"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, December 23, 2011


Yesterday, I mentioned our Christmas families in my blog and the generosity of our staff.  We provided Christmas for nearly 100 families in our community.  WMHS departments and individuals sponsor families who come to us from a variety of sources and all are vetted in advance to be sure that each family is truly deserving, unlike the first family that I was involved in providing Christmas for early in my career.  

It was in a neighborhood in Pittsburgh that was abandoned except for this one house.  We arrived at 4 AM Christmas morning as arranged in advance.  The family was living in complete squalor.  There was filth everywhere.  When I turned on the lights in what could have been the dining room, there were families of roaches all over the walls.  I never saw so many roaches in my life.  We came with a truck load of gifts for the mother and 5 kids.  New bikes for each child, dolls, games and clothes.  The faces on these children were priceless.   Finally, a real Christmas. 

Not so fast.  It turns out that there was no vetting process by the church that gave us the name of the family.  Mom was a hard core drug addict who sold or traded all of the gifts for drugs within days of Christmas.   I learned a lot from that experience.  A reliable vetting process is key in making sure that we are helping families who are truly in need.  Many of us at WMHS have so much to be grateful for this holiday season and it was clearly demonstrated this Christmas through our Christmas Family project.

Have a very Merry Christmas and a joyous holiday season.  I will be taking a blogging break between Christmas and New Year's as I need to develop some more material.

Thursday, December 22, 2011

Are You Serious?

For Christmas, WMHS provides a gift to every employee and we have been doing so for many years.  If affordability is an issue, it is something inexpensive, but it is done in conjunction with the holiday meal that I blogged about yesterday.  This year, as we did last year, we gave $25 gift cards to each employee from Martin's Supermarket.  Martin's is owned by Giant Foods and gives the health system a 5% discount, but this gift still costs the health system close to $60,000.  It is worth the amount of money based on the generosity of our employees during the holidays with the Christmas families that they sponsor and the good will that it brings from a most appreciative staff.   Last year, no problem with the acquisition; this year, not so fast.  Which brings me to the "are you serious" part. 

Our Community Relations Department contacted Giant Foods to arrange for the purchase and delivery of the gift cards.  Our person asked to have the cards delivered this week (the week before Christmas) and she was told that wasn't possible and the earliest delivery would be next Tuesday.  Our person said do you realize that this is a $60,000 order and it's for Christmas?  The person from Giant said yes but that was the best that they could do.  Our person asked to speak with her supervisor and she said please hold.  The supervisor never got on the phone but the rep said that we could pick the gift cards up at one of their local supermarkets over this past weekend, which we did.  Thank goodness, one of our more patient people handled the transaction.  I would have asked to speak with their CEO and congratulated him or her for their success in retail during such a challenging economic period that they didn't need a $60,000 sale.  Maybe, I still will!  With that said, it is still better than Wal-Mart who told us last year that there is no discount on a $60,000 gift card purchase since they already have very low prices and don't need to give a discount.  That was an easy one to walk away from with Wal-Mart’s arrogance; maybe next year we should pursue a gift card purchase with a local business that would be more appreciative of the business.

Wednesday, December 21, 2011

Holiday Meal

On Monday, WMHS held our annual holiday meal for our employees.  Our Food and Nutrition Services team prepared a wonderful meal that was served by the leadership of the organization.  It is a great time for me as CEO to reconnect with many of our 2200 or so employees.   The great majority of employees are so upbeat and appreciative of the amount of work that goes into the preparation and serving of the meal.  I have been serving formerly Christmas, now holiday, meals for over 30 years to employees and it is an event that I so look forward to each year. Thank you, John Wilson and your team, for a great day and a wonderful meal.

