A Central and Southwest Florida developer hopes to tap into Polk County, FL's growing and aging population by building a $250 million medical center. The center will include an assisted and independent living community, a fitness center, medical offices, and a pharmacy. Representatives from the company said its neighbor, the 142-bed Heart of Florida Regional Medical Center, will help lure patients to the medical facility because the hospital plans to provide physical therapy and other healthcare services at the new site.
AMA delegates this week pondered an ethics council recommendation to endorse the practice of secret or mystery shoppers—undercover patients hired by a hospital or physician group to pretend they are patients and report back on their experience.
Physicians who oppose the measure fret that the "fake" patients will interfere with the treatment of real patients. They worry that they might be disciplined if they happen to make one small misstep. They say mystery shoppers aren't a good way to measure quality.
But I don't think these or any other arguments hold water.
For starters, the ethics council proposal as written already addresses many of opponents' concerns:
Mystery shoppers should never go through with an inspection if it would interfere with the treatment of emergency patients. (In fact, many mystery shopping firms use people who need tests or procedures anyway.)
Healthcare organizations should inform doctors that they will be using mystery shoppers, though not announce the exact time of the visit.
Physicians and others who come into contact with mystery shoppers should not be disciplined for any issues that arise, but rather be counseled on how to improve based on the feedback.
But more importantly, think about the message physicians who oppose mystery shopping are sending to your patients: that they'll only behave if they know they're being watched. It might not be true, but do you really want your patients to think that physicians will only be on time or explain delays, wash their hands, be thorough in their examinations, explain treatments, tests, and procedures, and make sure to answer patients' questions if they think the patient might be a mystery shopper?
The American Medical Association ethics council's mystery shopper report points out what should now be obvious to every healthcare marketer and leader. "As healthcare becomes a more competitive marketplace in which ‘healthcare consumers' (patients) comparison shop for healthcare services, individual physicians and hospitals are realizing that patient perception is key to maintaining and growing practices," the report states.
In consumers' minds, perception is reality.
Take for example a doctor who washes her hands before entering the exam room. She doesn't see a problem—until the mystery shopper reports back that she didn't wash her hands. A simple adjustment to her usual routine—washing her hands in front of her patients—can change patients' perception of her.
In its report, the ethics council cites the many potential benefits of mystery shopping. For example, information from secret shoppers has led to improved patient flow and wait times and warnings about potential breaches of patient privacy. Business improvements might include more effective hours of operation, better customer service, a more pleasant waiting room, larger type on signs, and even nicer telephone exchanges between staff and patients.
"In addition to using secret shoppers to identify opportunities for improvement, information can be used to reinforce desired practices. Some healthcare facilities, for example, reward employees who receive positive feedback from secret shoppers with a range of incentives from cash, to better parking spaces, to engraving their name on a wall plaque."
I have another idea: Let's start treating every patient as if he or she is a mystery shopper.
Gienna Shaw is an editor with HealthLeaders magazine. She can be reached at gshaw@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media Marketing, a free weekly e-newsletter that will guide you through the complex and constantly-changing field of healthcare marketing.
Nurses aren't trained to be managers. They're trained to be clinicians. So how can your hospital ensure that it is providing the additional training and leadership development needed to create the next generation of chief nursing officers? The first step is identifying which nurses have the personality traits to be effective managers—and just because a nurse is a great clinician doesn't mean she'll be a great leader.
Recently, I spoke with M. T. Meadows, director of professional practice at the American Organization of Nurse Executives in Chicago, about the different skill sets that nurse executives need in smaller community hospitals versus larger health systems. She said that nurses in rural or critical-access hospitals have numerous responsibilities; for example, they may be in charge of the nursing units plus housekeeping and pharmacy. "They need to be able to identify with the groups of people that they are leading. They may have a nursing and a non-nursing department, and the needs of those departments are going to be different, so they have to wear more hats and work on their objectivity in dealing with multiple departments," she says.
