Stay Informed

April 29th, 2013

The recent release of statistical information from four years of hospital data by the Department of Health and Human Services overlooks an important point about a portion of the Affordable Care Act (ACA). The expansion of healthcare coverage for Medicaid is not about hospitals but about the health of our community and state. The current question being debated in the Legislature is really about whether to cover approximately 250,000 people with available federal funds.

McLeod Health is in favor of accepting the federal dollars for three reasons:

• Primary care for people without access to that care will improve health, lower the cost of care and prevent hospitalization. Many of these patients will never need the hospital but would have access to primary care where their health issues could be managed.

• The positive economic impact is clearly documented in the study from the USC School of Business, Medicaid Expansion in SC Report.  According to USC Research Economist, Dr. Joseph Von Nessen, “If South Carolina opts into the ACA Medicaid expansion, the April 2012 Milliman study prepared for the South Carolina Department of Health and Human Services estimates that it would generate a total net increase in federal funding for the state of approximately $11.2 billion between 2014 and 2020 due to newly eligible enrollees. These increased federal dollars, which signify an inject of new procurement activity to the state that would not exist otherwise, represent an unambiguous benefit to South Carolina’s economy.”

• Other portions of ACA call for Medicare payment cuts, taxes, fines, fees, increased premiums due to new coverage requirements – all set to be implemented by federal law – whether or not South Carolina accepts the available federal funds and participates in the Medicaid expansion. The State of South Carolina should not reject the first three years of federally provided coverage.

It is important that everyone remain informed about the health care issues and challenges which face us all in the weeks and months ahead.

Thanks,
Rob

Sequestration

April 12th, 2013

You have been hearing this word in the news a great deal lately.

So….What is Sequestration?

It is a term used to describe the practice of using mandatory spending cuts in the federal budget. If the cost of running the government exceeds the revenue it brings in during the fiscal year, sequestration means automatic reductions to government support programs.

How will it affect us? It is a question I have been asked frequently by the team. On elevators, in the hallways, after meetings – how will the sequester affect McLeod?

As you know, the sequester began April 1st and includes a 2% decrease in payments for medical services rendered to Medicare patients. We must provide the nursing care, give the medicines, perform surgery, take x-rays … and receive 2% less than we received last year for the same services.

Why?

Because health care is very expensive and the current cost is not sustainable … because the government could not agree on how to control expenses in this recession and the sequester cuts were necessary … both answers help us to understand the “Why” question.

But then I am asked … which is probably the intent of the first question … “How much?”

From April to September, the answer is nearly $3,000,000 for services at McLeod Health. This is the breakdown by facilities:

For remainder of 2013:

McLeod Regional $2,080,097
Darlington $42,990
Dillon $136,146
Loris Seacoast $329,696
MPA $320,000

Summary 2013 $2,908,929

For 2014 – full year:

McLeod $3,212,222
Darlington $75,075
Dillon $230,425
Loris Seacoast $544,440
MPA $640,000

Summary 2014 $4,702,162

We must find a way to remove cost from the process of caring for patients. How do we help the patient receive the right care in a safe way at a lower cost is the question we must ask and answer. The health of our nation depends upon our answer.

Thanks for your service to others,
Rob

President’s Day

February 18th, 2013

On the third Monday of February we celebrate Washington’s Birthday as a federal holiday. George Washington’s Birthday is commonly referred to as Presidents’ Day. This recognition day honors all past presidents of the United States, although it was probably established as a reminder that our nation’s “forefathers”, Lincoln and Washington, celebrated birthdays in February.

So, in Washington D.C., the House and Senate are scheduled to be out of session this week for the President’s Day recess, time to be spent with their own families and professions. They plan to return on Monday the 25th. That means four days before the across-the-board “sequestration” cuts are scheduled to take effect.

We have been advised, that hospitals and health systems should be prepared for a two (2) percent cut in Medicare reimbursement (which will apply to all healthcare providers, including McLeod Health). This reduction in payment would be triggered by the sequester on March 1st.

