Health Views: The Good, The Bad and The Ugly

The Planetree Difference

2009-04-08T11:54:00.001-04:00

April 8, 2009

Haven’t blogged for a while, so might as well start off with a really good one.

As I was walking through the Café this morning a good friend of mine stopped me to say “Hi.” Although she was here on community business, she wanted to talk about her family’s experience of being in a Planetree Hospital. She asked me to pass on comments to all of the appropriate personnel and colleagues --- especially those in our ICU.

Her father recently passed away here and she said that the total support and care given to her dad and entire family and all the accommodations that were made, left her feeling that there was literally nothing more that we could have done. She wanted to make sure our colleagues knew how much they were appreciated by all of the members of her family. Obviously, she said she could see the differences of being in a Planetree Hospital and how our staff seems to know just how to demonstrate their compassion and caring.

Recently, I had the privilege of attending the National Healthcare Conference in Chicago. There were many relevant sessions that I attended that will assist our organization, but the most rewarding and beneficial part of experience was the chance meeting I had with the author of “Why Hospitals should Fly,” Mr. John Nance. His book should be required reading for all who are interested in patient safety and quality in hospitals. Although some may view it as being farfetched and idealistic, I feel we need more writings of this nature that are transparent in a very meaningful way. It clearly identifies a very necessary cultural change that is needed in many of our hospitals.

Hopefully, it will inspire our organization as well as many others.

Going from Good to Great

2009-03-17T12:38:00.004-04:00

Going from good to great….all it takes is a willingness to want to be the best.
March 16th, 2009

Today was a good day. A colleague told me about a personal health caring experience regarding herself and one of her family members. Overall everything was really, really good….but yes; there was a but.

Treatment in the ER was appropriate and comforting…her relative was admitted and the family was advised that the surgeon would be in very early in the morning to meet with patient. Expectations were set and the whole family organized themselves to help. All their planning didn’t work out as well as expected and many things had to be rearranged because the surgeon’s and hospital's timetable changed by almost five hours. I am not sure whether the timetable could have been adjusted. Perhaps the only thing which might have helped would have been an explanation about the reason for the delay as soon as it could have possibly been communicated, so that the patient and their family would have been expecting the delay.

Is there a learning lesson here?

Having this discussion reminded me about something that is special about the way we practice here at ACH.

What is interesting to me is how often patients and members of their family use the words “I really don’t want to get anyone in trouble” and truly, they don’t. However, they do want someone to understand what dissatisfied them and didn’t meet their expectations -- or why their expectations were not met. Just as often when I follow up on a complaint (which I consider a great opportunity to do something better), I here these words from a colleague or a physician: “You have to hear my side of it”. Usually they are a little startled when I say that I don’t.

Then I go on to explain why. I let them know the reason I don’t have to hear "their side," is because I believed whatever they were doing, they were trying to do the right thing. The point is the customer, or in this case the patient, is always right. What is most important is that we have an opportunity to figure out what we could have done to meet or exceed their expectations.

Time is critical, especially if the patient is still at the hospital -- and the focus should always be on how could we make it better. If we are willing to accept constructive criticism, knowing that no one will get in trouble, and focus on what could we have done differently rather than worrying about explaining what happened, we are well on the way from going from good to great.

Below is a message we give to patients when they come into our facility. I think it is worth repeating. We actually tell our patients our expectations of them. We encourage them to express their complaints to us.

A Welcome To Our ACH/Planetree
Customers and Guests, Families and Friends
We, the Colleagues, Physicians and Volunteers are striving to help Alliance Community Hospital (ACH) become the Premier Community Hospital in the State of Ohio, which means:

The Best People Providing the Best Service and the Best Place To Work

As a Planetree Hospital our models of “Health Caring” are cultivating an environment and service philosophy that combines the best of hospitals with the best of spas and hotels…where just being here begins the comforting or healing process.

Our Expectation of You, our Customer and Guest
We can only achieve this vision with your help. Throughout your visit or stay here you will constantly be asked “Is there anything else I or a fellow colleague can do for You?” This is your cue to let us know how we could go from being good (in your eyes) to being great, or if we haven’t met your expectations, how we might do so. Other hospitals may view your advice or suggestions as "tattle tales" or getting someone into trouble; we view them as free consulting advice.

So please when you are asked, let us know the little things that you would appreciate to make your stay or visit with us special or more comforting.

Every department or service you visit or use has their Vision and Health Caring Standards posted or published. Please look for them and read them. We know we are not perfect and there are times when if you were rating our service you might not be able to say it was excellent. Please take the next opportunity when one of our colleagues asks “Is there anything else I or a fellow colleague can do for You?” to let them know what would help you or perhaps the next customer or guest. We thank you in advance for helping us help others.

During your stay or visit with us any of our colleagues may offer you their business card. On the bottom of their card is the leader of the service or department with whom the colleague works. If the colleague can’t respond to your request directly, their boss is available to help back them up. If for any reason they might not be able to respond to your need, feel free to turn the card over and contact me directly, Stan Jonas, CEO, Alliance Community Hospital. My direct business and home numbers, along with e-mail, are also listed. We know every one of our customers and guests are individuals and everyone may have different needs.

Again, we value your opinions and suggestions and for helping us to continually improve and pay attention to the things that are most important to you our customer and guest.