I have heard that hospitals should be looking for nurses who don't intimidate easily, are confident and compassionate, exhibit objective and independent thinking, have the ability to see the big picture, and embrace change as an opportunity for growth. But identifying potential leaders is just the first step. Next is establishing an in-house training program—which may be difficult for mid-sized or smaller hospitals because they often lack the infrastructure and resources required to establish such programs. One training tool that is fairly easy to implement whether you're a small or large hospital, however, is a mentoring program. Mentors can help groom new nurse executives by helping nurses identify what their learning needs are and directing them to that information. They can also help nurses transition into a new role by acting as a sounding board for new nurse leaders' questions or problems.
While it is beneficial for the mentor to have knowledge of the nurse executive's role, is it absolutely necessary to have only nurse managers mentoring other nurse managers? I wonder if smaller hospitals should establish a mentoring program in which non-nursing executives are partnered with new nurse leaders—especially since nurses in these facilities assume multiple responsibilities. Why not have the chief financial officer or chief operating officer mentor the new nurse executive? The CFO or COO could help get the nurse leader up to speed on the financial elements of the job—an area frequently requiring additional training—or the operational elements of the organization.
In addition, this type of mentoring program could give smaller organizations the opportunity to pick truly great mentors—people who have good communication skills and understand how adults learn—rather than choosing mentors based solely on their job. The bottom line is that the organization needs to foster an environment that supports learning. Staff members need to feel comfortable sitting down with a colleague and saying, “Tell me what I need to know about this spreadsheet.”
If you have a unique approach to mentoring or training new nurse executives, I would love to hear about it. Please drop me a line at cvaughan@healthleadersmedia.com.
Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at cvaughan@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media Community and Rural Hospital Weekly, a free weekly e-newsletter that provides news and information tailored to the specific needs of community hospitals.
Cooperation is absolutely essential to quality healthcare in rural areas, according to a national expert. The word "collaboration" might have negative connotations for some people and groups, but it is "central to what we're trying to do in rural American, rural health," especially because in rural areas, competition and free-market forces are sometimes entirely absent, Forrest Calico, MD, told a gathering of agencies that came to Plymouth State University in New Hampshire for a forum.
About 15 third-year medical students from Touro University College of Osteopathic Medicine in Vallejo, CA, will spend one year in North Coast clinics providing care to rural communities. The rural clinical rotations in Humboldt and Del Norte counties are new for the university, and give students opportunities to work at rural clinics as opposed to large, often hierarchical hospitals, say Touro University representatives.
It's a "Tale of Two Cities" story for individual health insurance plans: the best of times and the worst of times.
Individual health insurance plans are on the rise as more employers end health benefits and Americans turn to individual policies as a way to avoid being uninsured. According to American's Health Insurance Plans, approximately 18 million Americans are covered by individual health insurance compared to the more than 230 million who are enrolled in group plans through their employers or government programs. The rising use of individual plans is causing some states to review their laws governing health insurers and the plans' actual policies.
Take California, for instance. A woman won a $9 million judgment against Health Net for canceling her coverage while she underwent chemotherapy. With that making news from coast to coast, the Golden State's Department of Managed Health Care took notice. After a review of the situation and negotiating with two insurers, the state announced that Kaiser Permanente and Health Net would reinstate nearly 1,200 individual policies that were cancelled since 2004. California is seeking similar deals with Anthem Blue Cross, Blue Shield, and PacifiCare.
The news from California is making others take note.
Healthcare advocacy group Families USA recently released a 50-state survey of the individual insurance market called Failing Grades: State Consumer Protections in the Individual Health Insurance Market. In response to the survey findings that showed "many abuses" and "few state-level consumer protections," Ron Pollack, executive director of Families USA, called the individual market "the wild, wild west" of healthcare.
