Archive for July, 2009

Demonstrating the Service Excellence Standard of Personal Ownership

Thursday, July 30th, 2009

mcleodmedal.jpg

I was passing through the lobby of one of our buildings recently, and I noticed an employee assisting a woman as she helped her very weak mother out of her car, and into a wheelchair. The person helping was not one of our valet team, nor did it seem that she was involved in patient care. Rather, the employee was on her way to a meeting, and, rather than hurry out the door with her own agenda as her priority, she took the time to help one of our customers. What a surprise, when the patient’s daughter hugged that employee to thank her!

It may seem that helping someone get out of a car is not extraordinary, but when it is done cheerfully and with a willing attitude of service, it becomes an extraordinary demonstration of the McLeod Value of Integrity to that customer. In fact, here at McLeod Health, we have defined a standard of behavior that specifically addresses this kind of service; it’s called, “Personal Ownership.” Personal Ownership happens when we do what it takes to meet our customer’s need. It means that we never say, “That’s not my job.”

Yet another example of Service Excellence

Yet another example of Service Excellence

We are well on our way to introducing all of our ten Service Excellence Standards to our team, and Personal Ownership is just one of them. The Standards will provide very specific examples of behaviors that demonstrate our Values of Caring, Person, Quality and Integrity, and everyone is ‘cordially’ expected to act according to our Standards. 

As we introduce each of the ten standards this summer, we are asking our team to tell us stories of excellence that they see, as they observe their co-workers caring for our customers. Then in September, we will take some time to celebrate these stories, and to look together, at ways that our Service Excellence Standards can be exhibited by every one of us. Our people are learning, that when we apply Service Excellence Standards in how we do our work every day, our customers experience a consistent level of excellence across the entire organization.

Thanks,

Rob

Teamwork and Preparation Pay Off

Wednesday, July 29th, 2009

Three surveyors from the Joint Commission arrived at McLeod Medical Center Dillon for their tri-annual survey yesterday, at 7:30 a.m. on Tuesday morning. As many of you know and have experienced, this can be a highly stressful encounter. However, through dedicated teamwork and through survey readiness, the Dillon staff was prepared for the two-day survey. The accreditation cycle is every three years and the surveys are unannounced.

Dillon1

Debbie Locklair, Nancy Barnes, Joan Ervin, Linda Duncan, Cindy Causey and the entire Dillon team have been diligent in their efforts to support activities, education and improvement processes to help the hospital meet the highest standards of the Joint Commission.

I must say that when I walked through the hospital, there was a sense of pride and excitement.  People were full of energy and confidence.  While I was not a surveyor, members of the team would enthusiastically direct me to an area of their department and provide me an explanation of what they were working on for patients and improvements in care.

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I spoke with Dr. Wally Blum, Chief of the Medical Staff in Dillon, a member of the Community Board, and a general surgeon in Dillon.  He was at the nursing station encouraging the team as the survey was in progress. He was pleased with the review and provided excellent feedback to staff and the surveyors as well.

Dillon3

The team of people in Dillon who serve our patients deserve our recognition and special note of thanks. I also wanted to extend my appreciation to all of you for preparing for the standards and helping McLeod to be the Choice for Medical Excellence.

Rob

Opinion of the South Carolina Hospital Association MedPAC

Tuesday, July 28th, 2009

Here is an update from the South Carolina Hospital Association by Thornton Kirby (SCHA President).  Also attached is a letter with the SCHA’s opinion about the idea of a MedPAC with additional powers like the military’s commission on military base closings.  If you have any thoughts, please respond in the comments section.  I’d like to hear your ideas on this proposal.

