"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.

Thursday, October 29, 2015

Medical Marijuana

In today's Baltimore Sun, there is an opinion piece on medical marijuana by Shawn Hershberger, Executive Director of the Cumberland Economic Development Commission, and me.  I have blogged about my support of medical marijuana in the past and was asked if I would do an op/ed for the Sun as the decisions to award licenses are fast approaching.  I agreed.  So far, I have received positive responses to the letter, but it's still early.


Thursday, October 22, 2015

Recognition of WMHS by Healthgrades

Healthgrades is the nation's leading resource for helping patients make informed decisions regarding their health care provider.  They evaluated nearly 4,500 hospitals throughout the US for the most common inpatient procedures and conditions and selected the 50 best performing hospitals for each condition.

For 2016, WMHS has been recognized as one of the 50 best hospitals for Cardiac Surgery.

Wow, what an amazing result!  Little old Cumberland in the national spotlight for our cardiac surgery program.  Obviously, a great deal of the program's success is directly attributable to Dr. Mark Nelson and his team, along with the many staff who serve in support roles.  

In addition to our recognition for cardiac surgery, we received a five-star rating in clinical outcomes for coronary bypass surgery, pacemaker procedures and total knee replacement for the past three years.  The great majority of conditions and procedures received 3 stars with a handful of areas getting just 1 star (obviously a great deal of focus will begin if it hasn't already in these areas).  We also received an Excellence Award for patient safety.   

We are in very good company with the other hospitals in the Trivergent Health Alliance,  Meritus and Frederick, in both the 5-star ratings and excellence awards.

With all of the recent advertising in Cumberland for cardiac surgery, orthopedics and cancer coming out of Morgantown, WV, I wonder how they fared with the 5-star ratings and excellence awards in each of those areas?

We have a great deal to be proud of and will be showcasing these awards on campus and in the community.  Congratulations to all at WMHS on a job very well done!

Thursday, October 15, 2015

Hiring Physicians

Last week there was an article in Becker's Hospital Review, "Whistle-blower Physicians: We have got to get hospitals out of the business of hiring doctors."  The article was based on a physician who brought allegations against a Florida health system for engaging in improper financial relationships with physicians.  The health system settled with the federal government for $69.5 million.  

It was the same physician who stated that hospitals shouldn't be hiring physicians.  I couldn't agree more if their intent is to engage in illegal practices; however, that isn't the case for the great majority of hospitals.  There are always going to be some who push the envelope too far, but for the most part they eventually get caught.  The Feds have made it very lucrative for whistle-blowers, such as the physician in this case, by sharing in a percentage of the settlement payment.   

As for hospitals not employing physicians, that's ridiculous.  The ability to engage in improper financial relationships pretty much goes away when one takes volume out of the equation.  All US hospitals are transitioning to a new care delivery model and away from fee-for-service or volume-based care.  Basing payment and incentives on quality and performance as one does in a value-based care delivery model pretty much takes away the incentive for hospitals to pay for referrals.  

In addition, the federal government continues to make it very difficult for physicians to conduct business from a regulatory perspective.  With tens of thousands of federal regulations that both hospitals and physicians must comply with, physicians have found it easier to be employed by hospitals so they can focus on practicing medicine rather than complying with onerous regulatory requirements.  

There will always be an opportunity for hospitals and physicians to act inappropriately, but such opportunities as described by the physician whistle-blower are significantly reduced through a change in how both hospitals and physicians are paid.

Wednesday, October 14, 2015

Front Line Patient Engagement

Last week while I was on rounds with Nancy Adams, COO/CNE, she asked me to stop in the staff conference room on 7 South.  There was our Patient Experience and Culture team meeting with a group of nurses who started their own unit-based Patient Satisfaction Committee.  

I was blown away with how wonderfully prepared they were for this meeting.  They were reviewing the satisfaction scores for their patient unit when we arrived.  They showed us with great pride their "patient pick me ups," which are nicely done sayings, words of encouragement or Bible verses for patients primarily but also for staff should the need for a pick me up arise.  Their agenda also included purposeful rounding, scripting when speaking to patients and their new Oncology Family Room.  

Several weeks ago, they opened their newly created family lounge, which had been converted from a patient room.  More and more younger adults are now being diagnosed with cancer so having a place for families whose loved one is receiving inpatient cancer treatments has been very well received.   While we were there, the committee was talking about how to better serve the children who are now using the lounge to a much greater extent.  

I was thrilled to see the interaction among this group of dedicated nurses as well as their commitment to our patients and their families.  Hopefully, this is a model that other patient units will adopt as we try to bring continued improvement to our overall patient satisfaction.  I am so blessed to have the opportunity to work with such wonderful people each day.

Friday, October 9, 2015

Showcasing WMHS

The other evening, WMHS hosted the Maryland Chapter of Healthcare Financial Management Association for a reception. The attendees were mostly Chief Financial Officers from Maryland hospitals and their financial teams. They were at Rocky Gap for a three-day meeting.  We had around 200 attendees at the reception and, to a person, they were amazed at what we have accomplished both structurally and in our care delivery model.
In addition to hosting the reception for around 180 of the attendees, Kim Repac and I served on two different panels.  Kim's panel was related to the formation of the Trivergent Health Alliance and I discussed our shift from fee for service to value-based care delivery. 

Being able to show off our hospital to others from around the state was a lot of fun.  Those who attended the reception also wanted to know about our fabulous caterer in Cumberland who could put on such a wonderful event.  It brought great pleasure to our team to tell the group that the "so called" caterer was our own food service staff at WMHS.  John, Mary Jo, Tara and the team do an exceptional job with such events and they instill a great deal of pride in me with all that they accomplish.  

Thank you's go out to John Wilson and his team; Michele Martz for organizing so many aspects of the HFMA meeting and activities, the Finance folks at WMHS for their involvement in the meeting and planning some of the events, Kathy Rogers for conducting tours of WMHS for our out-of-town guests and John Sensabaugh for his AV expertise at the reception.  I continue to say how blessed I am to be surrounded by so many phenomenal people.

Monday, October 5, 2015

Amazing Accomplishments

I have had the opportunity over the last week to express my appreciation to the leadership of WMHS as to our accomplishments over the last year.  I also asked that they convey that same appreciation to our staff throughout the System.

Some of the more notable successes for fiscal year 2015 are as follows:

  • Created the Bridges to Opportunity program to address poverty throughout our region.
  • Established our first community garden, providing fresh fruit and vegetables to those who may not have the opportunity to get them.  We also  provided hundreds of pounds of fruits and vegetables directly to the Western Maryland Food Bank from the garden.
  • Strong recruitment year for physicians and advanced practice professionals helped to meet a number of previously unmet needs at WMHS.
  • Refinanced our hospital bonds and saved $43 million over the next 25 years.
  • Ended the year fiscally very strong with a total margin of 14.45%.
  • Grew days cash on hand to 208 days.
  • Ended the year as Maryland's top performing hospital for hand hygiene.
  • Received Premier's Platinum Performance Achievement Award for the treatment of myocardial infarction.
  • Selected as one of the nation's Most Wired Hospitals by the American Hospital Association.
  • Ranked as the 11th best hospital in Maryland by US News and World Report.
  • Received the Maryland Patient Safety Center's Distinguished Achievement in Patient Safety Award.
  • Saved over $8 million through the Center for Clinical Resources by caring for patients with heart disease, Diabetes, hypertension and COPD in a setting other than inpatient acute care.

FY 2015 was an exceptional year and only achievable through the hard work and dedication of some amazing people.