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  • Hospital Impact - Take a stand against sequestration cuts
    cuts that will kick in March 1 unless Congress acts indicates how devastating the result will be Medicare cuts totaling 11 billion Hospital Medicare reimbursements dropping 5 8 billion Prescription drug benefits for seniors cut by 591 million Food and Drug Administration budget reductions of 8 percent 318 million National Institutes of Health research cuts of 2 5 billion Centers for Disease Control and Prevention budget cuts totaling 490 million Indian Health Services reductions of 365 million Substance Abuse and Mental Health Services Administration cut by 275 million Office of the National Coordinator for Health IT cuts of 1 million Grants to help states form insurance exchanges under the Affordable Care Act reduced by 66 million The Prevention and Public Health Fund of the Affordable Care Act reduced by 76 million Roughly 766 000 in lost healthcare jobs the American Hospital Association estimates I am writing this blog post on Valentine s Day while the two sides are not showing each other or the nation much love and understanding Senate Democrats proposed a 50 50 combination of cuts and new revenues from closing loopholes for the wealthy and corporations to avoid the March 1 deadline of automatic cuts listed above House Republicans are insisting on eliminating the federal budget deficit over 10 years without any new revenues and they are predicting the sequester will go into affect March 1 The White House budget office has stated No amount of planning can mitigate the effect of these cuts Sequestration is a blunt and indiscriminate instrument It is not the responsible way for our nation to achieve deficit reduction Democratic and Republican healthcare leaders must demand Congress do its job and avoid the March 1 sequestration It is congressional malpractice to allow us to lose healthcare jobs at a time when the economy is finally recovering from the recession It is wrong to eliminate funding for hospitals that are trying to cope with an increasingly challenging economic environment It is foolhardy to cut funding for biomedical research and it makes no sense to make it harder to implement the Affordable Care Act with its complicated overhaul of the American healthcare delivery system Enough is enough Congress must act responsibly and come to a compromise to avoid the sequester slated to occur in less than two weeks Kent Bottles M D is a Senior Fellow at the Thomas Jefferson University School of Population Health 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

    Original URL path: http://www.hospitalimpact.org/index.php/2013/02/20/healthcare_leaders_take_a_stand_against (2016-02-10)
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  • Hospital Impact
    specific measurable attainable relevant and time bound and to set five year goals that would naturally lead me to my lifetime goals I was buying into the entire program until I read that setting goals would help me spot the distractions that can so easily lead you astray Read more Leave a comment Avoid 3 IT pitfalls to deliver high value low cost care December 11th 2012 by Kent Bottles Information technology will play a key role in whether hospital CEOs can transition from fee for service payment to global value based payment systems It should be clear to everyone that the major 21st century challenge for American hospital CEOs is how to delivery high quality healthcare for a lower per capita cost Information technology also is critical to successfully caring for populations of patients in a wellness system not the traditional disease system that has characterized American medicine Read more Leave a comment Election s over now what for healthcare November 14th 2012 by Kent Bottles The most important 21st century challenge for healthcare leaders was not changed by President Barack Obama s reelection We still have to decrease the per capita cost of healthcare and increase the quality and safety of the care we deliver to our citizens What does the 2012 election mean for the industry The Affordable Care Act is law of the land The most important result of the election is we now know with certainty that the ACA the permanent statutory law that sets the ground rules for healthcare will be implemented according to the timetable established by the legislation The ACA will not be repealed The healthcare industry including those who originally did not support the ACA welcomes the certainty that comes with Obama s victory Read more Leave a comment Pay for performance won t solve healthcare cost crisis October 16th 2012 by Kent Bottles I hate to say I told you so Three years ago I wrote an opinion piece questioning the wisdom of pay for performance programs to try to get hospitals and doctors to decrease per capita cost and increase quality of healthcare The main thrust of my argument was that behavioral economics has taught us that we live in two worlds with different sets of rules a world where social norms prevail and another world where market norms hold sway I described two of my favorite stories from the behavioral economics literature In Sway by O Brafman and R Brafman the Swiss government tried to pay villagers more money to get them to accept a nuclear waste depository near their town The government was surprised when such a proposal decreased the number of citizens who supported the initiative 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