July 28, 2009

Health Care Reform.The Senate has advised President Obama not to expect a bill before the August recess, and that means many Senators will get an earful from the folks back home before they cast a vote. Every day in this bizarre debate produces a new concept for reform, and ideas worthy of detailed study seem to receive no more than 24 hours in the sun before they are thrown out with the afternoon garbage. Last week’s big idea was the creation of a new executive branch agency similar to the Super MedPAC.  The concept—give the President the power to manage provider payments and make it very hard for Congress to intervene—scared many in our industry and provoked widespread criticism. SCHA heard your opposition to this new agency and delivered a letter to our delegation opposing it. A copy of the letter is attached. 

-South Carolina Hospital Association

SCHA Letter to Delegation

Healthcare Reform Outlook and Timeline

Friday, July 24th, 2009

As we read and listen to various news sources about the health plan proposals, you might begin to believe that everything will change immediately.  This is a complex process and the information below may provide some additional context.

According to Ricardo Alonso-Zaldivar, Associated Press writer in Washington, D.C, a timeline of the 1,000-page health care bill recently released by the House shows that it may take the better part of a decade, from 2010-2018,  to implement the components of the health plan proposals.

The timeline in the Associated Press report reflects the proposed expansion of government responsibilities. Here’s a look at the time line:

2010
The government sets up a Health Benefits Advisory Committee led by the surgeon general to recommend a basic benefits package. Community health centers serving low-income people get a funding boost. Insurance companies are barred from engaging in "rescissions" – the cancellation of existing policies. A campaign is launched to reduce health care paperwork. Doctors serving Medicare patients are spared a 20 percent cut in fees.

2011
The benefits committee unveils a recommended package for adoption by the Health and Human Services Department. HHS sets rules requiring insurance companies to spend a minimum percentage of premiums on medical costs. Medicare recipients get relief from the ‘doughnut hole’ coverage gap in their prescription benefits.
Tax hikes on upper-income earners take effect.

2012
In the presidential election year, low-income seniors get additional financial assistance with their Medicare prescription plans.

2013
The year of heavy lifting and major coverage changes. Insurance companies are barred from discriminating against people with health problems. The government opens the health insurance exchange – a new purchasing pool – to individuals and businesses with fewer than 10 workers. A government-sponsored plan is among the options available through the exchange, with premiums estimated 10 percent lower than private coverage. All plans in the exchange offer at least the basic benefits package. Individuals and families making up to four times the federal poverty level get subsidies to help pay for insurance. Individuals are required to get coverage – and employers to offer it – or face financial penalties. Businesses with payrolls under $250,000 are exempt from the mandate. Medicaid eligibility is expanded.

2014
The health insurance exchange is expanded to include companies with up to 20 employees and people who can’t afford premiums under their employer’s plan.

2015
The government decides whether to open the health insurance exchange – and the government-sponsored plan – to all employers.

2018
Employers who continue to provide coverage outside the exchange must offer at least the same basic benefits available through the government-regulated purchasing pool."

As I have related in our previous blogs on Healthcare reform, this issue is bound by great complexities. While we all agree that the provision of quality health care is essential, processes should be improved to reduce costs and eliminate waste in the industry, there is no easy, quick fix to many of these issues.  We must work toward solutions with a common goal of ensuring appropriate care for the people of our community.
We will continue to stay informed about the status of the government’s proposals for health care reform. I hope these communications are beneficial.

Thanks,
Rob

The Patient’s Voice About Service Excellence

Thursday, July 23rd, 2009

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I had the opportunity to read this note from a patient who responded to his great satisfaction with the care he received at  McLeod Health Dillon.  It is another chance to see the details from a patient’s perspective of what happens when a team of people pull together to deliver excellent medical service.  Expressed in the voice of the patient is the Value of Caring … demonstrating PROFESSIONALISM. The clear message here is that we should be fully present for our customers, displaying a positive image that shows respect for ourselves, for McLeod Health, and for the customer.

To Whom It May Concern:

I was admitted Friday morning and was pleasantly greeted and taken care of by Tanya McKenzie and Pat Kennedy.  These are the two nurses who took my information and prepared me for gall bladder surgery.

