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  • Hospital Impact
    and should remain central to our healthcare conversation So what is the state of patient experience Read more Leave a comment The patient experience family is growing and it should August 21st 2013 by Jason A Wolf I remain inspired by what I shared in a blog post earlier this year that there is a clear and growing movement for patient experience improvement While I have been fortunate to be an active participant in what I deem a noble endeavor it is important that we are mindful of the opportunities and pitfalls that come along with this type of systemic change Simply stated and perhaps related to the recent adventure of becoming a new father my metaphor here is that our patient experience family is growing and that says great things about the future of the movement The latest research on the state of patient experience revealed some very telling trends In asking patient experience leaders what they saw as the key drivers and roadblocks to success a clear message emerged While healthcare organizations see experience as a top priority there are still issues to be resolved Much of this remains in the domain of leadership at all organizational levels The data show and the trends support the idea that a movement is afoot Read more Leave a comment Celebrate your patient experience all stars July 16th 2013 by Jason A Wolf In the heat of the summer many of us are thinking about days by the pool family vacations or cool drinks It also brings us this very week to Major League Baseball s all star break This has always been an interesting and unique tradition in sports where rather than waiting until the end of a season to identify and recognize performance the league stops for a moment to celebrate what has taken place so far This pause in the action is a bit like summer itself An intermission of sorts where time is taken to reflect on what has been accomplished and what is yet to be achieved The question this raised for me is why this type of break is more difficult for us in organizational life I have been a student of organizational dynamics behavior and culture for most of my career Perhaps the one lesson I have taken above all else is this At the end of the day it is our humanity that matters most in organizational life Read more Leave a comment Bringing humanity to the patient experience June 20th 2013 by Jason A Wolf I intended my most recent Hospital Impact post to begin a dialogue on refocusing our conversations in healthcare I worry that at times we get lost in the policies and process programs and products and forget the most important P of all people I suggested in May that the how in healthcare trumps the what each and every day This too is evident in the conversations I continue to have with patients and family members including the

    Original URL path: http://www.hospitalimpact.org/index.php?blog=1&s=Jason%20A.%20Wolfe&page=1&disp=posts&paged=6 (2016-02-10)
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  • Hospital Impact - The power of physician leader confessions
    similar mistakes and how they enjoyed my slide on how to avoid amygdala hijack Amygdala hijack occurs when the midbrain s fight or flight response center takes over in times of stress Although it is a time tested way to deal with life threatening issues it destroys team cohesion when overused at work The key is to recognize when the response is about to occur and pause long enough for the frontal cortex which handles executive decision making to resume control For example we can Take a deep breath but not a loud sigh of exasperation Drink a sip of water Ask a clarifying question it may be that the other person was unaware that s he was causing stress Exit the room for a minute disguised as a bathroom break long enough to collect our thoughts I write this post only to confess that when we are tasked with influencing others behavior a good start ensues from revealing our own inadequacies I invite fellow healthcare leaders to share their stories on this subject All confessions are welcome Ken is a practicing general surgeon MBA and CEO of HealthcareCollaboration com who divides his time between providing general surgical coverage and working with organizations that want to engage physicians to improve clinical and financial performance 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/2014/01/14/the_power_of_physician_leader_confession (2016-02-10)
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  • Hospital Impact - Engage docs in business planning
    up that by improving the practice environment creates a multiple win for physicians allied healthcare professionals hospital leaders and most important patients and their families As I wrote in Shape Up Your Culture for Hospital Physician Collaboration a group of physicians and hospital leaders from Holy Family Memorial Hospital in Wisconsin transformed their culture by asking why They learned they shared a fundamental mission and vision which helped them accelerate transformation through multidisciplinary teams Since 2008 employee pride has risen from 71 percent to 87 percent and the number of people who recommend HFM s care to friends and family increased from 58 percent to 82 percent Accountants tracked the savings resulting from improvement at more than 10 000 000 since 2009 In business planning healthcare professionals come to consensus on Their reason for existence mission A positive view of the future vision Shared beliefs that guide choices values Unmet needs they meet business concept People who benefit from their service market analysis Alternatives to what they offer including the status quo competitive analysis The unique value they offer strategy Revenue expense projections financial plan People space and equipment needed operations plan How to deliver the proposed service on time and within budget implementation plan I hope in this brief post I convey the benefits of clarity intelligent use of resources and effectiveness outweigh the dilemma of how to invest time in yet another activity Ken is a practicing general surgeon MBA and CEO of HealthcareCollaboration com who divides his time between providing general surgical coverage and working with organizations that want to engage physicians to improve clinical and financial performance 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

