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Quote of the month
"Football incorporates the two worst elements of American society: violence punctuated by committee meetings."
George Will
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NEWS ITEM
The nation's hospitals, which have enjoyed steady and even improving finances in recent years, could see some rough times ahead, according to a new report.
New York-based Moody's Investors Service, which provides financial ratings and evaluates debt of the nation's nonprofit hospitals, said its "stable" outlook for 2008 will be less certain in 2009 and 2010 should the economy take a turn for the worse.
"Although the U.S. economy may be headed into recession, we maintain a stable outlook for 2008 because a negative economic downturn will take longer than a year to materially affect the broad credit position of not-for-profit hospitals," said Lisa Goldstein, senior vice president for Moody's public finance group who wrote a report on the nonprofit hospital sector's outlook.
"Our outlook for 2009 and 2010, however, is less certain as several industry challenges may outweigh the positive factors," Goldstein said. "These include uncertainties about the outcome of the 2008 presidential election and the persistent scrutiny of the not-for-profit hospital industry, and the rising numbers of uninsured and underinsured patients."
More hospitals are turning to mergers and acquisitions as a way to gain economies of scale and clout with health insurance companies who pay for hospital medical services in the face of increasing numbers of uninsured patients who cannot pay their medical bills. In addition, hospitals are looking at mergers and other strategic initiatives as a way to raise cash to expand and upgrade facilities.
Chicago Tribune
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MORE QUOTES...
Heart surgeon Denton Cooley, under cross examination:
Lawyer: "Do you consider yourself the best heart surgeon in the world?"
Cooley: "Yes."
Lawyer: "Don't you think that's being rather immodest?"
Cooley: "Perhaps, but remember, I'm under oath."
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Elderly smokers lie about their habit, study finds
Many older adults light up - but they don't like to admit it.
A total of 25% of people over age 75 deny that they smoke, said Monica Fisher, associate professor at the Case Western Reserve University School of Dental Medicine. That compares with 6% of 18-34 year olds. Researchers analyzed data collected from 15,182 adults who took part in the third National Health and Nutrition Examination Survey.
Researchers at the Case Western Reserve University School of Dental Medicine found that 8% of people will not tell the truth about their nicotine habits, even to their doctors. Additional measures are needed to validate who does or doesn't smoke, as false reports of non-smoking can have serious repercussions when it comes to treating patients, especially elderly patients with chronic diseases, researchers suggested. | |
Greetings!
How's your quality?
At one point, several years ago, if you asked healthcare managers about quality, many would tell you something like "we did that." It had been checked off their list. Today, more are realizing that quality must be a 24/7 - 365 effort. It must be nurtured. It must be everyone's business, from the parking garage attendent to the neurosurgeon, to the board of directors.
Even though most people understand that quality improvement can't be a "program of the month" or year, it can be difficult to stop the programization of quality improvement. Times change, new leadership emerges, focus shifts and improvements begin to decline. In other cases, new tools like Lean or Six Sigma or Re-engineering become approaches and programs in themselves rather than a tool to select for a particular problem.
Every few years quality improvement efforts should be reassessed, renewed and reinvigorated. Newer team members can be brought up to speed while current members reflect on the progress or lack of progress made over time. Have you met your goals? Are patients safer? Has productivity improved? Have costs declined?
From my point of view, quality improvement must remain one of the top 3 things the organization focuses on AT ALL TIMES. It must be systematic and inclusive. It must touch every work effort of every employee, physician, board member and volunteer.
Finally, your organization, your leadership, your managers, employees, physicians and board members must be the most knowledgeable experts on your quality. Too often the people with the in-depth understanding of YOUR quality are working for insurance companies, regulators and attorneys.
How's your organization doing in its efforts?
Ken Bast
KenBast@MgtConsultinginHealthcare.com |
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Why Manage Change? Won't It Take Care of Itself?
We all face personal change every day, from the mundane "Road Closed Ahead" surprise on the way to work to the arrival of a new baby in the family. It's the same for organizations of all sizes. Increasing complexity, competition and regulation, rising costs and new opportunities in new markets all affect how an organization conducts business.
What exactly is a change? For starters, it's nothing good or bad. Rather, it is a disruption in expectations. A dramatic departure from what was expected or what exists now. This definition helps explain the one constant change brings with it. Resistance! When people resist change, they are resisting the loss of control caused by their expectations being disrupted. Strong resistance will ALWAYS accompany major change.
Change Costs Money
Change and resistance have many costs, most are hidden and generally unaccounted for. Some of these costs are:
Absenteeism Increases
Turnover Increases
Error Rates Increase
Poor Customer Service Grows
Apathy and Non-involvement Increase
Personal and Departmental Conflicts Grow
Time to Make Decisions Increases
Loss of Focus
Won't Change Take Care of Itself?
Yes it will. If you avoid responsibility and walk away or ignore it, it will take care of itself, somehow. No matter what you do, your organization faces the costs associated with change. You can pay that price in planning and work on minimizing the costs; you can pay the price to heal from change or you can pay the ultimate price - failure.
What Can We Do?
Wouldn't it pay to learn how to plan for change? In fact, people go through a predictable emotional response to change. You can plan for it and help them through it.
Where Do We Start?
Start by conducting a guided assessment of the organization. Establish firm, agreed upon measures of where we are now. Then, with the assessment as a foundation, develop a plan to take the organization to the next level.
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Questions from the Executive Director of the National Emergency Management Resource Center
Does your organization have an emergency preparedness plan designed to include people with disabilities?
Have you considered surveying your employees to determine whether they will require assistance in an emergency?
Does your plan address the accommodation of individuals with cognitive, psychiatric, respiratory, hearing, vision, motor, and temporary impairments such as a broken leg or pain from a recent surgery?
Have you considered how to identify permanent disabilities, temporary impairments and
accommodation needs (e.g., evacuation chair, buddy system, service animal provisions)? |
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Patient Care Quality and Safety.
Nearly 90% of community health systerm boards have assigned oversight responsibility for their organization's patient care quality and safety functions to a standing board committee. Monitoring and evaluating the quality of patient care and ensuring the safety of patients, staff and visitors is one of the governing board's most important responsibilities. Strong, effective board oversight of patient care quality and safety programs is, without question, one of the most fundamental standards of good governance today. Obviously, assigning oversight responsibility to a standing committee is only one step in meeting that standard.
Initial Report on Governance in Nonprofit Community Health Systems
Grant Thornton, LLP - February 2008
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