    Original URL path: http://www.hospitalimpact.org/index.php?blog=1&s=kent%20bottles&page=1&disp=posts&paged=7 (2016-02-10)
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  • Hospital Impact - CEO gets patients' view of complicated healthcare system
    the system for him When the cardiologist said he couldn t get table time until the next morning because the staff was leaving I talked to that hospital s CEO who made it happen My smartphone also contained numbers for ambulance drivers nurse managers clergy and hospice all of whom I texted for help in navigating my Dad s life saving interventions I slept not really in a chair next to his bed for six nights in the intensive care unit Besides the crick in my neck I also got an insider s view into what a well oiled healthcare machine could look like Yes I weighed the fact that I am a hospital CEO I took that into consideration My vision is for a 1 1 nurse advocate to inpatient ratio One nurse who has a contact list similar to mine One nurse who will navigate care coordination One nurse to take blood obtain vitals give medications order food recite patient allergies repeat patient history to anyone who asks One nurse to transport the patient to radiology and back again One nurse who by this close association can advocate and protect the patient from errors Even at my dad s side even as this facility s CEO I intercepted an incorrect lab test I haven t calculated the financial impact and not every patient needs this 1 1 ratio But for the elderly alone and critical patients I wonder how many expensive errors unnecessary tests infections falls extended days and deaths this 1 1 approach could prevent It is crystal clear to me that we built a healthcare model that is too complex to fix If any of us had the opportunity to rebuild healthcare from scratch it would never look like it does today After a roller coaster ride that included catering a repast menu it now looks like my dad will come home I am profoundly grateful for this healthcare system and I will never forget the raw kindness everyone showed my dad and my family But after an insider s view I d love the opportunity to architect a system that works this well each time for every patient not just the CEO s dad Lynn McVey serves as CEO and president of Meadowlands Hospital Medical Center an acute care 230 bed hospital in New Jersey 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

    Original URL path: http://www.hospitalimpact.org/index.php/2014/02/26/ceo_gets_patient_view_of_complicated_hea (2016-02-10)
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  • Hospital Impact - What my 'summer vacation' taught me about US healthcare
    wonder why poor people were fat while healthy people were skinny If you had less money to spend on eating wouldn t you be thinner than people with more to spend Eventually I learned it s eating right and exercising more that creates health After three weeks without spotting even one overweight European my conclusion is the American lifestyle of convenience is killing us Back in the day maybe as early as 30 or 40 years ago I don t recall many overweight people Each neighborhood or classroom had that one chubby kid Today obesity is rampant especially as we age Early in May 2015 several New York City healthcare leaders gathered to discuss the future of hospitals and physicians Dr Hal Teitelbaum CEO of multi specialty group practice Crystal Run Healthcare said Our product is not healthcare Our product is health Like Etta James proclaimed At last I m not assuming that all healthcare leaders are embracing value based payments like Dr Teitelbaum seems to be but I m enthused to read that acceptance is creeping in Many players in my world feel that healthcare reform has been such a waste of time and will soon be reversed I ve lost the will to debate emotion over evidence I write blogs instead As embarrassing as this is to admit publicly my favorite summer activity is to review Centers for Medicare Medicaid Services updates to annual spending data I m excited to witness in patient spending reduce 4 7 percent since 2010 Apparently it is possible to reduce spending with mandated value based payments and penalties while improving patient outcomes Although there are hundreds of hospital quality metrics infections is one of the most important metrics The Centers for Disease Control and Infection reports major decreases in infections rates 46 percent decrease in CLABSI between 2008 and 2013 19 percent decrease in SSIs related to the 10 select procedures between 2008 and 2013 6 percent increase in CAUTI between 2009 and 2013 8 percent decrease in hospital onset MRSA bacteremia between 2011 and 2013 10 percent decrease in hospital onset C difficile infections between 2011 and 2013 Now that we re standardizing measuring and reporting hospitals are improving Isn t that why Weight Watchers succeeds Yup And it s called the Hawthorne Theory what we pay attention to improves If you are one of those paying attention to improving our healthcare system thank you Lynn McVey serves as chief operating officer of Meadowlands Hospital Medical Center an acute care 230 bed hospital in New Jersey 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

