"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.

Tuesday, September 20, 2016

Prescription Opioid and Heroin Epidemic Awareness Week

This week has been designated by the White House as an awareness week for the heroin and opioid epidemic facing our nation.  The focus is on those who have lost their lives to the epidemic as well as to support those recovering from the addiction.  The Obama administration is looking for $1.1 billion from Congress to address the epidemic.  
In Cumberland, those of us in health care, law enforcement, EMS, the legal community and public health are well aware of the epidemic.  In early August, WMHS sponsored a summit on the topic with the above-listed groups.  We took the opportunity to understand the issues facing each other in this crisis and to learn what we can do to better support each other.  Due to the success of the summit, we agreed that we would continue to have the summit on an every-other-month basis.  We also decided to add members to the group from the local Board of Education and the Dental Society as well as a local pharmacist.
The impact of this epidemic is widespread in our community.  We have had over 30 deaths since January; we average just about an overdose a day in our ED. The great majority of crime in our region is directly attributable to this drug addiction, and the epidemic continues to put an undue burden on our community in so many ways.
Enhancing community awareness was determined to be an area where our summit group could make an impact.  Everyone pledged to ensure such awareness related to this epidemic.  Hopefully, the President’s campaign will serve as an impetus to generate awareness nationally as so many communities like Cumberland are dealing with this horrific problem.

Friday, August 26, 2016

Where've Ya Been

I have heard from a number of people asking why no recent blogging.  There is an easy explanation and it’s called “there were too many distractions.”

Distraction number one was the birth of my first grandchild on August 1, 2016.  Matthew wasn’t expected for another 18 days, but he arrived early weighing in at 7 lbs 14 oz and 20.5 inches long.  As soon as being notified that our daughter was in labor we packed and left for Charleston, SC.

We arrived just after he was born and then stayed to help out.  This grandparenting thing is very cool and we are so looking forward to things to come.  Right now, we get a photo and/or video each day.  That helps with the 650 mile or so separation, but as he grows and starts crawling, talking, walking, that 650 miles will get further and further away.

Distraction number two has been the finalization of our strategic plan, especially a few key components in bringing them to fruition over the last two weeks.

Distraction number three has been catching up after being out of the office for two weeks, especially unexpectedly.  We thought that we had at least two weeks before the baby was due, but he threw us a curve.

My goal is to resume blogging with some frequency next week.  Have a great weekend!

Thursday, July 28, 2016

Preparing for the Future

Attached is an Update that was distributed to our Department Directors and Medical Staff yesterday afternoon.  It brings the first phase of our strategic planning process that began in April, 2016 to a close.  The Update describes Board actions taken last Friday in an effort better prepare WMHS for the future.  

Everyone recognizes the need to remain viable and to keep health care delivery local.  In order to do so, we will need to explore gaining greater access to physician specialists and sub-specialists to complement and enhance our existing clinical programs at WMHS.  A key component to any potential affiliation will be to bring those specialists to Cumberland and not have patients traveling out of town needlessly. 

The next phase will be to send a request for proposal to three academic medical centers, WVU Medicine, UPMC and UMMS in order to gauge their interest and commitment to such a partnership.  As this process proceeds, I will be blogging on the subject in an effort to keep everyone informed.

Tuesday, July 26, 2016

Clinical Quality in Western Maryland

Last month, the three health system CEOs in the Trivergent Health Alliance asked Nancy Adams, SVP & COO / CNE at WMHS, to serve as chair of the newly created Clinical Quality Initiative for the Trivergent Health Alliance (THA).  Nancy will lead a team of her clinical counterparts from Meritus Health, Frederick Memorial and WMHS with a focus on clinical quality at the three health systems.
The Trivergent Health Alliance has experienced a great deal of success with our population health initiatives and the management services organization, and we would like to build upon those successes in the area of clinical quality.  This team consisting of a Chief Operating Officer, Chief Nursing Officers, Chief Medical Officers and a Chief Quality Officer will be examining areas like understanding the clinical capabilities and program offerings at each health system, identifying which programs could benefit the Alliance as a whole, focusing on best practices in areas such as patient experience, strengthening physician engagement across the Alliance, exploring which clinical resources that could be shared, linking clinical quality to the THA’s Supply Chain and Value Analysis approach and working to reduce variation in clinical care specialty areas.
The Clinical Quality Team began its work earlier this month.  In addition to reporting to the three CEOs, they will be accountable to the Trivergent Health Alliance Board of Directors.
We are hopeful that we can experience the same level of success with this initiative that we have with population health and the MSO.
On a side note, the Trivergent Health Alliance was featured in Hospitals magazine article last week on ways hospitals can collaborate without merging.  The link is below. 