Unfortunately, I don’t remember the names of the two nurses who came to get me for surgery but would like to say thanks to them for taking good care of me and answering my questions and making me feel comfortable before going into surgery.

Everyone at Dillon McLeod in the West Wing went out of their way to see to my needs and made me feel very comfortable and even went out of their way to make my wife comfortable while I was in surgery.

The following are some of the nurses who took great care of me and I would like them to know their efforts are greatly appreciated.

Shannon Carter
Kelly Driggers
Lynne Livingston
Keshia Buckingham
Tammy King
Mary Quick, CNA
Tijuana Bethea
Thelma Bethea

Sincerely,
Patient

I want to recognize the team at Dillon and thank each one of you in the organization who displays the value of caring in your service to others.  Thanks for helping us continue to be the Choice for Medical Excellence.

Rob

McLeod Health Community Board

Tuesday, July 21st, 2009

Committed to Service

On Monday, I attended  the regularly scheduled meeting of the McLeod Regional Medical Center Community Board.  Comprised of 19 members, including 11 physicians, the Community Board serves the McLeod Health Board and is responsible for Quality, Safety, and Credentialing.  The members of the Community Board volunteer their time and energy to help guide McLeod. 

Please acknowledge their efforts on behalf of our organization by extending a thank you for their service if you know them or see them at work. The current members of the Community Board are:

John C. Pittard, MD, Chairman
Rob Colones, Vice Chairman
Marie Segars, Secretary

Walter Blum, MD, Chief of Staff for McLeod Dillon
Patrick Denton, MD
Thomas Dickinson, MD, Chief of Staff for McLeod Darlington
Fulton Ervin, Chief Financial Officer
Daniel Fox, MD
Beverly Hazelwood
Leanne Huminski, Chief Nursing Officer
Donna Isgett, Vice President of Clinical Effectiveness
Gregory Jones, MD, Chief of Staff for McLeod Regional Medical Center
Fred Krainin, MD
Dale Lusk, MD
John Ramsey
John Sonfield, MD
Alva Whitehead, MD
Isam Zakhour, MD
Benjamin Zeigler

The agenda for the Monday night meeting included: a review of recommendations by the McLeod Regional Medical Center medical staff on credentials for physicians (by Dr. Alva Whitehead), national recognition of McLeod by the Dave Ramsey organization for the Financial Peace Program (by Jeannette Glenn), a review of financial reports for nine months of this fiscal year (by Fulton Ervin), and a discussion about the impact of health care reform on patient care and programs (by Rob Colones).  The model we have shared with Congressional Representatives was reviewed and discussed.  Our Board had some interesting insight into how these changes should be modified in order to work better.  We will be incorporating these thoughts into our next round of discussion with our representatives. 

More information on McLeod Health Governance
The McLeod Health Board is a 19 member governing board that includes six physicians and members from six counties in our region.  Board members serve five-year terms and are eligible to serve three consecutive five-year terms.

The McLeod Health Community Board, is an advisory board selected by the McLeod Health Board.  More than 51% of the board members are physicians.  Board members serve three-year terms.

Mission Statement
The mission of McLeod Health is to improve the overall health and well being of people living within South Carolina and eastern North Carolina by providing excellence in healthcare.

Service Area
The primary service area has been defined as the six-county Pee Dee Region:
Florence, Darlington, Dillon, Marion, Marlboro and Chesterfield
The secondary service area includes the following counties: Clarendon, Georgetown, Horry, Lee, Sumter and Williamsburg.

Thanks! SFO Helps Preserve 35 Jobs!

Friday, July 17th, 2009

When we pull together we can reach our goals. It looks like will meet our third quarter (April, May, June) patient visits and SFO targets. I wanted to express my appreciation for all your help and hard work.

At the end of June, 97.8 percent of SFO days were taken (with 1,647 hours to go) by many members of the team! Others contributed with a variety of suggestions and ideas on ways to cut costs. Thanks to your dedication on SFO (Scheduled Furlough Off) we saved enough in salary dollars and expenses in the three months to save 35 jobs from layoffs.

