"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.

Tuesday, December 31, 2013

A Year in Review at WMHS

Over the Christmas holiday and that's what it was, "the Christmas Holiday" not the “Happy Holiday,” I had the opportunity to reflect on my many blogs throughout 2013.  Although it's tough to come up with a blog topic everyday, I really do enjoy it.

To recap, some of my more memorable blogs during the year included:  health care spending down for three consecutive years and the process necessary for continuing to get cost out of the system; our Door-to-Balloon team winning the Maryland Patient Safety Center's award for patient safety innovation; our many accomplishments under Meeting the Challenge of Health Care Change; the formation of Alliance Health between WMHS, Frederick Regional Health System in Frederick and Meritus Health in Hagerstown; the impact of Sequestration on hospitals, especially WMHS; a personal call from Senator Paul Sarbanes in reaction to some recent blogs (which turned out fine); the impact of social media in health care; efforts to legalize marijuana in Maryland; just how wrong Consumer Reports Hospital Compare data really is; the 86% increase in the gasoline tax in Maryland; my platform for success as shared with the business students at Frostburg State University; the “how to” of becoming a CEO; the senselessness of the bombing at the Boston Marathon; the importance of mentorship; some of the many books that I read during the year: Lean In; Patients Come Second; Linchpin; A Culture of High Performance; The Advantage; How to be Exceptional - Drive Leadership Success; the criticality of organ donation; Total Patient Revenue and disruptive innovation; the dual role of hospitals in communities across the US - economic engines and deliverers of patient care; recognition of WMHS physicians; the value of iTriage for consumers; recognition of our nurses; our high school wellness ambassadors; recognition of WMHS employees for their service awards; the roll out of our pay for performance for our docs; blogs on Governance; recognition of outgoing board member Don Alexander; lessons from the Joint Commission after their five-day survey;  joining CEOs against cancer; the absurdity of the Recovery Audit Contracting on the part of the feds; a Tribute to my father; a tribute to my daughter when she was promoted to Navy Lieutenant; the problems with wind power; critical thinking skills and common sense; many blogs on leadership; over-regulation of the health care industry (122,000 federal regulations......really); the opening of the Center for Clinical Resources; the failure of the Health.gov website and last, but not least how unforgiving the Feds would be toward any other organization's failure of a similar magnitude and the government's shut down.

Let me know if there are any of the blogs mentioned above that you may have missed and would like to see.  

Anyway, have a safe and happy New Year's Eve.  Here's hoping that 2014 will be as memorable as 2013.

Thursday, December 19, 2013

What's the Opposite of Affluency?

  I am having a great deal of trouble with the rich 16-year-old living in Texas who was driving three times over the blood alcohol level for adults, ended up killing four innocent people, but will not spend one day in jail.  His defense was affluency and the judge bought it.  Hard to believe.  

What is affluency?  It is when you get everything that you ask for because, in this case, your parents are rich and as a result you can't discern between right and wrong.  The defense said that the parents were to blame.  The young man has to spend one to two years in a high-end treatment facility in California that his father will pay for at an annual cost of $450,000.  My question is if you are rich and can't discern between right and wrong, what is it called if you are poor and suffer from the same inability to know the difference?  There are far more people who are poor and do bad things because they don't know the difference between right and wrong.  These people, many who are uneducated because they live in abject poverty, have a much better case.  Unfortunately, these individuals will never be given such a break because such opportunities will never be afforded to a person living in poverty.  Now don't get me wrong, I am not advocating applying the opposite of affluency to the poor.  Actually, I don't think that it should be a defense for anyone under any circumstances.

I will be taking a break from blogging until after the New Year.  Have a very Merry Christmas and a safe New Year!

Tuesday, December 17, 2013

Christmas Families

I arrived at work very early this AM before anyone else.  While walking around the floor, I noticed cubicles filled with food and gifts for some of our 84 Christmas families.  What a wonderful sight.

We have been engaged with our Christmas Families program for as long as I have been in Cumberland and I just started my 25th year this month.  The program has been improved upon year after year, with a team closely vetting the selected families.  In addition, we now identify patients who are in need as well as employees who have suffered a hardship during the year and include them in the program.  With our 84 families, our number is down from previous years, but again we are more closely vetting families to avoid individual families placing themselves on every organization's list and getting much more than their fair share for Christmas.

There are WMHS 51 departments participating in this year's program and the total number of individuals assisted will be 350, including 211 children.  The WMHS Employee Caring Fund provides $9000 for gift cards for food and that amount is supplemented by the Medical Staff with a $2000 contribution and the remaining $3000 coming from the Health System's Mission Services budget.  Food gift cards this year will exceed $14,100 in addition to the toys, games, dolls, clothes, coats, boots, bedding, pots, pans and tools that will be provided by the 51 WMHS departments.  

It doesn't stop here.  What is especially rewarding is that we not only provide Christmas for a family in need, but also in many cases provide resource assistance to the family beyond Christmas.  Our staff works to meet their social needs to the extent possible by getting their electric turned on, ovens connected, beds for kids, transportation arranged, better living conditions, addressing immediate health concerns and the list goes on.  

I am so proud to be a part of this program and to be associated with such wonderful people making a difference in the lives of others.