Tuesday, December 20, 2011

Crime at WMHS

Last week, I wrote about an increase in crime in the region.  It is important to know that crime, especially property crime, doesn't stop at the doors of the health system.  Our Security Department and the Cumberland police are investigating a series of thefts from patients and employees.  We offer to secure the valuables of our patients upon admission, but too few take us up on the offer.  For the most part, the thefts have been small amounts of cash stored in the patient's night stand.  Fortunately, Security has a pretty solid description of the individual from patients; a slightly built young white female with a head scarf.  We are also taking steps to better secure patient belongings in night stands if they refuse to place items in our safe, increase surveillance on the patient units and increase patient and staff education.  Employee thefts are routinely unsecured purses in unlocked lockers, unlocked desk drawers or unlocked file cabinets.  If employees would do a better job of securing their belongings, employee thefts would virtually be eliminated.   Our criminals must be extremely desperate to steal from patients who are at an extremely vulnerable point in their life.  We will be publicizing information about the thefts to heighten awareness and hopefully catch these individuals.

Monday, December 19, 2011

ACM Commencement

On Friday evening, I had the opportunity to attend the Allegany College of Maryland graduation for several hundred students.  This December graduating class had 66 nursing grads, wow!  One of the graduation speakers was a nursing student who for much of her life was homeless, living in shelters, under bridges, in parks, etc with her mother, who was a drug addict, and her younger brother.  In her speech, she spoke of a very hard life growing up, a life to which her mother eventually succumbed.  After her mother's death, she and her brother went to live with their grandmother.  Now at 24, she will be a nurse and go on to study for her Bachelor's degree in Nursing.  Her speech closed with the choices that each of us have in our lives; her mother made choices that eventually killed her.  Our graduate made a series of choices that should serve as an inspiration to all of us.  Congratulations, new grads and especially Aubrey Strachan.  God speed.

Friday, December 16, 2011

Transparency and Quality

This week, I had a briefing from one of our three internal fellows and her mentor on her six-month internal fellowship project, Transparency and Quality.  The project, which started in September, began as Transparency in Quality.  It became evident shortly into the project that both clearly have lives of their own.  Work is needed in both attaining the results as well as reporting the results.  Much work has been occurring on the attainment of quality, and now the reporting of our results is in our sights.   Our goal is to be transparent in our reporting of quality at WMHS by July 1, 2012.  Good or bad, we will publish our quality data internally and externally.  Currently, we are very limited in what we publish, but our quality data is out there for all to see, if you can find it.  The objective is to make us better.   We saw such improvement when we began publishing patient satisfaction data for all to see.  Our scores reached levels never attained at WMHS previously.  Our goal is to have best in class tools for reporting quality to our employees, our physicians, our board, our patients and our community.  The work done to date in both areas is thorough, comprehensive and most importantly, will increase accountability and ownership.  Currently, everyone's in charge of quality through the committee process resulting in no one being in charge or accountable, other than me and our Performance Improvement staff.  Our approach to quality and transparency will be a big step in getting better by sharing.  I am pleased with the progress that our internal fellow has made to date and look forward to the project's completion this spring.  More to follow.

Thursday, December 15, 2011

Crime In Allegany County

Yesterday, I received from our physician recruiter a link to a website showing crime statistics for Allegany County, MD.  I looked at it and said, "no way."  So I went to alternate sources to verify the data.  Actually, the website was accurate.  I knew that crime had risen in our region but was blown away to find out that we have substantially more crime than most Maryland cities.  In fact, we are only safer than 6% of the cities in the US.  Now, much of our crime is property related,  but violent crime rose to its current level in the early 1990's and has stayed constant.  Fortunately, our murder rate has remained very low at 1.3 per thousand up until last year when rose to 5.5 per thousand.  I still think that it's  a safe place to live and raise children, but such stats are somewhat disconcerting.  We are lucky to have the caliber of law enforcement that we have in that they do solve violent crimes pretty quickly.  Within the last few weeks there were a series of robberies at gas stations, culminating with two home invasions over this past weekend.  That type of violent crime doesn't set well with the community and within days four suspects were arrested.   In closing, this statistical information is certainly worth having as well as being able to explain it to prospective professionals coming to our region.

