An open letter to the Israeli government
Dear friends and colleagues,With everything else you face, the last thing you needed on your agenda was the financial collapse of the country's major academic medical center, Hadassah (comprising two hospitals in Jerusalem.) That the disruption in patient care, research, and education--not to mention the financial hardship of the doctors, nurses, and other staff--might have been avoidable is of little solace right now. It will take weeks of thoughtful negotiations and difficult decisions to sort things out and put the medical center back on a good path. But rest assured that there is a path to long-term s...
Source: Running a hospital - February 16, 2014 Category: Health Managers Source Type: blogs
Follow-up to the white coat issue: Enclothed cognition
A few weeks ago, I wrote that the robotic surgery advertisement acceded to by the University of Illinois in support of a private company made inappropriate use of the image of white coats. I argued that it did so to bring greater credibility to the advertisement: The public . . . views that symbol as emblematic of that sacred trust. We look up to and respect people wearing the white coats. We know they have devoted themselves to our well-being and have engaged in extensive training for our good.In this ad, for example, an administrative person was clothed in the white garb along with the medical staff...
Source: Running a hospital - February 15, 2014 Category: Health Managers Source Type: blogs
The difference between empathy and sympathy
As I head off into a blogging break through New Year's Day, I pass along this view by Dr. Brené Brown of the difference between empathy and sympathy, a distinction that those of us in the health care world would be wise to understand. "Empathy fuels connection. Sympathy drives disconnection." Animation by Katy Davis. Happy New Year! (Source: Running a hospital)
Source: Running a hospital - December 20, 2013 Category: Health Managers Source Type: blogs
The sun is not only a painter but a sculptor.
With thanks to Judy Miller--one of the finest nursing administrators I have met--now at Galloway Consulting. Look at this lovely excerpt from Florence Nightingale:Light essential to both health and recovery. It is the unqualified result of all my experience with the sick, that second only to their need of fresh air is their need of light; that, after a close room, what hurts them most is a dark room. And that it is not only light but direct sun-light they want. I had rather have the power of carrying my patient about after the sun, according to the aspect of the rooms, if circumstances permit, than ...
Source: Running a hospital - December 19, 2013 Category: Health Managers Source Type: blogs
Can you help this pregnant woman?
A friend called to ask for help on an issue related to her pregnancy. Do you know anyone who might be able to provide advice? Here is the situation:A bad termite infestation has been discovered in her apartment, as well as the other units in her block in San Franciso. The entire block of apartments will need to be tented and sealed while a pressurized gas called Vikane gas is pumped in over a period of 3 days to kill the termites. The active ingredient in the gas, which is supposed to be quite noxious, is sulfuryl flouride. All building occupants will have to vacate the premises for 3-4 days, taking ...
Source: Running a hospital - December 18, 2013 Category: Health Managers Source Type: blogs
On learning organizations
Please check out this new article I wrote for the Athenahealth Leadership Forum. The lede:A colleague once said, “Every plan is excellent, until it’s tested. It’s execution that’s the problem.” And so it is. Excerpts: Project advocates enter every endeavor with a theory of the case, a vision of how things should be. But, as my late colleague Donald Schön noted, reflective practitioners are constantly reviewing the evidence to modify their framework in response to reality. Lean organizations understand that there is no group of central planners clever enough to design an optimum complex process. ...
Source: Running a hospital - December 17, 2013 Category: Health Managers Source Type: blogs
A turning point for Partners Healthcare?
As we look back at the history of Partners Healthcare System (PHS) in Massachusetts, it is useful to consider what it is and what it might have been. What it is is an extraordinary collection of extremely dedicated and talented people--clinicians, researchers, and teachers--who do their best to serve humanity. What it is also is an incredibly successful business enterprise, carrying out a series of strategic plans that have led to market dominance in Eastern Massachusetts. What it is not is a leader in quality, safety, process improvement, and transparency. As I noted in March 2009:The Partners hosp...
