"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, October 28, 2016

Improving the Community’s Perception of WMHS

On Monday, I blogged about feedback that we received from our leadership related to improving the community’s perception of WMHS.  Lots of ideas were offered and I thought that it would be beneficial for everyone to know what we will be focusing on over the next few months related to perception.
Executing on Fundamentals
  • First and foremost, find out the drivers for the misperceptions
  • Educate and engage our employees to a much greater extent on the many positives occurring at WMHS
  • Hardwire the patient experience process organization wide
  • Explain why there may be long waits in the ED and the steps that are being taken to address
  • Ensure accountability of our staff that they are putting the patient at the center of everything that they do
  • Better manage patient and family expectations
  • Encourage patients to make complaints when problems occur – we can’t fix it if we don’t know about it
  • Do a better job of scripting staff when they hear negative comments about WMHS
  • Make sure that the staff know where complaints should be directed
  • Use Voice of the Patient findings from our patient satisfaction results to identify patient issues and follow up when possible
  • Patients need to understand how health care is changing and what to expect when you come to the hospital
  • Explain our triage process in the ED as to why some patients may be seen more rapidly than others
  • Need to engage physicians more so they have a better and more accurate perception of WMHS; especially those who no longer have a hospital practice
  • Establish a Patient / Family Council at WMHS
Prove Our Credibility
  • Tell our story to a greater extent; a little shameless self-promotion could be a good thing
  • More thoroughly explain the Hospital Medicine program and the credentials of these very well trained hospitalists
  • Make sure that the public knows that their primary care physician has chosen not to come to the hospital and that he or she has been replaced by a hospitalist
  • Encourage staff to intervene as quickly as possible to address problems and issues so they can be resolved as quickly as possible.
  • Send the latest annual report (Transforming Healthcare) to homes throughout the region
  • Provide that same annual report to every patient upon admission
  • Contact every patient post discharge to thank them for choosing WMHS
  • Provide blameless apologies while patients and families are still at the hospital
Demonstrate Value
  • Promote the positives, i.e. the WMHS Heart Institute, the Da Vinci Robot, the Wound Center, the Schwab Family Cancer Center, etc.
  • Increase engagement of patients and families
  • Ensure the community that it’s not only academic medical centers that have the latest technology.  We have state of the art technology for all programs and services offered at WMHS.
  • Provide ongoing education to staff on the latest happenings at WMHS that would benefit both them and their patients
  • Promote our quality measures that are already on our website to the community
  • Ensure that our Marketing Dept is well aware of the latest technology, equipment and techniques being used and applied at WMHS
Again, it was a day very well spent with many wonderful ideas being offered.  I have attached an electronic copy of our annual report, Transforming Healthcare, to this blog so you can see for yourself what we have been up to at WMHS over the last year.  Lots of great things are happening every day at WMHS; we just need to tell someone.

WMHS FY2016 Accomplishments

Monday, October 24, 2016

A Day Very Well Spent

On Friday, we had an all day meeting of our department directors and nurse managers.  We used the day to get feedback and validation on the results of our recently completed department director survey and on our strategic plan.  

The WMHS Board approved the strategic plan in September, and we have been presenting components of our plan to the leadership group since then. On Friday, there were two primary objectives to be achieved during the meeting:  generate ideas to improve the community's perception of WMHS and build tactics to support the strategic plan. The ideas coming from the group on improving perception were amazing and will be put into action immediately.

In the afternoon, the group broke into five teams to build tactics around each strategic goal.  Attached is the strategy map outlining each strategic goal and their supporting objectives.  There are a series of strategies for each objective, and tactics will be developed at the department and patient unit levels around each strategy.  There was a great deal of information provided during the afternoon session, as well.  Numerous tactics were built around each strategy and over the next few months, the teams will continue to meet to finalize the plan with department and unit level tactics.  It was also determined that the plan will be a very dynamic document complete with performance measurement and accountability at every level of the organization.  In the past, the strategic plan pretty much remained at the management level.  

In the morning session, one of the suggestions for improving community perception was to have greater engagement of all WMHS staff.  We have over 2000 potential ambassadors who with the necessary knowledge, background and education could tell the story of what actually happens at WMHS, including the wonderful things happening every day through the work of some amazing people.  

Again, Friday was a day that was very well spent for all of us.  There will be more to follow in subsequent blogs on the specifics of a very successful day.

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.