Monday, July 25, 2016

Unfortunately, There Is No End In Sight

The other day, I asked for an update about the number of opiate-related overdoses that our ED has treated from January 1, 2016 through June 30, 2016.  There have been a total of 198 overdoses, with 142 being opiate or heroin related.  Those 142 overdoses have resulted in 26 deaths.  For emphasis, that’s 26 sons, daughters, moms and dads who have died due to an overdose of heroin.  If the police, and now the public, didn’t have Narcan to be administered when an overdose occurs, the death rate would be much higher.  
Our ED is treating practically an overdose per day.  But, if it was only that easy.  On July 12, our ED staff treated five heroin overdoses in one evening.  As you can see, our July numbers aren’t even reflected in the total for the first half of calendar year 2016.  
Our ED staff and our EMS providers throughout the region are now dealing with an absolute crisis in our community.  On the evening of July 12, our staff not only dealt with the five overdoses, but also with nine behavioral health patients, a series of critical care patients and a host of other patients with a variety of emergent needs in our ED.  We were forced to go on diversion sending patients to another ED for a period of time with our staff being overwhelmed with a full ED and waiting room.  That diversion put a significant burden on the EMS community, which then had to travel much farther to an ED outside of Cumberland.  
To demonstrate just how significant our ED has changed, last weekend a Cumberland police officer was attacked outside our hospital when he went to question an individual who was wanted in another county.  Both the police officer and the suspect were treated in our ED.  The suspect came into the ED in a rage, knocking over a computer on wheels and threatening staff.  Such behavior is fast becoming an almost everyday occurrence as our ED staff and providers are being spit upon, threatened and assaulted.  
We now have an armed police officer in our ED from 7 PM to 3 AM every day.  We are reaching out to our ED staff and providers to get their input as we reassess security in the ED.  Knowing that an armed police officer is in our ED during peak times previously gave some comfort; however, that now isn’t even enough.  Our staff are dealing with challenging patients morning, noon and night.  We will be having an upcoming ED Summit to determine what changes need to occur to enhance the safety and security of our patients and staff.  
So, the next time you hear how long someone had to wait in our ED or the staff could have been nicer, please understand what these ED professionals are dealing with each day.  In no way am I condoning having anything less than a professional, courteous staff in the ED for our patients, but I am trying to enhance the community’s awareness of what has become a typical day in our Emergency Department.

Tuesday, June 28, 2016

How Our Garden Grows

As you know, I contribute to a blog called Hospital Impact published by Fierce Healthcare.  I recently had the opportunity to talk about our community garden project that began last year and how it has "grown" this year.  The link to the blog is below.  

However, the photo on the Fierce Healthcare website is not our garden--it's a stock photo of a generic garden.  Below are a few photos of the new orchard area that was added this year.  Planting took place during County United Way's Day of Caring and Sharing in May

Fierce Healthcare Blog

Wednesday, June 22, 2016

Addressing Gun Violence

Now this is an area in which I have little expertise, but like those in Hollywood or the music industry who weigh in from time to time on political and social issues without any knowledge or expertise, I am going to offer my unsolicited personal opinion. 
I don’t own an assault weapon, but my house contains a few less threatening weapons so I am a proponent of gun ownership.  However, when it comes to assault weapons, I can’t think of one good reason on God’s green earth that any individual outside of law enforcement or the military would need to possess an assault weapon.  But yet, 1.3 million such weapons are sold each year in the US.  The amount of carnage left by such weapons in the hands of radical extremists, those motivated by hatred or deranged murderers is unimaginable unless you have been directly impacted--and then I am sure that it’s surreal but in a bizarre way.  
The focus needs to be on gun control legislation, which disappointedly wasn’t passed by either party yesterday in the Senate.  How embarrassing. The American people deserve far better than what we are getting from our Senators and Congressional representatives as they allow special interest and partisanship to influence their voting.  We are going to continue to allow those on terror watch lists, those with mental illness and known or suspected terrorists to buy guns?  Seriously?  They couldn’t even support expanded background checks to weed out those who are a danger to virtually everyone.  
And don’t give me that we are trampling on the rights of gun owners.  If you don’t fall into one of the above categories, i.e. radical extremists or deranged murderer, then you have nothing to worry about.  You’ll get your gun, just not today.   I don’t think that our forefathers when writing the second amendment of the Constitution had weapons in mind that could mass murder its citizens in a matter of seconds.
What you don’t hear after a mass shooting like San Bernardino or Orlando is that more needs to be done to address behavioral health issues.  We already spend over $220 billion annually in the US exclusively on behavioral health, but it still isn’t enough or it isn’t being spent wisely.  Just look at the waste that occurs in the fee-for-service acute care setting with testing, retesting, unnecessary admissions, ED use for non-emergent situations and other potentially avoidable utilization.  Maybe, how those monies are being spent needs to be re-examined?  Congress needs to allow funding for gun violence research then work to appropriately apply funding that addresses behavioral health issues which can lead to gun violence.  
There is so much more that needs to be done and our leaders in Washington need to do their jobs in representing the American people and not special interests on this issue.  From 1994 to 2004, there was an assault weapons ban in the US.  During that time, there was only one outlier year and that was in 1999--the year of the Columbine High School shooting.  Since the ban was allowed to expire in 2005, there have been 44 mass shootings where three or more people were killed.  During the preceding ten years during the ban, there were 17 such shootings.  

In addition to the legislation and funding mentioned above, reinstituting the ban would certainly be worth a try because whatever we are doing currently, it isn’t working.