The Healthcare Experience

Daily perspectives of a healthcare executive in pursuit of patient safety, the premier healthcare experience, an engaged & healthy workforce and life balance.

Join the Challenge: Enjoy a Thinner Wasteline and a Fatter Wallet

Join the Challenge:

Enjoy a Thinner Waistline and a Fatter Wallet

 

By Mike Jackson

 

Our Chamber of Commerce has teamed up with Lee Memorial Health System for the 2013 Health and Fitness Challenge.  I’ve signed up, and I hope you will, too.  I’m confident I’ll get my money’s worth, because being healthy has cut my medical expenses.

 

Ben Franklin said, “A penny saved is a penny earned.”  My grandmother said, “you are what you eat.”  My financial advisor says “You get what you measure.”  Doctors say that if we lose weight, we can be healthier.

 

I have found all of this to be true.  By eating differently and losing weight, I am healthier.  Hopefully I’ll live longer.  All my numbers point in that direction.  What surprised me is that I’m also saving money!

 

Until a year ago, like two-thirds of Americans, I was overweight.  In fact, I was an overachiever.  I was obese, along with the upper third of Americans.  My Body Mass Index (BMI) was 33.

 

My doctors told me that being overweight increased my risk for high blood pressure, stroke, high cholesterol, high triglycerides, type 2 diabetes, coronary artery disease, sleep apnea and gallstones.  They were right – my numbers got bigger, and so did my medical expenses, for drugs and lab tests and doctor visits.  And my insurance company was paying even more!

 

Between us, we were spending about the national average for extra health care because of obesity.  In a 2010 study, George Washington University said the annual extra expense was $2,646 for men and $4,879 for women.

 

I decided to lose weight because I could see that taking pills didn’t go anywhere positive.  I changed my diet radically: hardly any meat, lots of green veggies, healthy fats, healthy carbs; and “just enough” calories every day.  I continued my workout regime and moderate exercise.

 

My weight dropped from 228 to 168; my BMI from 33 to 24; my waist from 43 to 34; and my blood pressure from high to normal.  I was doing pretty well, but chose to participate in last year’s Fitness challenge.  At the beginning, my “body age” (one of the assessment tools) was seven years less than my actual age.  I made the changes recommended, and three months later my body age was even younger; a total of 11 years younger.  The Challenge paid off!

 

This is all pretty personal, but I share because I hope to motivate others to sign up for the Challenge and do what is recommended.  If you take it to heart, you’ll learn new healthy habits that can provide a lifetime of health and economic benefits for you and those you love.

 

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How Do you Role Model Deeper Meaning & Purpose?

This afternoon, I was meeting with a group of supervisors. We were discussing what was working and what could work better on their unit.  It is certainly easy to point issues towards  people who work for you and people in other departments.  I was impressed with this grup's self reflection, when I asked the following:

If someone works for you, how could they tell you find deeper meaning and purpose in your work?  When you start each day, do you think of how the day will end - will it be better off than when you arrived?  My sense is when people see you show how you find this deeper meaning and purpose, it may help them do the same.

I know we all know this but the action is not as easy to follow....don't forget to look yourself in the mirror first before addressing others. 

 

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40 Years Left Until Retirement

When I first started our in healthcare management I remember my boss handing me a project to update all the physician and medical center leases. What I did not realize was the number of different arrangements which exsited. It was my job to move everyone to one lease with the same rate.  Certainly should not be a novel concept but one that needed to pass higher regulatory scrutiny and fall within a fair maret rate (FMV).

So, i invited the physician leader of all 26 physician groups who were renting from us at the time.  My boss thought this was a huge rookie mistake and I would get eaten up in the meeting. He told me...it's "us vs. them." To this day, that very conversation frightenens me...the one with my boss, not the one with the physicians.  I smiled and shared with my boss, " I have 40 years left until retirement...I have no desire to fight for that long." Besides, I felt if I shared everyone would get one rate, no matter what their specialty or tenure, everyone would be happy.  Well, that was a rookie mistake!  However, after less than an hour discussion and explaining how we came up with the rate and the fact that everyone had the same rate based on FMV, 25 of 26 moved ahead with their lease.  One held out for a few weeks but signed after coming to grips it was a very fair rate for the community and they had a great office setting.  

My boss was shocked and pleased...so much that he assigned me to do operational efficiencies (process imporvements) on the same groups.  Of course, I had a few share since their rent went up, perhaps I could make it up in efficiency recommendations!

