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Management Consulting In Healthcare
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Newsletter
Planning for Tomorrow's Success NOVEMBER  2008
 
  

Quote of the Month


"The Pilgrims made seven times more graves than huts. No Americans have been more
impoverished than these who, nevertheless, set aside a day of thanksgiving."

H. U. Westermayer

How Long Will Patients Spend In the ER Before They Get Mad?


Wall Street Journal blog - Posted by Jacob Goldstein

The longer it takes for a patient to get through the emergency room, the less happy the patient's going to be with the experience. But how long is too long?

A group of doctors posed that question for their own ER, and got a pretty clear answer: Three and a half hours.

The docs, from Beaumont Hospital in Troy, Michigan, looked at more than 2,000 patient-satisfaction surveys from the first part of 2007. They found that patients whose stays in the ER lasted up to three and a half hours had satisfaction scores in the 83rd percentile as compared with patients at comparable ERs around the country.
But for those who spent between three and a half and four hours, satisfaction plunged to the 49th percentile. And those who spent more than four hours had an average satisfaction score in the 24th percentile. The analysis looked only at patients who were sent home, and excluded those who were sick enough to be admitted to the hospital.

"I was surprised that they're so patient for three and a half hours," Aveh Bastani, the ER doc who led the study, told the Health Blog. "Three and a half hours when you're not feeling well is a long time."

Bastani presented the results this week at the American College of Emergency Physicians meeting in Chicago.

Like many ERs, Bastani's has been trying to figure out ways to make things move more quickly - for example, by having a doctor work out in area where incoming patients go through triage.
They've also been trying to make long stays less unpleasant; patients waiting for CT scan results now are given a private room to wait in, if one's available.


More
Quotes

"As we express our gratitude, we must never forget that the highest appreciation
is not to utter words, but to live by them."

John Fitzgerald Kennedy

-------------------

"Gratitude is a quality similar to electricity: it must be produced and
discharged and used up in order to exist at all."

William Faulkner
 
Greetings!
 
Thanksgiving

 

As we get closer to mid and late November, Americans focus on the upcoming Thanksgiving holiday.  This year, one of the many things I'm thankful for is that our recent national elections are finally over.  In spite of having two presidential candidates who are both, in my opinion, gentlemen in the full sense of the word, the election campaign too often degenerated to an extreme number of negative and repetitive television ads.  Often, it seems that leadership is defined as yelling at the other guy and saying he's wrong about a particular issue.  Apparently the polls tell the politicians and their advisors that people aren't ready to hear a positive; logical discourse, they aren't ready to be led.
 
Now that the election is definitely over, perhaps the government can turn its attention to the trivial issues like fighting two wars and repairing an economy in a shambles.  What many citizens are calling for at this point is thoughtful leadership.
 
Leadership is one of those concepts that people long for but sometimes have a difficult time defining in real life.  It's something that we say "we know it when we see it."  And no matter what your personal political persuasion - red, blue or purple, you and I will benefit from reasoned leadership at the federal, state and local level.  Take a look at the article I included about our new president's approach to decision making

Enjoy the coming holiday season which begins appropriately with Thanksgiving Day and ends with the New Year.  Take time to treasure your friends and families and to appreciate the freedoms that far too many of our brothers and sisters have died to assure us.

And, oh yes, stay out of the ER!

 
Ken 



 

KenBast@MgtConsultinginHealthcare.com
 
The 'Obama Way': Seven steps to success

What his distinctive approach reveals about his possible administration
By Howard Fineman
msnbc.com
Tues., Nov. 4, 2008

NEW YORK - I was sitting in David Plouffe's spartan office at Barack Obama's campaign headquarters in Chicago.

This horserace has been an interesting one, but that's not what I wanted to talk about. Instead, I asked the campaign manager about decision-making.

A lot of the campaign's choices have been better than good.  Cautious politically and bold organizationally, the decisions made amount to the best planned, executed and essentially mistake-free political effort I've ever covered.

So, I paid close attention when Plouffe told me there was an "Obama Way."

It sounded vaguely mystical, but if there is one thing we need to know to help assess an Obama presidency, this could be it.

Having said that, you have to be cautious about seeing a White House foreshadowed in a candidate's campaign.

Take for example George W. Bush. Some characteristics of his presidency - loyalty, insularity and reliance on a small core of advisors - could be noted in his 2000 effort. But unlike his presidency, that campaign proved adaptable to changing circumstances and more attuned to realities on the ground. The differences proved catastrophic. Obama's campaign has been so distinctive, disciplined and cutting edge that it's nearly impossible not to look at it for clues as to what his White House would be like.

