Except in emergencies, most states ban the practice of patients having their arteries unclogged at a hospital that lacks heart surgeons. But more small hospitals are trying it in non-urgent cases, and a study suggests it may not be as risky as has been feared. If confirmed by other ongoing studies, it could change state policies and would mean more money for community hospitals struggling to stay profitable and options for patients who must travel to big cities for care.
A Washington, DC, City Council member will propose a sweeping plan to mandate healthcare coverage for all District residents by offering a city-subsidized program for the uninsured. The plan is aimed at an estimated 25,000 uninsured residents who are not eligible for Medicaid programs or the city's Health Care Alliance. If approved, residents would pay monthly premiums of between $20 and $100, depending on their gross income.
Good doctor-patient communication helps reduce the risk of heart disease, according to a Temple University School of Medicine study. The four-year study included patients who were at risk for cardiovascular disease but were otherwise healthy. The patients were divided into two groups, a control group and a telemedicine group. Both groups were given a device to measure their blood pressure and a pedometer to record how many steps they took each day, along with advice on exercise and its benefits in preventing heart disease. Both groups involved in the study showed significant reductions in blood pressure, lipid levels and cardiovascular disease scores, and were able to walk further distances.
The Centers for Medicare & Medicaid Services has posted new survey information at the Hospital Compare consumer Web site. The site now has information from Medicare patients about their hospital stays, as well as information about the number of certain elective hospital procedures provided to those patients and what Medicare pays for those services. Representatives from CMS said the site provides consuners with quality information, patient satisfaction survey information, and pricing information for specific procedures that they need to make effective decisions about the quality and value of the healthcare available to them.
The Harris County, TX, Hospital District is treating a shrinking number of patients in its hospitals and clinics, and some officials are blaming the rise of walk-in clinics at retail outlets and expanded government prescription drug coverage for seniors. District officials are worried as the paying patients are replaced by uninsured charity patients who pay little or nothing. So far in 2008, the district has seen 5.5 percent more charity patients than in 2006.
Florida legislators are threatening to shut Lantana's A.G. Holley Hospital, the nation's last state-run, free-standing facility to treat tuberculosis patients. The closure would scuttle years of planning to turn the hospital's 145-acre campus into a $150 million research center for rare infectious diseases. The legislators estimate it would cost half of the $5.5 million they're now paying to run A.G. Holley to move the 40 tuberculosis patients there into private hospitals throughout Florida.
Pennsylvnia Gov. Ed Rendell has sent a letter to the state's doctors saying they will have to pay more for their medical malpractice insurance because no agreement has been reached on legislation to extend healthcare coverage to the uninsured. Rendell has championed payment reductions for doctors through the state's MCare abatement program, but has refused to approve them unless progress is made on affordable health insurance. Rendell said that if an agreement is reached, doctors could receive refunds of their abatement costs.
Anyone who's been through a divorce, death, or serious illness will tell you that adversity has a way of making or breaking relationships. It separates the weak from the strong, the loyal from the back-stabbing, the friend-for-life from the convenient-for-now. Perhaps more than any other event, adversity teaches you who you can count on--and who you can't.
Adversity in business is no different.
Last week I wrote about stay interviews and how organizations should use them to keep their best employees. But how do you know which employees are truly "best"? How do you know who will stand by you for today's successes and help you dig out from tomorrow's failures?
You might be surprised. It may not be the business school standout you've put on the executive fast-track; it may not be your managers; it may not even be the people with "chief" beside their names. As any leader who's been through tough times will tell you, loyalty and leadership during adversity are not guaranteed. It's during tough times that expected leaders sometimes disappear, and unexpected leaders emerge.
These leaders often come in non-traditional packaging. They don't always wear suits or hail from Harvard. They may not be the first people to speak up in management meetings or fit into the traditional leadership path, but they are committed to driving home the mission and they keep your organization running.
I met Masi at ACHE's annual conference earlier this month. In the days following Hurricane Katrina, Masi's organization treated thousands of 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 said. They'll be both pleased and disappointed by who rises to the top at those times. (In Masi's case, disappointment came in the form of a leader who left for vacation in the middle of the Katrina cleanup.)
An organization's success depends on its quiet leaders and their willingness and ability to rise to the top when top executives are tapped out. So, as leaders prepare their staffs and organizations for everyday challenges on calm days, they must prepare for hard times as well. "It's a no-notice war," Masi said.
In a lot of organizations, the CEO's role has evolved from one focused on hospital operations to one focused on strategic planning three to five years down the road. Part of this strategic planning includes succession planning and mentoring, but don't limit that preparation to your executive team or your "born leaders."
Who's outside of your executive suite? Who are your quiet leaders?
In times of adversity, it might be the community college intern or the soft-spoken mother of three who works nights in your ED who rises to the top. As Masi described, it might be the kid in shipping who hotwires a bus in order to deliver the first load of patients, some who'd missed dialysis for five or six days, to be triaged at the Astrodome.
How about you? How are you mentoring your future leaders? I'd love to hear about it.
Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.
Michael Millenson is a healthcare quality consultant and author of the critically acclaimed book, Demanding Medical Excellence: Doctors and Accountability in the Information Age. In this interview, Michael discusses the growing number of healthcare rankings and ratings and how hospitals can make sense of them all.
Hancock Regional Hospital is planning a medical facility in McCordsville, IN, that would become the hospital's 10th site in addition to its main campus. The proposed facility would offer services such as urgent care, physical therapy, imaging and lab work.