In the worst national recession in 30 years, patient visit volumes dropped as patients limited or postponed medical care. As a team we needed to reduce expenses and match staffing to patient visits. Again, your cooperation, compassion and willingness to help during these challenging times has truly made a difference. It is a tribute to the character of our employees and the commitment to our values at McLeod.

While this was a sacrifice, it did help us protect job security and eliminate the need for reductions in our work force. I understand very well that many of our people live within tight budgets and have a great deal of financial commitments. However, this furlough translated into saving dozens of jobs and more than $2 million to offset budget shortfalls resulting from this difficult economic time. The furloughs were scheduled during a time when census is typically low. The link to a Letter to Employees this past spring about the Furlough is attached below.

In the last quarter of the year (July, August, September) we will continue to be vigilant over expenses and allow those who were unable to take all of their SFO to catch up so we can reach 100 percent of our goal.

I wanted to again take this opportunity to thank you for your part. As we face this national recession together, may we find encouragement in our service of others.

Thanks,

Rob

Click here to view furlough letter

United Way Campaign

Wednesday, July 15th, 2009

This year’s United Way campaign is well on its way. This week I thought I  would share with you the story that comes from the Senior Citizens Association, one of the agencies the United Way serves. We are asking you to consider continuing your gift, if you are a past donor; or consider providing a new gift, if you have not participated in the past.

According to the Senior Citizens Association,  an eighty-nine year old woman who resides in Florence lives alone.  Her mobility is limited due to severe arthritis.  She is receiving home delivered meals and assistance with light house keeping chores to aid her in retaining her independence.  She feels stronger and better because “I have a community that cares about me.”  She also feels that she has peace of mind in knowing that “I live in a community that is united and shows that they care.”

With your donation this year, you will receive a small token our appreciation from McLeod. But more importantly, you will impact lives in a very positive way through your act of generosity.

In  addition to our McLeod Foundation, McLeod Health has approved employee fund-raising efforts on behalf of five community organizations which are in keeping with our mission and values: United Way, American Heart Association Cancer Society Relay for Life, Juvenile Diabetes Association and March of Dines.

Thank you for all you do to support McLeod Health and the United Way campaign in progress.

See your Department Director for more information on how to donate to this year’s campaign. Below is a link to the United Way website as well.
www.LiveUnited.org

Thanks,
Rob

Our Visit with Congressman James E. Clyburn on HealthCare Reform

Wednesday, July 8th, 2009

On Monday afternoon, I went to Columbia to meet with Congressman James Clyburn to obtain his counsel about health reform.  The meeting was held in his offices at 1225 Lady Street.  Ms. Barvetta Singletary, Deputy Chief of Staff and Policy Director, also attended the meeting from his staff.

Donna Isgett,  McLeod Vice President for Clinical and Operational Effectiveness, joined me for the meeting.  Donna updated the Congressman and his staff on the results of our work in a national quality project,  Quest.  This national project categorizes and compares patient outcomes in three areas:
     (1)  Evidence-Based Care,
     (2)  Cost of Care,
     (3)  Expected Mortality

In all three categories, the results for patient’s at McLeod is better than or equal to the top performance threshold.  There are 165 hospitals participating in the national quality project.  Donna explained how Physician-led teams use data and evidence-based care to find solutions for improving care for patients, achieving these results.

We also discussed a model examining some of the reform measures that are currently being discussed in Congress.  The model was prepared by Fulton Ervin and JoAnne Allen (see blog on 7/2 ).  Specifically, we shared how changes in ‘Disproportionate Share’ or the offering of a ‘Public Plan’ might negatively affect McLeod based on the planning model we are using.  We asked Congressman Clyburn and his staff for advice about the assumptions in our model.