Sincerely,
Stan W. Jonas, Chief Executive Officer
Alliance Community Hospital

Sometimes people still are hesitant to express their dissatisfaction until after they have left the hospital. So, if the patient or the family member is hesitant to express their feelings, how might we encourage that?

The easiest way is to always ask our strategic question. "Is there anything else I or a fellow Colleague can do for you?" It is what differentiaties us from our competition each and every chance we get.

Thanks for listening.
Stan

Catching Up . . .

2009-02-11T15:01:00.002-05:00

February 11, 2009

Catching up… an opportunity and two letters from January.

Yesterday one of our out patient guests called to suggest we do something about improving the
parking for patients and visitors of our professional office building on Arch and State. The good news is, it is very busy with many patients and visitors coming and going… the bad news is, sometimes the folks who shouldn’t walk far (particularly in inclement weather) are parked in spots that are the farthest away from the entry doors.

Although we hand out information throughout the campus about our Shuttle Service, many of our patients and guests are still not aware of how to take advantage of that service. Dan, who is the most frequent driver of our shuttle (which is a white Toyota Scion), carries a cell phone,330-417-5454. If you call him from your parking spot, he will pick you up and drop you off at the entrance which is most convenient to you. At the conclusion of your service, you can ask an ACH colleague to call Dan and he will bring you back to your car.

In January, one of our patients (J.W.) wrote, “Dear Mr. Jonas: During the night my temperature rose to a disturbing level and my nurse called a 'rapid response'…a team brought me back to normal with compassionate and loving professionalism…I ask that you express my appreciation to all the registered nurses, aides, and clinical technicians who treated me with great respect and skill…also commend your housekeepers who were also very friendly and caring. I would be remiss not to include Dietary who accommodated my special needs…(what a) wonderful hospital staff for the Alliance Community."

Also in January, our nursing supervisor received a call from the wife of one of our patients. She wanted to tell us about the excellent care that was received in the ER, "especially Dr. Kolb and the nurse that assisted… Dr. McNally picked up with Dr. MkParu.." She wanted all to know how grateful she was.

Hope to talk with you soon.
Stan

Thanks to All

2009-02-09T11:56:00.000-05:00

February 9th, 2009

C.T. writes:
"During a recent visit to my family in Ohio I became very ill, necessitating a visit to the ER…from the first person who I encountered …to the last person that discharged me, everyone was professional and kind. Lynn was very efficient and so caring…the radio logic technologists were also very professional and used two patient identifiers…I am sorry didn’t catch their names. They were instantly by my side when I needed them due to my medications……the doctor, nurses, and ancillary staff that took care of me were exemplary. Please convey my thanks and praise to all of them."

More Comments about Therapy Services

2009-02-09T10:45:00.002-05:00

February 6th, 2009

Once again therapy saves the day! Here are some other positive comments I received:

~D.P. called in to say he was going through a very bad situation until he got to our therapy services…All he could say was "excellent…couldn’t thank Tiffany and Gail enough…they were just super…P.S. what a great laugh Tiffany has!"

Say What You Mean & Do What You Say

2009-02-05T23:01:00.003-05:00

February 6th, 2009

Say what you mean and do what you say … touched and inspired by words of support.

("Everyone can shave a little if they have to...")

Just prior to Christmas 2008 we held special Colleague forums at ACH. Usually, every month for the last 12 years, I have held communication forums through which I update the staff and anyone who works or volunteers at the hospital can ask me questions.

The intent of this special forum was for me to ask people to be conservative in their personal spending as well as watch our hospital expenses. I wanted to share my concerns that 2009 and 2010 may be tough years as we try and turn our economy around. I really didn’t want to have layoffs in the future and wanted to let everyone know that we may need to take actions that would affect people’s incomes, in order to keep Colleagues employed through the tough times ahead.

Personally I told them --as a leader who might be asking them to take time off each month (without pay)-- that I would begin January 1st by voluntarily reducing my income by just under 7%.

We will watch our monthly performance and I will first ask management to take off one day per month. I will give them 30 days notice of putting that into effect. I wanted all staff members to know that leadership needed to step up.

The above is just one example of what we may have to do in 2009. I also stressed that this is a great time of opportunity for us, as well, because of the culture in our organization and the way we practice. We need to be thankful for every time a patient or customer chooses us and puts their faith in our hands with regard to their healthcare needs.

Several weeks after this presentation I was deeply touched by a message I received from one of our Colleagues. They told me they appreciated my actions and they, too, wanted to help. This Colleague makes around $20,000 per year and told me that "everyone can shave a little here and there if they have to," so they wanted to give back $50/month. They said how very much they appreciated their job here and felt they needed to help. too. I told them when the time comes I will take them up on their offer but for the time being, hold off.

As I was writing this blog today I was interrupted by a call from one of our outpatient guests…more to come tomorrow.

Stan

A Look Back, A Look Forward; Some Old & Some New

2009-02-05T14:10:00.002-05:00

February 5th, 2009

2007 and 2008 have proven to be very challenging years for hospitals and health systems, particularly for those with variable rate municipal bonds and for those seeking access to new capital to continue to replace and upgrade equipment and facilities.

