Phone Call

I just returned a phone call to the husband of a recent patient and found that you can learn a lot from the way people describe their experiences. According to the caller, he and and his wife are new to Ohio and they have visited hospitals in many other areas. Here’s what they had to say about Alliance Community Hospital:

“Wonderful stay, keep it up. Don’t know what you are doing but the caring attitude from groundskeeper and maintenance crew to everyone we met…made us feel like we were in a hotel. And that one male nurse on PCU--he was really concerned and caring and so attentive…Usually (in a hospital setting), you find someone having a bad day-we never did. We will be writing a letter to the colleagues here.”

I look forward to hearing more from them.

Talk with you soon-
Stan

July 28th Note

Well, I certainly can’t say it any better than was stated in a note written to me on July 28th by one of our patients. It read:

“Thank you so very much for your services. Joann in out-patient is AWESOME!! Our time at Alliance Community has been above and beyond our expectations. Dr. Mitchell and Dr. Hudzik are the best! Again thank you ACH team.”


Thanks for taking the time to share-
Stan

Happy Birthday to Me!

Today is my birthday…and aside from getting many birthday wishes I received two great compliments regarding our Colleagues and the caring Planetree environment and great services we provide. What a nice present; way to go team!

First up, another compliment for our Therapy team. Whatever they are doing in Therapy Services, it seems a week doesn’t seem to go by in which someone calls me to talk specifically about Therapy Services and their very special team.

1) Therapy…
A Therapy patient called in today to discuss what a wonderful experience she had in our Therapy department. “Everybody was so nice & friendly. Thank you!” she said.

Secondly, I got a visit from a Colleague regarding Planetree.

2) So Proud to Work at ACH…
One of our Colleagues came in to talk to me about how proud she is of our hospital and how much she enjoys working here. She said her mother is a currently a patient at another local hospital and she cannot believe how unfriendly the staff is. Some of her comments included, “They do not offer to open doors or assist you in anyway as we do at ACH. The food is terrible and the hospital is dirty.” She went on to say that her mother commented, “These rooms need cleaned.” The Colleague said that the room her mother is in is a makeshift ward with two beds stacked atop each other. “You can hardly get through they are crammed so close together. The staff does not pay attention to patients,” she said, noting that one day her mother needed to get up but nobody would help, so her mother was trying to get out of bed by herself. This Colleague said she spends a lot of time at the hospital with her mother because she does not feel safe leaving her there alone, adding that when her mother was a patient at ACH she never worried about leaving her.

Is our hospital better because of Planetree? Absolutely, because our Colleagues practice in a way that makes all of us proud to be on the ACH team.

Thanks for making my day a great one.

Stan

Calls from Patients and Guests

I am always amazed at how many calls I receive from our patients and guests. Most just want to let us know how much they appreciated a special moment that had been created for them (through the compassion of our staff) or to voice appreciation for a response they received from one of our Colleagues or physicians.

There a few calls expressing dissatisfaction. They are usually surprised that they can get the CEO on the phone so easily and they also appreciate the knowledge that our staff receives feedback from me in order to improve processes and/or better handle a patient’s or guest’s specific needs. Here is a recap of comments from a call I received today:

“Just received a call; ER was very busy. Patient knew she was bottoming out and requested OJ; something she usually kept with her. Without hesitation one of the staff members immediately responded and genuinely seemed glad to help. They were busy with so many others and just wanted to express thanks for this moment. It was an act of kindness and service she felt should not go unrecognized. Sometimes it is just the little things that can mean so much. Way to go team. It says a lot about practicing in a Planetree Hospital.”

Stan

It has been a while...

It has been a while so my last sign off …..”talk to you soon” was a bit of a long stretch.

Today we welcomed Brenda, Tamara, Brooke, Terry, Sue, Casey and Kelly as new Colleagues to Alliance Hospital. Three members of the group shared their thoughts about working at ACH. What was great to hear is that one of them will drive more than 30 miles to work --passing several of our competitors’ facilities along the way-- because she wants to work in a Planetree environment. Another was drawn here because she did some of her training at our place and really appreciated the mentoring and support of her preceptors. The third said she was glad to be at ACH because she had heard so much about us from friends who enjoy working here. I enjoyed my time as a presenter during the new Colleague general orientation process and discussing our dreams and the expectations for our organization with these newcomers.