As reported by the news media, there will be a ‘hue and cry’ that will follow the cuts. This is expected to bring both sides back to the negotiating table to try and work out spending cuts and tax increases.

One thing is for sure, health care reimbursement for medical services will be reduced. That means we will have to take appropriate care of the patient … provide the surgery, the medications, the therapy, hospitalization and treatments … but for less payment than we previously received.

Two percent does not sound like a great deal, but it comes on the heels of a 7% cut in Medicaid last year as well as another series of payment cuts as part of the new Affordable Care Act, now in effect nationwide.

While future reimbursements and the economic climate for health care providers remains a bit uncertain and causes us all to be uneasy, we must continue to remain steadfast in our commitment to be compassionate, innovative and resourceful. We must work together as colleagues in caring for our patients, providing the best in service and attention. In addition to meeting the needs of our patients, we must be stewards of our finances, people and programs, finding safe and effective ways to remove the waste and reduce our cost.

Thank you for your service to others.
Rob

Voices of Hope

January 2nd, 2013

In our communities and across the nation, we continue to adjust to an ever changing health care environment. Despite uncertainty, we can cling to one constant, patients and their families expect and deserve the very best in what medicine has to offer. Whether it is in healing the hurting, diminishing suffering or by providing hope through survivorship, the goal is the same – serving others with compassion and quality, rendering the most appropriate care available to those afflicted by illness or injury.

At McLeod Health, we strive daily to improve lives and outcomes. We are dedicated to the four values of Caring, Quality, People and upholding standards of Integrity. Pursuit of excellence is unwavering, as our teams of devoted professionals commit to best practices in the delivery of health care through superlatives in treatments and research, updating and enhancing our facilities for comfort and seeking to incorporate state of the art technology to conquer disease and restore wellness.

It is a privilege to serve the people of our 15 county region, in both South Carolina and North Carolina. Our five hospitals, McLeod Dillon, McLeod Darlington, McLeod Loris, McLeod Seacoast and McLeod Regional Medical Center in Florence, seek to be gateways for the best in medical care for more than a million residents. Each patient is important and unique. Together, we face the medical challenges, travel on the journey to better health, and celebrate the victories. Daily, we listen to the voices of hope. Please read our latest issue of McLeod Magazine as others generously share their stories, McLeod Magazine, Volume 27, Issue 3, 2012

Rob Colones
President,
McLeod Health

Voices of Hope:
Listen to these individuals share their personal or family experiences about compassionate and exceptional cancer care at McLeod.

Institutional Review Board [IRB]

November 13th, 2012

I had a chance to receive an update on our McLeod Institutional Review Board (IRB) last week. On November 8, Dr. Walter E. Connor, IRB Chairman, and Judy Bibbo, Vice President of Patient Services, provided the Medical and Educational Affairs Committee of the McLeod Health Board with an annual update and report on the McLeod Health Institutional Review Board.

During the meeting, they reviewed the responsibility of the Institutional Review Board – - to safeguard the rights and welfare of patients who participate in research studies at McLeod Health. The role of the IRB is to protect patients form physical, emotional and economic harm. Any healthcare organization that participates in research trials must have an IRB to review and monitor the trials.

Diversity of the IRB membership is also important in order to sufficiently evaluate the clinical study in terms of science, law, ethics and community attitudes. Membership cannot consist of entirely men or of women or entirely of members of one profession. In addition, there must be at least two members from non-scientific areas. One of those members must not be associated with the institution. Our McLeod Health board consists of 18 individuals who have supported our dedication to patient research and protection.

Over the years, the McLeod Health IRB has approved numerous types of clinical research, primarily in Cancer and Cardiac disease. This research has ranged from pharmaceuticals and devices to registries, databases, etc. Research has proven to be instrumental in not only providing an additional opportunity for a patient to be offered another avenue of care with a new treatment, but also in improving the performance and the long term safety and effectiveness of the research and devices. 