Tuesday, December 13, 2011

Beheadings in 2011, You Can't Be Serious

I just read that a woman was beheaded yesterday in Saudi Arabia for sorcery and witchcraft.  I am not joking.  I can't imagine in this day and age that a woman could be beheaded for such ridiculousness.  I know that sorcery and witchcraft, along with blasphemy, are punishable by death in Saudi Arabia.  Although no details are available in this case, I have read that sorcery is usually identified with someone in Saudi Arabia who has demonstrated their right to freedom of speech or religion.  Saudi Arabia continues to practice an extreme version of Islam with lots of actions demonstrated by citizens every day in the modern world punishable by death.  I am truly amazed that in 2011 that such executions are occurring in what is supposed to be a civilized country.  Where is the outrage?  Amnesty International said that they were deeply shocked and called for a halt to any further executions, although the number of executions has tripled this year to date with 79.  I know that this is a leap, but I can't think of a better reason to drill for oil in the US and partner with Canada on the Keystone XL pipeline.  We should be making every effort to separate ourselves from a country that practices such barbarism.

Monday, December 12, 2011

The Wild Ride of Health Care

Hold onto your seats is the message for anyone involved with health care.  We are all in store for a wild ride.  Talk about an industry that is changing dramatically and virtually overnight.  I have always said that trying to change anything in health care is like trying to turn an aircraft carrier; it takes quite a bit of time.  That doesn't seem to be the case today.  There is some good news from the financial crisis that our country has been experiencing; it is that quality and efficiency in health care have finally become the critical focus of payors, especially Federal and State governments.  Insurers are buying hospitals and hospitals are once again buying physician practices and, to some extent, getting into the insurance business by working directly with companies on the health and care of their employees.  Integration is rampant in health care and that can be a good thing. 

As I have written here before, WMHS is now operating under a new and different payment methodology that focuses on the value of the care that is being delivered with the patient being the center of care delivery.  We previously were paid based on volume of admissions, tests, procedures, patient days and the list goes on.  There was little in what we did that was based on quality and efficiency.  Then we saw the zero sum gain in Maryland related to potentially preventable conditions, core measure success, readmissions.  If we were successful in each area, then we were paid incentives; if we weren't, we lost money in rates.  Lose a million dollars in rates for poor performance and it is interesting to see what happens.  In addition to performance improvement and being rewarded for such performance, going forward, we are now paid very differently based on the quality and the efficiency of the care delivered.  The ride will continue to be wild especially until everyone is on board with all of the changes ahead in US health care.  Stay tuned.

Friday, December 9, 2011

Correctness Continues to Run Amok

The Defense Department continues to label the 2009 Fort Hood shooting as work place violence and not an act of terrorism.  Thirteen service men and women were killed and dozens were wounded by an Army Major who was both a psychiatrist and a Muslim follower of the now deceased American-born cleric, Anwar al-Awlaki.  In fact, the Army Major, Dr. Nidel Hasan shouted "Allah akbar" (God is great) as other al Qaeda terrorists exclaim at the time of their attack.  Not your everyday work place violence chant.  Other attacks against US service men have been labeled as crimes such as drive by shootings, as was the case in Little Rock outside of an Army Recruiting Station of two service men.  Their shooter also inspired by al-Awlaki.   Yet, our Defense Dept. is calling it anything other than what it is.  These shooters have been identified as heroes from within al Qaeda from where they draw their inspiration.  If it walks like a duck, quacks like a duck, it's a duck..........call it what it is and in these instances, they are acts of terrorism.  Call them homegrown acts of terrorism if you prefer, but don't minimize the threat such acts are to our men and women in uniform.

Thursday, December 8, 2011

Political Correctness is Out of Control

Since the weekend, there has been a collection of news stories that make, at least,  me wonder what the hell is happening to our country.  First, there was the 9-year-old boy who called his teacher "cute" and was suspended for two days for improper conduct.  Really?  I would have been home schooled from about the second grade because of teacher crushes and I was taught by nuns until the seventh grade.  Then there was the high school quarterback in Massachusetts who was penalized for lifting his fist in the air (excessive celebration and taunting) as he ran for a touchdown, costing his team a state championship.   The rules are the rules, but come on.  He didn't turn around and taunt the defenders; he's a kid who got excited on his birthday, no less, and he would have won the game with that touchdown.  And now, I just read that a high school in NJ censored all HOLIDAY music for a young children's program removing any reference to God, Jesus, Santa, Christmas and Hanukah.  What's left?  Thank God (or that non gender supreme deity who is everywhere) for snow and reindeer or are they too closely related to Christmas and soon to be banned in Jersey?  Where has common sense gone? My father used to say the world is nuts and he has been dead for over 22 years.  What would he be saying today?