    Original URL path: http://www.hospitalimpact.org/index.php/2013/11/20/engage_docs_in_business_planning (2016-02-10)
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  • Hospital Impact - Key elements to switch from volume to value
    of care for each medical condition 4 Reimbursement that aligns everyone s interests around improving value for patients 5 Requiring providers to compete for patients based on value 6 Electronic medical records that support integrated care outcome measurement and hardwiring of lessons learned into care processes and 7 Patients and families getting more involved in their health and healthcare using coaches navigators and community organizations to facilitate engagement and decrease the risk of caretaker burnout I contended that all seven conditions have a common element improved communication and collaboration As I noted in Collaborative Moderation with enhanced communication and collaboration physicians built on their training of making major decisions in the face of limited information to improve care for their communities Dealing with the disruptive innovation occasioned by healthcare transformation can help us all find our niche and leave a lasting legacy about which we can be proud Let s make this journey together 1 Porter M E 2009 A Strategy for Healthcare Reform New England Journal of Medicine 36 12 109 12 Ken is a practicing general surgeon MBA and CEO of HealthcareCollaboration com who divides his time between providing general surgical coverage and working with organizations that want to engage physicians to improve clinical and financial performance 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

    Original URL path: http://www.hospitalimpact.org/index.php/2013/10/21/key_elements_to_transition_from_volume_t (2016-02-10)
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  • Hospital Impact - Flipping the switch to value-based healthcare
    important core competency He provides innovation training to all employees and has built a culture of innovation through rapid prototyping and creating what he calls a cadence of accountability knowing that others are counting on you raises your commitment Rewarding learning rather than punishing failure empowers people to embrace innovation and creates a safe environment for reflection and dialogue 2 During the seminar we agreed authentic physician engagement is an essential component of healthcare innovation As a physician from upstate New York quipped When we don t have a seat at the table we feel like we are on the menu I mentioned in Collaborative Compact that a social compact between physicians and hospital leaders can clarify communication and expectations and facilitate improved collaboration and readiness The bottom up process also can improve physician physician communication and accountability People may wonder where we will find the physicians to participate in innovation and readiness efforts A group of committed physician champions can lead task forces in areas such as supply cost management recruitment and retention and consideration of new services as I noted in MAP MEC differences For instance one previously skeptical physician commented The reason for my change in behavior is that I feel like I am making my time count 3 A hospital CEO reinforced the need for physician engagement to flip the switch on healthcare innovation saying in Charting The Course Launching Patient Centric Healthcare The people if appropriately chosen and led through vision and engagement will do most of the hard tactical work provided we train them we trust them and we listen to them 1 Cohn KH Lambert M 2005 Embracing Complexity Better Communication for Better Care Mastering Physician Administrator Collaboration Chicago Health Administration Press 31 2 Cohn KH Fellows S eds 2011 Launching an Innovation Revolution in Healthcare Getting It Done Experienced Healthcare Leaders Reveal Field Tested Strategies for Clinical and Financial Success Chicago Health Administration Press 63 74 3 Cohn KH 2006 The Challenges and Opportunities of Collaborating with Creatively Abrasive Physicians Collaborate for Success Breakthrough Strategies for Engaging Physicians Nurses and Hospital Executives Chicago Health Administration Press 11 20 Ken is a practicing general surgeon MBA and CEO of HealthcareCollaboration com who divides his time between providing general surgical coverage and working with organizations that want to engage physicians to improve clinical and financial performance 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

    Original URL path: http://www.hospitalimpact.org/index.php/2013/09/03/flipping_the_switch_to_value_based_healt (2016-02-10)
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  • Hospital Impact - 'Show your work' to learn the real patient story
    in my charts I accepted there were many benefits to reflecting in print not only my conclusions but also how I got there It allowed me to think about the aspects of which I was sure as well as the alternative hypotheses that may need to be explored rule outs I also recognized the notes were not only for my reading all other participants of the patient s care team were hopefully going to read my notes and they would influence their perspectives This was a form of communication in the service of the patient receiving excellent care Presently with tremendous advances in new health information technology everything is becoming digitized so information can be stored shared and analyzed The use of narrative creates challenges because those free text elements cannot be easily transformed into packets of information the same way check boxes and prepackaged templates can So even though everyone agrees the work of patient care is often complex the goal is to show the work in as concise and standardized fashion as possible A string of short phrases linked by pre programmed verbiage captures everything that s needed to show your work adequately for reimbursement purposes What about all the other meaningful parts of the work How do you show you held the patient s hand while you broke the bad news That we helped patients build the skills needed for better self management by asking questions instead of inappropriately providing answers That we learned about them as people not just as patients and built our relationship with them based on who they are not their conditions Documentation to help all involved in the care team interact and learn together to co create effective care makes total sense Anything beyond or different from that is to benefit others regulators payers and other external agencies not the patient those that care about them or those that care for them We need to tell the story that matters in a way that fits into the provision of care Yes the computer can be a real asset if we allow it to be used as an enabler not as a constraint Perhaps computer documentation will be replaced by video clips of real patient interactions tagged and coded in the background to show my work and help us all learn the real patient story The record should be seen as a living compilation of the patient s story Multiple perspectives can blend to shape the narrative through the dimension of time This means at least some of what is contained needs to be fluid and adaptable allowing for the changes in perceptions and evidence that occur over the months and years Let s design systems that make our patients our philosophy professors and us happy confident that we re using the process of showing our work to reach meaningful conclusions Jeffrey Cohn M D served as a prior chief quality officer for the Einstein Healthcare Network in Philadelphia He is the President