As part of my presentation this morning, I discussed the importance of listening to our customers. Interestingly enough, immediately following my presentation I received a call from the wife of a recent patient. Part of the call had to do with the rudeness of one of our staff members, but the majority of the call was very positive. The caller asked me, “How do you find such wonderful people to work here?” The more I thought about it, I remembered what our new Colleagues were telling me this morning about why they came here. People join us because they know they will have the freedom to practice their passion in a proud manner – or because they know that coming here will afford them an opportunity to learn and grow -- and possibly find new passions upon which to build their strengths.

The caller ended our conversation by saying that what disappointed her husband the most during his stay here was that he was not able to stay for dinner the day he was discharged -- because he really loves our food and was looking forward to what he had ordered for dinner! Hopefully sometime soon he and his wife will just drop by for dinner since our Café restaurant is one of the best choices for a great meal at a great value in this area.

Better sign off with a thank you for listening.

Stan

Life Stories of our Community Care Center Residents.

Yesterday I had the pleasure of attending and listening to the presentations of Professor Nancy Pine’s freshman class of Mt. Union students. Dr. Pine is an Assistant Professor of English and her students were sharing their essays based on the conversations that each student shared with a resident partner from our Community Care Center. In attendance were all the students, many of their partner residents, family and friends, and Colleagues from the hospital staff. As promised there were recollections of happy and joyous moments, hardships, some shedding of tears, much laughter and many of life’s lessons to be shared. You could tell that what started out as part of a course curriculum evolved into much more. For most there seemed to be a true bonding not only of different generations but of friendship.

Thank you to all for this moment of sharing. I hope that Dr. Pine and her students appreciated the experience as much as I did and will consider coming back next year.

Talk to you soon.
Stan

Follow up to April 17th blog….

Well I lucked out because the hospital in Toledo was willing to take a cash payment for the allotted amount stated by our insurance company of $109; remember their list price was $249. If only I could have convinced my daughter to have her x-ray done here before she went back to school; our list price for the same exam is $91 before any adjustment.

If John McCain is going to be successful with his healthcare strategy of less regulation I sure wish he would figure out how to level the playing field for consumers; so that hospitals, doctors and insurance companies had to disclose in advance what services will actually cost out of the consumer’s pocket. I realize for many services it might be a range but for many services it can be an exact price.

Talk with you soon
Stan

Wanted to share some patient compliments I received yesterday…

Wanted to share some patient compliments I received yesterday…

Robert called in to talk about Therapy Services. He said that Erin, the person who took care of him was great and that he was more than satisfied with his care. If he ever needed such services again, he said this would be the first place he would come.

Kathleen wrote regarding our E.R. She said of her first visit to the ACH ER, “Each one (of the staff members) was friendly, caring and most professional. My husband and I were very impressed. A note has been sent to the E. R. also.”

What a great way to end the day.

Stan

A Must Read

April 24th, 2008

“The Third Path…Systematic Change Will Focus on Returning Value” is an article written by Greg Poulsen, SVP at Intermountain Healthcare that appears in Modern Healthcare’s, April 21st issue on page 26.

It is a must read; one of the most insightful, clear, forward-thinking approaches to health care…I hope all of the presidential candidates and their teams start listening, - and that whoever is elected stops listening to the special interest lobbyists.

In his article, for those of you who might not have access to it, he clearly points out that neither a consumer-driven approach nor the concept of universal insurance coverage addresses the core health care challenges we face: that of providing quality and value.

The core flaws, as he points out, are:

1. A fundamental flaw is not one of access or insurance – but rather, one of cost issues, structure and the need to align incentives.

2. Patients who lack complete medical histories must navigate a sea of provider settings. Poor communication increases the chances for errors. There is also a lack of real peer accountability.

3. The current system has powerful incentives to increase utilization; physician fees are affected by treatment decisions. Physicians can substantially increase their incomes by performing procedures versus providing consultations. Patients often request more expensive testing and medications. Finally, physicians with ownership in delivery systems such as ambulatory centers or imaging have their utilization incentives greatly magnified. Most physicians do what is right because they take their professionalism seriously; otherwise we would find our problems to be much greater.

Suggestions:

1. That the payment system move away from the fee-for-service structure to a more bundled approach.

2. Patients need to be motivated to opt for a high value approach.

3. The regulatory environment should change to better facilitate cooperation and coordination among the providers, doctors, hospitals and others.

4. Health information technology and EMRs need to be expanded.

Talk to you soon.

Stan

Become a Knowledgeable Buyer of Medical Services = www.bakboms.com . . . Our New Website!

