Celebrating Doctor's Day!

On Friday, we celebrated Doctor's Day with our medical staff in the Rudd Heart & Lung Conference Center. It is always a great occasion to be able to recognize our physicians for their dedication to their patients and support of our hospital's mission. Each year at this time I am reminded of the important role that our medical staff plays in helping to lead and grow our organization to continued new heights.

Over the past year we have taken on a number of new initiatives that have helped us to improve the quality, service, and efficiency of the care we deliver to our patients. Specifically, with the help of our medical staff leaders who took on the challenge of chairing our new service line committees that kicked off in 2009, we achieved significant improvement in each of our core measure "perfect-care" bundles*. This year, on Doctor's Day, we chose to recognize those physicians who achieved the highest level of achievement in quality and service.

This year's winners for Highest Patient Satisfaction at Jewish Hospital were :

• Outstanding Patient Satisfaction at the 99^th Percentile: Dr. Raymond Shea
• Outstanding Patient Satisfaction at the 99^th Percentile: Dr. Kelly McCants
• Outstanding Patient Satisfaction at the 92^nd Percentile: Dr. Brian Ganzel

And for Frazier Rehab:

• Outstanding Patient Satisfaction at the 99^th Percentile: Dr. Kenneth Mook
• Outstanding Patient Satisfaction at the 94^th Percentile: Dr. Douglas Stevens
• Outstanding Patient Satisfaction at the 92^nd Percentile: Dr. Louie Williams

Those physicians recognized for highest achievement of CMS Core Measures are:

• Perfect Care Bundle Results at the 96^th Percentile: Dr. Chandhiran Rangaswamy
• Perfect Care Bundle Results at the 95^th Percentile: Dr. Ibrahim Fahsah
• Perfect Care Bundle Results at the 94^th Percentile: Dr. Naresh Solankhi
• Perfect Care Bundle Results at the 94^th Percentile: Dr. Larry Leslie

I wish to congratulate all of these physicians for their outstanding outcomes in delivering the highest quality patient care and I thank our entire medical staff for their continued efforts at making Jewish Hospital and Frazier Rehab the best hospital in America!

*A note on the quality awards: The core measure bundle used for the physician quality award includes core measures within the AMI, Heart Failure and community-acquired Pneumonia core measure sets. The AMI-HF-PN bundle score is the percentage of patients meeting all core measure requirements relative to the specific measures for which they qualify within these sets. The denominator is the total number of patients that qualify for one or more measures within the AMI, HF and PN measure sets. The numerator is the number of core measure patients for which all core measure requirements were met. So, “perfect care” is defined relative to having followed the core measure evidence based practice protocols completely within each sub-set.

Celebrating Doctor's Day!

Health "Reform?" Not sure, but a step in the right direction

In the past week it has been hard not to notice all of the talk about the health "reform" legislation passed into law. As much as I prefer not to talk politics, many have asked me my thoughts on this reform legislation and its impact on healthcare as we know it. While I am by no means an expert on the 2,400 plus page bill and its 153 pages of changes, to sum it up simply, I would have to say its a step in the right direction.

Our current healthcare system is not sustainable for the long-term. There are over 47 million American's who are uninsured and with rising costs of labor, technology, pharmaceuticals, supplies and insurance premiums, healthcare will bankrupt our country if we don't do something about it. The New York Times reported that if we did nothing to change healthcare, by 2020 a family health insurance premium would be $24,000 or roughly a quarter of what the average American family is expected to earn at that time. Clearly, this is not something that can be sustained, but it is also not an easy issue to fix.

Everything in healthcare is very intertwined which makes any effort at true reform very elusive. While it was tried, you cannot separate the insurance companies, hospitals, physicians, lawyers, technology and device manufacturers, pharmaceutical companies and expect to come up with a comprehensive solution that will address the out-of-control spending that exists within our current system. Nor can you ignore the entitlement mentality that we have as a nation and neglect to address issues related to beginning and end of life care, preventive care and wellness, rampant obesity and nutrition issues, and smoking and hope that healthcare utilization will decrease. Couple all of this with the fact that our government does not partake in strategic planning, but rather short term partisan politics that are tied to a four-year election cycle and it becomes very easy to understand why "reforming" healthcare is such a daunting effort. So while the legislation that was passed may not be "reform" in the truest sense it will likely spur the discussions that need to begin happening in order for real reform to ultimately take place.

While certainly a deeply contested issue between the parties, I believe that this legislation has done a number of positive things that will begin moving the conversation of health reform in the right direction. Conversations about topics including:

• By covering an additional 32 million people we are beginning to put in place a system to match the entitlement mentality that our nation has around healthcare being a fundamental right of all citizens.
  
