Friday, December 31, 2010

CMS Launches Physician Compare

In the continuous journey on improving quality and transparency with our (healthcare providers) performance, Jessica Zigmond with Modern Healthcare writes:

The CMS has added new information about physicians and other healthcare providers to the agency's physician directory tool. Called Physician Compare, the new site updates the agency's healthcare provider directory that guides beneficiaries looking for Medicare-participating physicians online.

According to the CMS, the new site was required by the Patient Protection and Affordable Care Act and contains information about physicians enrolled in the Medicare program, including doctors of medicine, osteopathy, optometry, podiatric and chiropractic medicine. It also contains information about other health professionals who care for Medicare beneficiaries, such as nurse practitioners, clinical psychologists, registered dieticians, physical therapists, physician assistants and occupational therapists.

The CMS said it plans a second phase of the in 2011, which will indicate whether professionals chose to participate in a voluntary effort with the agency to encourage physicians to prescribe medicines electronically, as opposed to paper-based methods. In the future, the Physician Compare site will include information about the quality of care Medicare beneficiaries receive from physicians and other healthcare professionals who are profiled on the site.

“Today's release of Physician Compare moves us closer towards CMS' goal to improve the quality of healthcare for people with Medicare in all the places where they receive care, including the doctor's office,” CMS Administrator Donald Berwick said in a news release. “By using a considered, step-wise approach to spotlighting quality of care, we can create a tool that will help doctors and patients for decades to come.”

Certainly these efforts should help as more details are added over time. It seems Dr. Donald Berwick has wasted no time since taking his new post.

Happy New Year

Monday, December 27, 2010

"Biggest Loser" Work Competition

Our 5 South team just kicked off a tv show-inspired healthy challenge...
"Biggest Loser" (optional) Work Competition.

Check out the rules and let me know of other post holiday challenges going on in your workplace.
Thank you for getting this started 5 South team.


1. “HAVE FUN”, eat healthy, and exercise.

2. The first weigh in will be on Tuesday, Jan 11th at 7:15am or 7:15pm

3. The final weigh in will be on Tuesday, April 19th at 7:15am or 7:15pm(15 WEEKS)

4. Weigh-in’s will occur every Tuesday at 7:15am or 7:15pm.

5. There is a $5 registration fee which “MUST” be paid during your first weigh in.

6. (You can join at any time during the first three weeks but the longer you wait the harder it will be to win.)

7. All monies owing to the pot should be paid during the time of weigh in or prior to the following weigh in.(So if you have a bad week, be prepared break out the spare change)

8. There will be a penalty fee of $1 if you miss weighing in. This dollar will be combined with the weekly weigh in fee of $1, for a total of $2 dollars each time you miss a weigh in. However, you may weigh in within 24 hours of the weigh-in (with a witness), either before or after the designated Tuesday weigh-in times and record the weight in the "Biggest Loser" log book that will be located in the break room.

9. There will be a penalty fee of $1 added for gaining greater than 1/2 pound of weight.

10. Only weights recorded on the Biggest Loser scales on Tuesdays will be valid. (You will not be able to submit your weight via e-mail or after the fact. So unless you are sick, have made other weigh in arrangments or cannot make it in due to weather, a $1 penalty will be applied, as stated in Rule 8.)

11. The winner will be the person who loses the largest percentage of body weight. (start at 200 pounds and lose 10 pounds and you have lost 5%)…[(Start weight - Finish Weight) X 100 / Start weight = percentage lost.]

12. A percentage of the pot will be used to pay for the scale. At the end of the contest, the winner will be awarded the scales 60% of the pot. Second place will be rewarded with 30% of the pot. Third place will be rewarded with 10% of the pot.

13. Challenge your friends and LOSE WEIGHT

Saturday, December 25, 2010

History of an American Folk Song

I had never really thought about the origin of Rudolph until yesterday. Then yesterday - one foggy Christmas eve (I could not resist) I heard about it on the radio and then confirmed

The story of Rudolph, Santa Claus' special ninth reindeer, was written in 1939 by Robert L. May. He was an employee of Montgomery Ward, and the store created a book about Rudolph to give away to children on Christmas.

May's brother-in-law, Johnny Marks, turned the story of Rudolph into a song in 1949. It became a hit for Gene Autry and has since become so enmeshed in American culture that it's considered a folk song despite the fact that it's not in the public domain.

"Rudolph the Red Nosed Reindeer" Lyrics

The lyrics to "Rudolph" are based largely on May's story about Santa Claus and his magical reindeer. Its theme is similar to the story of the ugly duckling who grew up into a beautiful swan. Rudolph is teased and rejected by the other reindeer until he proves himself useful and industrious. It's a very American dream-like story line about how everyone can be special and important when they use their gifts and talents (isn't that what many of us look for in our personal and professional lives):

Then one foggy Christmas Eve Santa came to say:
"Rudolph with your nose so bright,won't you guide my sleigh tonight?

Merry Christmas. Enjoy a safe and healthy holiday weekend.

Thursday, December 23, 2010

Wash Those Hands With New Soap

As you walk around the hospital, you will notice additional soap dispensers. We know this is an easy time of year to get sick and spread holiday cheer in the wrong way. In the past, we have been told that our soap dispensers were rough on the hands. These soap dispensers are new. If you are in the hospital, try them out and let me know what you think.

Previous Statin Use: Article

I just have to brag...
Congratulations to Dr. Jason Day, Vascular Neurologist.

Great artice in Stroke: The Journal of The American Heart Association

Tuesday, December 21, 2010

CARE Fund Support Strong as Ever

What a great celebration we had yesterday. A couple hundred people were on hand for our annual raffle drawing that raises money for our CARE fund (Catostrophic Assistance for resource and employees fund).

Separate drawings take place at St. Joseph Medical Center and St. Mary's Medical Center. This year SJMC brought in over $10,000 with more than 25 gift baskets donating. We had amazing support from our volunteers, associates, physicians and community members. Thank you all.

Your Actions are Speaking so Loudly...I Can't Hear What You are Saying

This morning, our leadership team went through a training presentation on high reliability organizations. It started out with some great reflections by Sister Rosemary F. Her key message:

As leaders, we must set the example. We all have the opportunities to be leaders.

She spoke on the subject of "Habits."
"Do we have habits or are we our habits? It is the way we act that forms our characters. Actions performed over time become habits (e.g., compassion, stewardship). Do I steward the resources I have and do I steward these resources wisely? Jokingly, she said that when she was in school, her teacher would say, your Actions are speaking so loudly that I cannot hear what you are saying. So how do we acquire habits? Practice, practice, practice. Virtue is not taught - virtue is shown by example. It is the first, if not the only, teacher in moral development. We become who we are by the way we act over and over and over. One must study with practice. Culture is how we act. The way to instill a culture of safety is through example. As leaders, we must set that example first.

Rachelle B., our Regional Director of Quality and Process Improvement, then did an exceptional job discussing the expectations and continued improvement of highly reliable organizations. Surprisingly enough, the highest percentage of errors that take place are not due to communication, the reason everyone always touts. The reasons...62% of errors are caused by lack of critical thinking (failure to validate/verify) and compliance (taking shortcuts, non-compliant with known expectations.). Take a look at the example shown above!

Both presenters were extremely inspiring and certainly set a great tone for our continuous improvement journey.

Good Relationships - A Healthy Hearthy Option

Last night I was visiting with some of our patients and just have to brag. When they spoke of the care they received, each patient stated that of course, they received the care, or surgery or treatment they expected. What they were really pleased with was the relationship they were now forming with our nurses, techs, consulting physicians, volunteers and housekeeping (EVS).

Just last week my wife mentioned the same thing to me..."Isn't life just about the relationships we form at home, work, the gym, church, temple, social event....(and the list goes on)." It is so very basic yet easy to miss at times. When things are not going well, it could usually go back to a relationship and the expectations of each party. When things don't go well, the same applies.

There was even an interesting medical study noted by The Early Show's medical correspondent Dr. Emily Senay. "She notes that previous research suggests close relationships are good for heart health, and there's lots of evidence that emotions can have powerful effects on physical health. Psychological factors are now recognized as contributing to the development of heart disease."

As we hit the Christmas and New Year weekends, please enjoy those key relationships that make your world whole.