Source: Running a hospital - December 16, 2013 Category: Health Managers Source Type: blogs
The next patent cliff
Much attention has focused on the "patent cliff" faced by pharmaceutical companies. As their proprietary drugs lose patent protect, the drug companies face competition from low-cost generic drugs. With an exceptionally high cost and long lead time for new drug development, the pharmaceutical companies face significant strategic problems.There is another patent cliff approaching that has not yet received much attention--the end of patent protection for many minimally invasive surgery devices. Whether the basic stapling devices or more complicated instruments, the 20-year protection period on much laparoscopic eq...
Source: Running a hospital - December 15, 2013 Category: Health Managers Source Type: blogs
Outsourcing as an element of the private equity model
One of the things to consider about private equity ownership of a hospital system--given the inevitable desire of the investment firm to flip the system--is what it is has done to the cababilities of the organization during the holding period.For example, one such firm has a policy of outsourcing as many of the hospital functions as possible. It removes staff from the payroll and shifts their functions to a third party. Examples are campus security, food service, mechanical engineering (the people who maintain medical equipment), and laundry.What does this do? Well, if the goal is to attract as a potential buye...
Source: Running a hospital - December 15, 2013 Category: Health Managers Source Type: blogs
Sign of the times
Here's a sign in the Jacksonville, FL, airport. I've always had the highest regard for hospitalists, as I believe they make a substantial difference in the quality of care offered in hospitals. But I never realized that they had risen in stature to being viewed as a competitive differentiator in the obstetrics world, in which women often comparison shop before deciding where to give birth. (Source: Running a hospital)
Source: Running a hospital - December 14, 2013 Category: Health Managers Source Type: blogs
For students: Telluride Patient Safety Summer Camps Applications for 2014
David Mayer has just posted a request for applications for medical and nursing students for the Telluride Patient Safety Camps for this coming summer. Excerpt:Through the generous support of The Doctor’s Company Foundation and MedStar Health, scholarships are now available for 40 medical and 20 nursing student leaders to engage in an immersive experience with leaders, educators, and advocates in patient safety at the 10th Annual Telluride, CO and Washington DC Patient Safety Educational Roundtable and Health Science Student Summer Camps. The student scholarships cover travel, lodging, meeting registration fee...
Source: Running a hospital - December 13, 2013 Category: Health Managers Source Type: blogs
Oatmeal at IHI: The sequel
I never thought that I would be compelled to write another post about the manner in which oatmeal is served at the IHI Annual National Forum at the Marriott World Center in Orlando.Let me take you back to the original posts from 2010: 1, 2, 3, 4. Short version: The ladles (see above) provided to guests on the breakfast buffet were too large relative to the bowls, so oatmeal was being spilled all over people's hands and their bowls. Unsanitary and messy work-arounds were developed by the guests (like using the tea cup seen above.) I wrote a blog post about the issue, and the hotel responded by eli...
Source: Running a hospital - December 13, 2013 Category: Health Managers Source Type: blogs
Evans: Let's make our day harder
Check out this great animation from Mike Evans. (Source: Running a hospital)
Source: Running a hospital - December 12, 2013 Category: Health Managers Source Type: blogs
How to learn nothing from patients
As we consider again the expertise shown by the folks at Legoland in responding to customers, consider this alternative view presented by Rob Markey on the HBR Blog Network. The article is called "Five Ways to Learn Nothing from Your Customers' Feedback." I'm struck by how often hospitals behave in these ways--sometimes on their own volition, but often with the wrong kind of "encouragement" from the government and insurers. An excerpt:I have studied a lot of customer feedback systems in the 25 years I’ve spent working with companies on customer strategy. Many of them leave me sad and befuddled. So many comp...
Source: Running a hospital - December 11, 2013 Category: Health Managers Source Type: blogs
Echoes of Telluride
As we turn to the final day of the IHI Annual National Forum on Quality Improvement in Health Care, our intrepid band of Telluride graduates prepares for their session, "Student- and Resident-Driven Patient Safety Programs" The presentation will draw on their experience at Telluride in examining issues of quality, safety, disclosure, and apology--as well as work they have done at their home institutions following the Colorado seminars.Teambuilding was an important part of the Telluride experience. You see here that there is some residual of that training several months later. (Source: Running a hospital)
Source: Running a hospital - December 11, 2013 Category: Health Managers Source Type: blogs