Last week the health system of which I am pleased and proud to serve as CEO started an ad campaign to help provide consumers with access to pricing information. Our motivation was simple: a win –win situation.

For many of the services we provide, our prices charged to both our insurance companies and consumers have been kept lower than those of many of our competitors for the past several years.

As a Community hospital struggling to make more than a 2% operating margin, we hope to drive more business here, particularly in the areas in which we offer some of the best equipment and prices around -- yet people don’t know how, nor do they have the information they need to shop. Once they experience the value ACH offers and they meet the colleagues who practice and provide the services here, I am confident we will create even more loyal customers.

How ironic: Today I look at an Explanation of Benefits (service) on an x-ray for one of my immediate family members. Of course, this service was performed out of town in one of the most expensive areas of health care in the state, Toledo. The list price here in Alliance is $91.00 for that service, while, at the hospital in Toledo, it’s $249.00. Naturally, my family member’s deductible is not any where near being met, so what will we end up paying?

Well according to my EOB, if the service had been provided here, my plan would have covered 100% of the charge at an in-network facility -- it would have paid the full $91.00. But, with regard to the out-of-network facility, I will find out later. My plan did inform me that the usual and customary charge would be $109 – which means that $140 of the list price in Toledo would not even have been paid. I sure wish I’d have known, in advance, which outpatient center to send this family member to --since we will end up paying cash.

Please email me or comment on my blog if you have questions on how to become a knowledgeable buyer of medical services -- and let us learn together.

Everyone that’s taken care of me….the whole bunch…they worked him so hard, it was what he really needed…three stories. It’s what keeps me coming back

“Everyone that’s taken care of me, the whole bunch…you have very special people working here…because of all of them, they have given me a great deal of comfort and peace of mind…I am just not used to seeing that in other places I have been. This is just a very special of caring where everyone really cares.”

As CEO of this hospital, hearing comments from patients and their family members, such as the above words recently used to describe the team of health care professionals and colleagues comprising the ACH family, makes me feel proud to be part of the team.

Every so often things don’t go perfectly, but that too is what makes this place so special. Many of the colleagues I work with, including the physicians who practice here and the volunteers who give us their valuable time, are constantly talking, discussing, and listening to help us deal with all the imperfections and frustrations that our patients and guests deal must endure…for as good as we are, things happen.

Mr. James G. called this week, saying, “The ER team was great…I went to therapy for two weeks, every other day…the passion of the whole bunch taking care of me was obvious.The whole bunch was at it again in therapy.”

I thanked Mr. G. for taking the time to call me and let me know how he felt about the Colleagues caring for him.

I applaud our medical leadership because they are pushing administration and the board to be more public and proactive about Quality issues; encouraging what we do well and highlighting what we need to improve upon. They are working hard at looking at the way medical staff itself conducts it business and have embraced evidence-based medicine, which is not an easy thing to do.

Mrs. R. called to talk about her son’s therapy, saying, “We were so very happy with the services our son received. He had a terrible accident and was treated at Akron Children’s Hospital, but we wanted to be closer to home so we chose Alliance Community. Gail, Erin, Walt, Tiffany. All who called for our son worked him so hard and got him doing things we could not get him to do...he is now able to go back to school. We just felt so very welcome when we came…believe it or not but our son actually looks forward to going back and seeing his friends at therapy. A truly great experience. Thank you for giving us our son back...”

It takes a very special person to admit you could have done better, to apologize sincerely, to show that you care, to be open and honest, to want to improve, to accept constructive criticism, to hold others accountable for trying to be the best, to want to be better…to truly put the patient at the center of what we do. Because of all of you do, thank you for inspiring me to do the same.

Talk to you soon.
Stan

Healthcare is the Economy:

I read, with great interest, Todd Sloane’s editorial entitled “The New Insurance Backlash” in the February 25th issue of Modern Healthcare. To me, one of the most telling lines was, “On January 23, the day Wellpoint reported a 8% gain in 2007 profits (to $3.35 billion), its share price fell by $2.90 because it also reported that it spent almost two cents more of each premium dollar on –wait for it- patient care.”

I truly believe one could make a good argument that healthcare is the number one issue in this year’s election. It is the biggest challenge affecting the ability of both big and small businesses to compete.

Below, I offer my own assumptions or definitions that are necessary to frame my conclusion for a combined Hillary/Obama/Huckabee/McCain plan – one that would fit well with Bernake’s suggestions for stimulating economic growth. So how would this work?

