"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.

Thursday, July 24, 2014

The Buy Local Challenge

I was asked last week to provide a blog to Fierce Healthcare on the Buy Local Challenge in which many members of the Maryland Hospitals for a Healthy Environment's are participating.  It was scheduled to run in their publication today.  My blog was as follows:

The Western Maryland Health System is a member of the Maryland Hospitals for a Healthy Environment (MD H2E) and has been since the inception of the organization in 2005.  MD H2E advances a culture of environmental health and sustainability in Maryland's health care community.  WMHS is one of twenty eight Maryland hospitals / health systems participating in MD H2E's latest initiative, Buy Local Challenge.  Simply put, we have agreed to support farms by serving / eating local during Buy Local Week, which is this week, July 19-27.  We have pledged through our Food and Nutrition Service at WMHS to serve at least one local food item each day during Buy Local Week.  Our staff understands the importance of providing the freshest produce whenever possible to our patients and employees while supporting our local farmers.  Such support expands our regional food system as well as our local economy.  

And it doesn't stop there.  At WMHS, we support our local farmers though a weekly on-site Farmers' Market throughout the summer and our Dietitians work cooperatively with our staff and visitors with menu ideas and recipes while promoting the Farmers' Market.  They also have an Exhibition Cooking Day around the items that are available at the Farmers' Market for that day.  I am so very much encouraged by the active participation of our staff in every aspect of the Buy Local Challenge.  They are engaged participants in the various activities as well as regular purchasers of the produce. We clearly recognize that by providing healthier food choices for our patients, visitors and staff that we are fulfilling our mission of "superior care for all we serve."

Tuesday, July 22, 2014

Community Garden

I was recently in a conversation with one of our employees who is engaged with the City of Cumberland in the creation of a community garden in one of our more economically depressed areas of Cumberland.  After telling her of my admiration for her initiative, I asked to her to please keep the health system in mind as she is furthering her plans with the City.  I want WMHS to take more of an active role in healthy eating throughout our region.  

One of our physicians said at a recent meeting that "it is too expensive for poor people to eat healthy" and he's right.  If you have the opportunity to visit some of our smaller grocery stores in our more depressed areas, the fresh produce leaves a great deal to be desired. And in the more "affluent" areas, the costs can be prohibitive, especially if you are on a very fixed income.  So the doctor is right and we need to do more.  

As a result, we will be reaching out to a variety of potential partners in order to bring fresh produce to those who cannot afford or have access to such items.  It may take a while to get the concept up and running, but rest assured, it will be brought to fruition.  I will keep you posted; and if you are interested in working with us, let me know.

Monday, July 21, 2014

Proud to be a Part of WMHS

I had the opportunity to use the services of WMHS over the last two weeks; and quite honestly, I was left both proud and extremely impressed by what I saw and experienced.  Clearly, I realize that I am the CEO and that I was treated differently and I was.  With that said, I had the opportunity to see the staff in action; and at times not being in my suit and tie and in eye glasses rather than contacts, I wasn't immediately recognized.  I was also able to observe staff from a distance and in some cases they didn't know that I was right around the corner.  

Whenever I reflect back on what I saw and heard, I am immediately reminded of our mission, our values and our service excellence standards.  As they say in tennis, game, set and match.  A clean sweep.  These folks were demonstrating our mission in every instance by providing superior care, not only to me but to those around me.  They were caring, compassionate, respectful, funny, thorough, well organized, straightforward and pretty much excellent in their delivery of my care and the care of others in every instance.  To see these folks care for patients who are in an extremely vulnerable state cared for in such a manner was so rewarding for me.   

We focus on being a values-driven organization and, for the most part, that is supported by our patient satisfaction scores, but to see it evolve in front of me was both heartwarming and reassuring.  These people were truly excellent in all that that did.  As for those areas that could be improved upon, they were process oriented or documents that needed to be revised.  I am certainly pleased with the outcomes from the services that I personally took part in; but overall, I am thrilled with the consistent fulfillment of our mission, values and service excellence standards on the part of our staff.

Wednesday, July 16, 2014


Why do so many have so much trouble with the name of our System?  What is so hard about Western Maryland Health System?  It's not Western Maryland Health Systems, there is only one WMHS.  It's not the Western Maryland Hospital Center, that is located in Hagerstown, Maryland.  It's not Western Maryland Health Center as we were called in a recent article in a Cecil County newspaper.  It shouldn't be that hard.  