There are currently more than 140 total active clinical research trials at McLeod, with 29 new protocols opening in 2012. Oncology is one of the largest areas of research at McLeod. This year, the Cancer Research Department opened 11 new protocols in collaboration with the Southeast Cancer Control Consortium and MUSC Hollings Cancer Center. Currently, the department has 120 patients involved in cancer studies and a total of 25 protocols open that patients can be enrolled in. Areas of cancer clinical research currently available at McLeod include: Brain Cancer, Breast Cancer, Head & Neck Cancer, Leukemia, Pancreatic Cancer, Prostate Cancer, Sarcoma, Small or Non-Small Cell Lung Cancer and Smoking Cessation.

This research is part of our certification as a Comprehensive Community Hospital Cancer Program by the Commission on Cancer of the America College of Surgeons. This significantly differentiates the quality of our program from other cancer centers in our region.

Cardiology Services also has several studies currently open involving data registries, use of cardiac leads, pacemakers, and defibrillators or Cardiac Resynchronization Therapy (CRT) systems. 

Providing access to national and local research trials at McLeod allows patients to stay in their community and participate in research or studies that otherwise would only be available at nationally recognized institutions in other parts of the state or country.

We are pleased with the progress and development of our cancer treatment services. The McLeod Center for Cancer Treatment and Research supports our mission to improve the health and wellbeing of patients and their families. Join me in thanking these professionals for their work on behalf of others.

Rob

‘Capture the Value’

October 30th, 2012

Paul O'Neill, Sr.

A McLeod team of three people were invited to Pittsburgh, PA, last week for two days of education on quality and safety. Marie Segars, Donna Isgett and Rob Colones attended the session which encouraged hospitals “to achieve habitual excellence via one unifying focus, one value-based structure, and one performance system.”  We had the opportunity to meet with Paul O’Neill, Sr., former Treasury Secretary, Alcoa CEO and Pittsburgh Regional Healthcare Initiative Founder. Mr. O’Neill led Alcoa to become the safest workplace in the world. Alcoa operates in more than 40 countries at a lost workday injury rate that is more than 20 times lower than the average rate for American hospitals.

It was a great opportunity to learn directly from Paul O’Neill and his leadership at Alcoa from 1987 to 1999. To hear of his one essential focus on safety – no equivocation, inspired our team. To envision what it would be like for everyone in the organization, every day – in a quest for perfect care and perfect safety, for patients and staff alike. To seek the highest quality and safety, lowest cost, and shortest customer response time, without tradeoffs – the same approach used by the world leaders.

We also had the opportunity to learn from Dr. Richard Shannon, Chairman of the Department of Medicine, University of Pennsylvania Health System. Dr. Shannon’s pioneering work in patient safety has been featured in the Wall Street Journal and ABC’s “20/20″, and was recently the centerpiece for the PBS feature entitled “Remaking American Medicine.” During the two days, Dr. Shannon provided examples of focused work in quality and safety in health care organizations…reducing central line associated blood stream infections and a system level aim at why some patients experience readmissions.

The meeting was organized for member hospitals of the Healthcare Value Leaders Network. Helen Zak, President and COO of the Thedacare Center for Healthcare Value, also presented at the meeting. Helen shared her views on lean leadership. Formerly, COO of Lean Enterprise Institute, she worked with Jim Womack to spread lean principles throughout the world to a wide range of industries including automotive, capital equipment, healthcare, and high tech. Ms. Zak spoke on transforming health care by focusing on value for the patient. This includes continuous work in (1) care delivery redesign with a focus on the patient, (2) payment models that reward value, and (3) transparency of cost and quality data. 

The other hospitals present at the meeting included: Northeast Georgia Health System, New York City Health & Hospitals, Parkview Regional Medical Center (Indiana), St. Mary’s General Hospital (Ontario), HealthEast Care System (Minnesota), and Trinity (Iowa).

