"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.

Wednesday, November 30, 2011

Thank You, Secretary Panetta

Yesterday, I read an article in the Navy Times regarding Defense Department cuts and the impact on the Navy.  Currently, my daughter is on a 4-month deployment for her, but an almost 11-month deployment for her ship.  The article was about the expected increase in deployment time for all ships going forward to be more in the 10 to 12 month range rather than the traditional 7-month time frame.  The increase is due to the number of ships that will be taken out of service by the Navy for budgetary reasons.  In my opinion, not a good time to reduce the size of our Navy as China is dramatically growing the size of theirs, as well as with all of the unrest throughout the world.  Anyway, with the downsizing of the number of ships to what some say is pre-WWII levels, comes the downsizing of the fleet.  Lo and behold, hundreds of Navy Chiefs were notified yesterday that they will be leaving the Navy.  This notification will be the first of many in not only the Navy, but throughout our armed forces.  Is this the smartest move at this point in time?  I guess time will tell.  By the way, what a nice Christmas present for those Chiefs and their families.

Tuesday, November 29, 2011

Anti-Aging Eating

OK, I just learned that as you age your skin begins to dry out.  I guess that I really never thought of it.  Apparently, you can head off that drying out process by eating more fish, avocados, olives and walnuts.  Any foods that have omega-3 and omega-9 fatty acids and monounsaturated fats will do the trick.  Vitamin D decreases wrinkling of the skin so eat more broccoli, papaya and kiwi.  Oysters are high in zinc and help keep your skin plump and firm.  I guess these tips fall under the category of keeping you looking youthful.  Other suggestions for keeping that youthful appearance would be to moisturize daily and sleep 6  1/2 to 8 hours a night.  Getting old seems to be getting tougher and tougher.

Monday, November 28, 2011

Corporate Responsibility

A few months ago, I wrote about how pleased I was with Delta Airlines based on travel to and from the Canadian Rockies.  Well, today I am not so pleased after reading a blog regarding their position to support the National Vaccine Information Center by running a NVIC ad on their flights. 
The last thing we need is for more people to opt out of getting vaccines and immunizations, especially children.  Both are the greatest wellness initiatives that we have in our arsenal to fight illness and disease.  The NVIC uses emotion, movie star endorsements and very little science in their anti- immunization campaign and less than concrete advice in their anti-vaccine campaign.   They recommend that one cover one’s mouth when coughing and to wash their hands, as both should be sufficient.  Tell that to a toddler or a parent where consistent availability of running water may not be an option.  One would think that a company with the size and reputation of Delta would have consulted experts on both sides and made a more informed decision.  I can’t believe that they could arrive at such a decision being armed with all of the facts or recognize the controversy and don’t take any position.

Friday, November 25, 2011

Where Have Our Leaders Gone, Part 2

As a continuation from Wednesday, now for the rest of the story.  The crisis in Washington is an abject failure of leadership, starting with the President.  For the President, the Speaker of the House and the Senate Majority Leader to in one continuous motion to throw up their hands and then begin pointing fingers at each other is a disgrace and an embarrassment.  These are our leaders, who have been elected to do what is best for our country and our citizens, not what is best for them to get re-elected.  To entrench themselves in absolute positions with no compromise puts this country in dire straits. 

We have a $15 trillion dollar deficit with Republicans not budging on tax revenues and the Democrats still wanting to spend dollars that don't exist on social programs while touting their support of the "Occupy Everywhere" demonstrators. All of this is going on while the President runs for re-election, with his concept of leadership being the generator of political attack soundbites is mind-boggling.  All of these so-called leaders need to be replaced with individuals who are dedicated to addressing this crisis and returning our country to a position of economic stability.  As for the Super Committee, reconstitute it with members of the House and Senate who are not running for re-election and see what happens.  A lack of leadership, in this case, is crippling a country.

