Just months after breaking off talks with University Hospitals, Medina General Hospital has agreed to explore the possibility of joining the Cleveland Clinic system. Cleveland Clinic's President and CEO Toby Cosgrove, MD, announced the negotiations in a message to Clinic staff. "I wanted to inform you that Cleveland Clinic has entered into a Memorandum of Understanding with Medina General Hospital to explore the possibility of the hospital becoming a part of the Cleveland Clinic's health system," Cosgrove said. "The affiliation would maintain the current open medical staff model, where community physicians would continue to have privileges at Medina General Hospital."
Despite recommendations from the Centers for Disease Control and Prevention that all healthcare workers get vaccinated, nearly 60% of healthcare workers fail to get a flu shot. Experts say healthcare workers opt not to get vaccinated for the same reasons others are hesitant, and some also don't realize how easily they can spread the disease. William Schaffner, MD, chairman of the Department of Preventive Medicine at Vanderbilt University, argues that getting vaccinated for the flu should be standard for doctors and nurses because the flu virus can be spread so easily.
Koll Development Co. is seeking a zoning change to build a high-rise medical building with retail space across the street from Presbyterian Hospital of Dallas. According to filings with the city of Dallas' development services department, Koll wants to build a 12-story, 250,000-square-foot medical office building with parking and ground-floor retail. The zoning request says the building will be used for "general medical and clinical office space and ancillary services such as outpatient surgery and diagnostic imaging centers, medical research, laboratory, and pharmacy space."
A judge has renewed an order banning state officials from making payments under Illinois Gov. Rod Blagojevich's expanded healthcare program, and said it's time for the state to explain how it will comply. In 2007, the state legislature twice turned down the governor's plan to expand healthcare—first for universal coverage, then to expand income-eligibility requirements for state-subsidized care. But Blagojevich began enrolling families anyway, claiming he had sufficient authority. The move prompted a lawsuit by a lawyer and two business-group representatives.
As the presidential candidates push their healthcare plans, Sen. John McCain regularly presses Sen. Barack Obama to tell voters how big a fine he would impose on companies that don't offer their workers health insurance. Obama made a similar charge against former rival Sen. Hillary Clinton. Now Sen. McCain is taking the same tack in demanding that Sen. Obama detail his plans, a point McCain made again at Wednesday's presidential debate.
The global economic crunch is forcing a growing number of Americans to scale back on medical care. Consumers are pushing off seemingly less-urgent services in the hope that their financial health will improve. But the danger is that the short-term savings may translate into more severe long-term health implications, physicians say. Hospitals report that unpaid medical bills are on the rise, pharmacists are seeing a spike in cheaper generics, and demand for low-cost care is climbing.
Pennsylvania Gov. Ed Rendell and Senate Republicans have failed to agree on costs for the proposed expansion of the state's subsidized health coverage to thousands of uninsured Pennsylvanians. Pennsylvania is the latest state to struggle with approving healthcare reforms.
Press Ganey Associates has come out with its 2008 survey of job satisfaction among 200,000 healthcare professionals at 423 healthcare organizations nationwide—including 45,000 nurses—and the news is neither good nor surprising.
Take heart, however. As Press Ganey points out, there are simple, practical, affordable solutions out there to improve employee morale and patients outcomes—solutions that can be implemented by any hospital that is willing to honestly assess its own shortcomings.
The expected irritants are in the mix, namely, compensation and staffing. But there is also considerable discontent with senior management. "The most important issue to employees is how well senior leadership, including senior management and administration, listens to them," Press Ganey concludes in its 21-page report. "Organizations that take steps to partner with their employees can see not only increased employee retention, but also increased patient volumes and satisfaction and a healthier bottom line."
Included in the Press Ganey report is a National Nurse Loyalty and Retention Opportunity Index, which shows nurses' priorities. At the top of the list, nurses say they want senior leadership that: listens to employees; responds promptly to most problems; and can be trusted.
The nurses also want sufficient staff to ensure quality of care, and some level of involvement in decision-making. "Listen to the RNs," one nurse told Press Ganey. "Not listening to us leads to frustration, and frustration leads to vacancies."
Press Ganey recommends that hospitals implement regular communication between employees and leadership, and that leadership solicit suggestions for improving patient care and employee needs. Listening to employees' concerns and suggestions to improve your hospitals shouldn't be that difficult or time consuming, and it appears to pay dividends.
One facility that got the memo was Lowell General Hospital in Massachusetts, which was singled out by Press Ganey for a turn-around strategy that centered on employee satisfaction. In 1999, the 200-bed, nonprofit community hospital found employee satisfaction in the 14th percentile, and annual turnover of 30%. In 2007, employee satisfaction increased to the 58th percentile and turnover dropped to 13%.
What happened in the intervening years? For starters, LGH knew it couldn't improve patient care and outcomes without the support of a motivated and experienced staff. So, they made employee satisfaction and retention a priority. The hospital created a weekly internal newsletter that provides a forum for news and events, project updates, and employee recognition. LGH installed an Intranet communication program where employees can access senior leadership in a virtual town hall meeting format. The hospital also created improvement initiatives that reward and recognize staff, including personalized thank-you notes from senior leadership to exemplary employees, peer-to-peer recognition for outstanding work, and an annual in-house award for the hospital's five top managers.
If feedback from employees is any indication, the LGH strategy is working. "The best things about working here are the respect, collaboration and supportive teamwork among the nurses, doctors and ancillary staff; that I am continually learning and the fact that we put the patients first," one LGH employee told Press Ganey. "I love my role and responsibilities, feel valued, have fun, and I am very proud that I work here."
John Commins is the human resources and community and rural hospitals editor withHealthLeadersMedia. He can be reached at jcommins@healthleadersmedia.com.
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The current two-year legislative session is ending without a health-insurance compromise between the Pennsylvania Gov. Ed Rendell and Senate Republicans. The Senate GOP says that in the face of a weakening state economy, Rendell is overreaching with proposals that would require tax increases to sustain them over the long haul. But Pennsylvania is far from alone in falling short of Rendell's goal: To date, Massachusetts has made the greatest progress toward reducing the ranks of the uninsured through its 2006 health law. But similar initiatives in other states have been defeated in political arguments over how to pay for them, according to the Washington, DC-based Kaiser Commission on Medicaid and the Uninsured.
Under new state rules, California hospitals and physicians are barred from billing patients for the balance of emergency care not covered by insurers. But hospitals and physicians are protesting the rules in court. The disputes typically occur when an insured patient ends up in an emergency room that is not in his or her carrier's network, and hospitals and physicians may send insurers bills that are higher than what the insurance firms usually pay providers in their network. And insurers often balk, sending back less than the full payment.
