"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Tuesday, November 24, 2015

Celebrating the True Meaning of Thanksgiving

On Thursday, we will celebrate Thanksgiving; a time to give thanks for all that we have.  There are many who are far less fortunate than most of us.  In an effort to ensure that residents in our area had a Thanksgiving meal, Our Lady of the Mountains Roman Catholic Parishes asked for sponsors to assist with feeding those in need.  WMHS and Pharmacare joined these area churches as sponsors in feeding over 1000 people last Saturday.  There were 128 volunteers from the churches, WMHS and Pharmacare preparing, serving and delivering meals.  Meals were delivered to senior living apartments, Archway Station and the Union Rescue Mission. The meal was also open to police, fire and rescue personnel.  The group then fed hundreds at St. Mary's Church.  Jo Wilson, VP of Operations at WMHS, had the lead from the health system and shared some stories from the event.  

Notes From Jo
The folks from Friends Aware came from the individual group houses. It was so wonderful to see these people with special needs so happy and joyful. What really made one's eyes tear up was the fact that a couple of these people work at WMHS. They were so proud to be singled out when they arrived by their WMHS coworkers and could show their house mates that they were part of such a loving group of health system volunteers. 

We also dropped off food to the senior apartments in the area. Hana and Melody (two of our very young dieticians) came back to tell us how incredible it was to bring food to the individuals living there. These two young girls were floating in their happiness.

From Gabriela, our Social Worker at FRNC, and her husband Ray I got this story.......
Just wanted to let you know that Ray and I had a great time delivering meals at Cumberland Meadows on Saturday and that all the residents that received meals were very appreciative. We met a sweet lady named Rita who insisted on taking us for a tour of her apartment. She told me that more people would have signed up for a meal had they known about it earlier. She's on the activity committee there and offered to put up fliers by the front and back door if someone gives them to her next year. Thank you for organizing a wonderful experience for all. We look forward to helping again next year.

Another thing that really was spectacular was the double line of volunteers who came in early to get things ready for delivery to the senior centers. We did 280 meals in 30 minutes!! All totaled, just under 500 meals were delivered. It was incredible team work and really speaks to Mary Jo and Tara’s organizational skills.  

Also, one of the things were the people who came to eat. One elderly man came in and picked up a dinner for him and his wife. He said it was the first time that they had shared a true Thanksgiving dinner in more years than he could remember.

Another was a young father and mother with a toddler, a baby and one on the way. It was heartbreaking to see how carefully they scraped every drop of the leftover food on their plates into carry out containers for what I am sure is another meal. I wanted to give them everything.

Finally, a gentleman at the very end of the night came in through the back. He was so embarrassed to get food for himself and several children. Barry, he looked so hungry, it was pitiful. So I put all the turkey, stuffing and potatoes we had left in the line together and the other staff packed up the corn, beans, bread, pumpkin pies and cookies. Hopefully, this gave them food for a few days.

Barry, I just know this was a very good thing to do. Every one of us who volunteered, cooked, delivered or whatever we did felt a sense of giving back and warmth…it was like we paid back all the good we are blessed with because we have so much.

Thank you for allowing this to happen and me to be part of this. Jo

Monday, November 23, 2015

Is the Juice Worth the Squeeze?

Last week, a group of us from WMHS had the opportunity to visit a health system out of state that is doing what they describe as some amazing things with process improvement.  They have been involved with applying the Toyota Production System (TPS) since 2002 at their facility.  To this day, they take teams of their people to Japan annually for two weeks to study the Kaizen method of continuous improvement to eliminate waste and inefficiency.

In 2012, WMHS ceased our Lean Six Sigma efforts, a similar approach to process improvement, since the philosophy never really got any traction system wide.  We had so many competing priorities with transitioning to the new hospital and changing our care delivery model from fee for service based on volume to a care delivery model based on value (TPR).  Some areas at WMHS continue to use the Lean Six Sigma process improvement approach, but it is not applied throughout the system.  

The reason for the visit is that we want to re-engage our approach to process improvement, but as it applies to improved quality and care delivery.  This particular health system has dedicated their existence to TPS and it has worked in ensuring greater efficiency and eliminating waste.  What it hasn't done is dramatically improved quality, patient safety or even the overall patient experience as one would expect.  For the commitment of time and resources, one would have anticipated a much greater direct impact on the patient.  

They claim to be much more efficient, but it wasn't obvious when you toured their hospital and saw their outcomes.  It was apparent to me that "the juice hasn't been worth the squeeze," if you will.  They have committed millions of dollars and considerable resources each year for the last 13 years, including human resources, to this effort and yet they appear to be just like any other hospital with above-average performance in those areas that truly count: quality, patient safety and patient satisfaction.  

Sure they stand out in some areas as do most of us, but we have not spent millions of dollars year after year in being above average.  Quite honestly, I was expecting stellar performance in HCAHPS, clinical performance, US News and World Report rankings, core measures, hand hygiene and the list goes on.  But it wasn't there.  In fairness, there were a number of approaches that our team found useful for application at WMHS, but the effort and the commitment just didn't seem worth it.  Our journey will continue and I will keep you posted through future blogs.

Wednesday, November 11, 2015

Mea Culpa on My Care Zones Blog of November 10

Yesterday's blog opened with recognizing Care Coordination for their creative work on the newly created Care Zones.  I knew when I wrote it that a whole lot of other people were involved with their creation and application.  I used Care Coordination as a place saver, but failed to go back and add the many others who were involved until my drive in this AM.  I confessed to my error at Triple Aim Coordinating Council this morning.  