Friday, December 17, 2010

Aligning Forces for Quality Hospital Quality Network

St. Joseph Medical Center and its sister organization, St. Mary's Medical Center, are among seven hospitals in the Kansas City Metro area selected to participate in a national program designed to focus on improved models of care for national reform in health care.

The program, Aligning Forces for Quality Hospital Quality Network, is a quality improvement network of over 130 hospitals aimed to address the need to improve the quality, efficiency and equity of care delivered not only in Kansas City, but also in hospitals across the country. St. Joseph and St. Mary's Medical Centers are participating with the Kansas City Quality Improvement Collaborative and the Robert Wood Johnson Foundation (RWJF), the nation's largest philanthropy dedicated to improving the health and health care of all Americans, to support efforts to improve health care quality.

The program includes three separate quality improvement initiatives aimed at helping hospitals tackle key issues like racial and ethnic disparities, time spent in Emergency Departments (EDs) or readmissions of patients recently discharged. The Carondelet Health facilities have teams participating in all three areas.

Hospital teams in the program will pilot and test quality improvement strategies over an 18-month period. In all, 17 regions of the country have been designated as part of Aligning Forces. In each region, a range of efforts to help doctors, nurses and hospitals improve quality - as well as engage consumers to be better patients - is being tested.

Our nation is always seeking ways to improve patient care. Our selection into this program is a reflection of the hard work and dedication of our staff and physicians, and our continued focus on efficiency, effectiveness and quality outcomes.

A Microcosm of Leveraging Knowledge - Highly Reliable Organizations

Yesterday, I met with other Ascension Health ministries to discuss our High Reliability platform on our journey towards Healing Without Harm by 2014. This represents a commitment to an unending destination in quality, safety and experience for patients, associates, volunteers, physicians and leaders. In short, High Reliability Organizations in one that delivers on what it intends to and we all have dedicated ourselves to this endeavor.

We discussed 5 principles associated with delivering highly reliable care, each and every time. Yes, these are obvious - the consistent delivery of care and the leverage of knowledge will make our healthcare systems better across the nation. It starts with Engagement - engaged associates, volunteers, physicians, patients and families who participate and support in the care provided.

Our group yesterday served as just a small microcosm of sharing and leveraging knowledge across 70 hospitals. That is how we will all change our care delivery in a more effective way - truly sharing best practices.

At the end of the day the key is utilizing these High Reliability Principles as a guide to deliver on what you intended to to. The principles include:

1. Preoccupation with Failure
- Predict and eliminate harm
2. Reluctance to Simplify
- Acknowledge full range of opportunities for error
3. Sensitivity to Operations
- Recognize and address anomalies and potential errors by providing holistic patient care
4. Resilience
- Requires teamwork to adopt and respond quickly
5. Deference to Expertise
- Encourage teamwork by de-emphasizing hierarchy to allow people with the appropriate knowledge relevant to an issue to be included in decision making.

Again, things we know. It will be those systems who deliver these principles most consistently who will serve as the highly reliable organizations.

Thursday, December 16, 2010

Don't Ask, Don't Tell

A local hospital recently added a 'don't ask, don't tell' policy for all employees. It seemed they felt they could provide safer, more effective care if officials and co-workers of the organization were oblivious to facts about their associates. When asked what the healthcare system expected to accomplish, officials stated the "don't ask, don't tell policy" should help the organization advance their quality agenda, improve their relationships with key physicians and insurance companies, improve their patient satisfaction and associate engagement and drive stronger financial margins...

In these day where we need to provide more transparent leadership, how will the public respond to the tactics from the healthcare system above?

The same should hold true for our military. According to the Washington Post, House lawmakers on Wednesday again approved a bill to repeal the "don't ask, don't tell" law, delivering renewed momentum to the years-long campaign to end the ban on gays in the military ahead of a possible Senate vote next week.

As you probably imagined, the healthcare organization above is a made up story. There are many things we are far behind with in healthcare but the "don't ask, don't tell policy" is not one of them.

The nation needs continued transparency in all we do so we could make the most effective decisions based on our collective input.

Monday, December 13, 2010

Sleigh Bells Ringing on my 7th Cranial Nerve

The holidays are filled with lots of bells...Christmas bells, sleigh bells, jingle bell's, Salvation Army bells. And last Wednesday, the holiday brought me partial Bell's Palsy (also known as 7th cranial nerve paralysis).

Certainly, it was scary at first as I thought I noticed signs of a Stroke. I quickly called one of our physicians and headed into see him. After an MRI and other testing, I was cleared of a Stroke concern and put on proper medications. Times like this definitely get you to step back and think what led up to this. Looks like I had a "perfect storm" of possibilities including physical stress on the body with a marathon, less sleep, more travel and medicine that may have lowered my immune system over the past 3 weeks. Now, with a patch over my left eye for the next few weeks to keep it closed, it really provides me the chance to slow down (or smash into things) and watch my activities more carefully. Please note that I have appreciated all the offers to sign, decorate, add bling and bedazzle my patch. We could leave that contest for another day. I have also received several praises from kids today, complimenting me on my cool eye patch.
"Ahh, the joys of physical activity have caught up to you." as many have shared with me. "This is your body telling you to slow down." I suggested that a simple pep talk would have worked for me. During this evaluation phase it truly brought to light my key priorities and interests.
I do not take this situation lightly though and do appreciate the chance to reflect on key focus areas and priorities. This morning, our senior team discussed that very do we slow down and make sure we address our key priorities, ensuring that we move forward and involve the key people to implement any changes with more success. It led to a deeper discussion about shared leadership vs. one person making all the decisions. Sue C., a former boss of mine at the Rehabilitation Institute of Chicago once put it well with our team around her. She said, "most of our decisions could and will be made through our shared and collaborative leadership. There will be times that a final decision needs to be made and I realize that I sit in that seat." I really enjoyed that lesson of collaboration balanced with accountability. To have this balance, it is important to involve key stakeholders and also identify who "sits in that final decision seat."
Oh, and did you know (according to the world wide web) many famous people have had Bell's Palsy including George Clooney. Perhaps the healthcare bloggers could start choosing those actors/actresses who will play us in the future movie entitled, The Impact of Blogging on Healthcare Reform.
I look forward to hearing from you.

Friday, December 10, 2010

Is it About the Money?

A couple fo days ago, the Kansas City Star posted an aritcle entitled, Area doctors get pharmaceutical money for talks about drugs .

The articlew by Alan Bavley with The Kansas City Star stated:

A prominent cardiologist who’s written a diet book. A urologist who’s part of a booming group practice. A family practice doctor, two psychiatrists and two specialists in pain and rehabilitation.

They are area members of the $100,000-plus club — physicians paid six-figure sums by drug companies.

For their paychecks, the doctors give promotional talks to other doctors about the drugs the companies make. They lead forums. They serve as industry consultants.

More than 100 area doctors are taking money from drug companies for speaking gigs and other work, according to data from the nonprofit journalism organization ProPublica. From the beginning of last year through the first half of this year, area doctors have received at least $2.2 million.

The drug industry and the doctors themselves said they were doing an important job by teaching colleagues how to use medications and giving them the benefit of their experience dealing with patients.

Critics said education is not the only reason — or even the primary reason — why drug companies paid so much to doctors. They say it’s all about promoting the companies’ products.

And, critics said, the practice could lead to doctors prescribing drugs too often; prescribing problematic drugs; and writing prescriptions for more-expensive medications when cheaper ones would do.

Payments to physicians by drug companies is an issue that has simmered for years in the medical community.

The Association of American Medical Colleges and the Institute of Medicine have questioned whether doctors should participate in speakers’ bureaus for drug companies.

Certainly their are mixed reviews I have heard across the hospital and in the community. There is not necessarily a wrong or right answer, of course.

Overall, our healthcare system is trying to provide the highest quality care and help improve the health of our population, improve the patient experiences and lower the cost of providing our services.

So, what's your opinion on the physician fees received?

Thursday, December 9, 2010

Brown Mackie via Satellite

Last night, I presented to the Occupational Therapy Assistant students with Brown Mackie College in Phoenix. They have a fantastic school and curriculum for these students. We had a chance to meet via videoconference while I stayed in Kansas City.

The students had some great questions regarding the future career opportunities and the impact of healthcare reform on the country. A couple of their tough questions included:

1. What it the most challenging part of providing care to the patient from the time they are admitted until they are discharged. That, of course, reflects the entire experience and it almost always comes down to how we treat our patients and each other and how well we coordinate their care through the process.

