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Posts Tagged ‘Healthcare reform’

PVHS priority: Patient welfare

Posted in Corporate accountability, Greeley Medical Clinic, Healthcare reform, Uncategorized, tagged , , , , , , , , , on August 1, 2011 | 2 Comments »

The president and chairman of the board of directors for North Colorado Medical Center, Inc., published a guest editorial in mid-July in northern Colorado newspapers saying Poudre Valley Health System plans to build a hospital in west Greeley.

I’d like to make sure community members have the correct information.

The fact is that PVHS has never even discussed the possibility of building a hospital in west Greeley or anywhere in Weld County. We agree with the chairman’s assertion that such duplication often serves only to increase healthcare costs.

However, I can’t believe that Banner Health System—the Phoenix-headquartered organization that manages NCMC and owns McKee Medical Center in Loveland—is overly concerned about duplication because it has announced plans to build a third hospital in Morgan County.

As the largest locally controlled provider of healthcare throughout northern Colorado, PVHS is committed to ensure that our internationally recognized patient-care services remain both accessible and affordable to you.

For that reason, we will continue to work with physicians you have grown to know and trust in Loveland, Fort Collins, Windsor, or at the Greeley Medical Clinic in Weld County to explore innovative ways to provide state-of-the-art care close to the homes of community members.

The PVHS goal is for regional neighbors in the healthcare profession to work collaboratively so collectively we focus on what’s right for patients and physicians. We will continue to work with regional and local providers wherever possible.

The road has been less smooth at times than we would like. Since formalizing our relationship with the Greeley Medical Clinic we’ve endeavored to use existing medical services in Weld County, even if those services were part of another health system.

Unfortunately, our options were limited a year ago when NCMC leadership elected to deny access to the hospital to specialists working with GMC. Regardless, GMC and PVHS are committed to finding every way possible to meet the medical needs of residents of Greeley, Windsor, and the rest of Weld County, as well as Larimer County and elsewhere in our region, with our outstanding clinical care.

Our joint plan for growth in Frederick with Longmont United Hospital and our recent management agreement with the hospital in Sidney, Neb., are two recent examples of collaboration to ensure local control to keep quality high and costs low. Additionally, our impending affiliation with University of Colorado Hospital will ensure the PVHS tradition of world-class quality continues side by side with UCH’s world-class research and education.

Inaccurate assumptions and conclusions as were displayed in the most recent guest editorial serve only to confuse community members and erode the reputations of PVHS; McKee Medical Center, Medical Center of the Rockies, Loveland; Poudre Valley Hospital, Fort Collins; and NCMC. If my actions in the past have contributed to this inaccuracy, I want to apologize for the confusion.

Northern Colorado residents are fortunate because we have excellent hospitals in PVH, MCR, NCMC, and McKee. Like MCR and PVH, NCMC is a Magnet hospital for nursing excellence, a distinction enjoyed by only a small percentage of U.S. hospitals.

We also have access to the foremost in new technology, such as the TrueBeam STx linear accelerator PVHS is now installing and will be treating cancer patients with in the very near future.

As PVHS works to enhance services offered by our two hospitals—MCR and PVH—we have opened new clinics and affiliated with existing ones to maximize quality while creating efficiencies to keep costs down.

Such efforts are crucial as we work to address national healthcare reform. Organizations must work together to be more efficient and undergo a fundamental shift from the current model of treating patients in hospitals to keeping patients healthy so they remain out of hospitals.

I hope all of us in the northern Colorado healthcare community will be better able to work collaboratively as we address the constantly changing healthcare environment.

I encourage you to stay in touch with PVHS by reading http://www.pvhs.org and my blog (visionary.pvhs.org). Please offer your thoughts on what we do well and where you think we can improve. With all of us working together, I am confident we will better meet your healthcare needs.

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The more you do, the better you get

Posted in Corporate accountability, Healthcare reform, Quality improvement, tagged , , on April 18, 2011 | 1 Comment »

In an article several years ago, the New England Journal of Medicine pointed out that quality outcomes in health care are directly related to the number of procedures done. So, as you might guess, a hospital which does 1,000 procedures has higher quality outcomes (generally) than a hospital which only does 100 of those same procedures per year.

Given that background, I thought you might find some recently published data from the Colorado Hospital Association meaningful. The CHA is an industry leader in gathering and publishing utilization data such as this. I predict that the industry will come to them in the near future to learn how to do this stuff.

