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  • Hospital Impact
    find the papers that documented their final wishes It helped that these initial talks coincided with last week s National Healthcare Decisions Day which encouraged providers to talk about advance care planning with their patients and families One day a year to raise awareness about the importance of these documents may not be enough however Recent research shows that fewer than half of terminally ill patients have advance directives but among the people who do have them between 65 and 76 percent of their doctors don t know about them Read the full commentary at FierceHealthcare Leave a comment How Scripps Health CEO Chris Van Gorder engages employees every day April 15th 2015 by Ilene MacDonald It s not often you come across an executive of a 2 6 billion integrated health system with 14 000 employees who takes the time each morning to exchange pleasantries via email with a unit secretary who works at one of his hospitals But then there aren t many CEOs like Chris Van Gorder I recently interviewed him to learn more about his frontline approach to leadership which helped bring Scripps Health back from the brink of financial disaster and cut staff turnover in half As he talked about the importance of his Friday leadership rounds when he visits and interacts with employees at one of the system s five hospitals or 28 outpatient clinics he mentioned how one unit secretary from the 11th floor of Scripps Mercy Hospital in San Diego emails him every day And he responds every time She begins each email the same way Hi Boss On the day we had our scheduled interview Van Gorder says Arby Bautista had asked over email about his weekend and what was on his schedule for the day Knowing that she worked over the weekend he replied saying he hoped she could take a couple of days off during the week It only takes a couple of seconds to respond Van Gorder says Read the full commentary at FierceHealthcare Leave a comment How teamwork trust and improved communication reduce mistakes in the ER March 25th 2015 by Ilene MacDonald It s so easy to think you ve communicated a message clearly After all you understand the instructions so it only stands to reason that the person receiving them must also understand what you meant And though most misunderstandings can be cleared up quickly in everyday situations studies show that they pose a significant danger for patients when signals get crossed In fact an estimated 80 percent of the most serious medical errors in hospitals are linked to miscommunications To combat miscommunication in the emergency room one Sheridan Healthcare physician is leading an effort to practice communication drills with his teams at Baptist Hospital of Miami The program based on the aviation industry s crisis or crew resource management uses checklists and specific protocols to promote teamwork and communication I recently had a chance to talk to David Mishkin M D and Paula Barrass

    Original URL path: http://www.hospitalimpact.org/index.php?blog=1&s=ilene%20macdonald&page=1&disp=posts&paged=3 (2016-02-10)
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  • Hospital Impact - Hospital reputation lessons from the football field to the tennis court
    set of a close match Nadal s serve was affected by a fan s loud shout and Smyczek immediately told the umpire to let Nadal serve again because of the distraction I know my parents would have killed me if I didn t It was the right thing to do said Smyczek according to the New York Times More I think he deserves the sportsmanship award for the next 10 years I ve never seen that and I ve been in tennis for 19 years Unbelievable Benito Perez Barbadillo Nadal s public relations manager told the Times The Patriots have the reputation of a team that will break the rules to try to win in the past they have been penalized for stealing opponents signals Smyczek has earned the reputation of a tennis player who is a great sportsman even when his decision may have cost him a major victory No matter how successful the Patriots are many harbor the suspicion that perhaps they do not deserve their success Their records for many are tainted Would you rather have your hospital s reputation compared to Smyczek s or Belichick s or Brady s Kent Bottles M D is a lecturer at the Thomas Jefferson University School of Population Health and chief medical officer of PYA Analytics Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with moms Hospitals must train millennial nurse leaders in empathy frontline engagement St Louis hospital creates unit to improve outcomes through innovation 4 ways

