"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, July 28, 2016

Preparing for the Future

Attached is an Update that was distributed to our Department Directors and Medical Staff yesterday afternoon.  It brings the first phase of our strategic planning process that began in April, 2016 to a close.  The Update describes Board actions taken last Friday in an effort better prepare WMHS for the future.  

Everyone recognizes the need to remain viable and to keep health care delivery local.  In order to do so, we will need to explore gaining greater access to physician specialists and sub-specialists to complement and enhance our existing clinical programs at WMHS.  A key component to any potential affiliation will be to bring those specialists to Cumberland and not have patients traveling out of town needlessly. 

The next phase will be to send a request for proposal to three academic medical centers, WVU Medicine, UPMC and UMMS in order to gauge their interest and commitment to such a partnership.  As this process proceeds, I will be blogging on the subject in an effort to keep everyone informed.

Tuesday, July 26, 2016

Clinical Quality in Western Maryland

Last month, the three health system CEOs in the Trivergent Health Alliance asked Nancy Adams, SVP & COO / CNE at WMHS, to serve as chair of the newly created Clinical Quality Initiative for the Trivergent Health Alliance (THA).  Nancy will lead a team of her clinical counterparts from Meritus Health, Frederick Memorial and WMHS with a focus on clinical quality at the three health systems.
The Trivergent Health Alliance has experienced a great deal of success with our population health initiatives and the management services organization, and we would like to build upon those successes in the area of clinical quality.  This team consisting of a Chief Operating Officer, Chief Nursing Officers, Chief Medical Officers and a Chief Quality Officer will be examining areas like understanding the clinical capabilities and program offerings at each health system, identifying which programs could benefit the Alliance as a whole, focusing on best practices in areas such as patient experience, strengthening physician engagement across the Alliance, exploring which clinical resources that could be shared, linking clinical quality to the THA’s Supply Chain and Value Analysis approach and working to reduce variation in clinical care specialty areas.
The Clinical Quality Team began its work earlier this month.  In addition to reporting to the three CEOs, they will be accountable to the Trivergent Health Alliance Board of Directors.
We are hopeful that we can experience the same level of success with this initiative that we have with population health and the MSO.
On a side note, the Trivergent Health Alliance was featured in Hospitals magazine article last week on ways hospitals can collaborate without merging.  The link is below. 


Monday, July 25, 2016

Unfortunately, There Is No End In Sight

The other day, I asked for an update about the number of opiate-related overdoses that our ED has treated from January 1, 2016 through June 30, 2016.  There have been a total of 198 overdoses, with 142 being opiate or heroin related.  Those 142 overdoses have resulted in 26 deaths.  For emphasis, that’s 26 sons, daughters, moms and dads who have died due to an overdose of heroin.  If the police, and now the public, didn’t have Narcan to be administered when an overdose occurs, the death rate would be much higher.  
Our ED is treating practically an overdose per day.  But, if it was only that easy.  On July 12, our ED staff treated five heroin overdoses in one evening.  As you can see, our July numbers aren’t even reflected in the total for the first half of calendar year 2016.  
Our ED staff and our EMS providers throughout the region are now dealing with an absolute crisis in our community.  On the evening of July 12, our staff not only dealt with the five overdoses, but also with nine behavioral health patients, a series of critical care patients and a host of other patients with a variety of emergent needs in our ED.  We were forced to go on diversion sending patients to another ED for a period of time with our staff being overwhelmed with a full ED and waiting room.  That diversion put a significant burden on the EMS community, which then had to travel much farther to an ED outside of Cumberland.  
To demonstrate just how significant our ED has changed, last weekend a Cumberland police officer was attacked outside our hospital when he went to question an individual who was wanted in another county.  Both the police officer and the suspect were treated in our ED.  The suspect came into the ED in a rage, knocking over a computer on wheels and threatening staff.  Such behavior is fast becoming an almost everyday occurrence as our ED staff and providers are being spit upon, threatened and assaulted.  
We now have an armed police officer in our ED from 7 PM to 3 AM every day.  We are reaching out to our ED staff and providers to get their input as we reassess security in the ED.  Knowing that an armed police officer is in our ED during peak times previously gave some comfort; however, that now isn’t even enough.  Our staff are dealing with challenging patients morning, noon and night.  We will be having an upcoming ED Summit to determine what changes need to occur to enhance the safety and security of our patients and staff.  
So, the next time you hear how long someone had to wait in our ED or the staff could have been nicer, please understand what these ED professionals are dealing with each day.  In no way am I condoning having anything less than a professional, courteous staff in the ED for our patients, but I am trying to enhance the community’s awareness of what has become a typical day in our Emergency Department.