In 2007 the phrase "sub-prime" took on special meaning as many of the risks associated with variable financing that had never previously occurred -- actually happened. For some, interest rates on millions of dollars worth of debt hit double digits (in some cases, going as high as 20%). Fortunately for us at ACH, our rates (not quite) doubled from 3.5% to over 6% and only for about four months. Again in October 2008, for only 9 days, our rates hit 9% and then returned to normal. While many organizations were fully invested in the market, we have been financially conservative (earning our 4-7%) and we have learned to operate on what we make. So, while the market has been devastating to others, we were very fortunate to complete our new campus in 2006 and avoid huge losses in the market in 2008.

I remain optimistic about our future for several reasons:

First and foremost is the spirit of cooperation with our medical staff in terms of finding new ways to support each other and to serve our patients even better. We know in the future there will be shortages of primary care physicians and we have been able to recruit three additional family doctors to serve in Louisville, Alliance, and in new markets to our north. In addition, we have signed two new radiologists and will have, for the first time in a while, a total of three serving our community. We have a great team of dedicated colleagues and volunteers who exemplify the meaning of patient-centered care every day. Below are summaries of some comments from patients or their families that were received before I started my Blog, as well as some very recent ones from this past fall and our winter season:

OLDER SUBMISSIONS ~

A pat on the back, a hug and a handshake, who could ask for more…
One of our colleagues was seen walking an elderly gentleman to the lobby. Another colleague overheard the patient say, "You’ve been very kind to me. Thank you so much.” As usual our colleague asked “Is there anything else I or a fellow colleague can do for you?” The patient said no, but as they left he patted our colleague on the back, hugged him and then shook his hand. I was wondering what he might say about his health caring experience, but didn’t have to wonder long because as he was leaving he was already sharing his story with his wife.

A touching moment...
Dear Stan:
I had to write and tell you about a touching moment I had with an elderly gentleman that I discharged from PCU. Before he left the floor, he told me he received excellent care here and that all the nurses were excellent. He wanted me to pass on those words to all the PCU staff. He requested accompaniment down to his car, so I went with him and his two daughters to the car. As he was getting in I shook his hand and thanked him for letting us take care of him and how much we appreciated the opportunity. He looked at me sort of funny and then asked him why I would thank him? I told him that of all the hospitals in the area, he chose Alliance Community Hospital to provide his care. He took my hands(he had tears in his eyes) and he said, "I never looked at it like that, but that is a sweet thing to say and now if I ever need care Ill be back for sure.” Now I know I will not forget to say thank you to my patients.

A donation…December 23, 2004...
Dear Stan,
The enclosed check is in appreciation for the wonderful care I received from your exceptional staff during my recent stay at ACH. Enclosed was a very generous donation to our Foundation.

Health Caring Nurse...
"Kudos to the health caring nurse who [probably didn’t see me observing her as she greeted the person she was caring for with a warm and friendly, "Hi Mrs.____., I am here to help you with your medications." All I saw was an individual who had so much to do on a very busy floor, yet gave an impression of not being rushed at all. She stayed by the bedside and sat for a very brief moment, her patient smiled and thanked her and in the next moment she was off to take care of someone else. How you do things sure does make a difference."

The following was presented to our colleagues early on in our Planetree journey and judging from the comments above, it is the way most of us choose to practice each and every day...

Your Role (As a Member of the ACH Team) is to Create a Great Health Caring Experience;
Find that next right answer to do the extraordinary for just one person, be it a patient or by assisting a fellow colleague

I. All of our patients expect good clinical care.
They come to us because they or their physician have determined they need to be in a safe, comforting environment to receive more medical information or treatment.

II. What most patients are not expecting, and it is surprising how few hospitals still don’t provide them, are the simple courtesies of our five Health Caring Standards:

· Acknowledge their presence in a warm and friendly way
· When appropriate, address by name
· Provide a friendly, timely and comforting discharge or departure
· Thank them for allowing us to care for them
· And most important of all asking them, “Is there anything I or a fellow colleague can do for you?”

III. Think of your role at ACH as a cast member in a play that performs three performances every day, 365 days a year. You have been selected because you possess job skills and knowledge to perform in that role. Every day you’re blessed with an audience; many are new and some audience members are returnees. The best actors on Broadway do what they do each and every day … create special moments - they take their daily routine, which they do over and over again, and make it special over and over again for every audience. Each one of us possesses special talents to go with our job knowledge and skills. Your role is to find a way to express this talent either in your job or on a Planetree Caring Committee and to do something extraordinary for at least one patient/customer or guest a day.

Thanks to all who are making a difference each and every day.

-Stan

MORE RECENT SUBMISSIONS ~

Missed meal...
This past fall, one of our patients was very disappointed the afternoon of their discharge. When asked why they responded that "my favorite meal was ordered for dinner and now I will miss it." Speaks pretty highly regarding our nutritional services department. When our supervisor in the department found out, they contacted the husband and wife and arranged to have their favorite meal delivered to their retirement villa several miles out of town a week later. Now that is service the ACH way.

Jan. 19th, 2009...
Mr. Jonas:
This is a belated and remiss thank you and kudos to all your staff that served my wife and me last June. Carol, one of the nurses and Dr. P. our physician, especially. At any rate, we were continually amazed at the service from each and every department. The office and financial staff answered all our questions about costs and (in advance) worked out a pay schedule. Pre-op informed of what was going to happen and answered our questions very patiently. Jennifer met us in the lobby and was very sympathetic and helped ease our anxieties. Nursing and the therapists were attentive and gentle, yet assertive with their expertise and still flexible in working with us. The chapel, outdoor gardens and lobbies were peaceful. Our room was clean and full of amenities. And yes, the cafeteria food was diverse, well prepared and delicious. Of all the services (and perhaps the most surprising) welcome was the Concierge service. The concept of welcoming and orienting the clients could not have been executed more faithfully. Our stay exceeded our expectations in every way and could not have been better. The quality and depth of your facility’s mission was evident in every aspect of the facilities and services. We have raved about our exceptional experience that eased a health crisis into a very good and memorable time of challenge. Please pass this thanks on to all.