2. How do we provide the best care to our patients and advocate for all the necessary resources since many organizations "seem' bottom line driven. Another great question. As organizations need a bottom line, it has to start with Quality. If we need additional resources, we should request them. If we can not get additional resources, we must ask ourselves, "how can we still provide safe and effective care today?" If we can't provide safe and effective care, my vote is to get the patient to a place where they could get safer and more effective care. We have limited resources in healthcare and need constant communication to understand our priorities and back-up plans if we do not have all the resources we need.

Anyway, we had a lot of fun with the presentation. They told me this was their first video presentation so I made sure to take a picture...I could only capture a few in the class.

Tuesday, December 7, 2010

The End of the Line...We Should Talk

Tonight I had a chance to see my kids perform in a holiday charity event for Operation Breakthrough. It was an enjoyable way to end the evening after a day of following patients and observing several process improvement activities.

I started out this morning "In Your Shoes" with the preoperative staff before patients went to surgery. I had a chance to serve as a Patient Representative and follow Dr. Scott and Dr. Norm's patients through surgery, into Recovery and then paid them a visit once they were settled on the inpatient unit. I did try to go incognito, with scrubs and a badge with just my first name showing. Word got around fast - a family member asked if I was the CEO...they still agreed to let me observe the surgical flow process for the patient. Thank you to Lois, Sean and Dr. Norm for explaining things throughout the surgery.

Every step of the way, critical steps were followed with constant communication across all parties like a well conducted symphony. Of course, that is a key element when things go well and a key breakdown when things don't go smoothly.

Talking about the right communication needed, let me take you back for a minute to to the charity event with my kids. I parked the car and met my wife at the end of the line. She then took our kids to the back to get them ready. I noticed several people giving what I considered evil stares. After a few minutes, I was still at the end of the line with no one behind me and my son asked if he could walk around. He said since we were at the end it would be easy to regain our spot. Just then it hit me like the end of The Usual Suspects with Kevin Spacey...I went back and found the glares were still on me and, you guessed it, the "end" of the line was actually the front of the line. I confirmed with the person now behind me who had probably camped out since last night. Yes, my son and I headed to the real back of the line.

The point being, sometimes processes are not so obvious and we all need to speak with each other more freely to ensure we don't miss anything. As we enter these next few years, we are not only challenged with the changes with healthcare reform but with the overall new world as we now realize. We must continue to provide incredible care and an exceptional patient experience at a lower cost than we provide today. That will come from constant communication with each other and standardizing processes where we can. In addition, those process improvement competencies will be more critical than ever before.

Check out this initial flow chart for getting a patient from the emergency department to the inpatient floor. By involving the right people around the table, the new process will probably take out 40-50% of steps, getting patients to the most appropriate level of care in a very timely manner.

If you had the time and opportunity to improve 2-3 processes in your organization or in your daily activities, what would you change?

Friday, December 3, 2010

Safety Matters

Enjoy our Safety Matters video.

The video shows various safety tips and CH's own version of Dancing with the Stars. There was great participation in the making of the video, and while it's entertaining, it also carries serious reminders about the importance being safe in the care we provide to our patients. It is played to Men Without Hats popular 80's song, Safety Dance. Thank you Stefan!

Tuesday, November 30, 2010

Christmas Decoration Poem

A fun and safe way to celebrate. This went out to our associates (Thank you Shirley):

RE: Christmas decorations

All the departments throughout the hospital
Liked the Holiday Season a lot…
But the Environment of Care (EOC) Committee
It seemed, for some reason did not!

The Safety Committee was nervous,
Realizing the Holiday Season was here,
And let’s not forget – regulatory agencies are always near.

While departments are decorating and decking their halls,
Putting up trees and wrapping the walls,
The Committee knew it was the time to send out the information this year.
So, the Committee set up guidelines to which all departments must adhere.

All artificial decorations, including wreaths and trees
must be made out of non-combustible materials,
And proof of flammability rating we must see.

No decorations can be hung or strung from fire sprinklers, ceilings or lights.
All electrical decorations or string lights are just NOT permitted.
It is even stated that one cannot be committed
To decorating a large area or space
With wrapping paper used to grace
And cover the walls, deck the columns, wrap desks or floors,
And don’t even think of covering the Code Red Barrier Doors!

Last but not least, all decorations and/or trees
Should not be placed in corridors, landings or near these:
Hose cabinets, circuit boxes, informational signs, areas of EXIT keep free,
From covering as well as the fire extinguishers, blocked they should never be!

Wait! There is one more thing to hold dear.
Our decorations should not interrupt
The quality of patient care -
For that is why we are all here.

The moral of the story is the EOC Committee does like the Season,
For what they do, they do for a reason.
Keeping everyone and the building safe
Is a duty this Committee must face.

Have a Safe, Healthy and Happy Holiday Season!

Wednesday, November 24, 2010

Happy Thanksgiving

As we approach the Thanksgiving holiday, I wanted to take time to reflect on the many things for which I am thankful, starting with our Sisters of St. Joseph who set our foundation.  I am thankful for our veterans’ service to our country and the sacrifices they make so we can enjoy the many freedoms afforded to us in this country.  I am also thankful for our volunteers and the countless hours they donate to make our hospital a better place for patients.  Every day I hear stories of associates and physicians who exceed patients’ expectations and I feel truly blessed to work with the very best professionals.  Please enjoy time with your families and friends this holiday.  If you are traveling, please make it a safe trip.  For those of you who will be working on Thanksgiving, thank you for your dedication to our patients.  Always remember that because of your hard work, dedication and unwavering advocacy, we are able to provide compassionate, quality health care for our patients and for that, I am truly thankful every day. 
Have a safe, healthy and Happy Thanksgiving.

Thursday, November 18, 2010

Accountability Hits Home

Several blogs ago, I spoke about 200% accountability...ensuring each person stays accountable to their own performance as well as the performance of their colleagues.

Tonight, I was helping my kids with their homework. My son turned to me and said, "Dad, I would like to Google your hospital to see if there are any areas that need to improve. Since you ask us to improve when we are not performing well in school, I could now see where you could improve at work." Now that's accountability!

Monday, November 15, 2010

A Day to Celebrate New Lives

Today we had the most "planned" births in our hospital's history. Someone asked me to look back 9 months to see if the 14th or 15th of February was a significant date...

Thursday, November 11, 2010

Self Check-In Healthcare

We're all familiar with the interactive kiosks these days. Certainly, they do not take the place of human interaction. They are one part of an overall customer experience Usually, they have been used to help with decreasing time - both to those receiving service and those providing the service.

In the 1990s, I used an ATM for the first time. I was shocked to know that people actually trusted their money could be deposited into this "box"and then show up in their bank account. Now it is unheard of to go to a bank without ATMs. It seems, people rarely go into backs these days. Airlines are another major utilizer of the kiosks. The craze has spread to self check-out counters in grocery stores, photo shops, and now fast food restaurants. We are even seeing more in the healthcare sector including the utilization of "notebook tablets" replacing the typical sign-in "clipboard" and paperwork pile. Much more even takes place on-line to reduce time. Southwest Airlines is definitely one of the companies I am most impressed with as it comes to leading the way for the customer experience based on what is most important to their customers. They were one of the leaders in terms of their phone systems where customers would rarely wait on the line more than a few seconds. When you speak with their employees, the employees focus on safety, ensuring that the planes are turned around within a designated timeframe. They also know that they needed to keep the cost of service down and provide a great experience so customers will return. They were one of the first using kiosks and currently one of the best in terms of on-line check-in, making it easier to use them as your airline carrier.

In our hospital, we will be exploring some of these various options as another way to build on the experience for those we serve and decrease the amount of non-value added time it takes to provide the service. I'm interested in your perspective. I'll keep you posted as we investigate further.

Happy Veteran's Day

Happy Veteran's Day to all of our volunteers, physicians and associates who have served their country. Your sacrifices are appreciated by us all.

Tuesday, November 9, 2010

This morning, I heard the phrase, "slow down to speed up" one two different scenarios. One time was while I was swimming before work and the second time during a discussion with our executive team.

This means, slow down, focus on the right technique or process and ultimately you will be able to do the same activity faster and more efficiently without "running out of steam."

As a hospital executive, many decisions need to be made on a daily basis. I do not take this responsibility lightly. Many of us, throughout the hospital, make balanced decisions every day keeping in mind various perspectives before moving ahead.