Thursday, November 24, 2011

Happy Thanksgiving

This week, I received a Thanksgiving message, gift and invitation from Senator Ben Cardin.  The invitation was to contribute to his re-election campaign.   Hello, we are in Maryland, where Democrats outnumber Republicans 5 to 1 and you are a seated Senator who is very well liked, even by me, a Republican.  It also doesn't hurt that you are a Pitt alum, just as I am.  But, you need money, why?

Anyway, the gift was a Thanksgiving recipe for the Cardin Family Sweet Potato Casserole.  So, that gift got me to thinking.  I am going to share with you a recipe for Thanksgiving turkey leftovers and my daughter's favorite meal.  Enjoy!

Turkey Devonshire

Leftover Turkey
Toasted Bread
Cheese Sauce*  (any basic cheese sauce recipe will do)

1. Fry / microwave / bake bacon (two strips for each serving)
2. Toast bread (one piece per serving)
3. Place cold turkey slices and cooked bacon on toast
4. Pour cheese sauce on top
5. Place in the broiler for about two minutes* (Be careful, the plate should be placed on a trivet or heat resistant surface as it is hot coming out of the broiler and served immediately)

Simple and easy.  The above recipe takes about 30 minutes total from start to finish. 

Heat up the rest of the leftovers, add cranberry sauce and serve.

Happy Thanksgiving!

Wednesday, November 23, 2011

Where Have Our Leaders Gone?

The title of this blog I took from my father-in-law, who said that would be the title of his book if he ever got around to writing one.  He didn't, but if he did, it would have been about the steel industry.  He ran a foundry in Latrobe, PA, and blamed the collapse of the industry on the failure of management, surprisingly not the steelworkers.   In fact, he predicted it years before it happened.   It took me a while to figure that out, but I eventually did.  He would say every time the union would demand something, management would give it to them.  In many instances, there was absolutely no business sense involved in caving to the demand.  It was management that ruined the industry--not the unions.  Eventually, the industry couldn't compete against foreign steel because of wages and benefits provided to the steelworkers, who, after never being told "no," felt that management was bluffing when plants were first threatened with closure and then eventually closed for good.  When I lived in Pittsburgh, I would sometimes go to bars for lunch, to eat not drink, and there would be the steelworkers everyday waiting for the steel mills to reopen as it would was only a matter of time.  Unfortunately, the steel mills remained shuttered and never reopened.   So, a lack of leadership crippled an industry. That was a long explanation for a blog title, so you'll have to wait to Friday for the actual blog.

Tuesday, November 22, 2011

The Kennedy Assassination

Yesterday, I blogged about a joyous anniversary, the opening of the new hospital.  Today, not so much.  Forty-eight years ago, I was nine years old and in the 4th grade, boy have I gotten old.  On that brisk November day just after lunch, we returned from the school yard.  We had just settled into our desks for afternoon instruction and word came over the loudspeaker for the Sisters to turn on the classroom televisions.  At that point, we learned of President Kennedy's assassination.  I think everyone was in shock.  Sister Theresa cried while the class stared at the TV trying to understand which was pretty challenging for 8 and 9 year olds.  Within 30 minutes of learning of the assassination, we were all told to gather up our belongings and to go straight home.  The President Kennedy's death didn't really hit me until I got home and saw my Irish Catholic father standing in the kitchen crying.  I had never seen my father cry before.  It was certainly a day of many firsts and one that I will never forget.

Monday, November 21, 2011

Happy Anniversary Western Maryland Regional Medical Center

Two years ago today, WMHS moved into a brand new state-of-the-art hospital.  It seems like yesterday and the facility still looks like it was yesterday.  The facility is in great shape.  We have had a few areas where the product didn't hold up, mostly flooring, but in those areas where it was a problem the flooring has been swapped out.  We also have taken the initiative to replace carpeted areas with tile flooring due to wear and tear or staining.  Otherwise, it is amazing as to how well the new building and all of its operating systems have held up. 