Recently CHA published data (through third quarter 2010) about various volume rates at different Colorado hospitals. I thought you might find some of this information interesting. Here is a list of the three heart-related volume measures they published:

Heart Surgery:

HOSPITAL Number of Surgeries
EXEMPLA-ST. JOSEPHS 255
MEMORIAL-COLO SPRINGS 241
THE CHILDRENS HOSP 204
MED CTR OF THE ROCKIES 197
CENTURA-PENROSE HOSPITAL 190
UNIV OF COLO 173
CENTURA-ST. ANTHONY CEN 131
CENTURA-PORTER 127
ST. MARY-GRAND JUNCTION 114
MED CTR OF AURORA-SOUTH 106
PARKVIEW EPISCOPAL 101
SWEDISH MED CTR 97
EXEMPLA-LUTHERAN MED CTR 96
BOULDER COMMUNITY 84
NORTH COLO MED CTR 82
P/SL 68
SKY RIDGE MEDICAL CENTER 47
LONGMONT UNITED 37
ROSE MEDICAL CTR 22
TOTAL 2372

As you can see, Medical Center of the Rockies is the third-busiest heart surgery hospital for adult heart surgery in the state. That would explain a lot about why MCR outcomes are so good as well.

“Cardiac procedures: (Sometimes when a physician does a cardiac catheterization they just look around to see what they can find. These diagnostic procedures are most often done as an outpatient and include diagnostic catheterizations to look for blockage in a heart artery and heart valve and rhythm evaluations. Pacemaker battery changes are also done as an outpatient. Interventional procedures are more invasive and usually involve a hospital stay. This includes things like stents, new pacemaker, and internal defibrillators.)

The data listed below reflects the total number of cases performed in MCR’s Cardiac Cath Lab during the first nine months of 2010 at MCR.

The same method was used to pull comparative data from the Colorado Hospital Association database.”

HOSPITAL OP cases IP cases Total cases
MED CTR OF THE ROCKIES 956 814 1770
MEMORIAL-COLO SPRINGS 531 1196 1727
EXEMPLA-ST. JOSEPHS 763 674 1437
CENTURA-ST. ANTHONY CEN 816 496 1312
MED CTR OF AURORA-SOUTH 508 755 1263
SWEDISH MED CTR 578 474 1052
EXEMPLA-LUTHERAN MED CTR 542 483 1025

Because there are so many hospitals in the state which do interventions, I only listed those who had done more than a thousand interventions through the first nine months of 2010. As you can see, Medical Center of the Rockies has done more cardiac interventions than any other facility in the state, which speaks volumes (no pun intended) about the quality and the trust a patient can have in the facility.

Finally, I thought I would list the electrophysiology cases done at Colorado hospitals through nine months in 2010. Here is the list for 2010 (first nine months):

HOSPITAL OP cases IP cases Total cases
UNIV OF COLO 127 150 277
MED CTR OF AURORA-SOUTH 142 85 227
EXEMPLA-ST. JOSEPHS 130 45 175
MED CTR OF THE ROCKIES 95 66 161
SWEDISH MED CTR 128 24 152
CENTURA-ST. ANTHONY CEN 107 15 122
MEMORIAL-COLO SPRINGS 49 58 107
EXEMPLA-LUTHERAN MED CTR 59 17 76
CENTURA-PENROSE HOSPITAL 2 74 76
THE CHILDRENS HOSP 71 4 75
NORTH COLO MED CTR 35 25 60
ST. MARY-GRAND JUNCTION 41 12 53
DENVER HEALTH MED CTR 20 21 41
BOULDER COMMUNITY 1 21 22
P/SL 11 2 13
PARKVIEW EPISCOPAL 6 7 13
CENTURA-PORTER 4 8 12
CENTURA-ST. MARY CORWIN 0 3 3
ROSE MEDICAL CTR 2 0 2

As healthcare reform makes a bigger and bigger impact, these kinds of data will be more and more available. Programs which can’t do enough procedures to ensure quality and keep costs down will simply no longer be authorized. The prudent patient will make sure to go to the programs which have the most experience, and where it is right to expect they will get better outcomes.

Rulon

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Thank you for the conversation: Blog hits 100,000 views

Posted in Employee engagement, Healthcare reform, Patient satisfaction, Social Media, tagged , on January 10, 2011 | Leave a Comment »

This blog reached a milestone over the weekend that wouldn’t have been possible without you and the great conversation we’ve had over the last 10 months: 100,000 views.