Congressman James E. Clyburn

Congressman James E. Clyburn

Congressman Clyburn was thoughtful in his responses and willingness to discuss our assumptions for the model.  He gave us some additional insight into what to look for between now and October 15, the date the President has asked for a plan from Congress.  We also briefly discussed employer mandates and readmissions.  We thanked Congressman Clyburn for his time and the information he shared with us.  We offered to be available with additional information on these or other issues.

Additional Background on Readmissions
As mentioned above, one of the proposals being considered for hospitals with higher-than-expected readmission is a reduction in their Medicare payments for each Medicare discharge.  Performance would be evaluated based upon the 30-day readmission measures for heart attack, heart failure and pneumonia.  Hospitals with actual readmission rates higher than their Medicare-calculated expected readmission rate would see a reduction in payment by having their Medicare payments multiplied by an adjustment factor that is the greater of: (1) a hospital-specific readmission adjustment factor based on the number of readmissions to the hospital in excess of the expected readmission rate; or, (2) a reduction of .99 in 2011, .98 in 2012, .97 in 2013 and .95 in 2014 and beyond.

After the meeting, we reviewed our data, and on a preliminary basis, it looks better than the state or nation.  However, we understand the overall health of our patients, the distance some live from the hospital – - and we would be concerned about a provision which reduces payment for readmissions.  I plan to write the Congressman about the experience of our medical staff in working on readmissions.  In general, we would be concerned about reducing payments to hospitals or physicians due readmissions as there may be many reasons the patient needed readmission. 

If you would like to discuss this issue, please respond in the comment section below.  If you would like to write your representative to voice your thoughts or ideas, please the contact information below.

The Honorable James E. Clyburn
United States House of Representatives
Washington, D. C. 20515

The Honorable John M. Spratt, Jr.
United States House of Representatives
Washington, D. C.  20515

The Honorable Lindsey Graham
United States Senate
Washington, D. C.  20510

The Honorable Jim DeMint
United States Senate
Washington, D. C.  20510

Service Excellence

Monday, July 6th, 2009

Thanks for serving others!

Recently,  we began an effort to remind one another of the need to have a consistent service focus across the entire organization through Daily Huddles and other communications.  Serving others is the nature of our work.  We want to improve our consistency in meeting those standards, demonstrating excellence to satisfy our patients.  Recently,  a team working together developed 10 Service Excellence Standards to explain in greater detail the 4 Core Values of McLeod.  These standards reinforce our mission.

I received a letter from a patient on July 2nd that I wanted to share with you.  It reflects her gratitude and joy for the exceptional care she received.  For the sake of confidentiality,  I will not provide her name.  She lives in the Pee Dee Region and mentions several members of the McLeod team who she wanted to commend.  Thank you again for making our patients and their family have a positive and caring experience.

Dear Mr. Colones,

I feel that God has richly blessed me with good health for 80 years. Twice recently I had to visit McLeod Regional Medical Center.  I feel compelled to share my positive experience with you.

In April,  I was in the Day Hospital.  Dr. Spurling and the staff were wonderful to me.  Each person was so professional and caring.

In May,  I was admitted to the McLeod for surgery.  Dr. Tatum and his staff assured me that I would be okay.  From the moment I was admitted,  the entire staff was positive and encouraging.

My nurses,  Ms. Pat Powell,  Ms. Lee Lance and Ms. Melissa Chestnut,  anticipated my every need. The entire staff had a big smile and a “What can I do for you?” attitude.  I must also say that Dot Johnson is so special and a definite asset to McLeod.

I was impressed with the quality of care I received.  McLeod is a health care provider that I am proud to have in Florence County. You have every reason to be proud of the service you provide to the community.

I am recovering nicely and am grateful for all of the wonderful people I met at McLeod.  In this sometimes impersonal world, it renews my faith in humanity to have such excellent and personal care.

You apparently set a good example and always expect the best.  I’m impressed!

Sincerely,

A McLeod Patient