Clearly, the continued success is directly attributable to a visionary Board of Directors; great design team, Hord Coplan and Macht; a great construction team, Barton Malow / Mascaro; great leadership from the C-Suite to Kevin Turley to Jo Wilson and a wonderful staff of employees and physicians who planned and operationalized the new hospital.  Happy Anniversary and congratulations on a job very well done. 

Friday, November 18, 2011

Credibility Book Discussion

Earlier this week, I wrote about the book that the leadership team is reading, "Credibility, How Leaders Gain and Lose It, Why People Demand It".  The WMHS Leadership Institute held 8 book discussions on chapters 1 and 2 over the last two weeks.  I participated in a session with about 20 other leaders in the organization on Wednesday.  It was an hour very well spent.  Going in, I was a little concerned that with my attendance, those leaders would be reluctant to speak and participate.  Not the case.  It was a great exchange, even with some talking about not being able to effectively articulate the vision for the organization and their department to their employees.  Then, having others providing suggested approaches on how to get that staff better engaged.  Everyone seemed to get something out of the discussion and they all loved the book. I am now looking forward to the chapter 3 and 4 discussion.  Great job, Jeanie Seifarth in putting this altogether and Mark Kerns in effectively leading a session with me at the table.

Thursday, November 17, 2011

The Great American Smokeout Day

Today is the 36th Great American Smokeout Day sponsored by the American Cancer Society.  The year of origin for the Smokeout Day was 1975 when I was still smoking about a pack of cigarettes a day.  I started at age 16 for the sole reason of being cool.   The day my mother found my cigarettes stashed in my closet was a very uncool day.  I can still hear her screaming at me.  My father, who was a smoker from age 15 to 52 and who died at age 62 of a two-pack a day of Pall Mall's related death, laid out the ground rules.  No smoking in the house and no smoking in front of your mother; that lasted 2 years.  I then smoked to age 21. 

My quitting had nothing to do with the Great American Smokeout; I quit 3 months prior.  It had to do with a woman.  I had met Pamela, my wife of 35 years, five months before and I was still smoking.  I decided to relocate to Pittsburgh where she lived.  On the several day trip from Miami to Pittsburgh, with a stopover in New Jersey to visit my parents, I caught a horrible cold.  Every time that I caught a cold, I would stop smoking.  However, this time after the cold was over I had one cigarette and it tasted horrible.  The desire for a cigarette was gone and I haven't had one since. 

Now, for the interesting part.  Unbeknownst to me, Pamela hated cigarettes and the harm that they caused. She never said anything during our 4 dates in Miami nor in the almost daily letters that she wrote until I moved to Pittsburgh.  After I moved to Pittsburgh, she told me that she really wanted this relationship to work and didn't want her dislike for cigarettes to impact our future together.  She said that she prayed about it every day from the time that I told her that I was moving to Pittsburgh until after I arrived.  She said that she left it in Lord's the hands.  After I arrived, she quickly noticed that I stopped smoking and inquired why.  I told her about the cold and that I tried to resume smoking after the cold, but the taste and desire for a cigarette were gone.  The Lord works in mysterious ways at least he did for Pamela and me.  So, take advantage of today's message on the Great American Smokeout.  If you are still smoking, quit as was revealed today that President Obama quit, but it took 5 years.  The other option, pray about it, worked for me.

Wednesday, November 16, 2011

Decline in Admissions

The number of admissions to Maryland hospitals has dropped over the past several years.  For the FY ending June 2011, admissions at WMHS were down about 5%, which mirrors the state average.  Part of the admissions decline is in response to payment reform in Maryland, but the other part can be attributable to the efforts to improve the health care delivery system.  We have been working to ensure that the most appropriate care is being delivered in the most appropriate setting.  Routinely, patients who needed care and treatment beyond the Emergency Department were often admitted to the hospital; now they may receive care in our Observation Unit or discharged and followed up at home or in one of our clinics.  Lots of changes are happening as we try to stay on the forefront of care being delivered in a different way.  Stay tuned.