When I started writing last March, my goal was to connect with the community and Poudre Valley Health System employees during a critical time in health care. I wanted to tell you what PVHS was doing in the face of healthcare reform to continue to deliver world-class care to our patients and community, as well as share stories about employees and people in the healthcare community who go above and beyond. Sometimes the conversations were easy and sometimes they were a bit more difficult, but the blog allowed a forum for diverse perspectives, and that benefits all of us.

Stay tuned in 2011, and thank you again for participating.

Rulon

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More PVHS Leadership Training

Posted in Greeley Medical Clinic, Healthcare reform, Malcolm Baldrige National Quality Award, Quality improvement, Uncategorized, tagged , , , on November 24, 2010 | Leave a Comment »

If you will remember, I was giving you a summary of some of the things that happened at our leadership training a few weeks ago.  That day was so productive!

PVHS Fall Leadership Training

 

In addition to the other outstanding speakers I have already pointed out in my blog, we were also fortunate enough to have Dr. Dan Zenk, the President of the Greeley Medical Clinic, come and talk to us about the recent changes in their practice.  Earlier this summer the GMC physicians made the decision to align with the Poudre Valley Medical Group, even though their main campus is literally across the street from North Colorado Medical Center in Greeley.

Dr. Zenk speaking at the PVHS Leadership Quarterly Meeting

Dr. Zenk, a former member of the North Colorado Medical Center Board of Directors,  talked about the history of GMC and what their goals have been for the 75 years that they have been in existence.  Their goals have been and continue to be focused totally on the patient and doing everything they can to provide the best possible care to the patients of Greeley and Northern Colorado.  In pursing this objective the physicians of GMC, the largest multi specialty group in the region, decided that the The Poudre Valley Health System had the best track record of working with physicians to meet the needs of the patients we serve.  He argued that healthcare reform is going to require partnerships like we have never had before, and picking the right partner was of paramount importance to their group.

 Now that they have made the choice to partner with PVHS he said that they are more convinced than ever that they have done the right thing.  PVMG physicians continue to use NCMC whenever they are allowed by NCMC to do so, and he pointed out that in an effort to promote cooperation in the region, PVHS recently added NCMC as one of its authorized providers for PVHS employees.  Dr. Zenk suggested that this type of collegial relationship between PVHS, PVMG, and other community employers and physicians in the region is what has distinguished PVHS as one of the premier health systems in the entire country.

He used this background to suggest to all of the leaders of PVHS that in an era of healthcare reform they never forget what has distinguished them in Colorado and the entire country.  It has been the PVHS commitment to putting the patient first and meeting the needs of the physicians with whom we work that has set PVHS apart from the rest.  Dr. Zenk outlined to the leadership group of PVHS that they were the ones charged with making sure this continued in the future.  In an era of healthcare reform, he suggested that we will have many outside pressures to reduce our commitment to quality, to our physicians, to our employees and to the community.  His counsel was for each leader to continue to lead by example in their respective units.  Focus on the right things, he said, and the right things will happen.  It was an inspirational talk by one of the Deans of healthcare in Weld County and Northern Colorado.

Thanks so much to Dr. Zenk for taking time to help explain the process and outcome of the recent GMC affiliation with PVMG.
Rulon

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Looming Medicare cuts

Posted in Uncategorized, tagged , , , on November 15, 2010 | Leave a Comment »

One of the ways that the healthcare legislation which passed last spring was able to demonstrate some cost savings was because potential cuts to the medicare program were delayed. In June, they were delayed again, until December. This time, Congress can either delay those cuts again or let them go through. That would certainly reduce access to Medicare beneficiaries.  It could be a tense time for all.

The best explanation was given in Modern Healthcare a few weeks ago, which includes this passage:

According to a report released by the Medical Group Management Association at its annual conference in New Orleans, more than 62% of medical practices will likely limit the number of new Medicare patients they accept if scheduled reimbursement cuts, totaling more than 30%, go into effect. Nearly half of practices said they will stop seeing new Medicare patients altogether.

Rulon

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PVHS in London: Trip nets valuable ideas for staff training, patient care

Posted in Healthcare reform, Patient safety, Quality improvement, Uncategorized, tagged , , , , , , , , , , , , , , , on September 24, 2010 | 1 Comment »

Today’s blog is written by Priscilla Nuwash, president of the PVHS Center for Performance Excellence, who is in London with Medical Center of the Rockies CEO George Hayes and Poudre Valley Hospital Chief Nursing Officer Craig Luzinski.

George Hayes, Craig Luzinski and I just finished our fourth day of visiting top hospitals in London.

We’ve met many people who are dedicated to providing high-quality patient care – a common purpose for all who choose healthcare for a profession. We traveled from UCLH by the underground to St George’s Healthcare Trust in south London, a 1,300-bed acute care hospital and the largest hospital in London. We spent Wednesday afternoon and Thursday morning there.

