As discussed in the blog, Success or Failure: Healthcare Can Not NOT Change, healthcare is a business. And, considering the economic contribution they make throughout their region, it is big business. With each hospital closure that hits the media, it is not simply the services provided that is at issue, but the financial impact to the community as well.

Serving as a consultant at a very impressive $40M health system, I dove deep into the Community Health Needs Assessment and each component of the strategic plan. My initial task was to meet one-on-one with each member of the executive team and department heads – of course my daily rounds (LBWA) meant I was meeting front line staff throughout the day each day – before reporting back to the Board of the Directors at the end of the month.

Meeting with the CFO, she was gravely concerned with the system’s operating margins, which were the narrowest they had been in her entire 12-years. She provided me with benchmark data showing the continuous decline over the last several years.

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One can not, not change – especially in business. And, though not always a popular perspective, healthcare is not only a business, it is big business. With many rural communities, the local healthcare system is the primary economic driver. It may sound harsh, but in business, it has been said that we are either growing, adjusting or dying.

As an avid fitness enthusiast, I can personally attest that I must either work to improve, or I will lose the progress I have made - requiring almost constant re-assessment and modifications to my programs. Especially as I age. What I was able to do 10, much less 20 or 30 years ago will no longer render the same results today. Very much like rural health.

Change and growth can be intimidating. It requires making choices on probability weighted outcomes. There must be a willingness to make additional investments, or cutting budget of one area to expand another. And, perhaps the scariest issue is leaving the known (what has been done), to embrace the unknown.

With any business, we must continuously evaluate our market to make effective strategic adjustments. Our communities’ needs, demographics, reimbursement, regulations and staffing – the only constant within healthcare is change. Read Full Article.

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While talking with volunteers at the information desk, in walks the sweetest elderly couple. Both were in their mid to late 80s. The wife is using a cane with one hand and holding onto her husband for support with the other.

An early August day, outside temperatures were in the upper 90s. It was my first week working within a $40M health system as interim CEO and consultant. The facility offered a vast array of both general and specialized services. Without counting the licensed beds, one would never know it was not an urban health system, but rather a Critical Access Hospital.

As they approach, I greet them with a smile and ask if there’s anything I can do to help. The husband said they were here for some laboratory work.

The long walk from the parking lot during the heat of the day had clearly taken its toll on them both, but thankfully, the Laboratory/Radiology department was nearby. The lab tech quickly came out, offering the husband a seat in the hallway and taking the wife back into the offices for her blood work.

I looked around and noticed the “waiting area” consisted of a few hard-plastic chairs sitting in a major traffic area right off the main lobby.

Little did I know what awaited me, as I told the husband I would get him some ice water and be right back. That is when the adventure began … Read Full Article

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It was my first time back to a rural hospital. Though I had practically grown-up in rural health – both with frequent visits as a volunteer and as a support services employee – I had not been within the walls of a rural hospital in many years. And never had I been in one as a healthcare executive.

I arrived early, intending to look around and meet a few staff to better prepare me for a meeting with the Critical Access Hospital’s Board of Directors.

One of my first interactions was with a nurse coming out of a patient room. She was clearly emotional. Practically crying. I had seen the impact of caring for patients over the years. But this was not that. No, it was not simply a nurse and patient, but something much more. Even with my many years of experience, I didn’t yet know what I didn’t know – or regrettably, perhaps had forgotten. (Read Full Article)

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INTEGRATING SUPPORT SERVICES AND FAMILIES FOR PSYCHOSOCIAL CARE.

He is that family member we all know, regrettably often looked upon as bothersome, annoying or cantankerous. Throughout my career in home health, skilled nursing and acute care, these family members are at every level – anywhere that involves caring for vulnerable patients.

One doesn’t even have to be in patient care – simply working in healthcare means each of us will likely deal with these troublesome family members at one time or another.

I was still a teenager when I first encountered “the husband” as we came to know him. Little did I know that those few days with him would have an impact upon my entire future, and that of my very role as a healthcare leader.

Interacting with patients’ families while working both in dietary as a dishwasher/server and facilities as housekeeping/maintenance taught me the importance of both support services and family members within the patient care experience – beyond the medicine. Read Full Article

As healthcare (including acute care, nursing homes, home health and all downstream providers) moves towards a greater focus on patient/family satisfaction, the model of healthcare must also evolve, for both the government and patients/families will be closely reviewing these in determining healthcare provider(s) of choice. A satisfied patient is a more compliant patient, making for a more engaged patient. Providers at every level must now move beyond the patient centered approach, into an understanding of the patient/family perspective and be willing and able to convert input to action and measurable goals, benefiting staff, patients and families. Read Full Article

The landscape within rural communities was very different in 1977 than it was 20 years later when Congress created the Critical Access Hospital (CAH) designation through the Balanced Budget Act of 1997. The intent was to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities. In the 20+ years since, healthcare and the settings in which it is provided (and subsequent regulations) has continued to evolve.

Recently, there was H.R. 2957, Save Rural Hospitals Act. Creating a Community Outpatient Hospital (COH) designation. The focus would maintain the vital economic contribution the health system makes to the community, expand funding opportunities, along with telehealth and transportation for accessibility and improved quality of care. Read Full Article

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