We are learning from others as we seek to ‘Capture the Value’ for patients and families.

Thanks,
Rob

Open House, Open Hearts

August 24th, 2012

An open house was held this week to unveil the new addition at the McLeod Hospice House. This event provided an opportunity for guests to view the new patient rooms at this special facility, located along the McLeod Medical Mile at 1203 East Cheves Street in Florence, South Carolina.

Since the opening of the 12-bed Hospice House in 2005, the reputation of McLeod Hospice for care and compassion; and the desire for families with loved ones who are critically ill to receive inpatient hospice care close to home has grown steadily, resulting in increased demand for patient rooms in the McLeod Hospice House.

Responding to the needs of the community, the McLeod Foundation launched an effort to raise funds to expand Hospice service and the facility. The two new wings of the McLeod Hospice House include 12 inpatient rooms, two family comfort areas, and additional office space. A new Meditation Garden has also been created adjacent to the additional patient rooms to offer patients and families an area of respite. The project has been totally funded through philanthropic support.

With care centered on the unique needs of the patient at the end of life, the environment of the McLeod Hospice House speaks to the comfort and spiritual needs of both the patient and the family. The McLeod Hospice House is currently the only inpatient hospice facility in the region. Without the McLeod Hospice House, families wishing to receive care in a similar setting would have to travel to Georgetown or Columbia. McLeod Hospice serves patients in Florence, Darlington, Dillon, Lee, Marion, Clarendon and Williamsburg counties.

At a reception Thursday evening, McLeod presenters acknowledged the work of an extraordinary staff of professionals, the vision of medical leadership and outstanding community support. Hospice Administrator Joan Pavy reflected on the mission of Hospice and extended her gratitude for the support that has made the vision of Hospice comfort and care a reality. Honoring the lives and love that encourage others was also underscored in remarks shared by Dale Locklair, Vice President of Procurement and Construction. I’d like to share his heart-felt comments as well.

Dale Locklair emphasizes love and hope as part of the McLeod Hospice House expansion ceremony.

We’ve gathered to dedicate a new 12-bed addition to the McLeod Hospice House. But in the truest sense, it is not the place that we can dedicate. Instead, we dedicated the spirit of Hospice and the care that is provided here, which can be appropriate at any point in an illness and can be provided at the same time as curative treatment.
The Song of Solomon records the reflections of the wisest man ever to serve as king of Israel. In the Song of Solomon 8:6 we read, “Love is as strong as death.”

Only 10 months into their marriage, during an otherwise calm Sunday drive to church, one July morning, a young Navy couple’s car was broadsided by an ambulance racing through an intersection. The driver of the car, R.L. Alford, sustained minor injuries, but his wife was thrown from the vehicle. Hilda suffered a massive head injury, leaving her a quadriplegic, legally blind, and unable to speak.

In September 2006, fifty years after the accident, the R.L. and Hilda Alford celebrated their golden wedding anniversary.

For these 50 years, R.L. communicated with his wife through little more than the nods of her head. Fifty years he pushed her wheelchair, or as he preferred, cradled his dear Hilda in his arms, carrying her wherever they went. Fifty years, he emptied her bed pan and cleaned up her bowel movements. And in her last years, R.L. fed Hilda through a tube, learning how to insert her catheters. Looking back at that time, R.L. humbly remarked, “Sure, it’s been rough in some ways. But it’s been rewarding.”

On Saturday, August 14, 2010, Hilda L. Alford, age 72, of Blountstown, Florida passed away. During their 50+ years of marriage Hilda birthed two children, a son and a daughter. Hilda and R.L. had two grandchildren.

“When R.L. was asked to repeat the vow ”for better or worse,” a neighbor said, “he heard it real loud. Medically, it’s a miracle Hilda is still alive. She’s alive because R.L. gave his life to her.” Hilda lived…Hilda experienced life because R.L. loved Hilda and gave his life to her!.That’s the spirit of Hospice. Stephen Covey said that, “To touch the soul of another human being is to walk on holy ground.”