While swimming in the morning, there is a Coach who constantly watches our performance. He provides very timely and direct feedback. This morning he said to me "Every time you try to go too fast, you lose the intended technique and you slow down. You have to keep thinking and being mindful of what you are doing in the water as you swim. When you slow down, you will find that you will think more about your form and ultimately speed up. In the process, you will use less energy (wasted time) than you use now."

Please take note that he also enjoyed watching several others essentially swim over me as my form weakened and I slowed down. It was certainly a direct way of receiving immediate feedback! Getting the cues to slow down is not always so obvious. There is a need to constantly communicate and gain perspective from one another.

One way we needed to slow down happened this evening...tonight, I discussed a patient transfer with a few physicians and our Nursing Officer. The issue had been brought to me from a couple different people with differing viewpoints. "Slowing down" and reviewing our current processes with all the key stakeholders allows us a chance to "speed-up" and improve the process moving forward.

I look forward to hearing from you.

Saturday, November 6, 2010

I Could Do Better If...

Last week, I met with our Directors and Managers. It is amazing when I look around to many new faces and many people who have taken on a new or expanded role within the organization. On this day, we discussed the support they needed. One person brought up a challenge many of us face - how to prioritize things when you have fewer staff than you need, you have a lot of meetings and you still need to "get your work done". The conversation shifted to needed more staff, capital and other equipment. So we started to discuss how could we help each other while still helping our organization meet it's goals so we continue to sustain and expand our efforts.

After giving it more thought, we will continue to have this discussion on a regular basis. Ideally, we want to keep sparking those innovative ideas or ideas that frankly just simplify the way we do things. We want to continue to foster that ownership and entrepreneurial spirit.

On Thursday, I attended the Missouri Hospital Association's Annual conference. Richard Teerlink, the former CFO of Harley Davidson discussed how Harley went from a fledgling company to essentially one of the most existing motorcycles around. They focused on the "experience" of their customers. Obviously, the riders were the final customers but they bought their motorcycles through the dealers. Richard and the Harley executives focused on the dealer's experience and made sure their Engineers spent a significant amount of time with the riders to understand their experience. Through both avenues, the company found innovative things the dealers and riders were doing. Harley was able to shape the way they made the motorcycles through the continued engagement of dealers and riders. I enjoyed one of his quotes stating, "Create an operating environment allowing people to to great things on a daily basis." He went on to share that all employees needed a forums (e.g., department meetings, discussions with colleagues, one on one meeting with their manager) to say, "I could do better if..."

Another speaker stated that there is lots of opportunity out there. We will always need and ask for more staff and equipment but we can not wait. We need to do what we can today, tomorrow and next year with the resources we have and that includes coming up with new or simplified ways of doing this. Then align your daily efforts (both personally and professionally) with big goals and big dreams.

My takeaway was to make sure we continue to look for ways to work better together and challenge the way we do things now to make things better for the future. Fire up that entrepreneurial spirit. I look forward to hearing your innovative ideas and/or the ways you have simplified things you are doing.

Monday, November 1, 2010

"In Your Shoes" - Intensive Care Unit

This morning I was humbled once again as I was "In Your Shoes" on our Intensive Care Care Unit. I served as an Aide and worked for my boss Val W, Registered Nurse. She put me to work pretty quickly - after the initial shock and "recommended" assignments came from physicians and other staff members.

First I started out helping her move our patient so we could clean him. As an Aide I was allowed to help clean his mouth and remove a peripheral IV line (my boss walked me through both). I know it may seem easy and obvious to some however I was very nervous and my trembling hands made that obvious. Once the nerves settled, I was on my way serving as a better Aide. For those of you who may not know (and yes it was explained to me)...

A peripheral IV line consists of a short catheter (a few centimeters long) inserted through the skin into a peripheral vein (any vein that is not inside the chest or abdomen). Any accessible vein can be used although arm and hand veins are used most commonly, with leg and foot veins used to a much lesser extent. On infants the scalp veins are sometimes used (source: and Val W., Registered Nurse).
One patient just had surgery and was bragging about the pillow made by one of our Volunteers (we have a Sewing Committee and they make pillows and many other items for our patients to use). This same patient asked if I would give her some ice chips. One went into her mouth and another chip fell down her shoulder and back. The next time she asked if she could give herself some ice. I asked if it was due to my last incident of the ice falling onto her. "She laughed and said, "don't be a pri....." Again, very rewarding and humbling at the same time to do "In Your Shoes". Clearly she was starting to feel better! I look forward to hearing some of your stories.

Sunday, October 31, 2010

A Day at the Waterpark: Laughter, Water Rides, Gifts and Gray Hair

On Friday, I took my family to an overnight waterpark. We have been planning our "Staycation" for several months and our kids were very excited for the getaway in our own town.

The role of CEO or any of our positions for that matter is never easy to leave behind at the hospital. There are constantly areas that we are trying to improve or others we want to continue doing well. After arriving at the waterpark, I remembered seeing Undercover Boss with the CEO from this waterpark. I was pleased to see that the check-in lines were pretty easy and we were able to get settled into our room and get our kids to the waterpark in short order. Once in the waterpark, I was having difficulty taking off my work hat and started to further assess the safety of the park The lifeguards all seemed to have a strong focus on safety. They were clearly fanatical in the walking patterns they took to watch over the water areas. I did note some areas of rust, leaking and touch-up needs. Many of these same issues exist in older facilities and I know it is a constant job taking care of these on a daily basis.

Their gift shop was a must stop shop for our kids. Of course, all the items were broken within the that standard? Drives me nuts but that seems to be the norm in these type of shops - I should not be the norm. I may have to send our Gift Shop Auxilians over there as they run the St. Joseph gift shop like a Fortune 500 company!

All in all, just like hospitals, it was all about ensuring safety first. Of course the waterpark focuses on our fun and overall experience. The experiences always seem to come down to those little moments where the team goes just a little "above and beyond." My kids loved the ride where one of the employees gave just a little stronger push than the others. Just like in hospitals, that special caring touch by our employees, physicians and volunteers is what always separates the good from the great experiences.

On the way out, we were getting changed in the locker when my son said he overheard someone saying mean things about me. He said there was a boy staring and his father said "stop staring at that you want your hair to turn gray look his!"

Oh well, you have to take the good with the bad sometimes. Happy Halloween everyone.

Saturday, October 23, 2010

Dad, You NEVER Wash your Hands....

I stopped at the gas station the other day for gas and a "pit stop.". When I walked into the bathroom, I saw a father and his son who was around 5 years old. The father turned to the son and told him to wash his hands. The son then turned t the father and said, but Dad, you NEVER wash your hands after you go to he bathroom." The father, clearly embarrassed, looked over to me and then back at his son and said, "I always wash my hands." His son repeated "No you don't Dad. I never see you wash your hands." The father then made sure they both washed their hands as he said to his son, "let's hurry because others are waiting to wash their hands."

So many of us see this - when others are watching, the percentage of people washing their hands probably goes up. It should be 100% and in hospitals it should definitely be 100% given the probablity of spreading infections without washing. This is something we audit in the hospital.

I was browsing the website, It stated:

In the healthcare setting, handwashing is often cited as the primary weapon in the infection control arsenal. The purpose of handwashing in the healthcare setting is microbial reduction in an effort to decrease the risk of nosocomial infections.

Hand hygiene can also be a problem in busy health centers and clinics where patients are seen both in increasing numbers and treated in rapid succession.1 Prevention and control of infectious activities are designed to limit the spread of infection and provide a safe environment for all patients, regardless of the setting.2 In light of the emergence of antibiotic resistant organisms, effective infection control measures, such as handwashing, are essential to prevention.

According to the Center for Disease Control and Prevention (CDC), each year an alarming 2,400,000+ nosocomial infections occur in the US alone. They are estimated to cause directly 30,000 deaths and contribute to another 70,000 deaths each year. Nosocomial infections cost over $2,300 per incident and $4.5 billion annually in extended care and treatment.

This is not new news but it still is a major issue. If you are in our hospital or any healthcare organization, you have the right to ensure that those treating you are washing their hands before and after they enter your room. That could be with soap and water, the antibacterial foam soap or other similar products. If you do not see this take place, you could and should ask that provider if they washed their hands before entering the room.

Just like the boy and his father, sometimes people need that gentle or not so gentle reminder to do so.

Enjoy your weekend.