It would work, I believe, in a free market, competitive system. One with a fair and level playing field and--let’s face it-- the consumers of healthcare don’t have the information they need on quality and especially on price (i.e. money they will spend out of their own pockets). We have been preaching transparency, but truly have done very little about it because of all (issues posed by) the special interests; primarily insurance companies. Hilary and Obama would like to limit the amount of premium dollars that go to insurance companies. Under that theory, hospitals and doctors certainly could perform better and if healthcare consumers knew what they had to pay for in advance of many of procedures/tests they would certainly shop around for the best price.

We have been working on quality data for years and if we truly want peer review to work, we must do something about malpractice. However, I am encouraged that some doctors and hospitals are sharing their complication rates and mortality statistics with other key information on their websites. We don’t need a single payer system but we could certainly use a single payment system that is much simpler and makes individuals more accountable for themselves; we do need more of a wellness system than our current sick care system.

There is a lot that could change and bring both parties together and provide the stimulus for doctors and hospitals to improve as well; let’s quit talking about transparency and do something about it.

Two Great Valentine Gifts

Received a very nice note from several colleagues today, on Valentines Day, thanking me. I guess I just want to share that thanks with our leadership team at the hospital because of what the note said.

It read: “Thank you for the new equipment and for always trying to make sure we have everything we need to do our jobs”. Reading these words was a great gift, as were the three enclosed gift certificates for the ‘CAFÉ, one of my favorite places to eat.

Several minutes later, I received a thank you in the mail from a new patient (from Doylestown) praising our service, our Planetree environment and our compassionate caring of our colleagues. They wrote, “Through the reputation of Dr. Palutsi, we were introduced to your hospital. First impressions are always important and we were bedazzled ….as a patient and family we received wonderful care…special thanks to Barb and Dottie in Same Day care…your volunteers are also to be commended”. Sincerely S&L P.

Couldn’t ask for a nicer day.

Talk to you soon
Stan

Interesting Articles on Health Insurers and Health Reform

Thursday, January 31
By Bill Toland, Pittsburgh Post-Gazette
Insurer’s CEO Says Blues Deal Could Hurt Competition

Some big insurance companies in Pennsylvania are fighting for position, but what I found most interesting was the comments from James Buckley, President of the Delaware Valley Health Care Coalition, a multi-employer health purchaser. He said “he protested the lack of transparency among health insurers, saying true, healthy competition isn’t possible until the Legislature compels insurers and hospitals to be more open and accurate about the cost of procedures. The savings being touted in the IBC-Highmark wedding would be irrelevant if a transparency model is established, setting standardized hospital reimbursement rates. Instead of allowing the major health insurers to use their oligopoly power to receive preferential pricing and profits, health care providers should be able to charge reasonable prices to all health care customers.

I couldn’t have said it better.


DATA BRIEF
THE PRESIDENTIAL CANDIDATES’ HEALTH REFORM PLANS
Katherine K. Shea, Sara R. Collins, and Karen Davis
The Commonwealth Fund
January 2008
HEALTHCARE OPINION LEADERS’ VIEWS ON
THE PRESIDENTIAL CANDIDATES’ HEALTH REFORM PLANS

Typically I am pretty much a free market person, however I just don’t believe this has worked in healthcare. A majority of the public agree with the democratic position summarized below from the article.

Mixed Private–Public Proposals Favored
Most healthcare opinion leaders (61%) believe that the mixed private–public group insurance system reform proposals put forth by Democratic candidates are an effective approach to achieving universal healthcare coverage, with nearly two-thirds (65%) of academic leaders and half of business/insurance/other healthcare industry leaders voicing support for universal healthcare. Proposals relying on tax incentives for the individual market, however, are seen by the same experts as an ineffective method for achieving that goal, with 59% of respondents saying they were not effective. Twenty percent of polled business leaders (20%) think tax incentive-based reforms are more effective than do academic (4%) or healthcare delivery leaders (4%).

I was happy to see that most of my healthcare colleagues agreed with this position, at least in this poll.

Talk with you soon.

Stan

The Health of our ACH Colleagues and the Economic Health of the Alliance Community and Eastern Stark County

The Ohio Hospital Association challenged all of its members to promote wellness in our hospitals and encourage our communities to do so as well. Today we initiated our GET FIT campaign. It began with registration for those individuals who want to participate in our version of “The Biggest Loser.” We are organizing teams and have received a lot of help from Mt. Union College regarding the personal trainers. We will let you know how we do in May.

