Lest We Forget

What an appropriate title to today's blog.  I was prepared to blog about an entirely different topic and when I typed the date, it hit me.  So, I did forget based on how hectic the last few days have been.  However, I have to blog about September 11, 2001.   I can't remember feeling the shock that I felt when I learned what had happened in NYC, Northern Virginia and Shanksville, PA, ever before.  That awful awareness when that second plane flew into the other tower of the World Trade Center and at that moment realizing it was an attack on our nation and not just a horrific accident.  But, then came the unity of a nation and the outpouring of patriotism from coast to coast.  A country rallying around President Bush and Mayor Giuliani, no matter whether you liked or disliked either man;  it didn't matter whether you were a Democrat or a Republican; there was an outpouring of support for what needed to happen from a grateful nation as well as throughout the world.  This date has to remain a very special and solemn day for decades to come.  It can't become diluted with everything else that is happening around us.  It's been 12 years, but it still seems like yesterday.

Local Recognition of National Attention

Recently, I commented on a lack of coverage about the NY Times article by the local media in Cumberland.  That all changed this past Sunday when the Cumberland Times News did a feature story (above the fold front page) on the NY Times article.  Article is attached.  The CTN actually sent a reporter who interviewed our Chief Financial Officer and our Chief Medical Officer for the story.  Both were able to expand on our successes even beyond the NY Times article.  The reporter also included aspects of the original NY Times article.  All was very positive and I appreciate the recognition by the Times News.

http://times-news.com/latest_news/x789524231/WMHS-gets-national-attention-for-success-with-revenue-model

Five Hard Things

I read a piece this a.m. from the Governance Institute on Moving Forward Together.  Ken Kaufman of Kaufman Hall, a renowned health care consultant, laid out five disruptive steps, as he calls them, that organizations must take to prosper in the difficult health care environment ahead.  I like to compare our progress against such suggestions as I read them.  His five steps are:

·         Downsize the Delivery System - Stop offering services where the volume of patients is inadequate or where there are financial losses.  Easier said than done with the volume issue.  In our community, we have to offer services in a number of areas even if we are losing money because we are the only game in town.  We are constantly assessing and reassessing those services that we deliver; and if something changes in the industry that will allow that service to be changed, we will do so.

·         Reduce Unwarranted Variations in Care - Use data to evaluate physician performance and where individual physicians rank poorly, work with them on changing how they practice.  We have seen a great deal of success in this area, but there are a handful of docs with whom we are working more closely.  They have been informed that if you don't change then you won't be practicing at WMHS.

·         Eliminate Unnecessary Tests and Procedures - We are no longer paid on the volume of tests performed.  As a result, we have been reducing our ancillary use rates considerably.  We have a ways to go, but we have made great headway.

·         Address the Crushing Cost of Medicare - We need to better manage the care of all of our patients, especially the frail and elderly.  Five percent of the Medicare patients account for thirty percent of the cost.  At WMHS, we have a number of initiatives in place to better care for these patients as well as those who have multiple illnesses and who frequently return to the hospital.

·         Improve End of Life Care - In the late stages of life, many patients receive unnecessary care that drives up the cost of care.  At WMHS, we have done a great deal in expanding our palliative care programs.  Dr. George Garrow, our Chief Medical Officer, has brought his expertise as an Oncologist to this program, which has both been improved upon and expanded.

As Ken Kaufman puts it, the health care industry has been given permission to change.  At WMHS, we took advantage of that permission given to us by the Health Services Cost Review Commission and we have done so very well.  As I have described in the past, but not without many challenges.  We have improved the quality of care, the overall patient experience, the cost of care and the health of our community.  We have become THE health care company of our community.  We have taken on risk and provide services along the continuum of care through WMHS or through the many partnerships that we have developed over the last three years.  At WMHS, we are moving forward.

Food Insecurity

There was an article in the paper yesterday on food insecurity, which is a term that I was unfamiliar with.  It is defined as the disruption of eating patterns or a lack of food consumption due to a lack of money and access to food. 

Food insecurity is affecting 49 million Americans who are mostly poor, female headed households, families with children, Blacks and Latinos.  One in five households with children is affected by food insecurity.  The US is continuing to set records in this area for the fifth consecutive year.  This certainly is not a set of statistics that we can be proud of;  in fact, it's disgraceful.  As country with the kind of wealth that we have, as well as the extent of government support through a plethora of entitlement programs, no one should be wondering where their next meal is coming from.

