Have you ever read of those "Oh my god books?" The one that you think the author was actually looking in your head and stole your thoughts? My latest is, "What I know now" edited by Ellyn Spragins. This short read is a compilation of letters written by very successful women to themselves. They are writing at the point in time when they were most in need of advice. So the women, give that advice, in the form of a letter “to their younger self.”
This year, I will be 43. I remember that there was a time in my life - probably the age of many of you - that I thought 43 was SO OLD! Here is what I know now - the things I thought would literally prevent me from living the life I had all planned out - the toughest things - not having children, getting divorced, losing a job.
Here's what I know now - you live through all of it. Just like the kids who end up in our care - the worst things happen, the unthinkable and whether you want it or not - the sun is going to come up tomorrow. Always. And you will be left to have the courage to figure out whatever situation you are presented with. I wonder whether at 30, would the book have talked to me in the same way - I am not sure - some things only come with age. But if the book can talk to you and help you see what a tremendously wonderful person you are and how much you have to offer, whatever is going on in your personal and work life, then it is all good.
I highly recommend this book - it shows you great insight into some of the most amazing people of our time (Cokie Roberts, Queen Noor, Beverly Sills, Pikaboo Street and more) and shows you at their darkest moment - the thing they needed to remember was that they had more than they knew, and that they needed to listen to their inner voice.
I would love to know what you think of the book.
Have you ever had a “What I Know Now” moment you’d like to share?
Maybe a family move that changed everything for you?
Or maybe a life style change that catapulted you in a new direction?
Friday, May 30, 2008
Wednesday, May 21, 2008
Census and Productivity… The Numbers Game
Many of you have asked - is this blog real? Yes it’s real. I’m personally writing each entry and always welcome suggestions for topics.
People also ask, “Are you just going to talk about soft issues or will you use the blog to talk about the hard stuff?” Okay - so I heard you and I took on the challenge and this post is one of the issues I know there is chatter about, not necessarily to me but chatter none the less. This post is about productivity and pressure on keeping the census in all our programs.
So, what’s with all the numbers? Why do we have a daily census report? Or monthly cash goals?
And why do we put so much emphasis on patient productivity in our outpatient sites?
First and foremost know that Senior Leadership knows how hard you all work. Whether it is treating kids or scheduling appointments, we are all giving our best. We also know that if you don’t measure what is meaningful, you have no way to know whether you are being successful or not.
The easiest answer for why we measure things like efficiency and collections is in some cases these numbers generate bills, which generates cash, which is how we pay our employees and all of our bills. Just like in your budget at home, your salary covers most of your bills and provide you with the recourses to do your job. There may be some flux with a check from a family member for a holiday, but 99% of the dollars come from your salary. When we treat a child in any of our settings, billing for that service is what pays our bills. When kids aren’t admitted, or don’t get treated, or cancellations occur - we don’t get paid and then we can’t pay our bills.
Every year we set a budget for each department based upon our mission and strategic plan, as well as your requests for new programs, equipment, and how we expect to be paid for each of our services. We also examine how many children are on the waiting lists to be served. We take that budget number and then determine how many children we would have to treat in all of our areas: inpatient, outpatient, EIP, the school, medical day care and long term care. For the last few years, we have had to hire more staff to be able to meet those numbers,
There have been lots of questions about productivity - how is it calculated?
On the inpatient side, we are budgeted for an average daily census of 50 and children should receive on average, three hours of therapy a day. In long term care we need to have a total of 64 children being treated in both sites and in medical day care 25 children need to be treated every day. In EIP we have made a change recently to our hours based upon the changes in the market places. On the outpatient side, we ask staff to treat children 24 hours a week if they work a 40 hour week. That leaves 16 hours for meetings, cancellations, paper work etc.
We anticipate for TOP time, conference time when we calculate these expectations. When we fall below those budgeted numbers, simply put, we can't pay our bills.
Now we all know that kids get sick, there are holidays' there are cancellations and it makes it hard some weeks to make the numbers. But overall, those are the numbers we have to make. When we don’t make those numbers, we fall behind and can’t pay our bills.
I know this isn't the fun stuff. This isn't the warm and fuzzy stuff that makes you feel good about getting up and coming to work. I know these questions are out there and wanted to address them head on to help clear up the gray areas.
Let’s hear it: Do you have any questions/comments about patient census or productivity?
People also ask, “Are you just going to talk about soft issues or will you use the blog to talk about the hard stuff?” Okay - so I heard you and I took on the challenge and this post is one of the issues I know there is chatter about, not necessarily to me but chatter none the less. This post is about productivity and pressure on keeping the census in all our programs.