    Original URL path: http://www.hospitalimpact.org/index.php/2015/06/11/what_my_summer_vacation_taught_me_about (2016-02-10)
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  • Hospital Impact - How will millennials improve hospital leadership?
    program More Thirty years later I ve witnessed the effects of promoting great clinical managers who have not been properly mentored If I had a nickel for every tenured manager who asks for help to calculate FTE utilization I d be rich Two very confident clinical managers once told me that FTE was a full time employee As a speaker at a CEO conference I relayed that story Later at the reception five CEOs approached me in duck formation The duck in front asked I m the brave one So what does FTE stand for I ordered a second martini While we wait for the oldest generation of physicians to retire so that we can embrace evidence based medicine I anticipate the next generation of millennial managers to enter and improve healthcare leadership Fortunately I have witnessed the stark differences already Here are my observations Millennials don t ask questions They continually use Google to find the answers to everything all day long Millennials are efficient They do not use pen and paper which eliminates one level of their workload Millennials are fun to work with Because they are not burdened down by cumbersome management practices they have more time to engage and connect Millennials are helpful Their willingness to teach others is unfortunately not always met with the same willingness to learn Compare those observations with what global training organization Sandler Training reports about the generation Millennials believe in transparency and equality As hospitals develop evolve industry standards transparency will be key to insure there is equality in hospital spending and quality Millennials are comfortable with evolving technology They analyze the shortest distance between problems and solutions They are adept at troubleshooting and enjoy tackling problems head on Millennials are creative thinkers This generation is comfortable taking risks and thinking outside the box These creative trailblazers focus less on their place in a company and instead look at the big picture Millennials are a generation of natural leaders They possess huge amounts of confidence They will take a role as a leader without waiting to be asked Millennials are believers in work life balance They won t want to spend late hours and weekends in the hospital so they re more efficient Millennials are always reachable via text so when you need them you ll find them Lynn McVey serves as chief operating officer of Meadowlands Hospital Medical Center an acute care 230 bed hospital in New Jersey 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/2015/04/15/how_will_millennials_improve_hospital_le (2016-02-10)
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  • Hospital Impact - The benefits of data-driven healthcare
    mess For me it is impossible to manage operations without metrics Myers Briggs told me I m not very emotional or sensitive I do not sense without input When asked how their departments are running an emotionally based manager will answer Morale is high patients don t wait doctors are happy whereas an evidence based manager will answer HCAHPS scores have risen 15 percent in last 12 months expenses are down 12 percent revenues increased 4 percent and CORE measures are 10 percent better than last year Year ago I attended a hospital wide quality committee where the quality director announced we had four falls that quarter I was surprised when nobody asked for clarification She went on to announce that four patients waited greater than 1 hour for a CT scan In a huffy fit the CEO demanded that I do a root cause analysis to find out why four patients waited so long In the past I usually discovered CT delays were linked to contrast which may take 90 minutes to prep I did manage to respond that 22 000 or 99 9 percent of our CT scan patients were scanned within the 1 hour benchmark which makes four delays statistically insignificant I then asked for clarification regarding our patient falls Was it four falls of 400 patients which would be atrocious or was it 4 of 4 000 which would also be statistically insignificant Although this happened about 10 years ago I continue to hear similar meaningless reports To me this means we are nowhere near being a data driven industry Ugh So how do we lead change from emotionally based management to evidence based management Change by definition is what good leaders do Change is the hardest thing to achieve Change is the place where risk meets return But where is the risk in changing from emotion to evidence Aha Glad you asked The risk of providing evidence and metrics is that now you are being measured And what if you don t measure up Once you discover which departments are carrying expensive variations you can immediately repair them I feel the risk is bigger if we keep our heads in the sand Many have not hospitals are struggling to stay open while many have hospitals post millions of dollars in expenses and revenues There must be equity in U S healthcare because that s the right thing to do Anything easy ain t worth a damn coach Woody Hayes so famously and eloquently said Lynn McVey serves as chief operating officer of Meadowlands Hospital Medical Center an acute care 230 bed hospital in New Jersey 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