Cardiac Team...
I am writing to compliment two members of your Cardiac Rehabilitation Team, Kelly and Dave. My interaction with them has been very positive and I wanted to make sure you knew how important they have been. Kelly’s sincere interest in my personal medical situation put me at ease…She went out of her way to explain details…her medical knowledge was impressive…Dave was awesome when it came to the physical aspect…thanks to his personal attention I was able to stop all pain meds within a month and am now pain free…they genuinely practice “quality patient care” in every aspect of what they do.
Sincerely,
B.

Dear. Dr. M:
First of all, I just want to say thank you. I deeply appreciated your expertise and good judgment. Would you also thank your associate Dr. H. for he helped me assuage my fears by his kindness… overall my experience at Alliance Community Hospital was 5-star…a wonderful staff.
From G.M.:
Don’t want to name any one person since everyone has been great! You know, (I had)an experience many years ago was not that favorable but I must say I can’t find one thing to complain about…you can always improve something but this visit and stay has just been great.

From J and M:
My husband was scheduled for a knee replacement in October. We arrived at the hospital at 6am and were met by Jennifer and you thought we were checking into a 5 star hotel not a hospital! J’s room was 373 and the nursing staff was wonderful, Lois, Natalie, Emily, and Debra. All the CT’s were great. You would have thought these ladies were family instead of someone assigned to take care of you. It didn’t matter what you asked they always took time to answer and help. If I ever need another hospital visit I wouldn’t hesitate to come back or recommend your facility.

An anonymous call...
Please thank big time Bob, John, Kristen, Cathy, Tiffany and Gail! (Although the caller didn't identify an area, my guess is this person was referring to therapy services.)

There's a slice of the kind of feedback we've been receiving.
Thanks team,
Stan.

Phone Call

2008-08-04T14:46:00.001-04:00

I just returned a phone call to the husband of a recent patient and found that you can learn a lot from the way people describe their experiences. According to the caller, he and and his wife are new to Ohio and they have visited hospitals in many other areas. Here’s what they had to say about Alliance Community Hospital:

“Wonderful stay, keep it up. Don’t know what you are doing but the caring attitude from groundskeeper and maintenance crew to everyone we met…made us feel like we were in a hotel. And that one male nurse on PCU--he was really concerned and caring and so attentive…Usually (in a hospital setting), you find someone having a bad day-we never did. We will be writing a letter to the colleagues here.”

I look forward to hearing more from them.

Talk with you soon-
Stan

July 28th Note

2008-08-04T14:01:00.002-04:00

Well, I certainly can’t say it any better than was stated in a note written to me on July 28th by one of our patients. It read:

“Thank you so very much for your services. Joann in out-patient is AWESOME!! Our time at Alliance Community has been above and beyond our expectations. Dr. Mitchell and Dr. Hudzik are the best! Again thank you ACH team.”

Thanks for taking the time to share-
Stan

Happy Birthday to Me!

2008-07-28T16:17:00.001-04:00

Today is my birthday…and aside from getting many birthday wishes I received two great compliments regarding our Colleagues and the caring Planetree environment and great services we provide. What a nice present; way to go team!

First up, another compliment for our Therapy team. Whatever they are doing in Therapy Services, it seems a week doesn’t seem to go by in which someone calls me to talk specifically about Therapy Services and their very special team.

1) Therapy…
A Therapy patient called in today to discuss what a wonderful experience she had in our Therapy department. “Everybody was so nice & friendly. Thank you!” she said.

Secondly, I got a visit from a Colleague regarding Planetree.

2) So Proud to Work at ACH…
One of our Colleagues came in to talk to me about how proud she is of our hospital and how much she enjoys working here. She said her mother is a currently a patient at another local hospital and she cannot believe how unfriendly the staff is. Some of her comments included, “They do not offer to open doors or assist you in anyway as we do at ACH. The food is terrible and the hospital is dirty.” She went on to say that her mother commented, “These rooms need cleaned.” The Colleague said that the room her mother is in is a makeshift ward with two beds stacked atop each other. “You can hardly get through they are crammed so close together. The staff does not pay attention to patients,” she said, noting that one day her mother needed to get up but nobody would help, so her mother was trying to get out of bed by herself. This Colleague said she spends a lot of time at the hospital with her mother because she does not feel safe leaving her there alone, adding that when her mother was a patient at ACH she never worried about leaving her.

Is our hospital better because of Planetree? Absolutely, because our Colleagues practice in a way that makes all of us proud to be on the ACH team.

Thanks for making my day a great one.

Stan

Calls from Patients and Guests

2008-07-25T14:49:00.000-04:00

I am always amazed at how many calls I receive from our patients and guests. Most just want to let us know how much they appreciated a special moment that had been created for them (through the compassion of our staff) or to voice appreciation for a response they received from one of our Colleagues or physicians.