    Original URL path: http://www.hospitalimpact.org/index.php/2015/01/26/hospital_reputation_lessons_from_the_foo (2016-02-10)
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  • Hospital Impact - Physicians, policy experts, public diverge on how to fix healthcare
    their expertise judgment and skills remain intact Ensuring physician competence is necessary in order to retain the privilege of self regulation There s growing evidence that MOC can improve physicians performance and patients outcomes New 2015 American Board of Medical Specialties standards for MOC reflect changes made to take into account concerns expressed during a two year review of the program The second article written by practicing Scripps Clinic cardiologist Paul S Teirstein M D reflects the opinions of some 19 000 physicians who have signed an anti MOC petition A meta analysis of 33 studies on MOC found 16 with an association between certification status and positive clinical outcomes 14 found no association and 3 found a negative association The MOC program elements are not relevant to the actual practice of medicine and are not an accurate gauge of physicians knowledge The ABIM received more than 55 million in fees from MOC in an era when everyone is called upon to cut costs The Association of American Physicians and Surgeons has filed a lawsuit against the ABMS for restraining trade and decreasing patient access to physicians MOC and other rules and regulations regarding medicine are being controlled by people not directly involved in patient care who have lost contact with the realities of day to day clinical practice I am unaware of any recent polling about how the lay public views the MOC debate but there is a 2009 Henry J Kaiser Family Foundation survey that revealed lack of agreement between the public and policy experts Experts view up to 30 percent of care delivered in the United States as unnecessary but 67 percent of Americans say they don t get the tests and treatments that they need Experts contend that there are big differences in the quality of care delivered in the United States but 70 percent of the public says there is no big difference in quality among doctors in their area Experts support comparative effectiveness research because it is vital to get a handle on costs and to practice evidence based medicine but 55 percent of the public says insurers should pay even if their doctor recommends a treatment that has not been proven to be more effective than a less expensive one Health care reform will fail unless patients and practicing physicians support and understand the changes that are being made There is a need to get the public practicing physicians and policy experts are on the same page of the transformation playbook Kent Bottles M D is a lecturer at the Thomas Jefferson University School of Population Health and chief medical officer of PYA Analytics Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming

    Original URL path: http://www.hospitalimpact.org/index.php/2015/01/14/physicians_policy_experts_public_diverge (2016-02-10)
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  • Hospital Impact - Look past uncertainty surrounding ACA to improve healthcare
    lens of studies investigating whether the ACA accomplishes its stated goals the law seems to be a success The Urban Institute in early December reported that the uninsured rate fell nationally by 30 percent In early December the Centers for Medicare and Medicaid reported that health inflation for 2013 fell to its lowest level since government statistics were tracked Hospital acquired medical conditions fell 17 percent since 2010 which saved billions of dollars and 50 000 lives Insurance companies which were wary of participating in the insurance exchanges last year flock to provide more competition and more health plans for enrollees to choose from and average premiums for 2015 increased by less than 4 percent Gallup poll shows that a majority of newly covered health insurance enrollees are pleased with their coverage It s hard not to be confused by the uncertainty of the fate of the ACA as we approach 2015 and I am certainly not smart enough to be able to predict what will happen in the coming New Year However I hope to apply the wisdom of Schwartz and Fromm by being curious not choosing up sides I search for meaning as I continue to monitor America s messy quest to support the Triple Aim of decreasing per capita cost increasing patient satisfaction and increasing the population health and wellness of the American people Kent Bottles M D is a lecturer at the Thomas Jefferson University School of Population Health and chief medical officer of PYA Analytics Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to