Your generous gifts and support touch others. People live life to the fullest at McLeod Hospice, because others give selflessly of their money, their time and themselves. At times it is surely difficult and taxing to be a selfless giver. At times, it can be draining, but if he were speaking to us, I suspect R.L. would tell us, “it’s rough in some ways, but it is rewarding.”

Ralph Waldo Emerson, the American Essayist and poet, wrote,

“To laugh often and much;
To win the respect of intelligent people and the affection of children;
To earn the appreciation of honest critics and endure the betrayal of false friends;
To appreciate beauty, to find the best in others;
To leave the world a bit better, whether by a healthy child, a garden patch, or a redeemed social condition;
To know even one life has breathed easier because you have lived.
This is to have succeeded,”

Emerson was in a true sense referring to the men and women who serve others by providing hospice care.

“I wanted a perfect ending,” the late actress, Gilda Radner once said, “Now I’ve learned, the hard way, that some poems don’t rhyme, and some stories don’t have a clear beginning, middle and end. Life is about not knowing, having to change, taking the moment and making the best of it, without knowing what’s going to happen next.”

The doctors, nurses and caregivers at McLeod Hospice give selflessly each day so that. Our neighbors – like the man who lives three streets over, or…Our friends – like the dear woman who lived next door for years and who brought chicken soup and chocolate chip cookies when we were sick, or…The sweet, young woman who is suffering from a devastating illness and who with her husband of seven years and the two small children live just two houses down, or…Our dearest friend’s mother, and yes, Our own beloved family member can live their lives as fully as possible with comfort and quality of life.

McLeod Hospice is not here to hasten death or “help” someone die. Everyday, the caring people at McLeod Hospice focus on relieving the pain, symptoms and stress of a life-threatening illness and improving quality of life for our neighbors, our friends and family members.

Today let us dedicate this new addition with the commitment that it will always be used in the spirit which is McLeod – the spirit and commitment of service to others and to the men and women who have and who will give themselves as an affirmation of life, so that on those days when the poems don’t rhyme or there seems to be no clear beginning or middle or end, the patients we serve can live the remainder of their lives as fully as possible. Today, we affirm their work, and we honor their spirit because this is a noble and worthy calling, and because love is not just as strong as death, love is more powerful than death.

Thank you to all who make the work of Hospice a gift to others.
Rob

“Becoming a Better Person”

July 5th, 2012

The writer of the book of Hebrews reminds us to care for others ‘as though you feel their pain in your own bodies.’  This is a good reminder as we respond to our calling in health care for patients and families.  In the process of serving, we become better able to listen to needs of others and provide comfort.  One of the ways this happens is by listening to the voices of patients and families. Another is to try to work in one accord, with a spirit of encouragement and compassion, as we share the journey of living.

The following video clip is a six minute talk by Alanna Shaikh on understanding Alzheimer’s disease from a patient and family perspective.  I hope you are able to listen to the full six minutes and the part where she speaks about “Becoming a Better Person.”  She inspires us to add another dimension to our own humanity by gently nudging us to be kinder, more selfless advocates for those who may be suffering quietly or without the ability to tell us how they really feel.

*Note: TED (Technology, Entertainment and Design) is a clearinghouse offering free knowledge and information from inspiring thought leaders.  It provides a diversity of opinions and thoughts which can challenge our thinking and provide understanding.  This particular talk helps to understand this disease from a patient’s perspective.  It may have a broader application for you. It may also apply to us as a McLeod Health family working together on behalf of others.

Let me know what you think.

Thanks,
Rob

McLeod Magazine Echoes Choose Wisely Message

May 3rd, 2012

Look for this issue of McLeod Magazine coming soon.