Monday, October 18, 2010

Healthy Challenge Anyone?

Registration for the Boston Marathon began this morning and closed in 8 hours (yes,I am racing it again).

Last year, it took 2 months (approximately 1,400 hours) for the same amount of registrars. Technology and peoples' comfort with technology increases daily. Many people were hoping to race this fall in order to qualify for Boston next year. Looks like the game changed.

As we head into the fall and winter season, I open up a Boston Marathon challenge to all...

We are 6 months until Patriots' Day on Monday April 18, 2011.

Time to do a 360• on yourself and go 360 miles in preparation for Boston. That's 15 miles per week for the next 6 months - run, walk, bike and swim. Any way you can get there, just keep moving! Of course, we'll have a 26.2 mile challenge the week of the race and a special recognition for all those who complete any marathon through April 18th.

Send me your weekly mileage and race success stories (e.g., 5k, 10k, 1/2 and full marathons, triathlons, etc.). I will post updates on my blog including all competitors (I will not publish your last name unless you approve). Plan on fun giveaways as you hit your goals of at least 60 miles per month.

Let the healthy training for life challenge begin...

I look forward to hearing from you.

Check out the New Website

Check out our updated website. In addition to our Carondelet Heart Institute advertising campaign launch, last week also marked the unveiling of phase one of the new Websites. Please take some time to review the sites. I think you’ll agree it is a vast improvement and visitors can find a physician, do health risk assessments, search our health library and learn about upcoming events, classes and support groups at our facilities.

However, it is a work in progress, so if you notice content needing updating or have information that should be added, please e-mail me with the information.

Again, this is just phase one and improvements will continue to be made. Please click on one of the links below to visit our new sites.

Let me know what you think.

Friday, October 15, 2010

ER In Your Shoes

Last week, I did another In Your Shoes. This time I worked in the Emergency Department (ED) with Kimberlee, my boss for the shift (that's us in the picture). She made sure I was oriented to the unit. Laurie, our unit educator put an exceptional orientation packet together for me. She showed me the ropes in the supply area so I could quickly find what was needed. I had a chance to transport and move patients. I had the opportunity to watch great care and a team effort by the entire ED team. As luck would have it, I was told, it was "not a typical day in the ED and it is usually much busier." I joked that it is never a typical day when I do In Your Shoes but they could count on a lot more action once I left the ED - that always seems to be the case. The Emergency Department accounts for approximately 50% of the patients who are admitted into our hospital so it is extremely important that we are able to get patients in and out in a timely manner so they could be discharged home or admitted to the most appropriate level of care. This is this the right thing from a clinical perspective and serves as a strong patient and family satisfier. The patient flow in our ED has been a major focus of our LEAN Six Sigma initiatives.

As usual, I had a great experience and recommended that others in the department try In Your Shoes in other areas to get a different perspective. It has helped me understand our current issues and opportunities and also allowed me to see where other staff could support different departments. In this case, I know I could help transport, get supplies, etc.

I spoke to some of our EMS folks and noticed that they had a new mechanism to reduce any potential injury for their team and their patients. There is a cable and hook that goes onto the back of the patient cart and pulls the patient up the ramp leading to the back of the ambulance - I was told it could pull up to 700lbs.

Having watched too many ED shoes over the years, I walked out to the Ambulance Bay hoping to see other colleagues either playing basketball or meeting their co-workers waiting for multiple ambulances to show - while a couple ambulances were present, we lacked the basketball court. Probably a good thing in this case!

Monday, October 11, 2010

AH Convocation

Every couple of years, Ascension Health has their convocation. This year the themes around Remember - Celebrate - Believe gave us the opportunity to explore the past 10 years since AH started. We also had a chance to hear many great ideas across the country where the various hospital ministries are improving the way they currently deliver care and the overall patient experience. We had a glimpse into some future ideas on delivering patient centered care outside the hospital settings. Certainly an effective forum to further relationships and leverage knowledge across the country.

Check out our banner above focused on Unwavering Advocacy for those we serve.

I look forward to hearing how your organizations share ideas in order to deliver a more effective product to those you serve.

Wednesday, October 6, 2010

Visionary Award Winner in September - 5 South

Congratulations to Jeff, Jenn and their 5 South tea, , our Visionary Award Winner for September. They realized substantial growth over last year and provided exceptional care to our patients.

Accidental Success Stories

This past weekend, my family was sitting at the dinner table. My daughter took out her gum and put it on a spoon so she could chew on it after dinner. Our kids enjoy gum and we limit to one pack per month so they maximize the lifetime of each piece to say the least. Anyway, I scooped the meal from the serving plate onto my dinner plate. After a few minutes, I went on and on about the great taste of the tofu and vegetables. Jenny, my wife, said it was similar to what she has done in the past. I then noticed a different texture and color and started to catch on to this new flavor. At the same time, my daughter said, "where's my gum". Yes, you guessed it, I accidentally mixed her chewed cinnamon gum with my tofu and vegetables. Tofu really does pick up the flavor of other foods!

As I get around the hospital, I love to see all the care takes place. We are constantly talking about new, different of just more effective ways of doing things. Several years ago, I was working at another hospital and our Nursing Director for the Short Stay Unit left with very little notice period. At the time, she spent a majority of her day staffing this area. I was very concerned as I had was not familiar with all the details on how she did staffing so I met with the staff to see how we could help each other to get through this transition while still meeting our goals. They asked if I could meet with them every other week to keep them posted on organizational updates, key focus areas, and overall goals. Then they took it from there. They staffed each shift within the resources they had, they ensured we were in compliance, they grew the service by fostering and developing key relationships and they made sure the care was superb. When the new Director started, the staff asked to keep doing these things so the new Director had an opportunity to focus on different priorities and our organization was able to perform even better than we had in the past.

Remember the Post-it® notes history (see Most people use them. Most people love them. But Post-it® Notes were not a planned product. No one got the idea and then stayed up nights to invent it. A man named Spencer Silver was working in the 3M research laboratories in 1970 trying to find a strong adhesive. Silver developed a new adhesive, but it was even weaker than what 3M already manufactured. It stuck to objects, but could easily be lifted off. It was super weak instead of super strong. No one knew what to do with the stuff, but Silver didn't discard it. Then one Sunday four years later, another 3M scientist named Arthur Fry was singing in the church's choir. He used markers to keep his place in the hymnal, but they kept falling out of the book. Remembering Silver's adhesive, Fry used some to coat his markers. With the weak adhesive, the markers stayed in place, yet lifted off without damaging the pages. 3M began distributing Post-it ® Notes nationwide in 1980 -- ten years after Silver developed the super weak adhesive.

Sometimes we find out better and different ways of doing things "by accident". I look forward to hearing about your accidental success stories.

Taking Back My Profession

Two weeks ago, I was in Nashville attending Healthcare Performance Improvement’s annual Safety Summit. Physician, Nursing and Administrative leaders from across the country attend. It provided such a great perspective on improving the safety of our nation’s healthcare organizations. Dr. Antonio S. from Milwaukee shared with me his story. He is a practicing surgeon with ‘no title’ as he put it. However, he had a passion for safety and these summits along with the network of people he meets revitalize him and keep his passion for safety alive. He indicated the difficulty in keeping that energy he goes back into the day to day grind. He spoke about his desire to "take back his medical profession and not lose sight of why he entered into the field."

With Healthcare Reform on many of our minds, I am trying to get a sense of what other health systems are doing as we explore our own strategies. One large health system indicated their focus on Reform with a few "simple" focus areas: Manage supplies and labor expenses, incorporate LEAN processes throughout their organization, grow key services and always, always provide exceptional care. Another reminder on why we all entered into the field.

Today, I was reading some information on and came across the following that made me think about the examples above:

In 1979, M*A*S*H star and actor, Alan Alda, provided the commencement address to Columbia University College of Physicians and Surgeons’ graduating class. He was the first non-physician to provide this address.

"It’s certainly true that I’m not a doctor. I have a long list of non-qualifications. In the first place I’m not a great fan of blood. I don’t mind people’s having it, I just don’t enjoy seeing them wear it. I have yet to see a real operation because the mere smell of a hospital reminds me of a previous appointment. And my knowledge of anatomy resides in the clear understanding that the hip bone is connected to the leg bone. I am not a doctor. But you have asked me, and all in all, I think you made a wonderful choice."