There a few calls expressing dissatisfaction. They are usually surprised that they can get the CEO on the phone so easily and they also appreciate the knowledge that our staff receives feedback from me in order to improve processes and/or better handle a patient’s or guest’s specific needs. Here is a recap of comments from a call I received today:

“Just received a call; ER was very busy. Patient knew she was bottoming out and requested OJ; something she usually kept with her. Without hesitation one of the staff members immediately responded and genuinely seemed glad to help. They were busy with so many others and just wanted to express thanks for this moment. It was an act of kindness and service she felt should not go unrecognized. Sometimes it is just the little things that can mean so much. Way to go team. It says a lot about practicing in a Planetree Hospital.”

Stan

It has been a while...

2008-07-16T14:58:00.003-04:00

It has been a while so my last sign off …..”talk to you soon” was a bit of a long stretch.

Today we welcomed Brenda, Tamara, Brooke, Terry, Sue, Casey and Kelly as new Colleagues to Alliance Hospital. Three members of the group shared their thoughts about working at ACH. What was great to hear is that one of them will drive more than 30 miles to work --passing several of our competitors’ facilities along the way-- because she wants to work in a Planetree environment. Another was drawn here because she did some of her training at our place and really appreciated the mentoring and support of her preceptors. The third said she was glad to be at ACH because she had heard so much about us from friends who enjoy working here. I enjoyed my time as a presenter during the new Colleague general orientation process and discussing our dreams and the expectations for our organization with these newcomers.

As part of my presentation this morning, I discussed the importance of listening to our customers. Interestingly enough, immediately following my presentation I received a call from the wife of a recent patient. Part of the call had to do with the rudeness of one of our staff members, but the majority of the call was very positive. The caller asked me, “How do you find such wonderful people to work here?” The more I thought about it, I remembered what our new Colleagues were telling me this morning about why they came here. People join us because they know they will have the freedom to practice their passion in a proud manner – or because they know that coming here will afford them an opportunity to learn and grow -- and possibly find new passions upon which to build their strengths.

The caller ended our conversation by saying that what disappointed her husband the most during his stay here was that he was not able to stay for dinner the day he was discharged -- because he really loves our food and was looking forward to what he had ordered for dinner! Hopefully sometime soon he and his wife will just drop by for dinner since our Café restaurant is one of the best choices for a great meal at a great value in this area.

Better sign off with a thank you for listening.

Stan

Life Stories of our Community Care Center Residents.

2008-05-07T14:55:00.000-04:00

Yesterday I had the pleasure of attending and listening to the presentations of Professor Nancy Pine’s freshman class of Mt. Union students. Dr. Pine is an Assistant Professor of English and her students were sharing their essays based on the conversations that each student shared with a resident partner from our Community Care Center. In attendance were all the students, many of their partner residents, family and friends, and Colleagues from the hospital staff. As promised there were recollections of happy and joyous moments, hardships, some shedding of tears, much laughter and many of life’s lessons to be shared. You could tell that what started out as part of a course curriculum evolved into much more. For most there seemed to be a true bonding not only of different generations but of friendship.

Thank you to all for this moment of sharing. I hope that Dr. Pine and her students appreciated the experience as much as I did and will consider coming back next year.

Talk to you soon.
Stan

Follow up to April 17th blog….

2008-04-30T15:53:00.001-04:00

Well I lucked out because the hospital in Toledo was willing to take a cash payment for the allotted amount stated by our insurance company of $109; remember their list price was $249. If only I could have convinced my daughter to have her x-ray done here before she went back to school; our list price for the same exam is $91 before any adjustment.

If John McCain is going to be successful with his healthcare strategy of less regulation I sure wish he would figure out how to level the playing field for consumers; so that hospitals, doctors and insurance companies had to disclose in advance what services will actually cost out of the consumer’s pocket. I realize for many services it might be a range but for many services it can be an exact price.

Talk with you soon
Stan

Wanted to share some patient compliments I received yesterday…

2008-04-25T15:46:00.001-04:00

Wanted to share some patient compliments I received yesterday…

Robert called in to talk about Therapy Services. He said that Erin, the person who took care of him was great and that he was more than satisfied with his care. If he ever needed such services again, he said this would be the first place he would come.

Kathleen wrote regarding our E.R. She said of her first visit to the ACH ER, “Each one (of the staff members) was friendly, caring and most professional. My husband and I were very impressed. A note has been sent to the E. R. also.”

What a great way to end the day.

Stan

A Must Read

2008-04-25T15:43:00.001-04:00

April 24th, 2008

“The Third Path…Systematic Change Will Focus on Returning Value” is an article written by Greg Poulsen, SVP at Intermountain Healthcare that appears in Modern Healthcare’s, April 21st issue on page 26.

It is a must read; one of the most insightful, clear, forward-thinking approaches to health care…I hope all of the presidential candidates and their teams start listening, - and that whoever is elected stops listening to the special interest lobbyists.

In his article, for those of you who might not have access to it, he clearly points out that neither a consumer-driven approach nor the concept of universal insurance coverage addresses the core health care challenges we face: that of providing quality and value.

The core flaws, as he points out, are:

1. A fundamental flaw is not one of access or insurance – but rather, one of cost issues, structure and the need to align incentives.

2. Patients who lack complete medical histories must navigate a sea of provider settings. Poor communication increases the chances for errors. There is also a lack of real peer accountability.