I realize from time to time, there are still some who have an "us vs. them" mindset.  Or as one physician shared with me, "it's not you we dislike, it's the position you stand for, we despise.  The fact is we are in this together to create an enhance our natonal healthcare system - that includes physicians, administrators, nurses, support staff, volunteers, community members...the list goes on.  In years to come, there could always be inherent conflict when more than one person enters the room. It's up to us to minimize the politics, enhance the respectful tension, conflict and dialogue towards a shared vision.

To this day, I still have a strong respect for the boss who handed over that challenging project and to the physicians who knew I was over my head in thay first meeting and treated me with respect as we worked through potential conflict towards an appropriate resolution.

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Burnt Toast

According to ChaCha!, Burnt Toast is used to refer to celebrities or public figures who were once the "toast of the town" but became has-beens!

Perhaps that reflects what happened today. I am embarrased to say that I actually burnt toast.    Yes, I do know how to make toast and usually get it right (I realize this is not considered a big accomplishment). I enjoy ezekiel bread which granted toasts pretty fast. Well, I started to talk to someone only to hear the overhead announcmenet...there was a fire alert in the same area.  While I was the first to arrive at the scene, I would like to thank all those who were there so quickly and prepared to put out the "burnt toast'.  There was not a fire but needless to say it was quite humbling.  Several have suggested I buy or bring in my own prepared lunch. Perhaps this is a sign I should be a raw foodist!

On a lighter note, I stepped out of my comfort zone and tried the balance of a 6a Yoga class. Thank you Mary Parker, our Instructor. She was helpful and encouraging as she realized my body was not made for that type of twisting.

Another interesting and balanced perspective of a health system executive!

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Cynical or Realistic

When I was younger I always thought I was optimistic. When I shared my perspective, sometimes my father, Steve, would jokingly state, "you are so cynical". I used to respond back..."cynical or realistic?" Even today I keep those optimistic and realistic viewpoints. Let's be clear of one thing...no matter what happens with the "fiscal cliff", there is not enough money to cover all the things we want to do or have to do. There are things we can influence in the short run such as eliminated non-valued activities in your home and work life. You can be more present and mindful in your conversations and interactions. No one will be upset if you stay present in your discussions with them! There are also the evolving and longer term activities we must address. Continue to embrace the need to eliminate processes through LEAN or other proven methods. Continue to push for improving chronic health and overall population health starting with yourself, your family, your workplace. Let others learn from these experiences and determine how we can share the success. This will take commitment from providers, payors and community members. Throughout the healthcare industry (healthcare organizations and supporting entities) are many optimists (and realists) who have the energy, knowledge, commitment and determination to work together towards a better care delivery system. We won't agree on everything. We have a realistic perspective of the massive challenges ahead and still remain optimistic. Together, will find common ground and move towards a shared vision. As the saying reflects, be part of the positive change or stay out of their way.
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Perspective from Portugal

This weekend Jenny and I met up with a friend of mine and his family. He is a healthcare executive in Portugal. Every couple years he gets to the US. He and his family love to explore our country. They love visiting. We did compare some perspectives and they shared their views on healthcare and the overall health of Americans. They were surprised to see such a large percentage of obesity. The restaurant meal portions were twice as much as they had in Portugal. My friend's wife shared that we have such great access to fresh fish yet we usually freeze it then thaw it out, fry it, add butter, too much salt, over season it and then eat it. She said they eat fresh fish with very little salt, minimal seasoning and just grilled. They also noticed the large ice cream containers for home freezers compared to their small, more individual sized servings. They shared concern some of the fast food and quick fix meal options were hitting Portugal. With younger people cooking less and going to these quick options, they could be heading towards the same obesity trends we have realized in the States. Their healthcare system is mainly paid through their socialized system. My friend felt our "legal bills, various insurance options, confusing billing systems, large fixed non-clinical support systems and inefficient processes led to a much higher healthcare cost. They know these are also major areas of focus for us. It's always good to compare notes across departments, other hospitals and other countries to see what we could learn and bring back to our respective systems.
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Favorite and Unfavorite Few

As we move into 2013, I will continue to push for a positive organizational culture. One enjoyed and appreciated by our patients and families but first and foremost respected and appreciated by their own colleagues. There is no doubt we have an impact - positive and negative on our colleagues who, in turn, impact the patient and family experience. Do you have a favorite few or just as importantly an unfavorite few? How would you describe each? Do you and your team acknowledge those favorite few and address the non-favorite who bring down the mood and frankly hurt the culture of your organization? Let's make 2013 our year to show our communities and our nation how we deliver a consistent, intentional and mindful approach to delivering healthy care to our patients and colleagues.
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It's Not Where You Start...it's where you finish!