Businessmen and politicians will reverently study the campaign for years to come as a model of innovative branding and an example for digital sales strategies.

Politically, Obama's ability to finesse tough issues - to anticipate criticism and play off of it - is a model of tactical skill. In terms of public character, his vaunted coolness is state-of-the-art.

Altogether, this strategy is seven-pronged - and it's a veritable play book for political success:

Be decisive: This is what Plouffe meant by the "Obama Way." "Everybody speaks his or her mind," he told me, "and then Barack makes the decision. After that, there is absolutely no second-guessing or looking back."

The trick is to stick with it. Outside the campaign there was considerable hand-wringing a few months ago about the wisdom of pursuing an "expanded map" Electoral College strategy. Obama didn't budge.  "It's better to have one strategy and stick to it," Plouffe told me, "than to try ten in pursuit of the perfect answer. The point is that there is no perfect answer."

Have a tight circle: Obama has a very small circle, although it's not the circle of one (Karl Rove) that Bush had.

Obama's core group consists of four people besides the candidate himself: the "two Davids," Plouffe and David Axelrod, the reporter-turned-consultant and the keeper of the Obama message and the mythology; Valerie B. Jarrett, a Chicago lawyer, fundraiser, and former city hall official; and Obama's wife, Michelle.

"It's the two Davids and those two women," said a top party official. The result is an ability to keep a secret. The choice of Sen. Joe Biden for Obama's running mate, for example, wasn't leaked to the press.

Stick with the plan: Obama's game plan was devised by that inner circle, plus maybe a ring or two beyond it, and has been in place since the moment Obama announced his candidacy in 2007. It's remained mostly intact.

The plan was carefully back-timed with the general election in mind. Except for his commitment to a specific timetable for withdrawal of American combat forces from Iraq, the overall platform has remained substantively centrist in tone and content.

I've never seen another campaign so willing and able to stick to the script.

Sweat the details: Planning strategy is one thing, but executing it with almost obsessive precision is another.

All winning campaigns must be able to do that, even ones that have benefitted, like Obama's, from historical trends, including Bush's travail and a near-collapse of the Republican Party.

But the Obama campaign has not missed a single detail - including, as a recent example, an unprecedented effort to win one stray Electoral College vote in Nebraska.

Understand your brand: Obama lacks a background in business, but you could never tell by looking at his campaign.

It has adapted and improved upon key techniques of modern, international marketing. One of them is branding through iconography.  His campaign is literally centered on a symbol. The Obama camp created that road-meets-the-rising-sun logo two years ago. And that's just one part of a larger focus on visual sales.

Remember the stage for his speech at the Democratic National Convention? The vast set, covered in faux Greek columns and video monitors, was designed to embody the idea of a mass movement or a crusade for change.

And at a recent rally in Cleveland, the entire Obama family wore matching outfits, representing a united familial front by smiling and rocking out with Bruce Springsteen to "The Rising."

Go digital:  Obama's campaign devotion to semiotics is matched by and married to an innovative, envelope-pushing use of web-based and digital communications.

One example, demonstrated to me by Chris Stern of Bloomberg: an Obama applet for the iPhone, developed by a supporter in London. Among other things, it organizes all contacts according to key swing states, allows users to distinguish friends as Obama supporters, and lists (for those with GPS-enabled phones) local Obama meetings and events (complete with maps and directions).

The campaign's texting efforts are perhaps better known. Enticed by contests, supporters sent in their phone numbers at major rallies. Electronic participation continued and hit new highs in August when the Obama camp promised to reveal their veep choice first via e-mail and text message.

Use caution: Speaking of vice presidential selections, Obama's selection of Biden speaks volumes.
 
Given the range of choice, Obama made the safest pick - and one that he had reason to believe would yield a specific, tangible benefit: help in Pennsylvania (specifically, northeast, where Democratic turnout is essential).

So what's the bottom line? Pretty simple. If past is prologue, Obama and his circle are already very hard at work - and very far along - planning the details of his presidency.

The game plan will be comprehensive, detailed, clever and cautious.

That's good news, whether you're for him or not. As Plouffe says, it's always better to have a plan. It's the Obama Way




 
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Management Consulting in Healthcare

is:
 
A small, focused consulting firm that...
 
Believes hands on, down in the trenches operational  experience combined with consulting expertise is vital in obtaining real, lasting results for clients.
 
Has experience in acute care, long term care, health systems, CCRCs, medical schools and other healthcare organizations.