Monday, December 16, 2013

Community Benefit

The Western Maryland Health System's Community Benefit Report for Fiscal Year 2013 was submitted to the State of Maryland on Friday.  This report was shared with our Board of Directors on Thursday and the year-after-year increase in the amount of our community benefit gives us all reason to pause.  Since FY '09, we have increased our giving by 295%.  

For those of you who aren't familiar with the report, it breaks down all of those activities and initiatives that we perform for our region of a charitable nature and allows us to remain a not-for-profit organization.  With the State of Maryland substantially decreasing its programs and services for the poor and disenfranchised since 2008, the responsibility for those with social and health needs in particular has fallen to hospitals across Maryland.  We cannot discharge a patient unless they are going to safe place like one's home, a nursing home, etc.  If a patient has no place to go, the responsibility falls to the hospital to meet their needs until they can be discharged safely.  This certainly makes sense, but most of the time, the financial responsibility falls to the hospital in these cases.  Fortunately, we get to capture the amount of Charitable Care on our community benefit report and for FY'13 it was $17.5 million.

The report's areas of focus are Community Health Services; Health Professions Education; Mission Driven Health Care Services; Financial Contributions; Community Building Activities; Community Benefit Activities; Community Benefit Operations; Charity Care and Medicaid Assessment.  The amount for FY '13 was $47.8 million, an increase of 20% over last year's $40 million.  Our areas of increase included Mission Driven Health Care Services, which allows us to include those services necessary for the community but where we lose money due to a lack of reimbursement.  We also saw an increase in Financial Contributions, which in FY '13 included the difference in the value of the land that we received adjacent to the WMHS campus and the Braddock Campus that was donated for the new Allegany High School.  Other areas included Community Benefit Operations; Charity Care, which grew by another $1.5 million; and the Medicaid Assessment (a tax on hospitals leveled by the State of Maryland).

When one sees the breakdown of what is behind the numbers, the programs, the services, the amount of giving throughout the region and the free care provided, it is remarkable.  As I told the Board of Directors, we have a great deal to be proud of when you look at what we are doing for our community year after year.

Friday, December 13, 2013

Some Things That I Think That I Think

Today's blog has a tidbit of items collected throughout the week and they are as follows:

A six-year-old Colorado boy kisses a girl's hand in school and is suspended for two days along with being charged with sexual harassment.  Really?  The "victim's" mother says that the first grader repeatedly harassed her daughter.  Really?

Staying in the schoolyard, a 10 year old in Pennsylvania is suspended and threatened with expulsion for pulling out an imaginary bow and arrow and pretending to discharge the arrow.  I am not making this up.  The principal said that the fifth grader (who most likely just saw the Hunger Games) violated the school's weapons policy.  Again, I am not making this up!  

How about the fake sign language interpreter at the Nelson Mandela Memorial Service who claims that he is a schizophrenic, heard voices and saw visions of angels while on stage?  The entire time he was within striking distance of the President of the United States.  The fake interpreter was never vetted by the Secret Service; they said that was the South African government's responsibility.  The South Africans are investigating how this happened, although they used this same interpreter on two previous occasions and there were complaints at that time that he was a fake.  Wow, who would have thought that in this day and age that the protection of our President would be that lax.

Remaining at the Memorial Service, the handshake between Barrack Obama and Raul Castro............so what!  Much to do about nothing.  It was a handshake, not the lifting of an embargo.

Speaking of much to do about nothing, the selfie of the President; David Cameron, the British Prime Minister and the Danish Prime Minister, Helle Thorning Schmidt; again, so what.  Irreverent, inappropriate, give me a break.  It was a celebration of Nelson Mandela's life just as much as it was a memorial service.  Get over it.

Lastly, congratulations to Patty Murray and Paul Ryan (see my December 10th Blog) on the budget compromise and the House overwhelmingly approving the two-year budget plan.  It's about time Washington compromised on something.

Tuesday, December 10, 2013

Bridging the Gap Between Being a Present Leader and a Future Leader

In yesterday's issue of Chief Executive magazine, there is a wonderful article on how to drive high performance by moving away from focusing on short-term results and driving longer-term sustainable performance.  The challenges and demands that leaders face today are relentless, but by focusing on six dimensions of leadership health, one can form the foundation for great leadership going forward. The six dimensions are:
  1. Physician health provides the energy and stamina to keep pace with the change.  A work / personal life balance is needed and the leaders needs to lead a healthy lifestyle.
  2. Emotional health enables leaders to understand their strengths and their weaknesses by tapping into the positive ones and jettisoning the negative ones.  As leaders, we need to understand what's important at any given time and apply our energy there.
  3. Intellectual health involves deep curiosity and mental awareness.  We need to innovate quickly to meet the demands of our fast changing, ever-complex work environments.
  4. Social health by being transparent, honest and values focused in our interactions is key.
  5. Vocational health is being that linchpin in your organization.  By being indispensable you can drive achievement and success in your professional life.
  6. Spiritual health allows you to be community focused and socially responsible.

If you are the picture of health by possessing what it takes in these six dimensions, you are well on your way to meeting the challenges facing today's as well as tomorrow's leaders.  Through leadership health you should be well prepared as a leader by allowing yourself to drive what you do and how you perform.