare is reminding folks to get their shot, but I am also hearing from people who have opted out of getting the flu shot in previous years that they are getting it this year.  That's a good thing, but unfortunately it has taken the Ebola scare to get people motivated.  Isn't it enough that tens of thousands die every year from the flu?


I will be traveling for the next week and a half so I will be blogging intermittently.  Be well!

Friday, October 31, 2014

The Flu

I couldn't resist writing at least one blog during the influenza season on the flu.  I find it almost amusing as to the fear that is being expressed over Ebola by those outside of health care.  Yet, many of these same people who live in fear of contracting Ebola are still opposed to getting a flu shot.  On average 36,000 people die each year from the flu and hospitals are inundated with hundreds of thousands of  patients with the flu or flu-like symptoms usually from December through February each year.  

Getting the flu is far more easier and dangerous than Ebola, at least at this point in time.  Many say, "no" to a flu shot, but when asked if they would get vaccinated for Ebola, they say, "of course."  Americans are funny people.  According to a New Yorker article on "Ebola vs Flu," we underestimate the risk associated with common perils such as the flu, but overestimate the risk of novel or remote perils such as Ebola.  Similarly, we worry about flying and subsequently dying in a plane crash yet, by driving our cars everyday, our chances of dying are almost equal to dying from the flu.  There are around 30,000 car accident deaths per year in the US.  

So, if you haven't yet gotten your flu shot, get one.  You owe it to yourself, your family, your co-workers and if applicable, your patients.  Also, your chances of becoming a statistic will be significantly reduced.