3. The current system has powerful incentives to increase utilization; physician fees are affected by treatment decisions. Physicians can substantially increase their incomes by performing procedures versus providing consultations. Patients often request more expensive testing and medications. Finally, physicians with ownership in delivery systems such as ambulatory centers or imaging have their utilization incentives greatly magnified. Most physicians do what is right because they take their professionalism seriously; otherwise we would find our problems to be much greater.

Suggestions:

1. That the payment system move away from the fee-for-service structure to a more bundled approach.

2. Patients need to be motivated to opt for a high value approach.

3. The regulatory environment should change to better facilitate cooperation and coordination among the providers, doctors, hospitals and others.

4. Health information technology and EMRs need to be expanded.

Talk to you soon.

Stan

Become a Knowledgeable Buyer of Medical Services = www.bakboms.com . . . Our New Website!

2008-04-17T13:37:00.002-04:00

Last week the health system of which I am pleased and proud to serve as CEO started an ad campaign to help provide consumers with access to pricing information. Our motivation was simple: a win –win situation.

For many of the services we provide, our prices charged to both our insurance companies and consumers have been kept lower than those of many of our competitors for the past several years.

As a Community hospital struggling to make more than a 2% operating margin, we hope to drive more business here, particularly in the areas in which we offer some of the best equipment and prices around -- yet people don’t know how, nor do they have the information they need to shop. Once they experience the value ACH offers and they meet the colleagues who practice and provide the services here, I am confident we will create even more loyal customers.

How ironic: Today I look at an Explanation of Benefits (service) on an x-ray for one of my immediate family members. Of course, this service was performed out of town in one of the most expensive areas of health care in the state, Toledo. The list price here in Alliance is $91.00 for that service, while, at the hospital in Toledo, it’s $249.00. Naturally, my family member’s deductible is not any where near being met, so what will we end up paying?

Well according to my EOB, if the service had been provided here, my plan would have covered 100% of the charge at an in-network facility -- it would have paid the full $91.00. But, with regard to the out-of-network facility, I will find out later. My plan did inform me that the usual and customary charge would be $109 – which means that $140 of the list price in Toledo would not even have been paid. I sure wish I’d have known, in advance, which outpatient center to send this family member to --since we will end up paying cash.

Please email me or comment on my blog if you have questions on how to become a knowledgeable buyer of medical services -- and let us learn together.

Everyone that’s taken care of me….the whole bunch…they worked him so hard, it was what he really needed…three stories. It’s what keeps me coming back

2008-03-10T13:55:00.003-04:00

“Everyone that’s taken care of me, the whole bunch…you have very special people working here…because of all of them, they have given me a great deal of comfort and peace of mind…I am just not used to seeing that in other places I have been. This is just a very special of caring where everyone really cares.”

As CEO of this hospital, hearing comments from patients and their family members, such as the above words recently used to describe the team of health care professionals and colleagues comprising the ACH family, makes me feel proud to be part of the team.

Every so often things don’t go perfectly, but that too is what makes this place so special. Many of the colleagues I work with, including the physicians who practice here and the volunteers who give us their valuable time, are constantly talking, discussing, and listening to help us deal with all the imperfections and frustrations that our patients and guests deal must endure…for as good as we are, things happen.

Mr. James G. called this week, saying, “The ER team was great…I went to therapy for two weeks, every other day…the passion of the whole bunch taking care of me was obvious.The whole bunch was at it again in therapy.”

I thanked Mr. G. for taking the time to call me and let me know how he felt about the Colleagues caring for him.

I applaud our medical leadership because they are pushing administration and the board to be more public and proactive about Quality issues; encouraging what we do well and highlighting what we need to improve upon. They are working hard at looking at the way medical staff itself conducts it business and have embraced evidence-based medicine, which is not an easy thing to do.

Mrs. R. called to talk about her son’s therapy, saying, “We were so very happy with the services our son received. He had a terrible accident and was treated at Akron Children’s Hospital, but we wanted to be closer to home so we chose Alliance Community. Gail, Erin, Walt, Tiffany. All who called for our son worked him so hard and got him doing things we could not get him to do...he is now able to go back to school. We just felt so very welcome when we came…believe it or not but our son actually looks forward to going back and seeing his friends at therapy. A truly great experience. Thank you for giving us our son back...”

It takes a very special person to admit you could have done better, to apologize sincerely, to show that you care, to be open and honest, to want to improve, to accept constructive criticism, to hold others accountable for trying to be the best, to want to be better…to truly put the patient at the center of what we do. Because of all of you do, thank you for inspiring me to do the same.

Talk to you soon.
Stan

Healthcare is the Economy:

2008-03-05T14:34:00.001-05:00

I read, with great interest, Todd Sloane’s editorial entitled “The New Insurance Backlash” in the February 25th issue of Modern Healthcare. To me, one of the most telling lines was, “On January 23, the day Wellpoint reported a 8% gain in 2007 profits (to $3.35 billion), its share price fell by $2.90 because it also reported that it spent almost two cents more of each premium dollar on –wait for it- patient care.”

I truly believe one could make a good argument that healthcare is the number one issue in this year’s election. It is the biggest challenge affecting the ability of both big and small businesses to compete.