It's not where you start..it's where you finish. That's a quote that Nancy Kashman, my mom, would state on a regular basis. I was speaking with Sydney, one of my daughters last week and found myself delivering the same message. I said that's a lesson passed down from Grandma Nancy. She then said "and now it's a lesson passed down by you!"

When I look at my personal and professional life, it is constantly in motion and that quote holds true. In the past, I've discussed my running partner and very close friend, Mark Fleischman.  We constantly push each other...one day I was the "dog chasing the rabbit" and another day he was the "rabbit being chased by the dog".  No matter what, we both wanted to do better and were able to do so through that constant push.  The "rabbit and dog" need each other to constantly push, encourage and support one another through positive change.

In healthcare, it's the same way, we have hospitals & healthcare systems, physicians, insurers, consultants, support companies, volunteers & auxilary members, community leaders, associations, etc. all trying to move towards their own vision and realizing more than ever that we need to find the commonalities and progress towards a shared vision.  We are each other's "dog and rabbit."

Many days, I think I could just spend the time forced on "what we can agree we could do together."  That way we stay in constant motion...moving in the right direction.

For those of us in the healthcare field, we all have a period of time before we get off the healthcare delivery side of our career.  We certainly want to make sure we make it a better healthcare delivery (and prevention) system than when we started.  We want to leave it a greater starting point for newcomers so they can do the same for the next generation.

As Nancy says, it's not where you start, it's where you finish.  It's been a great year for many and a tough year for others.  Look to the positives from 2013 and learn from the not so positive experiences.  Continue to build on this for 2014.

Enjoy your holidays.

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Common Bond

Nancy Ellis serves as one of our CNAs.  She was asked to provide the Pinning Ceremony Speech as she just completed the 2012 Edison Nursing Program.  This afternoon she discussed how we can raise the level of professionalism for CNAs and how we ensure they are respected and an equally contributing member of our care team.  I enjoyed and wanted to share Nancy's speech:

To all who have joined us here today, our class is deeply appreciative to our entire Edison nursing faculty here at Edison as well as our family and friends.  These last two and a half years have been filled with major ups and downs.  During this time we have relied heavily on each other and especially our family and friends. Only those who have been personally vested in our journey can fully comprehend the impact it has had on all of us.  We all realize we didn't travel this journey alone.  You all went through it with us and the success we feel today is your success as well.  We want to thank you from the bottom of our hearts for all of your sacrifices made to ensure we could be standing here today.

I talked about major ups and downs.  Some of you have come to realize that these are simple words yet mean so much.  One day we feel confident and ready to provide the best nurisng care available.  The next day we are looking in the mirror and scared to death that we are making the biggest mistake of our lives.  It is during these times we question our knowledge, confidence and our time and our families time vested in this endeavor.  It is also during these times that our instructors, friends, and family have had to suffer and help build us up.  Everyone standiing up here today has a deep passion for the care of others.  That common bond has held us together no matter how tough things have gotten.  It is an honor as I look at each one of them to stand here with them today and be in their presence and now our profession.  I would like to personally thank our class leader, Candi Mason, for keeping us on track with the who, what, where and whens of our program.

As mentioned, one day we are majorly up and the next day majorly down.  That is why when choosing our guest speaker for today we found it fitting to choose Dr. Susan Wells.  Dr. Wells has spent the majority of her nursing career in psychiatric nursing and has instructed most of us during our nursing career.  She has listened to many of our woes whether instructing us or not, during these two and a half years.

Thank you Nancy and congratulations!

 

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Attacked by Soap in an Interview