Wednesday, December 7, 2011


Someone was describing the other day what happens at Antietam National Park,  just north of Sharpsburg, MD, this time of year.  I found it fascinating that for the last 25 years volunteers light over 23,110 luminaries to commemorate the number of casualties during our nation's bloodiest one-day battle on September 17, 1862.  Apparently, this event occurs the first Saturday of every year and for some unknown reason this is the first that I have heard about it.  You would have thought that during my 22-year stint in Maryland that I would have come across that information.  Well, maybe it's not that surprising in that it took me 20 years to get to Antietam National Park and it was by accident that I happened by and stopped.  Shame on me!  Antietam is just as hollowed and as sacred as I found Gettysburg to be many years ago.  A visit to Antietam next December has already been added to my bucket list.

Tuesday, December 6, 2011

The Auxiliary

On Sunday, I had the opportunity to thank the WMHS Auxiliary at their Holiday Tea for their contributions to our health system throughout the year and to wish them a blessed holiday season.  The work of these women and yes, they are all women, is remarkable.  From the employee socials to the book sales to their fulfilled $1M pledge for the new hospital to the running of the Gift Shop and so much more.  The Auxiliary works tirelessly on behalf of our organization and we don't always take the time to thank them for what they do.  So, ladies, please accept a most sincere and heartfelt thank you for your 2011 accomplishments and contributions to our health system.

Monday, December 5, 2011

The Holidays Part II

On Friday, I blogged about the start of the holidays and getting into the holiday spirit.  The ability to enhance that spirit came on Friday evening with the Health System's holiday party for board members, physicians and upper-end donors to our Foundation.  What a party!  The Food Service staff once again outdid themselves as has been the case year after year.  The party gets better each year and attendance grows year after year.  All of the food is prepared on site by an extremely talented group of employees.  I love when I am asked the question, "Who does the catering for this wonderful party?  I have to get their name."  Guests can't believe that such an event can be delivered by the "kitchen staff."  Let me tell you, it is the holiday party of the season and one that everyone wants to be invited to.  An invite is easy,  just contribute at the $10,000 level or higher, become a physician or be invited to serve in some governance related capacity at WMHS.  Although I thanked our Dietary staff throughout the evening and after the event was over, I can't recognize them enough for the outstanding effort in delivering the party of the holiday season.  Great job, everyone!

Friday, December 2, 2011

The Holidays

Yesterday was the monthly department director's meeting at WMHS.  It is always held on the first Thursday of the month.   It was a little difficult to get into the holiday spirit this early in December, but we figured out a way.  At every meeting, we spend time on recognition of departments and individuals.  We were quickly put in the holiday spirit as one of our employees was recognized for her role during the recent Santa parade at the Country Club Mall.  During the parade, one of the participants went  into cardiac arrest.  The daughter of one of our nurses was attending the parade and knowing that her mother was shopping at the Mall, called her.  Our nurse rushed to the scene and began CPR.  Another employee knew where the AED was located and our nurse shocked the man back to life.  What a great way to start off the holiday season.

Thursday, December 1, 2011

Congratulations, Ruthie Stonebreaker

Yesterday, I had the pleasure of attending Ruthie Stonebreaker's retirement reception at WMHS.  Up until today, Ruthie had worked at the first Sacred Heart Hospital and then the second location on Haystack Mountain and most recently at the Western Maryland Regional Medical Center.  The significance of Ruthie's retirement is that she has worked for us for 47 1/2 years in Environmental Services.  What an amazing tenure.  I asked Ruthie what she was going to do in her new life of retirement and she said that she has no plans.  She said, "in fact, I could be back to work next week".  What an amazing woman who has seen a great deal and has been a part of an evolution in health care in Cumberland.  Thank you, Ruthie, and God speed.