Freedom Award Nominee

Myself and Tom Krahenbuhl, Area Chair, Missouri Committee, Employer Support of the Guard and Reserve

Last week SJMC received a plaque from the National Committee for Employer Support of the Guard and the Reserve. It recognized St. Joseph Medical Center as a 2010 Secretary of Defense Employer Support Freedom Award nominee, in recognition of exemplary support of employees in the National Guard and Reserve.

Smokin' Elvises

Check out the Smokin' Elvises at the American Royal. We are all here in support giving "The Claw" at the Kansas City American Royal. That's our fearless Regional Director of Emergency Services, Andrew B. (dressed in white - the middle Elvis).

Thank you Smokin' have one mean pulled pork!

Wednesday, September 29, 2010

LEAN Updates

Today, we had our first report outs from the 5 LEAN Six Sigma projects. I want to thank all the teams who pulled together to lead and develop these projects. Each one was driven by improving our quality (e.g., coordination of care, clinical outcomes, regulatory compliance, access to care, patient throughput, use of resources). This focus on quality creates more associate and physician engagement and participation. From there the improvement in financials will naturally happen but it starts with the drive to improve quality.

I enjoyed the dialogue on how hitting 97% would only get us to 2.6 sigma...and our goal is 6 sigma....97% is not good enough. These process changes are a true journey and need focus and discipline to stay on course and not get 'project creep', where you allow the project to get bigger and broader. The discipline to 'table' potential other projects is very important. This discipline and focus is one more way we will continue to build on a culture of safety and improvement.

I look forward to sharing the initial outcomes over the next few months.

Please share your Lean Six Sigma projects or process improvements you have made in your organization.

Monday, September 20, 2010

Root Cause Analysis - Workplace and Ironman Triathlons

Last Sunday, I had the opportunity to race in my first Ironman triathlon-technically 1/2 Ironman consisting of 1.2 mile swim (approximately 80 lengths of a 25 meter pool though you swim in a lake), followed by a 56 mile bike and 13.1 mile run. Essentially it is almost a full workday from arrival to race completion.

My blog tagline references training for life and I have spoken about many similarities to health & wellness and our workplaces. Both involve continual assessment and advancement. The vision for both are rooted in a journey and a constant pursuit of excellence related to your goals. So you work diligently, celebrate milestones, assess ways to improve and have fun and good humor along the journey.

At our hospital, we are committed to providing the safest hospital for everyone we serve. We have daily safety huddles where we review any potential safety concerns brought forward by our associates and physicians who are closest to the bedside. Through these efforts, we dig in and complete root causes on concerning trends or events. It allows us to not only learn from it but also re-evaluate and possibly change our processes for better outcomes.

So, I thought I would complete a deep dive on my performance last Sunday...
My goal was under 6 hours and my actual was 6:11. I started the swim and swallowed a lot of lake water-felt like stopping within first minute. Then was grabbed and slapped around by my fellow triathletes so I moved to the far outside and probably swam closer to 2 miles than 1.2! Then I fumbled around too long at the first transition though it was much more relaxing than the swim. The bike was in the Ozark mountains so I was either climbing hills or going too fast downhill. My legs were not made for biking hills. Then off to the run when it was 90 degrees. I stopped several times as my socks were soaked from dumping water over my head and getting sprayed by 2 guys with hoses (actually those
were more enjoyable moments). I finally stopped, dumped the socks and carried on to the finish. There is a lot that went well and many parts a comedy of errors. Certainly I will change some key things as it is all about training for life...and continuously improving along the way.

I look forward to hearing your stories in and outside of work when you apply the same deep dive review.

Congrats to all the race participants and thank you to the volunteers and Ryan Robinson, the Race Director, for keeping us safe.

And the race winners are...
Ironman 70.3 Branson
Branson, Missouri
September 19, 2010
S 1.2 mi. / B 56 mi. / R 13.1 mi.



1. Ben Hoffman (USA) 4:02:53
2. Tom Lowe (GBR) 4:05:38
3. Brian Fleischmann (USA) 4:08:25
4. Michael Lovato (USA) 4:11:04
5. James Cotter (USA) 4:14:36
6. Brent Poulsen (USA) 4:15:14
7. Gavin Anderson (USA) 4:21:40 * M30-34
8. TJ Tollakson (USA) 4:21:44
9. Jonathan Shearon (USA) 4:37:39 * M35-39
10. Scott Bredehoft (USA) 4:39:34 * M25-29


1. Kelly Williamson (USA) 4:25:47
2. Angela Naeth (CAN) 4:33:47
3. Pip Taylor (AUS) 4:41:57
4. Nina Kraft (GER) 4:42:41
5. Marisa Asplund (USA) 4:59:16
6. Tami Ritchie (USA) 5:02:30 *W25-29
7. Ali Rutledge (USA) 5:22:00 *F35-39
8. Betsy Mercer (USA) 5:22:52 *W30-34
9. Kari Fritchie (USA) 5:26:03 *W18-24
10. Jessica Imm (USA) 5:26:09 * W25-29

How you Feeling...In Your Shoes on 4 East

Last week I had another great In Your Shoes on 4E where I worked for Becky B. As always, it is eye opening for me. The amount of effort it takes with each patient encounter is really amazing. It is sometimes difficult to imagine until you are 'In the Shoes' of someone else.

Becky and the team provided great direction for me. They showed such a great team effort with each other among the nurses, PCAs and other support staff. Their handoffs at change of shift were like watching a well-orchestrated play or musical. After each patient handoff, the nurse leaving would find their next nurse partner and 'handoff' their next patient. Becky said the nurse leaving usually takes the lead to find the next nurse. I understand that this coordination of care is key in any healthcare system but it does not always play out that way.

Of course I once again found myself using the insulation gowns which are always very heat intensifying. I walked into one patent's room and asked how she was doing. She responded, 'how do you think I'm doing...terrible! That's why I am her in the hospital.' Then she immediately followed with, 'but I am comfortable, thank you for asking'. She gave me a huge grin and it made my day. Of course it should be obvious that people are not in the hospital because they want to be in a hospital. They are there to get the care and treatment they need. And that is why we are here.

I had dinner with some of our executive team members the other day. Bob F. said our physicians are great, our nurses are wonderful, we have a great support team at the hospital and pretty good facilities and equipment. But our patients, our staff, volunteers and our associates will see our greatest difference by the way we care for one another. That's what will always make us shine. And I saw that true focus on caring when I worked on 4 East. Thank you Becky, Angela and the 4East team. It was a great experience.

Thank you to those of you who would like me to do In Your Shoes with you. I have upcoming sessions with our PBX Operators, one of our surgeons (no, I will not be performing surgery) and our nurse navigators. I look forward to hearing your In Your Shoes stories. The experience will certainly give you a greater perspective.

Friday, September 17, 2010

Computer Cake Anyone

We have a new and improved Information Technology support group. Check out this computer...100% cake!

Thursday, September 16, 2010

Jayhawks in the House

Last night I had the opportunity to present to graduate students with The University Of Kansas. We discussed the challenges I face as CEO of SJMC.

It is interesting to reflect back on the many challenges faced over the past couple years and also a time to reflect on all the good... This morning, while driving into work 810 radio was discussing the Kansas City Chiefs game as they beat the San Diego Chargers. One of the comments brought up was the fact that the team is not perfect and has lots of things they could continue to build on this year and over the next few years. However, the city needs to 'allow ourselves to celebrate'. It is easy to beat up on all the bad or all the potential opportunities but we need to allow ourselves to celebrate the good. The same need to celebrate the good exists in all of our organizations along with the need to evaluate the ways to continually improve.

This brings me back to last night's presentation with the students. We have seen many changes st SJMC over the past few years and I am so proud to be a part of this organization and the great care we provide to those we serve. One of the students mentioned that she had worked at the hospital 5 years back and realized some of those similar challenges existed back then. SJMC has seen strong growth in our volumes and improvements in quality and satisfaction. Certainly cause for celebration.

The students asked great questions which certainly kept me on my toes. We discussed key skill sets needed for the healthcare field. I think the needs are critical thinking/analytics, process improvement, writing and relationships.

I am interested in hearing your recommended skill sets for our future and current leaders?

Sunday, September 12, 2010

I'm Sorry, I Forgot to Pay Attention - Information Overload

A few weeks ago, my daughter Sydney asked me to tell her a story from when I was a little kid. It was late and the story was less than 30 seconds. When I finished the story, she looked at me for a moment and said, 'Dad, could you repeat the story?...I'm sorry, I forgot to pay attention.' It just cracked me up because we have all been there.