Tuesday, November 15, 2011


At WMHS, our leadership group is reading, "Credibility: How Leaders Gain and Lose It, Why People Demand It" by Kouzes and Posner.  Recognizing that the average Fortune 500 CEO reads 24 management / leadership books per year and the average manager reads one per year, we have stepped up commitment to leadership development through the creation of the WMHS Leadership Institute.  One area of focus is reading a book a quarter.  We buy the book, distribute it to our supervisors, managers, directors and VPs and then hold book discussions usually based on two chapters in the book.  The timing of this book is incredible with the horrific situation at Penn State.  With credibility as the cornerstone for effective leadership, quite a few folks at PSU could have greatly benefited from this book.  As the new leadership at Penn State begins to form and address the many challenges ahead, they may want to start with reading this book and taking to heart the acronyms DWYSYWD (Do What You Say You Will Do) and DWWSWWD (We Say We Will), as both drive superior employee performance.

Monday, November 14, 2011

Veteran's Day

On Friday, we celebrated the 22 million living veterans in our country, including those who are affiliated with WMHS.  We had a breakfast for our veterans and those employees who have family members currently serving our country.  We were also fortunate to have a few patients and their families join us for the recognition.  This was year two for such recognition on Veterans Day and long overdue.  We can't do enough for these men and women who reportedly have service connected disabilities and a reported unemployment rate that is double the national rate of 9%.  Please take the opportunity to thank a veteran or a member of our armed services currently serving as every day should be Veterans Day as these a people who have sacrificed so much for our freedom. 

Friday, November 11, 2011

Look Out Healthcare, Here Comes WalMart, Again

I just read that WalMart is getting into the primary care business, adding to their previous ventures into retail clinics and prescription drugs.  They are seeking partners to propose low cost health care plans as they pursue their goal of being "the largest provider of primary care services in the nation."  After singlehandedly putting Mom and Pop grocery stores, pharmacies and other small town retailers out of business, their latest target is health care.  Hopefully, their efforts to take over primary care services in America will suffer from the same lack of success as their retail clinics and electronic health records.  I am sorry; I can't imagine receiving medical care from WalMart.  By the way, their other areas of interest in the health care arena include monitoring for asthma, sleep apnea, osteoporosis, allergies, diagnostic testing and lab services.

Thursday, November 10, 2011

Limiting Outpatient Visits for Medicaid Patients

In their infinite wisdom, the Department of Health and Mental Hygiene in Maryland is proposing as a cost saving measure to limit the number of outpatient visits to ten per year for Medicaid patients.  A few weeks ago, I commented on that some states were limiting the number of inpatient days for Medicaid patients.  Maryland's approach is the same shortsighted planning as the other states.  Applying an arbitrary limit would disrupt the care for some of our most vulnerable citizens.  Individuals suffering from AIDS, mental health conditions, high-risk pregnancies and substance abuse would be harmed by limiting access.  These patients would delay treatment until they needed to be hospitalized or would seek treatment in the ER, generating a higher cost of care in both instances. This approach runs contrary to what hospitals are now trying to achieve by providing care in the most appropriate setting in an attempt to keep patients out of the hospital.  The Maryland Hospital Association has presented a five-point plan to create Medicaid savings that hopefully DHMH will embrace.

Wednesday, November 9, 2011

Maryland's Competitiveness

Yesterday, I blogged about the O'Malley administration beginning to embrace the business community.  Today, I will expand on areas where the state leads and where we lag related to our competitiveness. This information is based on a presentation to the Maryland Chamber of Commerce last week.  Maryland leads other states in workforce quality, access to capital, quality of life, fiscal stability and economic performance.  Where we lag would include high labor costs,  a greater tax burden, commercial energy costs that are higher than most (Maryland ranks 40th), an unfriendly liability and regulatory environment, 50th in mean travel time to work and 44th in cost of living.  Governor O'Malley's new focus on bringing and retaining businesses in Maryland is both welcomed and critical to our future.