    Original URL path: http://www.hospitalimpact.org/index.php/2014/12/11/look_past_uncertainty_surrounding_aca_to (2016-02-10)
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  • Hospital Impact - What the Philadelphia Eagles can teach hospitals about culture
    determine how group members actually perceive think and feel about the workplace and the world Basic underlying assumptions are hard to discover because they re invisible rarely talked about and usually taken for granted Some basic underlying assumptions that led were successful for physicians in the traditional fee for service world include Clinical and financial success is due to one s own individual effort Autonomy is important and leaders do not speak for physicians Meetings are a waste of time Hospitals are necessary but they are just a workplace that should provide physicians with equipment Leaders who do not deliver clinical care are suspect By embracing the Triple Aim of decreased per capita cost improved patient experience and improved population health for a group of patients physicians and hospitals that accept value based payments will find the above basic assumptions counterproductive As physicians and hospital leaders learn together how to succeed under a new system of payment they will discover that new basic underlying assumptions will become necessary Clinical and financial success are dependent on a team approach where physicians and hospital systems align Physician leaders who don t see patients can provide needed expertise and competency to an organization that accepts risk Physicians must accept more individual accountability for cost and clinical outcomes Leaders aren t able to focus on what s best for physician local interests at the expense of the overall goals of the delivery system Individuals who were stars under the old culture may find themselves out of sync with organizations that struggle to redefine their culture in order to respond to healthcare reform Fans in Philadelphia were shocked when Eagles football coach Chip Kelly released their star receiver DeSean Jackson Although he never articulated the reason for the dismissal his praise for tight end Brent Celek provides a clue Several times Kelly mentioned the game last year where Celek caught a pass in the last two minutes of a game where the Eagles were up by two touchdowns but he voluntarily went down at the 10 yard line instead of scoring a touchdown How many people in that situation would give up running it in for a touchdown But understanding not running it in for a touchdown is better for the greater good Kelly said Philly com reported Eagle fans now realize that Kelly is willing to release a speedy star player who does not always practice hard or block downfield because he is developing a new culture in the locker room one where the greater good of the organization is more important than any one individual As the Affordable Care Act continues to shape the healthcare environment provider payment cultural norms that worked in the past will not work under the new set of circumstances Healthcare organizations that create new ways to solve their external adaptation and internal integration problems are ahead of the game Kent Bottles M D is a lecturer at the Thomas Jefferson University School of Population Health and chief medical

    Original URL path: http://www.hospitalimpact.org/index.php/2014/11/06/what_the_philadelphia_eagles_can_teach_h (2016-02-10)
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  • Hospital Impact - How the ACA forces payers to reinvent their business models
    More Erie Insurance recently announced that they will drop Highmark health insurance and offer UnitedHealth insurance to their 4 600 employees Under the new plan patients received coverage at both UPMC and Allegheny Health Network providers This development may encourage other Pittsburgh area employers to switch away from UPMC and Highmark for their health insurance coverage It s also noteworthy that the CEO of Erie Insurance serves on the Board of Directors of Highmark The other story out of Pittsburgh is that twelve hospitals are suing Highmark for withholding 2 percent of Medicare Advantage payments When feuding between Republicans and Democrats in Congress resulted in the sequester cutting all Medicare funding Highmark decided to pass along the reduction to the hospitals The lack of bipartisan Congressional support for the ACA and the inability of Congress to agree on funding legislation adds to the uncertainty and confusion that insurers face as they try to adapt to the transformation of the American clinical delivery system In Los Angeles last week the announcement of the Anthem Vivity HMO was front page news This new virtual health system with a common budget and quality metrics is composed of seven hospitals that have until now been fierce competitors Cedars Sinai Good Samaritan Hospital Huntington Memorial Hospital MemorialCare PIH Health Torrance Memorial Medial Center and UCLA Health The new insurance offering will be priced 10 percent cheaper than the standard HMO product and the California Public Employees Retirement System already signed up as the first customer The move is directly aimed at competing with Kaiser and responding to the decline of fee for service payments Anthem s Pam Kehaly noted that under fee for service hospitals want to keep occupancy rates up and that Vivity is in complete opposition to that For this joint venture to succeed we have to keep occupancy rates down according to the article Another critical success factor for Vivity will be the difficult task of aligning physicians who aren t employed by the new system All parts of the healthcare clinical delivery system rethink their business models in order to respond to the ACA and payment reform The status quo is no longer sustainable but the best road forward is not always obvious These three recent stories about the healthcare insurance sector demonstrate that the future of healthcare is messy and uncertain Kent Bottles M D is a lecturer at the Thomas Jefferson University School of Population Health and chief medical officer of PYA Analytics Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with moms Hospitals must train millennial nurse leaders in empathy frontline engagement St Louis hospital creates unit to improve outcomes through innovation 4 ways hospitals can