It is so easy to go on information overload these days - between texts, emails, podcasts, standard reports, blogs, tweets, get my point. The question is determining what information to review and what decisions do you make with this information. What true value does it add?

Of course, in your personal life, there are some basics like looking at your gas tank gauge to determine if you need to fill up the tank, reviewing what is in the pantry or refrigerator to determine what food you need in the house, looking at the overflow of laundry to determine how many sets 'necessities' do you have before you run out and need to was a load.

Earlier today, I was speaking with a Chief Financial Officer, Chuck, who works with an outdoor retailer. He discussed how he focuses on the vital few in his business and only reviews key reports he will use to make decisions. Sure this seems basic but many people and business overload themselves with data they will not use to make decisions. There is certainly data that may need to be tracked for compliance or trend purposes. Even this information needs to be reviewed to make decisions even if not reviewed daily. Chuck said he reviews staff productivity per unit of service, lead time to get a product and back orders. These were 3 things valued by his employer and the customers he served. In one case he found, he could increase his lead time and his customers were still okay as long as they knew when to expect the item and that it would be there when he said it would arrive. This reduced his inventory and cost and he could pass on the savings to his company and his customers.

I enjoyed reading an article by Herb Meyer entitled, How to Analyze Information - which spelled out some focused ways to review and analyze information.

I look forward to hearing what information you review and how it adds value.

Sunday, September 5, 2010

Strange Today...The Expectation of Tomorrow

Happy Labor Day Weekend. I am in Milwaukee for a couple of days to surprise a friend for his birthday. I'll fill you in on the birthday weekend in a later blog entry.

With 2 weeks left until my first Half Ironman triathlon, I headed out this morning for my last brutal workout before the taper phase. I went out for a 15 mile run and 1.3 mile swim and it provided me some time to think about service (actually that is what popped into my head - one never knows what will come to mind during a long stretch of time). Along the route, I came across a golf course where my 'birthday' friend was playing. I saw the 'cart person' come around and stopped her. I asked her to relay a message to my friend when she saw him...within 15 minutes, I received a call from him that the message was received. I was very impressed that the message was provided so quickly. She was truly wired for service.

Then, I made a stop for some water at a restaurant and the people working there were so nice even though I technically wasn't buying anything. They treated me well knowing I may be back after the workout or another day for lunch - a potential future customer.

After the run, I went to swim and tried out a gym where I had a pass. Wow, there was essentially a full spread continental breakfast in the locker room. It was clear to me why people spent just as much time in the locker room as they did working out. Again, taking note that organizations are continuously elevating the bar to ensure customers stay loyal to them.

After the swim (and a bagel and coffee to go), I headed to Bayshore Mall. If you haven't been to Milwaukee recently, or ever, this is a totally new look than 5 years back. There were many shops and restaurants. I was really impressed with the Apple Store. I walked into the store a saw a huge crowd of people. Halfway into the store, I thought this was going to take too long so I almost turned around to leave. Just then, one of the sales people, asked me if he could help, found what I needed and went to ring me up. I asked if I had to wait in the long line at the front. He indicated they now could check me out from his 'office' located anywhere in the store. With his hand device, he scanned the product and my credit card and emailed my receipt within a couple of minutes. He said, 'what seems strange now, will be the expectation in the future.' He is right...think about the start of credit cards at the gas station pumps, the increased use of ATMs instead of walking into the bank, self check-out at the grocery stores...obviously, these are just a few basics but the world has changed what we expect from the time we thought 'this seems strange'.

This is how we will have to change how we do things in our healthcare system. Yes, things have evolved and technology has helped. However, we do still have a ways to go to ensure we provide the experience our patients, physicians and associates expect every time they are in the hospital. We also need to look at ways to make things more forward thinking and intuitive based on where we expect the next set of expectations.

I look forward to hearing the forward thinking changes your organizations are making towards those next set of expectations.

Wednesday, August 25, 2010

No Mighty Mouse in Here!

Phines, Antonio & Scott

Steve, Phines and Antonio

This week, I went 'In Your Shoes' on the Receiving Dock where I worked for Phines and Antonio. They were not shy to give me orders and put me right to work!

Shipment Arrives and the Match Game Begins:
The 2p shipment just arrived. Our task was to get the right products to the right department for our patients. Easy right? Absolutely not! First, we had to match the order with the boxes. Of course, the shipments did not arrive with each order on the same pallet. This added a lot of wasted time for us. I was certain that those sending the boxes were just playing games with us. Could you imagine looking for cereal at the grocery store only to find the different brands spread over 5 aisles. Phines was so good that he pointed to a box I was looking for without even seeing the label!

Don't Cut the Product:
Another interesting lesson was the need to start out cutting from the 'top' of the box as a beginner. There was a thin cardboard sheet (only placed at the top of the closed boxes) that protected the sterile products from being cut. Ideally, you would not cut the cardboard and could then advance your skills by flipping the box over and cutting from the 'bottom' of the box. This allowed you to empty the box more quickly without pulling up (and therefore, hurting your back). Needless to say, I was not able to move past this beginner stage as I cut into just about every cardboard protective sheet. I will steer away from a future career as a surgeon as well.

Safety First:
At one point, I picked up the boxes and Phines said, "Hey, no Mighty Mouse in here. Use the cart. We need everyone safe and back to work tomorrow."

Try out 'In Your Shoes':
It was another great 'In Your Shoes' Experience. I recommend everyone try it with another department to better appreciate other perspectives. My next stop is back on the nursing floors.

Thank you Steve F, Regional Manager, for your support and to my two bosses Phines and Antonio.

Let me know about any of your 'In Your Shoes' experiences.

Case Manager or Interior Decorator...Or Both

Now this is what I call true ownership! Take a look at what Laura, one of our Case Managers did with her office. In the immortal words of Paula Abdul (please tell me I did not just say that), 'she truly made it her own.'. Laura took 45 square feet (give or take - but not by much) and completely personalized it. This is roughly 1/2 the size of what you have in a physician's exam room. She wanted to make sure those antlers were shown. Thank you Laura.

Perhaps we have to do a contest where Laura redecorates your office!

I look forward to hearing from you.

Tuesday, August 24, 2010

Watch it Mr. Broken Crash Cart Man!

A few months back, we were challenged with a Crash Cart in one of the areas (it needed to be plugged in to an outlet). The issue was quickly resolved (no patient was impacted)....I'll be back to this reference...

This afternoon, we had a meaningful and lively discussion in our strategy and operations meeting. This is a meeting where our Directors, VPs and Managers from all areas discuss and address key strategic and operational priorities. We started with some overall updates and I shared a few stories about my recent 'In your shoes' experiences. Ben, our KU Intern then presented a process improvement opportunity in Surgery. He shared our current and ideal future state for Surgery turnover times. Turnover time is the time elapsed between one patient leaving the OR and the next patient entering.
From there, we started discussing our regulatory updates and the level of engagement and accountability among the leaders was amazing. The discussion centered around two focus areas and the need to bring to final resolution. All we needed to do was hold each other and ourselves accountable...200% accountability as we say.

They really challenged each other and brought a new level of "respectful tension" to the room - it was refreshing for everyone. Dr. W, our Chief Medical Information Officer, also spoke up providing his perspective as a surgeon.

What did we all agree at the end of the day? It is all about the safety of our patients and our consistency in delivering safe and coordinated care to our patients. We needed to remain true Unwavering Advocates for those we serve.

One final comment came when one Director turned to another and said he could probably go on her unit and point out some areas to improve. She turned to him in a kind and direct manner and said, "Watch it Mr. Broken Crash Cart Man...people in glass houses should not throw stones" (note: from crash cart reference at the start of this blog).

We all enjoyed a good laugh at the end and stayed committed to resolving the two issues we needed to address. A great job by the team.

I look forward to hearing from you.

Saturday, August 21, 2010

A Collaborative Evening with Competitors

Last night, I enjoyed dinner with Mike D., the head of the area's healthcare council, Damond and Kathy, two competitor hospital CEOs and their respective spouses.

