Happy 13th Birthday

Today is my cousin's 13th birthday.  She was born in 1960, but technically can lay claim to only celebrating thirteen birthdays.  Actually, she celebrates her birthday on the 28th of February when there isn't a leap year.  Just what the heck is leap year and why does it come every four years, you ask?  Well, it takes the Earth exactly 365 days, 5 hours, 48 minutes and 46 seconds to travel around the sun.  So, leap day is necessary every four years to keep us aligned with the four seasons.  It is also important to note that when we elect a US President; that occurs every leap year.  So, in celebration of Leap Year or Day, in this case, a very unique day on the calendar, do something different today.  Have fun!

Unlimited Vacation Time

Joe Reynolds is the owner of an event production company called Red Frog.  He provides a unique benefit to his employees, unlimited vacation days.  He says it treats employees like adults; it reduces cost by not tracking vacation days and it's a great recruitment tool.  Joe claims that it's not abused.  I have trouble believing Joe's claims.  I can't imagine providing such a benefit in this day and age within real businesses, and I don't consider myself a dinosaur.  I know that this benefit sounds very Generation Y-like, but I just think of the abuse that is currently out there related to the Family Medical Leave Act (FMLA).  Many employees could serve as experts in how to game the FMLA system and the abuse (all within the law) doesn't go over very well with their responsible co-workers.  I can't imagine unlimited vacation days with this group; their employers would never see them.  Maybe the unlimited vacation days’ concept is a great idea for boutique startups, but not real employers.  By the way, everyone at Joe's "company" gets to pick their titles, as well.  That's a lot of CEOs.

Harvard Business Review

I just read most of the recent issue of HBR (March 2012); this issue should be required reading for every level and branch of government, every Chamber of Commerce Board, every member of the C- Suite, every college and university president and list goes on.  Wow!  The issue contains articles on the importance of US competitiveness, the criticality of manufacturing, the challenges to our competitiveness, rethinking our approach to education (incorporating new tools), fixing our political system, reviving entrepreneurship and how GE is sparking their manufacturing renewal.  Our many competitive strengths as a nation seem to be waning a bit.  Our renewal is dependent on our business leaders taking the lead to address our weaknesses, i.e. our education system, information technology shortcomings, our declining aerospace and defense industries, much needed enhancements to our auto industry, just to name a few.  Government needs to follow with addressing our tax code, our declining infrastructure, over-regulation of business and paving the way for the work of our business leaders.  The Dean of Harvard's School of Business, writes, "our problems are huge, but not insurmountable; we can move forward even when it's difficult to craft political compromise and even in a climate where businesses are feeling public hostility."  The time for action is now.   Go out and get your copy of the March HBR and then be inspired to do something.

The Vulnerable Patient

Yesterday, I wrote about the vulnerable patient and the impact on our hospital and other hospitals.  There are solutions that we are pursuing for such patients.  First and foremost, we need to forge a relationship with our community in the care for such patients.  Many of these patients don't require hospital admission.  We need to work with them and our community partners on keeping them in their home.  Support them in their environment with personal care, home care, transitional care, medication management, better education of them and their families, meals on wheels and respite care.  We need to keep them out of the hospital unless they are truly ill and meet the requirements for an acute care admission.  We need to do a better job of advocating for such individuals and make sure that our elected leaders are aware of their plight and ours.  This issue is far from being resolved, but I think that we are on the right track at WMHS.   Even working to educate our staff and physicians on this issue is a great start.

There's a Hole in the Safety Net

Yesterday, I convened a meeting at the health system of a variety of professionals to talk about the vulnerable patient and how to support the needs of such patients without WMHS going broke in the process.  Previously, there were a multitude of agencies to assist; today, not so much.  The funding has been cut and many of the agencies that could assist previously are either gone or refocused in other areas where funding may exist.  The shelters are full, assisted living is too expensive and drug rehab funding has been severely cut.   Many of these patients have no one; no family, no friends or at least no one who cares; some are drug abusers; many have behavioral health issues.  As one physician in the meeting described these patients, "they are truly pathetic people who may not survive without that safety net." 

Unfortunately, hospitals no longer have the luxury of being that safety net; although legally, we may not have a choice.  Not only are we no longer paid for such patients, we are now penalized for caring for and keeping such patients in our hospitals.  Yet, we cannot discharge these patients until a safe discharge plan can be successfully executed.  Last month, there was an article in the NY Times about a hospital in NYC that had an illegal immigrant from China who was a patient for over 4 years, costing the hospital millions because no one would take the patient.  He was eventually placed in a rehab facility once the federal government certified him as a permanent citizen.   The hospital even offered to fly him back to China at their expense, but the Chinese government refused.  We deal with such patients all of the time.  Four years isn't the norm at WMHS, but it can be many months as for these vulnerable patients until we have worked through all of the legal requirements in getting such individuals placed. 

Hospitals are now being required to be responsible for the health of the population that they serve.  In order for that concept to be successful, there needs to be a faster way to get our vulnerable patients into the most appropriate care setting.  If that doesn't happen, hospitals will not be able to sustain the losses created by having patients who are in need of care, just not acute care.

He's Wearing Us Down

I spent a long weekend in South Carolina and drove home yesterday.  I marveled all of the way home at the increased gas prices since last week.  Gas in Virginia and South Carolina was the least expensive in the $3.78 range for premium.  North Carolina and West Virginia were higher in the $3.85 range for premium, but then you arrive in Maryland and it was over $4 a gallon.  Other states weren't even close yesterday to Maryland's price for gas and, yet, the Governor wants a 6% sales tax phased in over three years on an already exorbitant tax rate of $0.235 cents per gallon.  So, how is he wearing us down?  My speculation is that the Governor wants a 1% increase to the sales tax.  A sales tax increase on the surface looks a lot less onerous than another increase in the gas tax, especially when the per gallon cost of gasoline is expected to exceed $5 this spring.  It will be interesting to see how it all plays out.

Hello My Name Is..........

Have you ever heard of Scott Ginsberg?  He is the author of "The Nametag Principle."  For over 4000 days, Scott has worn a "Hello My Name Is Scott" name badge.  It started in college when he attended an event that required a name badge.  After the event, he kept the name badge on and has worn it every day since.  What is so interesting is how many people have approached him over the years, the new friends, the contacts and yes, the weird looks, but most importantly, it gave people the opportunity to say "hello.”  Scott says you don't need to wear a name badge to get noticed.  He says be receptive like you are wearing a name tag; when people see you as approachable, all sorts of opportunities open up.  He says decide what you makes you unique and leverage it.  Lastly, have confidence in your identity; find some way to tell the world who you are.