Below, I offer my own assumptions or definitions that are necessary to frame my conclusion for a combined Hillary/Obama/Huckabee/McCain plan – one that would fit well with Bernake’s suggestions for stimulating economic growth. So how would this work?

It would work, I believe, in a free market, competitive system. One with a fair and level playing field and--let’s face it-- the consumers of healthcare don’t have the information they need on quality and especially on price (i.e. money they will spend out of their own pockets). We have been preaching transparency, but truly have done very little about it because of all (issues posed by) the special interests; primarily insurance companies. Hilary and Obama would like to limit the amount of premium dollars that go to insurance companies. Under that theory, hospitals and doctors certainly could perform better and if healthcare consumers knew what they had to pay for in advance of many of procedures/tests they would certainly shop around for the best price.

We have been working on quality data for years and if we truly want peer review to work, we must do something about malpractice. However, I am encouraged that some doctors and hospitals are sharing their complication rates and mortality statistics with other key information on their websites. We don’t need a single payer system but we could certainly use a single payment system that is much simpler and makes individuals more accountable for themselves; we do need more of a wellness system than our current sick care system.

There is a lot that could change and bring both parties together and provide the stimulus for doctors and hospitals to improve as well; let’s quit talking about transparency and do something about it.

Two Great Valentine Gifts

2008-02-15T08:08:00.003-05:00

Received a very nice note from several colleagues today, on Valentines Day, thanking me. I guess I just want to share that thanks with our leadership team at the hospital because of what the note said.

It read: “Thank you for the new equipment and for always trying to make sure we have everything we need to do our jobs”. Reading these words was a great gift, as were the three enclosed gift certificates for the ‘CAFÉ, one of my favorite places to eat.

Several minutes later, I received a thank you in the mail from a new patient (from Doylestown) praising our service, our Planetree environment and our compassionate caring of our colleagues. They wrote, “Through the reputation of Dr. Palutsi, we were introduced to your hospital. First impressions are always important and we were bedazzled ….as a patient and family we received wonderful care…special thanks to Barb and Dottie in Same Day care…your volunteers are also to be commended”. Sincerely S&L P.

Couldn’t ask for a nicer day.

Talk to you soon
Stan

Interesting Articles on Health Insurers and Health Reform

2008-02-06T09:08:00.000-05:00

Thursday, January 31
By Bill Toland, Pittsburgh Post-Gazette
Insurer’s CEO Says Blues Deal Could Hurt Competition

Some big insurance companies in Pennsylvania are fighting for position, but what I found most interesting was the comments from James Buckley, President of the Delaware Valley Health Care Coalition, a multi-employer health purchaser. He said “he protested the lack of transparency among health insurers, saying true, healthy competition isn’t possible until the Legislature compels insurers and hospitals to be more open and accurate about the cost of procedures. The savings being touted in the IBC-Highmark wedding would be irrelevant if a transparency model is established, setting standardized hospital reimbursement rates. Instead of allowing the major health insurers to use their oligopoly power to receive preferential pricing and profits, health care providers should be able to charge reasonable prices to all health care customers.

I couldn’t have said it better.

DATA BRIEF
THE PRESIDENTIAL CANDIDATES’ HEALTH REFORM PLANS
Katherine K. Shea, Sara R. Collins, and Karen Davis
The Commonwealth Fund
January 2008
HEALTHCARE OPINION LEADERS’ VIEWS ON
THE PRESIDENTIAL CANDIDATES’ HEALTH REFORM PLANS

Typically I am pretty much a free market person, however I just don’t believe this has worked in healthcare. A majority of the public agree with the democratic position summarized below from the article.

Mixed Private–Public Proposals Favored
Most healthcare opinion leaders (61%) believe that the mixed private–public group insurance system reform proposals put forth by Democratic candidates are an effective approach to achieving universal healthcare coverage, with nearly two-thirds (65%) of academic leaders and half of business/insurance/other healthcare industry leaders voicing support for universal healthcare. Proposals relying on tax incentives for the individual market, however, are seen by the same experts as an ineffective method for achieving that goal, with 59% of respondents saying they were not effective. Twenty percent of polled business leaders (20%) think tax incentive-based reforms are more effective than do academic (4%) or healthcare delivery leaders (4%).

I was happy to see that most of my healthcare colleagues agreed with this position, at least in this poll.

Talk with you soon.

Stan

The Health of our ACH Colleagues and the Economic Health of the Alliance Community and Eastern Stark County

2008-01-31T10:44:00.000-05:00

The Ohio Hospital Association challenged all of its members to promote wellness in our hospitals and encourage our communities to do so as well. Today we initiated our GET FIT campaign. It began with registration for those individuals who want to participate in our version of “The Biggest Loser.” We are organizing teams and have received a lot of help from Mt. Union College regarding the personal trainers. We will let you know how we do in May.

We keep hearing that we are transitioning to a service economy and in many school systems vocational programs are the first programs to be cut. Well, in Alliance we had to make some tough cuts regarding the school budget that impacted these programs. There are many more students graduating from Alliance High School who won’t attend college than those who will. Interestingly enough, in Alliance and many of the surrounding communities, local business owners are saying they need more skilled workers in the trades; they would be most interested in interns, and work-study students.

Well, we are very fortunate in Alliance to have a superintendent of schools with a vision of how best to match the needs of our business communities with those of our students. Dual credits could be offered that might inspire those who thought they could never enter college to do so. If most of the students graduating have hope of a good career path, then we could help local businesses grow; with more and better jobs, we could help stabilize the housing market, which needs all the help it could get right now.