However, I still needed to sincerely apologize to Pam Ackerman and her Home Care team, who started using the Care Zone concept in the care of their patients years ago, Helen Morris and Suzie Layton who converted the concept to patient education and so many others who were involved in bringing the Care Zones to fruition.  Again, great job everyone.  The Care Zones are going to have a profound impact on our patients and community.

Recognizing My Veteran

I have blogged in the past about my daughter Lauren, who was an active duty Naval Officer up until June 1, 2015.  After four years at the Naval Academy, Lauren graduated and was commissioned as a Surface Warfare Officer.  

She was first stationed in San Diego, California, where she was then deployed to the Middle East for seven months.  It was on her return trip to the US that her ship stopped in Hawaii and I was one of around 60 family members who got the privilege to spend eight days on her ship as it returned to its home port in San Diego.  What an experience; it was like take your dad to work for eight days.  

Lauren was then transferred to Little Creek, Virginia, and was again deployed to the Middle East.  She had to meet her ship off the coast of east Africa.  At 25, she had to fly alone from Norfolk to Detroit to Amsterdam to Kenya to Djibouti, Africa. After her 32-hour adventure half way around the world, she was picked up by hovercraft and brought to her new ship.  That deployment was for "only" four months, but for her shipmates, it was 11 months of being away from their families.  When her ship docked in Norfolk, there were close to 100 new fathers who were allowed to leave the ship first to greet the latest addition to their families.  The attached photo was from that deployment.  

Subsequent to her return, Lauren was part of a group of ships and Navy personnel that were dispatched to the NY / NJ area to provide relief after the devastation of hurricane Sandy.  They were thrilled to be lending critical assistance until they were told to "get the f*** out" by a union boss.  They were apparently taking jobs away from the unions so the NJ politicians caved and the Navy was sent packing.  Recovery continues in both NY and NJ from Hurricane Sandy; can you imagine the impact that our military could have had on the recovery effort if it wasn't for powerful unions and spineless politicians?  

Lauren then found herself at Fort Meade involved with cybersecurity.  She said that it sounded much more glamorous than it really was.  Working with civilian government employees and contractors was quite an experience to the point that when Lauren was leaving the Navy after attaining her MBA from Maryland's Smith School of Business, she chose to pursue a career in marketing rather than cybersecurity or defense contracting.

The bottom line is that this is Lauren's first Veteran's Day since leaving the Navy and I couldn't be more proud of what this young woman has accomplished over the last ten years.  She served her country with honor and distinction and has created in me an lasting appreciation for our service personnel and our veterans.  Having never served, I feel a personal void after experiencing military life with Lauren and living through the sacrifices that Lauren and those with whom she has served have made for me, her family and her country.

A joyous homecoming!

Tuesday, November 10, 2015

Care Zones

Our Care Coordination team came up with a very cool way to educate patients as to their disease state.  For COPD, CHF, renal failure, diabetes and pneumonia, patients now have a much easier way to gauge the status of their illness.  

I have attached a sample related to managing pneumonia.  For example, if you have easy breathing, no fever and no cough, you are in the Green Zone.  If you have thickening phlegm, increased coughing, wheezing, shortness of breath or slight fever, you are in the Yellow Zone and should call your doctor.  If you are really short of breath, your skin color is blue or gray, you have unrelieved chest pain or an increased heartbeat, you are in the Red Zone and should call 911 immediately.  

These Care Zones are a great education and reference tool to be used in our nursing homes, physician offices, clinics, our Center for Clinical Resources and Home Care.  Great job by our staff in always exploring creative ways to better educate our patients as to their varying conditions and trying to enhance awareness related to their specific illness.

Thursday, November 5, 2015

Driving While Intexticated / It's Still Against the Law

Yesterday, I was on my way home from the BWI Airport and was truly amazed at the number of drivers who were texting while driving.  I wouldn't be exaggerating to say that one in four drivers who passed me or whom I passed were texting while they were driving.

To test my theory, I looked it up today and, much to my surprise, the national average is 34% who say that they text and drive.  My favorite was a guy in a shiny black Chrysler 300 traveling at a very high rate of speed over 90 mph (I was going 75 to 80 miles an hour and he passed me like I was parked) and even he was texting.  They say that driving 55 mph is equivalent to driving the length of a football field without looking.  This guy was driving the equivalent of almost two football fields paying very little attention to the road and more attention to his phone.  

Those texting while driving came in all shapes and sizes, all different age groups, new cars and old cars; either it's a new phenomenon or I just never noticed.  I still can't believe it.  This is one law that is virtually being ignored in Maryland as it is pretty much elsewhere.  Texting is against the law in 39 states, but you would never know it.  During my last trip to South Carolina, I thought that texting while driving was not yet prohibited by law since EVERYONE was doing it.  

Talking on the their handheld phones while driving is permitted; but then again, only ten states like Maryland have banned talking on your cellphone while driving.  In SC, texting while driving is against the law and it is a primary offense.  But then again, it's a primary offense in Maryland as well, but you would never know it.  Be careful out there!

Thursday, October 29, 2015

Medical Marijuana

In today's Baltimore Sun, there is an opinion piece on medical marijuana by Shawn Hershberger, Executive Director of the Cumberland Economic Development Commission, and me.  I have blogged about my support of medical marijuana in the past and was asked if I would do an op/ed for the Sun as the decisions to award licenses are fast approaching.  I agreed.  So far, I have received positive responses to the letter, but it's still early.