The average cost of a liver transplant and first-year follow-up is nearly $490,000, and anti-rejection medications can run more than $30,000 annually, according to the United Network for Organ Sharing. Donor livers are also in scarce supply. In California, nearly 3,700 people are on a waiting list for livers, and in 2007 767 liver transplants were performed in the state. More than 90% of the organs were given to U.S. citizens. A recent case in California highlighted some controversial issues: Should illegal immigrants receive liver transplants in the U.S. and should taxpayers pick up the cost?
The first phase of work for St. Luke's Hospital's new Mid America Heart Institute in Kansas City is nearing completion. The new institute will be the cornerstone of the hospital's $350 million expansion of its main campus. The campus' expansion also will include the new $23 million, 21,000-square-foot Ellen J. Hockaday Center for Women’s Care; the $10 million, 9,000-square-foot Muriel I. Kauffman Women’s Heart Center; and new quarters for St. Luke’s Brain and Stroke Institute.
For the third time in less than a year, The Western Pennsylvania Hospital and its Forbes Regional affiliate have a new chief executive officer. Healthcare consultant Dawn Gideon will replace Ed Klaman. Klaman re-emerged from retirement to run Western Pennsylvania Hospital on an interim basis after Mark Palmer resigned. Palmer's exit came just a week after Jerry Fedele, chief executive of parent group West Penn Allegheny Health System, departed amid concerns about the pace of a long-promised consolidation of The Western Pennsylvania Hospital and Allegheny General Hospital.
Nothing makes my eyes glaze and my pulse slow like the ubiquitous “pillars” of healthcare. Usually comprising some variation of “people, community, finance, quality, and growth,” pillars are the focus of staff retreats, mission statements, and annual reports.
When done right, pillars give organizations a consistent focus and a foundation on which to base goals, employee evaluations, and strategic planning. But at too many hospitals, “pillars” are nothing more than the rhetoric of media interviews and filler for web sites and marketing.
How can organizations ensure that their pillars are more than words? I recommend you start by asking three key questions.
Did you spend more time last year coming up with pillars or actually using them to plan your short- and long-term goals? It astounds me how much time some organizations spend working on the pillars themselves. Should the pillar be named “community” or “service”? Is “growth” a pillar on its own or can we combine it under “finance”? Some organizations spend so much time coming up with pillars and crafting mission statements that they forget to actually implement them.
Do you measure your effectiveness in each pillar? A pillar list is all well and good but how do you evaluate how you’re doing in each? A story I wrote about executive compensation in this month’s HealthLeaders magazine highlights two organizations that put their money where their pillars are. These hospitals use organizational pillars as the basis for compensation, ensuring that their pillars are more than just a list of overused words. Sarasota Memorial Health Care System in Florida uses a report card that judges leaders on the system’s seven pillars. It’s updated yearly, reviewed monthly, and annual raises are awarded based on performance in each pillar.
How do you prioritize your pillars? Many organizations list “people” first among their pillars, presumably to symbolize that people are the organizational priority. If you’re telling me that people come first, your annual investments should reflect that (over and above salary). Great, you built a $4-million Women’s Health Center, increased capacity by 25 beds, and increased revenues, but what are your people-related investments? If you list people first, make sure you put them first in real life.
I’m all for strategic focus and consistency, but before you go around pillar-thumping, take a close look at them. If you and your staff can’t see beyond the words to the implement them, you may want to knock your pillars down and start over.
Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.
The embattled director of Los Angeles County's public healthcare system abruptly quit on the same day negotiations with a private entity to reopen King-Harbor hospital fell apart. Bruce A. Chernof, MD, leaves as the county Department of Health Services faces a projected budget shortfall of $750 million over the next two years and undertakes the task of moving County-USC Medical Center to a new, smaller complex. Los Angeles County operates the second-largest publicly funded healthcare system in the nation. It has an annual budget exceeding $3.3 billion, three general hospitals and a network of clinics that together treat about 700,000 patients a year, most of them uninsured.
A week after announcing plans to close St. Francis Hospital & Health Center in Blue Island, IL, because its treatment of uninsured patients was a financial drain, SSM Health Care has announced plans to build a 50-bed hospital in Janesville, WI. SSM’s chief executive acknowledged that the timing of the announcement to build in a more prosperous region than Blue Island was "difficult." Janesville is home to a General Motors plant with more than 2,000 union workers known to have some of the richest health benefits in the country. The St. Francis closing had already had escalated the debate about whether non-profit hospitals should be required to provide a specific amount of care to the uninsured in order for them to keep their tax-exempt status.