• By increasing taxes and requiring all citizens to purchase insurance we are promoting the concept of personal responsibility and the realization that all entitlements do come with a cost that must be ultimately be paid for by someone.
  
• By creating a healthcare exchange and eliminating the ability to disqualify based upon pre-existing conditions and removing lifetime caps we are allowing insurance companies to prove they are a real partner in healthcare and not merely a profiteer from it.
• By reducing payments to hospitals we will find new ways to partner with physicians, suppliers and insurers in efforts to better coordinate the care we deliver in a more efficient and cost-conscious manner.
  

There are many other topics that will undoubtedly come from this passage of legislation that will have some perceived positives and negatives for all involved. For the people of America, I think we have done something that will positively benefit the welfare of our nation. For healthcare, I think that our time has come to show our innovation and adaptability to ensure that we continue to provide a high quality product at a more affordable price. This will require us all to work together in ways that have previously eluded us. As they say, nothing worth doing is easy, but we needed to get something done. I for one look forward to the challenge!

Health "Reform?" Not sure, but a step in the right direction

Mr. Smith Goes to Washington

For the past year that I have been writing, I have somehow managed to keep politics out of my conversations here, but as they say, all good things must eventually come to an end! Last week I had the opportunity to take a quick trip to Washington, D.C. to meet with members of our Kentucky delegation to discuss issues affecting our system and healthcare in general. While my trip may not have exactly been like the movie, it was certainly an interesting and thought provoking experience. After reflecting on the trip I was both fascinated and frustrated by my time at the Capitol.

On the one hand, to see the variety, pace, and sheer volume of issues that must be dealt with on any given day in any given legislators office is mind-boggling to say the least. Constantly shifting gears from issues ranging from education to labor to healthcare to energy to transportation to (you get the point) requires a level of study and preparation that no one person can possibly master in any significant way. Yet through the coordination of legislative aides, assistants, and directors our public officials manage to do a pretty good job of being knowledgeable not only about the issues, but also the pros/cons and political consequences of any decision that they must make or support. Specifically, I was impressed to see the level of understanding that our elected officials have about the activities taking place in our hospital ranging from our research efforts in spinal cord injury and composite tissue allotransplantation (hand transplants) to our local issues affecting patient volumes, insurance, and reimbursements just to name a few. We should be comforted by the fact that our legislators are very aware (in a positive way) of the excellent care we provide to the community and the reputation that we hold as we carry out our mission.

On the other hand, after spending some time in the Capitol and seeing the level of competing priorities, agendas, and partisan politics, you can't help but get a bit dismayed at how difficult it really is to get anything accomplished. I just happened to be in D.C. as Senator Jim Bunning was in the news for blocking legislation to increase federal spending by $10 billion. Nevermind the fact that the Senator was really not opposed to spending the money per se, all he was asking was that we be accountable and have a way to pay for the proposed new expenditures (just as we must be accountable in our business). The result is an avalanche of chaos and commotion as lobbyists, constituents, and the media all flood the office, phone lines and email boxes as they scramble to position their personal agendas and biases in order to put pressure in overturning the last vote needed to sway in their direction. After seeing that display, you can't help but wonder where our issues on healthcare stand and to what degree they evaluated on their merits versus simply how objectionable or valuable they might be to any single legislators portfolio that they must manage as they attempt to barter with their votes to make progress.

However, as one legislator said to us, it really isn't the people in Washington that are the problem, but rather the process and I think he was correct in his assessment. When you look at a problem as complex and controversial as healthcare, to expect meaningful reform to occur in a single session is highly unlikely if not impossible. The number of variables that must be addressed to achieve true transformation is simply to large to be accomplished at one time. In my opinion we need a deliberate process to address not only hospitals and insurance companies, but also physicians, pharmaceuticals and supply companies, technology, tort reform, education, and even our entitlement philosophy as a nation. Unfortunately though, our government does not partake in a true strategic planning process, but instead resorts to politics and reconciliation to try and make good on a worthy, yet overambitious campaign promise regardless of the fact that the "reform" now being discussed will no longer provide a solution to the real problems we face. There ought to be (and is) a smarter and more thoughtful approach to tackle something as important as the health and well being of our nation. Hopefully we will figure this out before our current healthcare system collapses and bankrupts the country.

(But in the words of Dennis Miller, one of my favorite comedians)...Of course that's just my opinion, I could be wrong.

Mr. Smith Goes to Washington