In the last year, the Bush administration has sought rule changes that would shave $15 billion in the next five years from Medicaid, and the changes have consumed healthcare leaders across the country. Hospital leaders and local government officials across the country say that if Congress doesn't block the regulations, patients will lose. In addition, some say the rule change would force some rural hospitals into the red. In North Carolina, for example, half the state's rural hospitals could run deficits because of the cuts.
The North Texas Specialty Physicians organization is reaching out to about 15,000 doctors and encouraging them to take advantage of free software that would enable them to send prescriptions to pharmacies via the Internet. The physicians group is distributing information to doctors in Tarrant and 11 other North Texas counties, and the organization has spent more than $100,000 on the effort.
Visiting the bustling United Arab Emirates, you can see the world's tallest building and the world's grandest shopping mall. These are testaments to the commitment of the UAE's leaders to recreating the region into one of the globe's financial powers. About two-thirds of its population is made up of expatriates, brought in to help expand the UAE's economic infrastructure.
These non-nationals work in retail, construction, hospitality, and--increasingly--healthcare. Smartly, the leaders of the UAE realize that dazzling skyscrapers and a robust financial exchange isn't enough. So they've focused on enhancing the healthcare system as a cornerstone of the region's economic development. Initially, the region's healthcare system will support other industries. But as plans for world-class facilities in Abu Dhabi and Dubai come to fruition, the region might someday compete for the world's medical travel dollars.
American expatriate David L. Printy, president and CEO of Oasis Hospital in the city of Al Ain and the emirate of Abu Dhabi, has seen much of the healthcare system's expansion in the region first-hand. When Printy was visiting the States last week, I had a chance to talk with him about some of the top challenges hospital leaders in the UAE face.
Compliance with quality standards: Like many hospitals in the West, UAE hospitals must meet increasingly stringent quality regulations. These standards are set UAE-wide and within individual emirates, the strictest being Abu Dhabi and Dubai. Many of these regulations relate to the quality of clinical staff. For instance, Abu Dhabi requires that nurses have two years of professional experience before they could be licensed in the emirate. And physicians must practice five years past certification and undergo a peer-led interview process. These extra barriers are meant to weed out fraudulent clinicians, which traditionally have been a known problem for many developing nations.
Increased healthcare utilization: Last year, Abu Dhabi mandated that employers provide health insurance. That effort, combined with the state-provided coverage, has led to a swelling of emergency room patients for Oasis and other facilities. "That has increased the utilization of healthcare dramatically," says Printy. "[It's] one of the highest [increases] I've experienced in my over 30 years of healthcare leadership."
Clinical staff recruitment and retention: There just aren't enough good doctors and nurses to go around. Printy recruits physicians from around the globe--from the Philippines to Chicago. It might not seem easy to woo expats, but he says there's a budding interest in international healthcare that's helping him attract high-quality clinicians. But, just like hospitals everywhere, it still takes a lot of effort and partnerships with organizations near and far to maintain the clinical staff. Part of that effort is dedicated to building the supply of local healthcare workers. "I am a firm believer that the quality of healthcare in any nation cannot be sustained without nationals taking leadership roles," says Printy.
Healthcare as a business sector: While the UAE works to address healthcare quality and coverage for its citizens, Printy and other healthcare leaders in the region continue to promote the advancement of professional healthcare management. Recently the American College of Healthcare Executives has given approval for a Middle East/North Africa chapter based in Dubai. "So now we're providing a framework for healthcare executives, and we have members from Egypt and Lebanon and all over the region," says Printy.
The UAE's ongoing investment into healthcare infrastructure and leadership is a sign of things to come for the region. "Leaders see a business opportunity in healthcare that supports the development of the country," says Printy. "They believe that over time they are going to compete with Singapore and other regions of the world for tourism healthcare."
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Rick Johnson is senior online editor of HealthLeaders Media. He may be reached at rjohnson@healthleadersmedia.com. View Rick Johnson's profile
"Mission" and "vision" are words that I hear a lot from healthcare leaders. But, as I heard yesterday at the American College for Healthcare Executive's annual conference, a leader's ability (or inability) to give the organizational mission meaning for all employees is what will make or break an organization's success during times of adversity.
George Masi, executive vice president and COO of Harris County Hospital District in Houston, TX, knows adversity first-hand.
In the days following Hurricane Katrina, his organization treated more than 17,000 misplaced patients in a virtual hospital in Houston's Astrodome. Their rescue efforts tested hospital resources and staff like no other event in the organization's history, Masi said. And it was Harris County's "quiet leaders"--staff not in official leadership roles--who made the effort successful.
Hospital executives don't really know who their true leaders are until they are faced with adversity, Masi told ACHE attendees; leaders will be pleased, surprised, and disappointed by who rises to the top at those times. So, as leaders prepare their staffs and organizations for everyday challenges, they must ensure the mission has meaning for each and every employee.
But how do you make 30 or so words that sound good on paper matter to your shipping staff, billers, and housekeepers?
"Chunk down the vision," Masi said; that is, rework and reword the mission for each employee so it has meaning for them and their jobs. This may sound almost sacrilegious to leaders who have spent months word-smithing their mission statements, but, as Masi said, it's not. "You have the right and prerogative to retool the vision so that it has relevance to the people working with you," Masi said.
Organizations spend so much time crafting the perfect mission statement they often lose sight of what the words in that statement actually mean. Part of your job as leaders is to make the vision something everyone can relate to on an ongoing basis. How well you do that will determine how well your organization fares during times of adversity.
Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.
Hospitals have long been seen as one of the top waste-producing industries, and in 1998 the American Hospital Association and the Environmental Protection Agency agreed on goals to reduce the effect of healthcare facilities on the environment. Now Evergreen Medical Center in Kirkland, WA, and other hospitals in the Seattle area are taking steps to not only protect the environment, but cut costs, as well.
Union-represented registered nurses will strike at Sutter Health-affiliated hospitals in Northern California for 10 days beginning March 21, according to the California Nurses Association. The latest strike will mark the third strike at Sutter facilities in less than six months. The union said the strike is intended to call attention to "serious problems with patient care," and a "pattern of patient safety risks caused by Sutter's refusal to schedule RNs to care for patients when nurses are on legally mandated meal or rest breaks."