Mike certainly has a wonderful way of getting competing hospital's together in a collaborative and non-confrontational manner. I participate in these dinners about once a year and always look forward to them. It gives the CEOs a chance to better know one another and frankly more of a comfort to explore ways to collaborate down the road. Damond is a BBQ aficionado and I can always count on him sending the, BullSheet, a BBQ magazine with upcoming competitions and ways to certify as a BBQ judge. Kathy and her husband enjoy cycling so it was fun to hear about some of their excursions.

One opportunity for collaboration is the focus on improving the health of our communities with each of us trying to serve as role models with our own healthy lifestyles (although last night with all the food and dessert, we were not quite the role models of health).

We did discuss how many times we just recruit physicians from one another and it does not add any additional physicians to our community as a whole. Recruiting more medical staff to our area is certainly another opportunity as we look to sustain and expand our medical community (especially as retirement accounts 'may' start to improve, we will see more retirements occur).

Certainly a good time getting together with competitors in a collaborative manner - Thank you Mike and Stephanie. We had a great time.

Any collaborations you could share in your communities?

Enjoy your weekend.

Thursday, August 19, 2010

Hey, Who's the New Guy?

I had a chance to work "In your shoes' with Vanessa, our Barista in Starbucks. That is not easy work though Vanessa makes it look easy. What I loved about this role is the chance to interact with many associates, volunteers, physicians and visitors. It gives the Barista a chance to help shape the day of so many people which in turn helps our patients and each other. To put things in perspective, we probably see almost as many people in our Starbucks as our Emergency Department sees in 24 hours - that's a lot of people.

When Vanessa went on break, Evan, our back-up Barista and Food Service Associate came over with Laura, our new Associate. She did not know I was the CEO and asked Evan why I was not given a 15 minute break with Vanessa. I let her know that 'Vanessa would not allow such a break for me.' I did see Laura later and we enjoyed a laugh about her concern for my well being- thank you Laura.
I had a chance to meet Marty who was visiting a family member. Marty knew Vanessa and asked, 'hey, who's the new guy?' She introduced us and let him know she was training me today. He asked how I was doing and she motioned 'so-so' with her hand. Later in the day I went up to visit Marty (I changed back into my suit and took off my hat). I re-introduced myself as the guy who served him his coffee today...he did not recall. I asked if he met the new Barista, Scott, and he said yes. He was certainly surprised when I told him that was me. We spoke for awhile and mid conversation he asked again if it was really me who served him coffee.
And for those of you who were particular with the piece(s) of cake or scone you wanted (you know who you are), that cracked me up as well.
Thank you all for your patience today with the new Barista guy.
Vanessa - you are a wonderful trainer and truly represent the spirit of our mission.
PS - Some coffee tips from's all about the caffe latte (coffee and steamed milk). From there, a 'Macch'iato can be remembered as 'marking' the cup with chocolate and caramel syrups. And the 'cap'puccino is all about 'capping' the coffee off with foam.
I look forward to hearing from you.

Wednesday, August 18, 2010

Associate of the Month - August

Congratulations to our Associate of the Month, Janille from Respiratory Therapist.

We had a great time today at our celebration of Janille.

Thursday, August 12, 2010

Getting Perspective

My grandmother-in-law ('grandmother') is living on a memory unit in a long term care center. One day the residents were going around the room sharing their favorite desserts. The lady before her stated her favorite deserts were Sundaes. My grandmother stated that her favorite were 'Mondays' and she proceeded to laugh...

We just returned from a family wedding and flew there/back. On the way back, my kids were reviewing the drink options - my daughter tried a cranberry juice...

A while back I discussed one of our executive retreats. We talked about 'understanding separate realities' and coming fom a place of 'curiosity vs. judgement' when trying to learn more about another person and what they are really thinking for feeling - their true motives. Well, in the cases above, the following took place:

The staff member on the memory unit shared with my mother in law that my grandmother indicated her favorite dessert was a Monday and that she was confused. My mother in law stated that this happened to be an ongoing joke my grandmother liked to share so actually she was showing some good signs of memory...

When I asked my daughter why she chose the cranberry juice, she stated that she did not know it was offered on planes until now. She actually took he time to explore all the various beverage choices. I can't remember the last time I did that and their were some different options now...

Basically, it was interesting to me that when more questions were asked or the situations were further explored, we found out another perspective.

In the workplace and in our own personal lives, it is very easy to get caught up in one perspective, especially when we may tend to believe that perspective as well. I would encourage everyone to get that extra perspective or two so you could truly validate what you think you are hearing or seeing. It is certainly not easy for me to remember this at all times but a great reminder when I get that extra perspective.

I look forward to hearing from you.

Tuesday, August 3, 2010

Clean Living

Last blog, I spoke about improving mind, body and spirit...

I saw a very good article in Kansas City's very cool magazine, 435 South.

Check it out. Very informative and truly provides some ways to make all our communities healthier.
Wellness Wisdom by Mitzi Dulan, RD, CSSD

Have you ever heard you should “eat clean” but didn’t really understand exactly what it meant? Simply put, clean eating is to eat food as close to nature as possible. It means you avoid artificial ingredients (colors, flavors, and sweeteners) and highly processed foods. By eating clean, you will improve your energy levels and get leaner. Here are my top tips for eating and living clean.

1. Drink ½ your body weight in water. Take your body weight in pounds and divide by two. This number is how many ounces of water you should be drinking each day. If you want to add a little flavor squeeze a lemon into your water.

2. Slow it down and savor. Eating should be an enjoyable part of life. Take your time to embrace the slow food movement by savoring the flavors of your meal while enjoying a good glass of wine. Most importantly, allow yourself time to relax and be fully present to spend time with your family and friends.

3. Eat healthy fats. Most people have heard that trans fats are the worst type of fats for your body and you should aim for a consumption of ZERO trans fats. You want to focus on eating more foods with omega-3 fats such as salmon, halibut and walnuts.

4. Avoid artificial ingredients in your foods. Aim to eat clean, real foods with simple ingredients that are easy to pronounce. The shorter the list the better. Reading an ingredient label shouldn’t feel like you are taking a chemistry test.

5. Pack it up. Make some meals like black bean soup or clean chili and pack it up for a clean lunch the following day. This helps you to eat clean and also save money.

6. Avoid the clean plate syndrome. Do you always clean your plate? If so, I’m giving you permission to leave food on your plate. In fact, I’m encouraging it! Unfortunately, you aren’t helping the starving children of the world by stuffing yourself at mealtime. Please stop eating when you feel satisfied; not full, stuffed or sick. This saves calories and helps you feel better.

7. Avoid drinking calories. Calories from soda, juice, and high calorie coffee drinks can sabotage your weight loss efforts and don’t satisfy your appetite. Did you know drinking an extra 150 calories a day can pack on an extra 15 pounds per year?

8. Eat a source of protein at every meal. Protein keeps you satisfied and helps prevent food cravings from sabotaging your diet. Aim to get at least 20 grams at breakfast and 30 grams at lunch and dinner.

9. Start lifting. I’m definitely an advocate of weight training and that is for all the ladies, too! Aim to do about 10-30 minutes of weight training three times per week. You can buy some inexpensive dumbbells at Wal-Mart or Target.

10. Avoid eating after dinner. This one is HUGE and has helped countless numbers of my clients to successfully lose weight. By avoiding these extra calories you will promote a weight loss. Which would you rather be doing while sleeping: burning fat or digesting a meal? If you want to burn fat then skip the after-dinner eating.

11. Get moving! Alternate jogging and walking with a goal of eventually building up to 30 minutes four to five days per week. Aim to sprint for 15 seconds and then walk for 45 seconds while gradually adding more minutes. (Always talk to your doctor first prior to starting an exercise program).

12. Out with the white, in with the whole grains. No more buying white pasta, white bread, white rice, etc. Instead, choose whole wheat pitas, whole wheat pasta, whole wheat bread, oatmeal, etc.

13. Record your food intake daily. Research shows that people who lose weight and maintain the weight loss are more likely to log their food intake. Food logging keeps them accountable. If you have an iPhone check out the Lose It application which allows you to log your food intake and track your weight loss.

14. Aim to eat at least one plant-based meal each day. We know that eating more plants is good for you. This will also save you money and is good for the environment. Just make sure even when you are eating plant-based that you still include foods like beans or quinoa.

15. Remove five highly processed foods from your diet. You want to eat fewer packaged and processed foods so write down five processed foods that you are throwing out of your refrigerator and pantry RIGHT NOW!

Thanks 435 South...

I look forward to hearing some other health & fitness tips you'd like to share.