    Original URL path: http://www.hospitalimpact.org/index.php/2015/03/11/the_benefits_of_data_driven_healthcare (2016-02-10)
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  • Hospital Impact - Hospital leaders must overcome resistance and disrupt their own organizations
    have been years ahead of where we are now in terms of Meaningful Use standardizing and sharing information Yes this country is proud of its free market but I question whether healthcare should remain a part of that market especially given what we now know about the fraud abuse unnecessary testing and corruption in the industry More I had the absolute pleasure of speaking to Chuck Lauer on the phone recently Lauer published Modern Healthcare magazine for many years and now is a frequent consultant He reminds me of my father a former Marine with integrity honesty and a passion for hard work If you have read any of Lauer s published works on the current fiasco in healthcare leadership you can immediately sense his commitment to commit About 2014 s soaring 20 percent resignation rate among hospital CEOs he said I and a number of other observers think the data reflect a lack of will and commitment Faced with a once in a lifetime opportunity to overcome the silos inefficiencies and quality problems plaguing American hospitals more and more CEOs are making a beeline for the exit hefty retirement packages in arm My dad Chuck Lauer and others from The Greatest Generation are not afraid of the hard work needed to fix this healthcare mess To survive it is not business as usual A manager just asked me to pre approve eight hours of overtime for a project tonight A traditional executive might trust this manager and blindly approve it An evidence based executive asked for the details The project added up to only three hours so I only pre approved three hours An hour later he walked back into my office to proudly say he could break up the project into several nights so he wouldn t need any overtime after all Years ago I replaced a manager who told me on his way out This department runs itself What I heard was This department is padded so that I have less work to do I used six national key performance indicators KPIs to quickly locate and eliminate several inefficiencies which added up to 50 000 per month Because traditional management does not use comparative KPIs to gauge managers performance the administration never knew it wasted 12 million over the 20 years the manager oversaw the department We may be called micro managers when we drill down for evidence but I call that my job Lynn McVey serves as chief operating officer of Meadowlands Hospital Medical Center an acute care 230 bed hospital in New Jersey 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

    Original URL path: http://www.hospitalimpact.org/index.php/2015/02/19/hospital_leaders_must_overcome_resistanc (2016-02-10)
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  • Hospital Impact - Does decision support actually work?
    patients upon discharge What else would a non clinical IT decision support staffer count Luckily I m a clinical COO who knows 20 percent of ER patients get admitted and will subsequently be defined as an IP in patient This was the discrepancy the two teams argued about for months It was fixed immediately More To me it doesn t make sense to delegate decision support away from decision makers As a self proclaimed Data Diva I truly love playing with data As 2014 was nearing an end I was playing with our absenteeism data and illustrating the data in multiple ways When I formatted the data to compare quarters it became obvious that our absenteeism increased every fourth quarter of each year Quickly we informed the staff that effective immediately their sick hours would be carried forward We changed our policy of wiping out the remaining balance of sick hours on Dec 31 Sick time is not paid out upon termination therefore it cost us nothing to continue to accrue sick hours We ended the quarter reversing our sick call spike equal to a 2 percent labor expense avoidance To the average sized U S hospital this is estimated to cost 300 000 I had the privilege of reviewing an article for the January February 2015 issue of the American College of Healthcare Executives Journal of Healthcare Management The research was an extensive review of peer related articles on Capacity Management in the ER The authors findings included anecdotal outcomes of initiatives but they could not support this with data Unfortunately the authors could not report on the financial impact of this issue either because they reported hospitals are usually unwilling to share proprietary data I was thrilled to review this because it supports my mission to standardize all 5 000 hospitals before I die Note that I m actually very healthy In 2015 we have thousands of microcosm metrics most often associated with excessively narrow software applications developed due to a unique hospital specific problem Rather than poke fingers in thousands of leaking dikes this evidence based practitioner suggests capturing the six existing common metrics that are already found in every department in every hospital When 5 000 hospitals participate in a national data warehouse standard actionable metrics will be created Think about the profound benefit this would have on the entire healthcare industry We need to act as one Lynn McVey serves as chief operating officer of Meadowlands Hospital Medical Center an acute care 230 bed hospital in New Jersey 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

    Original URL path: http://www.hospitalimpact.org/index.php/2015/01/27/does_decision_support_actually_work (2016-02-10)
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