Several years back I was interviewing for Chief Operating Officer with Mercy Health Partners in Cincinnati. My first interview was with then system CEO and President, Tom Urban. I was told if things went well with Tom, then I had a shot at the job. If not, I should pack up for the day. Well, I wasn't exactly told it would mean pack it up for the day but you get my point. Anyway, right out of the gate, I met with Tom and the meeting seemed to go real well. Afterwards, I took a quick "pit stop" before my next interview. I went to wash my hands and who walks in? You guessed it...Tom. Well, it was a little awkward but we continued some light dialogue. I pressed down on the soap dispenser (this was pre auto-dispense days) and it had some soap stuck to it....and it ended up spraying all over my shirt! Still trying to keep my composure and hoping Tom would not see this, I quickly tried to clean up. He then looked over, told me to button my jacket, told me I looked fresh and ready for the rest of the day. He gave me a pat on the back (I know, not too many times that literally happens), told me to enjoy the rest of the day and that I'd do well the rest of the day. My experiences with Mercy Health Parters led to broader involvement in LEAN initiatives, additional physician and health system partnerships and a more formalized approach towards a health & wellness model in healthcare. Although it was quite a few years ago, this experience made a lasting impression and reminds me how much of a positive influence we can have on others. Thanks Tom.
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Determine Your Success or Failure

I'm highly inspired by people who push to be exceptional or the push to reach their own full potential. Just saw this old quote by Lou Holtz... "The answer to three questions will determine your success or failure. 1. Can people trust me to do my best? 2. Am I committed to the task in hand? 3. Do I care about other people and show it? If the answers to all three questions are yes, there is no way you can fail." -Lou Holtz
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Grey's Anatomy Doctor

Last night I shadowed with Dr. Encarnacion in our Emergency Department. The ER physicians asked if I'd join them one evening to check out our overall flow and operations. Certainly putting on scrubs instead of the usual work day suit does change the dynamics. While I have shadowed and done "in your shoes" for many years, each experience brings new perspective. It's great to gain a stronger understanding of the work and compassion of our team. It was very helpful to see our challenges in person as we focus our efforts on our emergency department's patient experience. It was easier to see through the eyes of the patients and providers. This ER is truly the front doors to our hospital. Nationally many hospitals have approximately 45-55% of their inpatients arriving through the ER. We average closer to 70-80% given the different demographics. It was especially rewarding to visit the same ER patients on the inpatient floor today (this time back in my suit!). Thanks to Duke Bamberger, last night's Supervisor, Dr. K. Encarnacion and the entire ER team for your exceptional care. PS- I also appreciate the patient who thought Dr. Encarnacion and our care team provided the best patient experience she has ever encountered. On a lighter note, she did ask if I was one of the Grey's Anatomy doctors. Hmmm...perhaps the new character, Dr. McShorty!
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Nemeses

In the past, I've spoken about the importance of having your nemeses. I don't mean this in a bad or evil way. You need that person or persons who push you to be your best and reach your full potential. Without them, you may not hit your peak.

When I was younger, I did not realize my brother Brian did this for me. When it came to meal time, especially involving pizza or potato skins (my prior unhealthier living), we would typically fight over the last or even first piece!  Once he left for school, I noticed I overate and felt lousy after many meals.  When he returned from school, I noticed the balance was back and my eating was back in balance.

This past week, we had our annual 5k Turkey Trot.  I had several people I knew were targeting me as their nemeses and I was doing the same.  In the end, most of  us probably did as well and better than expected. 

At work and non-work activities, do you have your positive nemeses? Do they know it and have they targeted you.  Enjoy the respectful tension and challenge with each other, fostering your full potential.

Turkey Trot 2013...be ready...you know who you are!

 

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Sumo Wrestling Towards a Healthy, Engaged Organization

What a weekend...from an amazing Cape Coral Chamber Leadership graduation ceremony (congratulations to the graduates and our very own Kim Mitchell) to our Cape Pride picnic hosted by our Fun Committee - included a BBQ (actually grilling) Sumo Wrestling, Survivor Challenges, Manager vs. Non-management volleyball, push-up contests and an unexpected balloon fight (with an "innocent" throw from Denise Sawyer and a bucket of water over my head thanks to Ben)...I know where to find you Ben. Healthcare and leadership have their challenges. Major challenges. It's days like today when I am re-inspired and remember why I got into this field. They help off set the more challenging days. Our team is engaged, supportive of each other and our shared vision. Spending that off-work time certainly strengthens the health of our organization. And yes, Wendy Piascik, our fearless nursing executive, did beat me in the Sumo challenge!
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Exceptional

It's easy to be good and certainly a challenge getting to great. While this term may get overused a times, I don't think we share enough stories. It's time to start sharing even more stories so we can all read and hear about the exceptional work of our respective teams. Let's hear your story and definition of "exceptional" in your department or organization.
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(Not) Running The New York Marathon

The New York Marathon has been on my wish list for years.  Last year I had to defer until this year so I was extremely energized to run the race.  The excitement was really about the true NYC Marathon experience, not just running 26.2 miles.