    Original URL path: http://www.hospitalimpact.org/index.php/2013/08/06/show_your_work_to_learn_the_real_patient (2016-02-10)
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  • Hospital Impact
    part of the definition and assume our work is done Couple that with the fact that many things referred to as best practices are developed elsewhere and shared with us for us to adopt Often these decisions are made near or at the top of our organizational hierarchies and the challenge becomes one of implementation Do what worked for them and it should solve our problems too Read more Leave a comment A tribute to a person in the integrated care arena May 29th 2013 by Kenneth H Cohn Julie Manas Hospital Impact post Integrated care The bridge between quality and efficiency inspired my post this month because people in her organization are doing what is necessary to improve performance As the president and CEO of the Western Wisconsin division of Hospital Sisters Health System she wrote about the need to view patient centered care quality safety and efficiency collectively to provide improved care coordination Read more Leave a comment What nurses taught me about compassionate care May 8th 2013 by Kenneth H Cohn In anticipation of National Nurses Week I dedicate my monthly guest post to them not only because my wife of 28 years is a nurse but also because nurses have taught me lessons about how to be a more caring physician I reinforce my previous salute to Nikki an emergency room nurse in Massachusetts who took me aside and told me Just because that was your eighth patient with the same condition doesn t mean that it was her eighth sprain Eventually I got over my wounded pride and adopted the perspective that she viewed me as teachable Read more Leave a comment The what and how of physician engagement April 24th 2013 by Kenneth H Cohn The inspiration for today s post comes from an external and an internal source For the external source I thank Drs Kenneth Bertka and Robert Heizelman at Ohio based Mercy for their post entitled Leading Physician Engagement Spanning Boundaries Communicating Change Having had the pleasure of working at Mercy I assure readers that it is a faith based system that lives its values daily of reverence for all people community justice commitment to the poor stewardship courage and integrity The authors wrote the first step to physician engagement entails establishing a direction achieving shared understanding of goals and strategy around a team approach and care coordination for optimal population health management Read more Leave a comment Previous Page Next Page 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

    Original URL path: http://www.hospitalimpact.org/index.php?blog=1&s=cohn&page=1&disp=posts&paged=4 (2016-02-10)
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  • Hospital Impact - The ACA and separation of church and state
    1987 Teaching â œcreation scienceâ in lieu of evolution in the schools is a violation of the First Amendment due to its religious intent Allegheny County v ACLU 1989 A nativity scene inside a government building violates the establishment clause of the First Amendment Due to this ongoing conflict in 1993 Congress passed the Religious Freedom Restoration Act signed into law by President Clinton that affirmed that government shall not burden a person s access to religion unless there is a compelling government interest or the religion in some way restricts the government s interest Enter the Affordable Care Act which requires employers to provide employees with birth control and access to abortion inducing drugs e g RU 486 as preventive health measures Although churches and houses of worship are exempt from this requirement religious affiliate organizations such as charitable organizations universities and hospitals are not In an attempt to find a middle ground the U S Department of Health Human Services on behalf of the Obama administration advised that the religious affiliated organizations would not be responsible for administering the medications but may sign a form authorizing an insurance company or health plan to do so This did not appease the concern that participating in an authorization may violate an employer s religious and moral beliefs During the federal sequester and shutdown in September 2013 the Republican Party introduced a conscience clause amendment to the ACA as part of a spending bill that would have allowed employers to opt out of providing birth control for moral or religious reasons On Nov 1 2013 the federal court of appeals for the District of Columbia Circuit decided 2 1 that the ACA birth control mandate substantially burdened the owner s free exercise of religion and the government failed to survive the strict scrutiny definition of the Religious Freedom Restoration Act of 1993 Gilardi v United States Department of Health and Human Services 2013 Interestingly two of the judges also pointed out that secular corporations cannot exercise religion and so an employer s personal religious beliefs may or may not pertain to federal law As predicted HHS appealed the case to the Supreme Court which will hear arguments on a related case Sibelius v Hobby Lobby that addresses the rights of business owners to operate a family owned company without violating their personal religious beliefs on March 25 2014 with a decision pending early in the summer The Supreme Court also will hear a similar case Conestoga Wood Specialties v Sebelius that specifically addresses the inclusion of abortion pills as a part of the preventive health mandate On Dec 31 2013 hours before the official implementation of the ACA Supreme Court Justice Sonia Sotomayor responded to a request from an order of catholic nuns in Denver Little Sisters of the Poor Home for the Aged and issued a stay blocking the mandate from taking effect for 200 religious affiliate not for profit organizations This was upheld by a federal appellate court and

    Original URL path: http://www.hospitalimpact.org/index.php/2014/01/23/the_aca_and_separation_of_church_and_sta (2016-02-10)
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