    Original URL path: http://www.hospitalimpact.org/index.php/2014/10/02/how_the_aca_forces_payers_to_reinvent_th (2016-02-10)
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  • Hospital Impact
    automation with its belief that humans can and will develop trusting relationships with sociable humanoid robots My skepticism was gradually overcome by Kvedar s examples of Karen the virtual wellness coach avatar who motivates human patients to exercise more than a control group and the Boston hospital patients who preferred a robot discharge planner to a human nurse In the latter case the patients commented that the robot was never in a hurry and did not talk down to the subjects Read more Leave a comment Disruptive innovation Does the theory work in healthcare June 25th 2014 by Kent Bottles As the uncertainty and anxiety about how to respond to healthcare payment reform increases daily many hospital leaders turn to Clayton Christensen a Harvard Business School professor for guidance In The Innovator s Prescription and in many keynotes Christensen proclaimed how disruptive innovation can ambush successful organizations that ignore how new technology creates cheaper alternatives In one of the many stories he tells to support his theory he describes how mainframe computer manufacturers did a good job selling and refining their product However they were blind to customers desire for personal computers which eventually replaced the mainframe and caused many company failures Christensen provides a theory of disruption that gives hospital leaders and physician executives a road map for how they need to respond to change brought on by healthcare reform and the transition from fee for service to value based payment programs Read more Leave a comment Will new health IT developments really revolutionize healthcare June 11th 2014 by Kent Bottles Three recent events forced me to think about how and when data will revolutionize healthcare For years I ve read and heard about how data wireless sensors and personal health records will change how I interact with my doctors Full disclosure I contributed to this overhyped hysteria The three events are Apple s unveiling of its cloud based HealthKit platform and Health user facing application the annual Health Datapalooza summit of true believers and the reorganization of the Office of the National Coordinator ONC Apple s Worldwide Developers Conference revealed that its iOS 8 operating system will facilitate the development of new health and fitness apps and that Apple created new partnerships with Epic Systems Mayo Clinic UCLA Cambridge University Hospital in the U K Stanford Penn Medicine and other prominent medical centers Read more Leave a comment ACA Tune in to all sides of the debate May 22nd 2014 by Kent Bottles Your doctor s unhappiness is a catastrophic problem that the new law didn t anticipate and is not prepared to address said Marc Siegel M D associate professor of medicine at NYU Langone Medical Center To us supporting the Affordable Care Act makes moral and medical sense according to Jeffrey Drazen M D editor in chief and Gregory Curfman M D executive editor of the New England Journal of Medicine In the last two months I chatted with physicians in various cities including Dallas Philadelphia

    Original URL path: http://www.hospitalimpact.org/index.php?blog=1&s=kent%20bottles&page=1&disp=posts&paged=3 (2016-02-10)
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  • Hospital Impact - Aetna CMO: Harness the power of scale to cut costs, improve outcomes
    dean as well as CEO of two medical group practices and a large health system and medical center I was always proud of the care we provided in our local communities These organizations improved patient access and satisfaction reduced costs and transitioned to a system of population health management in their respective regions But while we made the people around us healthier our impact would always be limited by two factors our geography and the size of our organizations Aetna s connection with more than 1 1 million healthcare professionals including more than 675 000 primary care doctors and specialists and 5 600 hospitals gives us the opportunity to help improve care in more places Our collaborative relationships with healthcare professionals focused on quality of care for patients have improved health outcomes and lowered costs Our proposed acquisition of Humana will enhance our capabilities and allow us to accelerate the transformation of the healthcare system Read the full commentary at FierceHealthPayer Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with moms Hospitals must train millennial nurse leaders in empathy frontline engagement St Louis hospital creates unit to improve outcomes through innovation 4 ways hospitals can foster family centered care Pediatric ER seeks to limit stressors for autistic patients Nurses hospital groups clash on Massachusetts bill to improve response to violence Superbug linked scopes Feds failed to act on earlier outbreak 8 developing healthcare trends Hottest Products Compare Top Solutions in Hospital Management Electronic Medical Billing Software Healthcare Revenue

    Original URL path: http://www.hospitalimpact.org/index.php/2015/12/10/aetna_cmo_harness_the_power_of_scale_to_ (2016-02-10)
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