Founded in 1733, St George’s has trained physicians since its founding and today has a large medical teaching university as part of its campus. Like health systems in the U.S., UK hospitals are highly regulated, and performance measures are tracked and trended for external comparisons to other hospitals in the NHS and to identify areas for improvement.

While there we observed a simulation hospital in action where participants treat mannequins that respond to their care, including eyes that dilate, arteries that pulse, and chests that expand and contract. Through simulation, participants are able to learn how to diagnose and treat patients, but just as important, they learn how to communicate and work as a team.

We met the manager of the Patient Advice and Liaison Service (PALS), an access point for patients to receive information and resolve problems, as well as the department that is a catalyst for making improvement changes. All three hospitals we visited were beginning to use LEAN as an improvement methodology. The OR, called a Theatre, uses “Productive Theatre,” and the nursing units use “Productive Ward” which is similar to the U.S.’ Transforming Care at the Bedside initiative.

Part of using Productive Ward is to assess making a difference so real-time patient feedback is gathered weekly using the Patient Experience Tracker, an electronic survey device that allows patients to enter responses at bedside and aggregates results posted on bulletin boards for staff review.

For learning purposes, a yearly mandatory meeting called Clinical Convergence Day is held at the hospital so employees can hear first-hand about serious adverse patient care events that happened at St George’s, so future occurrences can be avoided.

From St George’s we traveled to Queen Mary’s Hospital, a community hospital built in 1915 to provide treatment, rehab and artificial limbs for those who lost limbs in WWI. Queen Mary’s was completely rebuilt in 2006 and among many other services, maintains a department that creates artificial limbs.

In the UK, community hospitals do not provide any services that require general anesthesia; they have a therapy focus on care, rather than treatment. Queen Mary’s will be merging with St George’s hospital next month, and if a patient arriving at Queen Mary’s needs acute care, they are transferred by ambulance to St George’s. I can’t possibly explain in this small space all that we saw and learned, but there are many ideas that we are looking forward to sharing when we return to the states.

Priscilla

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PVHS in London: Healthcare issues similar across the pond

Posted in Healthcare reform, Quality improvement, tagged , , , , , , , , , , , on September 21, 2010 | 1 Comment »

Today’s blog is written by Craig Luzinski, Poudre Valley Hospital chief nursing officer, who is in London with Medical Center of the Rockies CEO George Hayes and Priscilla Nuwash, president of the PVHS Center for Performance Excellence.

Sometimes we think that the challenges in health care only exist in the United States. We think that if the U.S. was like Canada, France or the United Kingdom, life would be easier and the challenges would be less.

As we are finding out life is not always greener on the other side of the fence, or, in this case, the ocean.

Meeting with representatives from the Great Ormond Street Children’s Hospital (GOSH), in London, England, Priscilla Nuwash, George Hayes, and I found that the challenges are more similar than different.

A little bit about GOSH: Since its formation in 1852, the hospital has been dedicated to children’s health care and to finding new and better ways to treat childhood illnesses. Its mission is to provide world-class clinical care and training, pioneering new research and treatments in partnership with others for the benefit of children in the UK and worldwide.

GOSH, a 250–300 bed facility is recognized as an international referral center for outpatient and inpatient pediatric services. Much like Poudre Valley Hospital, they are land-locked in the center of London. Talk about a parking problem. GOSH basically has no parking; it’s serviced primarily by bus, the Underground subway system, and walking.

The National Health Service (NHS), which is similar to a combined Centers for Medicare and Medicaid and Social Security Administration in the U.S., is under heavy scrutiny and likely to go through significant budget reductions in the near future. We were told yesterday that the three largest workforces in the world are the Chinese army, the British Railway, followed by the NHS.

Although significant changes are needed due to the financial burden of the NHS on the economy of the UK, the NHS is seen as a “crown jewel” of pride in the UK. It has been difficult for any of the political parties in the UK to make changes to the NHS due to its complexity and status of pride. Sounds a bit like the health system in the U.S.

In addition to the financial pressures for change, there is increasing pressure for improvement in quality and service outcomes. GOSH has been working on a program simply titled “The Transformation” for the past couple of years. Their aim is to transform the quality of care provided by 2010 in three ways:

  • No unnecessary waits
  • No waste
  • Zero preventable harm

In addition, GOSH has identified the following objectives:

  • Financial sustainability and health
  • Service portfolio and growth
  • Working better together

Sounds a lot like PVHS, without the British accents. We have developed another partnership with an organization with similar a similar vision. Sharing best practices will be valuable as we attempt to maintain and in some cases improve our quality and service outcomes, while being challenged by likely reduction in reimbursement.