It is an honor and privilege to once again present our McLeod Magazine to the community, as we share the stories of personal experiences and medical victories. McLeod Magazine, published for nearly three decades since 1985, continues to be one of the most valued instruments by which we communicate lifesaving treatments and medical care, inspired by the voices of our patients, families, physicians and staff. These accounts relate heroic journeys through physical, emotional and even spiritual challenges.

In this May issue, we recognize the efforts of our physicians and staff to provide exceptional quality care. These outstanding outcomes are achieved through the dedication to the mission and the values of McLeod Health. You will read how our health care teams have been honored by the state and the nation for our quality initiatives.

Our McLeod mission is to improve the health and well being of people living within South Carolina and eastern North Carolina by providing excellence in health care. The core values of McLeod include: the Value of Caring, the Value of the Person, the Value of Quality and the Value of Integrity.

Within this edition, our mission and values are reflected in “miracle children” who experienced the expertise and compassion of our McLeod Children’s Hospital team. Celebrate with our patients, both young and aging, who beat the odds by combining a tenacious will to survive, with new techniques and superlative experience and equipment.

We also welcome our new affiliation with McLeod Loris and McLeod Seacoast, joining our medical family to care for families in Horry County and beyond. We pay tribute to the legacy of visionaries who started the system and embrace a future of healthcare excellence, service and growth along our eastern coast.

Often we take our health for granted, and most hospitalizations, surgeries or lifesaving treatments come as a result of facing life’s unexpected interruptions.

At McLeod Health, we are grateful for the expertise and compassion of those who serve our patients and their families, and we appreciate the opportunity to participate on the paths to restoration and recovery with those who entrust us with their care.

Please connect with our McLeod Magazine, May Issue, 2012. If there’s not one in your mailbox in the next two weeks, then go to www.McLeodhealth.org and click on the link to McLeod Magazine.
http://www.mcleodhealth.org/Wellness/library.cfm

Thank you for Choosing Wisely. Thank you for making McLeod the Choice for Medical Excellence.

Thanks
Rob

Health Care Reform and Transformation

March 1st, 2012

On Wednesday, I participated in a ’spirited’ discussion about health care reform and the need for transformation.  We are planning for the future.  We are listening and learning.  We are creating a safe place from which to share different perspectives and ideas.  In a stubborn moment … suddenly these words … these paragraphs from author Paul Tripp flashed through my mind.

‘So, who’s schooling you? 

There is never a day that passes without you being taken to school in some way.  Life is really all about teaching and learning.  And there is a way in which neither teaching or learning stops from the first until the last day of your life.  So, perhaps one of the most important diagnostic questions that each of us should be asking is this,

“Do I approach life as a student?”

Willingness and openness are the essential characteristics of any good student.  Why, you may ask?  Because learning not only shows me what I didn’t know, but points out the places where what I thought I knew was, in fact, wrong.  I cannot tell you in my many years of teaching how many defensive students I have met.  “Defensive student” is an oxymoron, like “jumbo shrimp” or “low-fat butter.”  You can’t be defensive … and be a student.  You have to open up your heart.  You have to be willing to be told that you are wrong.  You have to submit yourself to someone who knows better and knows more.  Defending what you know will not lead to either further or corrected understanding.  Willingness to listen, consider, and change are in the heart of every good student.’

So, I am sure I will have a round two or three with my colleagues as we work together on the changes that are taking place in health care.  May we each have discernment, focus and determination on behalf of patients and families.  Discernment suggests we are serving with qualified teachers.  From Paul Tripp’s writing:

‘We … live in a world of many, many voices.  All of them are interpreting your world and all of them are vying for the allegiance of your heart.  And you have to remember that learning is a process not an event.  One truth opens the doorway to another truth.  One truth functions as an interpreter of a truth previously introduced, but now understood more fully.  Learning is a lifelong process and because it is, it requires perseverance.’

May we have perseverance on behalf of our patients to walk through these complex and difficult times as we strive to be The Choice for Medical Excellence.  May we be open and willing to learn from patients and families, other team members and be evidence-based in our approach.

Thanks,
Rob