When it was announced recently that Meritus in Hagerstown was assuming operating control and interim responsibility of the Western Maryland Hospital Center, I started getting emails and calls as to why was I, along with my leadership team, fired based on poor performance?  In fact, another Maryland CEO saw me at a meeting shortly after the announcement, gave me a hug and asked what happened?  Last he had heard was that there were many successes that WMHS was experiencing through value-based care delivery and then he is reading that I was fired.  I laughed and let him know that apparently, the leadership team at Western Maryland Hospital Center was terminated by the Secretary of Health and Mental Hygiene after a state survey. The CEO at Meritus was then asked to assume control for an interim period which they did.  The names are similar, but not the same.  

One reason why folks may have jumped to the conclusion that it was WMHS may have been because of our Alliance relationship with Meritus through Trivergent.  Quite frankly, many people didn't even know that the Western Maryland Hospital Center existed.  It is a state specialty hospital serving the brain injured or those requiring Dialysis, long term and skilled nursing care.  

I guess many of us have to deal with the name issue.  A few years ago, Allegany College of Maryland changed its name from Allegany Community College.  The College then started getting threatening letters from the leadership at Allegheny College in Pennsylvania and their attorneys.  They said that it was too confusing for perspective students when they searched for Allegheny College on the Internet.  Really?  I thought that Allegheny College recruited the best and the brightest (which they really do) and they don't know the difference between Maryland and Pennslyvania?  Anyway, that situation finally was resolved when ACM said that they would always emphasize "Maryland" in the name of the College.  

Sooner or later, folks will get it right; after all, Western Maryland Health System has only been around for 18 years or so.

Friday, July 11, 2014

Leaders for Tomorrow

Recently, I was asked what I thought would be the skills required to be a successful health care leader in the future.  My take was that these same skills can be applied today as well as tomorrow and they are as follows:

  • Embrace change
  • Be a visionary
  • Use common sense
  • Surround yourself with the best
  • Be flexible
  • Be willing to adapt easily
  • Be an effective communicator; most importantly, LISTEN
  • Use your early adopter physicians to your advantage as you work to build a value- based care delivery model
  • Encourage a learning environment by making sure that your staff understand what it is that you are doing and why you are doing it; you can't teach or communicate this enough
  • Be tech savvy
  • Lastly, and most importantly, act with integrity.

Thursday, July 10, 2014

It's Working....at least at WMHS and in Maryland

I just read that the Robert Wood Johnson Foundation is embarking on a monitoring project to determine as to whether or not the Affordable Care Act is working.  Well, look no further as it is definitely working in Cumberland.  Remember the NY Times article in August of 2013 on the TPR demonstration project at WMHS?  The article said that "this hard-scrapple of a city at the base of the Appalachians is an unlikely hotbed of health care innovation that (through the Western Maryland Health System) is carrying out an experiment that could leave a more profound imprint on health care than President Obama's reforms.  That's exactly what we have been doing and the results are as follows. We have successfully reduced inpatient admissions by 32% from 19,000 four years ago to 14,000 today; readmissions by 42% with emphasis on heart failure, COPD and diabetes; nursing home readmissions by 38%; ED use rates by 3%; ED admissions by 6% and ED visits by 20% by around 10,000 over the last few years from almost 60,000 to just under 50,000.  

Collectively through these efforts, we have saved over $1.5 million; that's caring for patients in a location other than the inpatient acute care setting.  We continue to build upon the success that we have experienced over the last several years.  All of our efforts have translated to a FY '14 year to date operating margin of almost 9% and a total margin of close to 12%.  The experiment continues to be an ongoing success at WMHS.

Tuesday, July 1, 2014

US Health Spending: It's More Than Just the Economy

According to the Commonwealth Fund, US health care spending has been declining since 2009 in a similar manner to other industrialized nations.  However, they attribute the decline to the economic downturn from 2008 and beyond, not the Affordable Care Act (ACA).  I disagree that the reduction is exclusively due to the decline in each economy.   

Two factors related to the ACA are greater control of health care spending by government and a dramatic decrease in labor costs in US hospitals due to less admissions, readmissions and ED visits.  Now, price increases for supplies and small equipment having been significantly reduced and major equipment suppliers having excess inventory so equipment is priced to sell are directly attributable to the economy.  So, both have played a part, but it is not exclusively the economy; just my two cents for what it's worth.  

Actually, I am surprised that the Commonwealth Fund didn't take the opportunity to promote the ACA as they have been doing since its passage.