Both of our organizations agree that successful transformation of any kind is about people feeling that the change is making an impact on the outcome of their work, versus just going through the process itself.

Craig

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Wellness and healthcare reform: Poudre Valley Medical Fitness

Posted in Fitness, Health, Healthcare reform, Wellness, tagged , , , on August 19, 2010 | Leave a Comment »

There are a lot of changes coming with healthcare reform, many which are not yet too clear.  However, what we do know is that there will be an economic incentive to keep people well rather than just fixing them when they are sick. Plus…that is just the right thing to do.

So, I thought you would like to know that in November, Windsor will become home to the first medically supervised health, wellness and fitness center model in northern Colorado – Poudre Valley Medical Fitness. This unique model not only demonstrates the PVHS commitment to patients and community, but also the PVHS trend in leading the way in groundbreaking services.

Poudre Valley Medical Fitness will provide residents throughout the region a very real opportunity to stay healthy and productive! We are very excited about making this happen.

Thanks to the PVHS team who worked so hard to put this together, and to Martin Lind and his entire team at Water Valley in Windsor who provide the vision for a fantastic location. This will be fun to watch!

Rulon

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Times Are Changing

Posted in Aging population, Employee engagement, employee turnover, Healthcare reform, Quality improvement, Talent Management, tagged , on August 15, 2010 | Leave a Comment »

I have been impressed at how different the healthcare industry is than it was just five years ago.  You can do your own survey, but I feel like there has been more change in the industry in the past 5 years than in the prior 15.  Differences in technology, payment structures, relationships…everything.  It is clear to me that those who are able to adjust to these changing times will be the successful organizations in the future.

To that end, many years ago I saw a video on You Tube called Shift Happens.  I recently saw the updated version which I think describes many of the changes internationally which are driving a lot of the change in the United States.  I believe that organizations which will be successful in the near future will learn the information contained in this video and prepare accordingly.  In any event, I thought you might find this interesting.  Click here to see the latest version.

Rulon

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More reflections: The future of Poudre Valley Health System and Greeley Medical Clinic

Posted in Uncategorized, tagged , , , , , , , , , , , , , , , on July 26, 2010 | 5 Comments »

In my last post I offered some thoughts that had been on my mind relative to the growth of Poudre Valley Health System over the past many years, and more specifically, the recent surge during the past few months. I have a few more:

Walking through Greeley Medical Clinic last Friday I was reminded of those in the Greeley community who have been told that PVHS will now require that GMC patients will be moved to Loveland for their care. I thought it was amusing to talk to the staff at GMC who know that such a requirement has never been discussed, let alone implemented.

Interestingly, many PVHS physicians have applied for privileges at NCMC to be better able to take care of Greeley patients in Greeley but, so far, the requests to work there have been denied. Ironically, the biggest barrier to Greeley patients being able to receive care in Greeley is a policy at NCMC that does not allow certain physicians to admit patients to their hospital.

I have often been asked what makes PVHS different, and I have to suggest it is the effort to put patients first no matter what. The result has been a healthcare system that is outpacing others in the industry. Some of the information to support that claim:

  1. Malcolm Baldrige National Quality Award. Still the only healthcare organization within 650 miles to be recognized by the president of the United States. Honestly…just WOW.
  2. American Nurses Association Magnet designation. This is a designation for organizations that make a truly unique effort to allow nurses the opportunity to provide the highest quality nursing care. Poudre Valley Hospital was only the 11th hospital in the country to ever receive this designation, and only the 7th in the country to be designated three times. Medical Center of the Rockies will receive its first site visit later this year, and was selected to receive that visit literally the first day they were eligible. Again…wow.
  3. Thompson-Reuters Top 100 Health Systems. Announced just last month, this is a list of all the best health systems in the country. PVHS is the only Colorado-owned health system on the list.
  4. Colorado Performance Excellence. PVHS was the first organization in any industry to receive Colorado’s highest quality award, and still today is the only organization to be recognized with that distinction twice.

The list could go on and on but I think you get the picture. PVHS, with its amazing physicians, staff and volunteers has simply put together a remarkable organization that has distinguished itself throughout the country and the world. What an honor it is for me to be associated with so many talented and dedicated people. Further, how thrilled we are to be associated with an organization like GMC with people of such similar background and commitment.

The future looks very bright!

Rulon

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