 

Locally, I have pledged to Kim Repac, CFO at WMHS and a newly appointed board member for the Western Maryland Food Bank, that the health system needs to step up and do more to support the Food Bank.  All they need to do is to tell us how we can help.

Redesigning Care Delivery

This morning, I read a quote on the redesign of care delivery offered by James Skogsbergh, CEO of Advocate Health Care, the largest health care system in Illinois. He said "It takes more time to build new infrastructures than any of us think.  Whatever amount of time you thought it would take, double it."

He's right.  At WMHS, it took us well over two years to redesign our care delivery model from one of volume based to value based.  We thought that it would take a good year to year and a half.  We finally saw progress during the last half of FY'13, which ended June 30, 2013, two and one half years later.  There was a great deal of education involved with stakeholders, the Board, the medical staff, our employees, our patients and the community.  We had a number of starts and stops with the many initiatives that we had to put in place.  We were constantly re-evaluating the many aspects of care delivery, from patients going home with their medications to developing care plans for patients post discharge.  We added new staff to Care Coordination, Pharmacy, and RN Transitionists for the nursing home patients, Care Link Coordinators and the list goes on.  We reinvented the delivery of care and it took longer than anticipated, but we are all better because of it.  We reduced the cost of care; our patients are better cared for in a multitude of settings from acute care to clinics to home; the health of our population hasn't worsened and we have seen some improvement in a variety of health status areas such as obesity, tobacco use, access to care to name a few; and we have once again become profitable so we can reinvest in continuing to seek new ways to better care for our patients under this redesign of care delivery. 

The staff at WMHS have a lot to be proud of with what has been accomplished over the last several years.

Upgrading Your Life

I was thumbing through the summary of a new book the other day, "Upgrade / Taking Your Work and Life from Ordinary to Extraordinary" by Rana Florida. 

The author asked some famous people as to how they made things work so well for themselves.  From her work, she came up with six principles to leading fulfilled, successful lives:

1. Envision your future
2. Realize your passion and creativity are key to everything
3. Protect your time
4. Collaborate
5. Take risks
6. Embrace failure as a part of success

Actually, I can relate to the principles and could add a few, such as never forget where you came from, there will always be luck involved and prayer can pretty worthwhile in lots of situations.  

According to the summary, Rana Florida, who is a columnist for the Huffington Post, presents her insights and findings in an engaging way.  She says that the majority of us are riding through life in coach class and that the book should motivate us to get an "upgrade."  I have added her book to my reading list of at least two management / leadership type books per month.

A Chaplain Who Doesn't Believe In God

The other day I read an article about a guy who wants to be a Navy Chaplain but he doesn't believe in God.  Really?  He has a Master's in Divinity from Texas Christian University and another Master's in Ecclesiastical History from Oxford, but he is a Humanist. 

A Humanist is one who advocates for equality among Freethinkers, Atheists and Humanists.  Being a Humanist means a lot of different things according to their website.  In a nutshell, they don't seem to be big fans of God but seem like very good people based on their beliefs.  Clearly, not believing in God is the wanna be Chaplain's right, but to be a Navy Chaplain which is synonymous with being a man or woman of God?  What on earth is he going to talk to the 13,000 declared non-believers in the Navy about?  Good clean living?  Actually, that's what your superior in the Navy is charged with and many are very good at it.  In addition, a "real" Navy Chaplain could also be there to listen and guide a non-believer when they are in need without imposing his or her faith on the sailor.  Oh wait, he says that because of his religious training and background, he can still minister to the believers. But he still doesn't believe in God; how do you suppose that will work?  He says that his life is one of ethical personal fulfillment aspiring to a greater good of humanity.  What he stands for sounds very good, but to serve our country as a Navy Chaplain who doesn't believe in God just seems to miss the mark.  What is crazy is that our current Defense Department is considering his application.  They say that they don't endorse any specific religion or organization (since when?).  They observe the tenets of a member of the military's respective religion as well as those who have no religious beliefs.  Sounds like political correctness to me.  What's next for our military, pilots who don't fly; a Surface Warfare Officer who doesn't like the water; a claustrophobic submariner who never wants to go below the water's surface.  I have no problem with this guy wanting to serve in the Navy but do so in a position that makes sense. 

In closing, I'll leave you with a quote from Congressman John Fleming, who says, "The notion of an atheist chaplain is non-sensical; it's an oxymoron."  Well stated, Congressman.