Very shortly, local citizens will get the chance to vote on a school levy Issue 20, which is focused on achieving the vision described above. A healthy local economy and investing in our kids’ collective future is a great way to GET FIT Alliance.

Talk with you soon.
Stan

As promised, here’s some closure to my last Blog

2008-01-21T14:56:00.000-05:00

After hearing from our candidates, I must say I was encouraged. Although I am personally not a fan of Dennis Kucinich’s all-public governmental approach to healthcare and the elimination of all for-profit healthcare entities, he spoke well and was much more likeable than I had expected.

Mitt Romney has already shown he can make change happen. Even if Massachusetts isn’t the perfect approach, you have to start somewhere. Of course, it would be nice to know in advance where we are going to end up before we begin our journey and Romney seems to at least have a plan. I was impressed because he was the only candidate that actually asked for my vote.

John McCain’s free market approach is one I usually prefer, but you need a level playing field in healthcare and in my opinion, we, like the government, need a lot more checks and balances.

John Edwards was certainly the most likeable of those present. His accent sounded more Cantonese than southern and his story about encouraging his daughter to attend Mt.Union College instead of Harvard University was perhaps one of the lighter moments of the day - and it was very well-received by the audience.

Not to be out done, Barack Obama showed a sense of humor as soon as he entered the room by asking the crowd, "Can you smell it in the air? Change is coming and much of it is good. Out with the bad odor of stagnant old time politics; in with the good. BO is for Barack Obama and I want to be leading the good changes that we need.”

Our audiences voted only on the merits of each of the candidates’ healthcare platforms.
Hilary and Obama combined for about 32 %( 16% each) of the vote. John McCain and Mitt received the most Republican interest with 23% and 18%, respectively.

My hope is that whoever is elected will implement the best ideas of all the candidates, in order to actually change the system -- even if those ideas came from former competitors.

Talk with you soon.
Stan

Presidential Candidates Address IHN Leadership Summit Conference

2008-01-14T16:06:00.000-05:00

Canton, Ohio - Eight candidates seeking to be the next President of the United States were present to speak before the Independent Hospital Network Leadership Summit Conference in Canton on Friday, January 11.

Here’s a summary of the events from a roving reporter’s first-hand perspective.

Taking time out before heading off to the primary in Michigan, four of the leading Democratic and Republican Presidential hopefuls presented their Healthcare Reform Plans to delegates from the Independent Hospital Network.

Hillary Clinton opened, and clearly let her emotions of the campaign process show when she started talking about the strain of campaigning and then quickly regrouped to focus on a hardluck story about how our healthcare system failed a man whose life was destroyed by the current system. She said that what he had worked a lifetime to achieve, was ruined after he lost his job and then suffered a heart attack; both of which ultimately led to the loss of his life savings. Hillary said that because of our flawed health system, this man, yes, is still alive, but everything that he has worked for is all gone.. Hillary, like two of her fellow Democratic colleagues, is pushing both a private and public platform of change.

Rudy Giuliani, on the other hand, said he prefers a market place approach to fixing our nation’s health woes. In a lighter moment, he said he really had to question why our legislators seem to be spending more time worrying about sports and steroids than healthcare. He asked that we focus more on the health of the nation and a little less on the well-being of the Yankees.

I believe “Huck” was up next,(by the way, I failed to mention that none other than Chris Matthews from NBC’s Hardball was our MC). I must admit I liked Mike Huckabee’s remark that people need to be more responsible for their own health and that a consumer- driven model makes a lot of sense.

More to come from this reporter on today’s events, but that will have to wait until tomorrow…I have some scheduled meetings and our team is working on gathering consumer information… a story for another day.

At the end of today, however, we did take a straw vote-- just based on the Healthcare Reform issue. I will share those results in a future blog.

Talk to you soon.

Stan

December Praises…and Holiday Wishes

2007-12-26T12:12:00.001-05:00

‘Twas the day before Christmas and . . . I was catching up on details.

No unusual calls, but some very nice correspondence received via e-mail, letter and voicemail messages. For instance, Angela K. wrote of past reluctance to seek therapy [due to hearing horror stories about such experiences] and her dread in attending therapy sessions. To her delight, she found that the stories were all wrong and that the therapists helped make her feel very comfortable and didn’t make her do anything she was unable or uncomfortable doing. Another caller described our ACH Therapy Colleagues as “friendly, courteous, and very team oriented” ... saying that they were all especially attentive to her specific needs. She said she has been other places and was particularly impressed with the attention paid to small, yet important details, (such as cleaning the exercise equipment) here at ACH.

Thank you, Maintenance, for another job well done. Security recently returned a wallet that was found by one of our Maintenance Colleagues. The wife of one of our patients thought she had dropped the wallet somewhere between her home and the hospital as she was rushing her husband to our ER. When he was admitted to his room, a member of the Security department was already there with the missing wallet and all of its contents were in tact, including several hundred dollars in cash. The patient and his wife wanted to let us know how much they appreciated our Colleagues; not only for their kindness, but for the care they give to all patients.

To all our great Colleagues, physicians, volunteers, Board leadership… here’s wishing everyone a very Merry Christmas and Happy New Year. It is indeed a pleasure and an honor to be part of the ACH family.

Stan