Over this past week, we've all had a chance to see the devastation through Jamaica, Bahamas and now the northeast in New York and New Jersey.

There was a lot of talk starting on whether the marathon would proceed.  Well, the marathon is a go.  From a runner's perspective, I appreciate the training and push both physically and mentally on your body (and thank you to all those who listened to me complain about my hamstring strain over the past few months).

As I spoke to family and friends in New York, New Jersey and even here at home (thank you Jenny, Nicole and Aunt Jude), it really seemed the marathon and the consuming resources was now becoming a distraction.  It no longer represented the very positive energy I was expecting when running my 1st New York Marathon.

My training motto comes from a friend Jennifer Ringel who claimed the importance of "Training for Life..." This is beyond the training for one event and creates a mindset that we are constantly training for the expected and unexpected things in life.

Wednesday evening I made the decision to defer the marathon once again until 2013.  Our lives are a constant balance with family, friends, work, hobbies, activites we like (and dislike) and unexpected events that are beyond our control or influence.

I'll continue my Training for Life mantra and encourage the same.  It helps bounce back from the obstacles we face.

I want to wish a speedy and safe recovery to the citizens of NY, NJ and all others impacted by Hurricane Sandy.

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Intention

We are 24 days into our new fiscal year. Our focus areas and measurements are probably similar to many organizations...safety, quality, patient experience, engagement and financial viability. All or at least a very high percentage of our organizations have good intentions. The compassion, respect and trust among and between staff, physicians, patients and families is key. We will Intentionally (different than just good intentions) provide an Optimal Healing Environment by focusing on health, wellness, healing and Connectivity. We are reconnecting with each other, our patients and community. Let's continue a strong dialogue, challenge each other to be better and bring out the best in one another.
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Encouraging Behaviors...Bags Don't Fly Free

This morning, I traveled by airline and was hit with the $25 baggage fee. I was told that Spirit Airlines is increasing their carry-on fees to $100. It really make me wonder, are the airlines encouraging us to take bags on, check them underneath, mail them ahead of the trip, not take any bags or not fly at all? It seems the pricing needs to be more transparent including the benefit we all will receive (company and customers), by following these encouraged behaviors. No doubt the healthcare industry has wrestled with a similar issue for years. We want to encourage people to better manage their own health before the vicious cycle of the "unhealthy" spiral takes off (e.g., increased medication costs, other health issues, rising hospital equipment and structural costs to accommodate these trends). We also want to encourage a coordinated effort in care across all providers. As a nation and healthcare industry, we will continue work through ways to better show prices and "pass on" the benefits of healthy lifestyle and coordinated care. Like the airline industry, how and what we pay will play a factor - not the only on, yet certainly a relevant one.
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College Fund

Do you ever wonder about the true influence you have on people. Seriously, there are days people just lose me in their message and I'm sure I'm guilty of the same. However, there are days when the message hits home. My daughter arrived home the other day and showed her piggy bank - actually it is a ceramic purse given to her several years ago. She added a note to it stating "College Money." While my wife and I speak to our kids about the importance of school and eventually college, many times it seems to go around their interest level. Well, my daughter spoke to us about a speaker at school who told the kids about college and potential costs. He clearly discussed college and medical school as my daughter let me know she was saving $300,000 for college and already had $1.52 towards it. While I'm sure she does not fully understand what it entails to save $300 let alone $300,000, I do appreciate her drive towards higher education. Who's inspired you lately? Who have you inspired? I'm sure more than you think.
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Mutual Trust

All too often, I hear people make statements regarding what is "owed to them" by their employer, family, friends, community, etc. I really sense the main issue is people not addressing what is really bothering them and expectations across the involved parties. Specific to your workplace, I'm interested in more dialogue regarding what we each bring to our workplace (e.g., the key value as it pertains to the organization's goals) and what you would like from your organization. For example, a physician may share the value of delivering care with specific clinical outcomes in a high quality, safe and cost effective way. From their practicing organization, they may request staff competencies/knowledge for key procedures, minimal downtime between patients and preferred access to a surgical schedule. Another example could include the employee who brings great value towards the organization's goals. They may be looking for full time hours even if it means working in multiple departments. The key here is the open communication to discuss what each party is looking for to meet their respective needs. This will continue to build trust and keep us all focused on delivering exceptional care to those we serve. If not addressed, there is ultimately an underlying tone of distrust which could unintentionally lead to negativity and unsafe practices. I look forward to hearing from you.
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