Tuesday, November 8, 2011

Maryland Now Embracing the Business Community, What's Up With That?

All of a sudden, Governor O'Malley is reaching out to the Maryland Chamber of Commerce, of which I am a board member, to make Maryland more business friendly.  Well, it's about time.  Maryland has slipped to one of the most business unfriendly states in the country under Governor O'Malley due to high taxes and excessive regulations.  So under the "what's up" category, we just learned that yet another company has decided to move 625 jobs out of Maryland to one of the most business friendly States in the US, Virginia.  The Bechtel move comes after Governor O'Malley reached out to Bechtel to keep 1250 jobs in Frederick, Maryland, and was successful ,which is a good thing, but it wasn't enough to keep Bechtel's Global Operations Headquarters here.  Hopefully, the Governor finally gets it that creating and keeping private sector jobs in Maryland is critical to our future and that we can't exist off of our close proximity to DC and federal government jobs exclusively.

Friday, November 4, 2011

NOLA, Part 2

I had the opportunity to see New Orleans by daylight.  Bourbon Street does so much better under the cover of darkness.  During the day, looks especially seedy.  Not very attractive women with piercings and tattoos dressed in a bikini top and a G-string trying to lure you into the too numerous to count Gentlemen's Clubs.  It doesn't matter that you are with your wife, she can come too!  Yeh, right.  Royal Street was a nice surprise with the very many antique shops with some amazing inventory. The food continues to be excellent.  We ate in Arnauld's last evening and what looks like a 1 star restaurant during the day is transformed into a 5 star restaurant at night. 
I mentioned yesterday my first experience with a beignet which is unique to NOLA.  If you haven't had one, it's fried dough drenched in powdered sugar (photo below). 

My visit to New Orleans ends tomorrow morning and I would probably return.  I won't stay at the Marriott in the French Quarter.  Very poor service orientation.  It's hard to imagine that Ritz Carlton with the highest level of service orientation of any hotel chain is owned by Marriott.  I have a suggestion for Bill Marriott, why don't you have the Marriott hotel managers attend the same Service Excellence program that WMHS attended conducted by the Ritz Carlton?

Thursday, November 3, 2011


I am attending a meeting in New Orleans, LA, through tomorrow.  My first visit to NOLA or Norlands and based on what I had heard, I was dreading it.  I am happy to report, so far so good.  Travel was uneventful since my last trip for a total of ten days, I didn't have luggage for four of those days thanks to the airline industry.  Hotel is fine, food is great and Bourbon Street was better than I expected.  I had my first experience with Beignets, fried dough covered in powdered sugar.  Not bad, but not great for the waistline.  All in all, I would return in the future.

Wednesday, November 2, 2011

Enterprise Risk Management

Risk management has been around for a very long time in hospitals.  Yesterday at WMHS, we embarked on a new approach, an enterprise risk management initiative.  We will assess every aspect of the health system to determine what and where the risks to the organization may be.  System-wide risk will be assessed starting with a review of the strategic plan and then priorities will be determined in areas of regulatory compliance, patient safety, internal audit and the list goes on.  As we get further into the initiative, I will blog on our progress.

Tuesday, November 1, 2011

The Grocery Store Tour

Beginning tomorrow, November 2, at Martin's in LaVale at 10 AM, WMHS will begin our free guided tour of one of our local grocery stores.  There are 4 other tours scheduled:   WalMart (11/8 at 2 PM), Food Lion in Cresaptown (11/9 at 2 PM), Food Lion in Frostburg (11/15 at 2 PM) and More for Less on Industrial Blvd (11/17 at 2 PM).  The intent of the tour is to learn how to make healthy choices when shopping for food for you and your family, as well as how to read food labels.  As WMHS takes the lead in our region for improving the health status of our population, the grocery store tour fits perfectly with our goal.  Thanks to Allison Heavner, a registered dietician at WMHS, for taking the lead on this initiative.