Some of the findings did not put laws that govern individual insurance in the best light:
Only five states prohibit insurance companies from "cherry-picking" the healthiest consumers and excluding "everyone else from coverage"
In 21 states and the District of Columbia, insurers can exclude coverage for pre-existing conditions, such as cancer and heart ailments, for more than one year
In 44 states and the District of Columbia, insurers can revoke an individual's health insurance without advance review by the state
In 45 states and the District of Columbia, insurers do not have to spend at least 75% of their revenues on healthcare
In 20 states and the District of Columbia, insurers can set and raise premiums without oversigh
It's easy for health plans to dismiss the Families USA survey as the latest criticism of the individual market. Rather than simply ignoring the report, health plans should review individual policies to make sure they are providing the best consumer protections. One only needs to look at California and the more than a dozen health insurance-related bills in the legislature to see that if there is enough bad publicity the states will rise up and make decisions that could harm health plans.
AHIP released a report in December 2007 called Guaranteeing Access to Coverage for All Americans in which it offered a new strategy that included limiting the use of pre-existing condition exclusions, restricting rescission actions, and establishing a third-party review process for pre-existing conditions and rescission decisions.
As more businesses end health coverage because of costs, the individual health insurance market will continue to rise. With that greater interest will come more opportunities for government intervention.
The question is: Are health plans going to get ahead of this issue and review their rescission and coverage policies, or wait until the state comes knocking on their doors?
Les Masterson is senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com .
Note: You can sign up to receive Health Plan Insider, a free weekly e-newsletter designed to bring breaking news and analysis of important developments at health plans and other managed care organizations to your inbox.
Although the overall financial health of Pennsylvania hospitals continues to improve, many small, rural hospitals are struggling. Overall, 42 hospitals, or 25% of the state's hospitals, lost money, according to a report by the Pennsylvania Health Care Cost Containment Council. "This is troubling because most of these smallest hospitals are a vital resource for rural Pennsylvania communities," the report said.
While there's a community health center and some doctors in town, for them, residents of Chincoteague Island, VA, either have to drive an hour to the north or south for hospital care. This story highlights a problem that many small or rural communities face when hospital care is sometimes hours away.
With recent expansions, Children's Hospital and Health System in Wauwatosa, WI, launched a community-focused campaign to instill ownership and a sense of connectivity in the community and to make it more than just a 12 story, 425,000 square foot structure.
Children's expanded its facility in response to increased need. However, with the expansion came the realization that they also needed a way to reach out to the community on a larger scale than they ever had before.
"We have a dozen and a half audiences," says Stephanie Hungerford, senior public relations specialist for Children's. "It's difficult to create a single campaign that appeals to everyone." But when Core Creative, of Milwaukee, WI, pitched the "This is MY Children's" concept to Children's, they recognized it as an all-inclusive idea.
"Their concept spoke the most strongly out of any we had seen because it gave a sense of ownership over the hospital. It connects people to the hospital," says Hungerford. "Children's is very much a part of the community," says Beth Crivello-Wagner director of public relations for Core Creative. "That's the message we wanted to get across—that Children's is interwoven within the fabric of community."
The campaign had two primary focuses—engagement and versatility. In order to engage the community the team brought the community's perspective into the campaign. It featured various individuals who all had experiences with or felt connected to Children's. The campaign incorporates their stories.
"Versatility was extremely important because we're actually a health system and the concept can be used across different entities," says Hungerford.
The multi-integrated campaign also includes an artwork project that features drawings by children (ages 3-18) of their visions of what Children's hospital looks like and what it means to them. One child's work from each of four age categories will be chosen to win a trip to a local water park for their family. "It's unique," says Hungerford. "It's actually two simultaneous campaigns. It's also interesting to see the hospital from the child's perspective."
"What we are really passionate about is spreading wings, when it comes to a healthcare campaign it's important to look at everyone as a part of it—everyone working together," says Crivello-Wagner. The campaign will continue throughout the expansions opening and Children's plans to take the artwork submissions on a community tour.
Kandace McLaughlin is an editor with HealthLeaders magazine. Send her Campaign Spotlight ideas at kmclaughlin@healthleadersmedia.com If you are a marketer submitting a campaign on behalf of your facility or client, please ensure you have permission before doing so.
Dexter Campinha-Bacote, MD, medical director at Aetna, talks about the reasons why health plans should create a health literacy program and the economic reasons that drive the need. Campinha-Bacote is taking part in a July 22 audio conference on how to create a health literacy program.