We keep hearing that we are transitioning to a service economy and in many school systems vocational programs are the first programs to be cut. Well, in Alliance we had to make some tough cuts regarding the school budget that impacted these programs. There are many more students graduating from Alliance High School who won’t attend college than those who will. Interestingly enough, in Alliance and many of the surrounding communities, local business owners are saying they need more skilled workers in the trades; they would be most interested in interns, and work-study students.

Well, we are very fortunate in Alliance to have a superintendent of schools with a vision of how best to match the needs of our business communities with those of our students. Dual credits could be offered that might inspire those who thought they could never enter college to do so. If most of the students graduating have hope of a good career path, then we could help local businesses grow; with more and better jobs, we could help stabilize the housing market, which needs all the help it could get right now.

Very shortly, local citizens will get the chance to vote on a school levy Issue 20, which is focused on achieving the vision described above. A healthy local economy and investing in our kids’ collective future is a great way to GET FIT Alliance.

Talk with you soon.
Stan

As promised, here’s some closure to my last Blog

After hearing from our candidates, I must say I was encouraged. Although I am personally not a fan of Dennis Kucinich’s all-public governmental approach to healthcare and the elimination of all for-profit healthcare entities, he spoke well and was much more likeable than I had expected.

Mitt Romney has already shown he can make change happen. Even if Massachusetts isn’t the perfect approach, you have to start somewhere. Of course, it would be nice to know in advance where we are going to end up before we begin our journey and Romney seems to at least have a plan. I was impressed because he was the only candidate that actually asked for my vote.

John McCain’s free market approach is one I usually prefer, but you need a level playing field in healthcare and in my opinion, we, like the government, need a lot more checks and balances.

John Edwards was certainly the most likeable of those present. His accent sounded more Cantonese than southern and his story about encouraging his daughter to attend Mt.Union College instead of Harvard University was perhaps one of the lighter moments of the day - and it was very well-received by the audience.

Not to be out done, Barack Obama showed a sense of humor as soon as he entered the room by asking the crowd, "Can you smell it in the air? Change is coming and much of it is good. Out with the bad odor of stagnant old time politics; in with the good. BO is for Barack Obama and I want to be leading the good changes that we need.”

Our audiences voted only on the merits of each of the candidates’ healthcare platforms.
Hilary and Obama combined for about 32 %( 16% each) of the vote. John McCain and Mitt received the most Republican interest with 23% and 18%, respectively.

My hope is that whoever is elected will implement the best ideas of all the candidates, in order to actually change the system -- even if those ideas came from former competitors.

Talk with you soon.
Stan

Presidential Candidates Address IHN Leadership Summit Conference

Canton, Ohio - Eight candidates seeking to be the next President of the United States were present to speak before the Independent Hospital Network Leadership Summit Conference in Canton on Friday, January 11.

Here’s a summary of the events from a roving reporter’s first-hand perspective.

Taking time out before heading off to the primary in Michigan, four of the leading Democratic and Republican Presidential hopefuls presented their Healthcare Reform Plans to delegates from the Independent Hospital Network.

Hillary Clinton opened, and clearly let her emotions of the campaign process show when she started talking about the strain of campaigning and then quickly regrouped to focus on a hardluck story about how our healthcare system failed a man whose life was destroyed by the current system. She said that what he had worked a lifetime to achieve, was ruined after he lost his job and then suffered a heart attack; both of which ultimately led to the loss of his life savings. Hillary said that because of our flawed health system, this man, yes, is still alive, but everything that he has worked for is all gone.. Hillary, like two of her fellow Democratic colleagues, is pushing both a private and public platform of change.

Rudy Giuliani, on the other hand, said he prefers a market place approach to fixing our nation’s health woes. In a lighter moment, he said he really had to question why our legislators seem to be spending more time worrying about sports and steroids than healthcare. He asked that we focus more on the health of the nation and a little less on the well-being of the Yankees.

I believe “Huck” was up next,(by the way, I failed to mention that none other than Chris Matthews from NBC’s Hardball was our MC). I must admit I liked Mike Huckabee’s remark that people need to be more responsible for their own health and that a consumer- driven model makes a lot of sense.

More to come from this reporter on today’s events, but that will have to wait until tomorrow…I have some scheduled meetings and our team is working on gathering consumer information… a story for another day.

At the end of today, however, we did take a straw vote-- just based on the Healthcare Reform issue. I will share those results in a future blog.

Talk to you soon.

Stan