So, what’s with all the numbers? Why do we have a daily census report? Or monthly cash goals?
And why do we put so much emphasis on patient productivity in our outpatient sites?
First and foremost know that Senior Leadership knows how hard you all work. Whether it is treating kids or scheduling appointments, we are all giving our best. We also know that if you don’t measure what is meaningful, you have no way to know whether you are being successful or not.
The easiest answer for why we measure things like efficiency and collections is in some cases these numbers generate bills, which generates cash, which is how we pay our employees and all of our bills. Just like in your budget at home, your salary covers most of your bills and provide you with the recourses to do your job. There may be some flux with a check from a family member for a holiday, but 99% of the dollars come from your salary. When we treat a child in any of our settings, billing for that service is what pays our bills. When kids aren’t admitted, or don’t get treated, or cancellations occur - we don’t get paid and then we can’t pay our bills.
Every year we set a budget for each department based upon our mission and strategic plan, as well as your requests for new programs, equipment, and how we expect to be paid for each of our services. We also examine how many children are on the waiting lists to be served. We take that budget number and then determine how many children we would have to treat in all of our areas: inpatient, outpatient, EIP, the school, medical day care and long term care. For the last few years, we have had to hire more staff to be able to meet those numbers,
There have been lots of questions about productivity - how is it calculated?
On the inpatient side, we are budgeted for an average daily census of 50 and children should receive on average, three hours of therapy a day. In long term care we need to have a total of 64 children being treated in both sites and in medical day care 25 children need to be treated every day. In EIP we have made a change recently to our hours based upon the changes in the market places. On the outpatient side, we ask staff to treat children 24 hours a week if they work a 40 hour week. That leaves 16 hours for meetings, cancellations, paper work etc.
We anticipate for TOP time, conference time when we calculate these expectations. When we fall below those budgeted numbers, simply put, we can't pay our bills.
Now we all know that kids get sick, there are holidays' there are cancellations and it makes it hard some weeks to make the numbers. But overall, those are the numbers we have to make. When we don’t make those numbers, we fall behind and can’t pay our bills.
I know this isn't the fun stuff. This isn't the warm and fuzzy stuff that makes you feel good about getting up and coming to work. I know these questions are out there and wanted to address them head on to help clear up the gray areas.
Let’s hear it: Do you have any questions/comments about patient census or productivity?
Thursday, May 1, 2008
Five Years and Counting…
On September 29, 2003, I can honestly say that I was thrilled at the opportunity to work with each of you in the role of President but I wasn’t really sure what the position would hold. I was so excited about the chance to be part of Children’s Specialized Family but was so worried that what needed to be accomplished was more than the organization had ever done in its history. Could I be part of the team that would make all this happen?
As an organization, you had gone through so much change. In 2001 you had instituted a new mission, a new vision and new values for the organization. You had bold plans about how much we were going to grow and of course the plans to build the new inpatient hospital. Now what seems like a blink of an eye, here we are five years later. I will join Pam Radel who will be celebrating her 35 year at Children's Specialized Hospital, and 200 more employees who will be honored at the this year’s employee recognition event on May 9.
The last five years have flown by. We have seen many firsts - the first time we have had more than 1,000 employees, the first time we were ranked top children's hospital by NY Magazine, the first time we have ever raised $33 million in one campaign, the first time one donor ever gave us $5 million, the first time kids in NJ will have access to acute care, rehabilitation, on an academic medical school campus with the opening of our new hospital, and been ranked as a top NJ employer three years in a row with this year being ranked number 1.
While all of those accomplishments are so very important, it is personal memories I have had the privilege of sharing with many of you that are my reflections over the last five years.
It is watching one of our little girls in LTC walk with a walker for the first time. It is the excitement over the lung transplant that has since allowed one of our little guys to go home and live with his family, it was each of the “beach balls” and having a chance to let down our hair and spend personal time together. And is all the many tears of both joy and sadness that our kids have allowed us to partake in.
Our success comes from our commitment to our mission and our values. The pursuit of excellence, with the commitment to our values, is what makes Children's Specialized so unique. There are many places in the country that are the best in their fields in health care – the Mayo Clinic, the Cleveland Clinic, Texas Heart, Johns Hopkins. All of them have that drive for clinical excellence but it is how they provide the care that is so different than what we do. You are literally one of hundreds and the relationships you develop with your individual physician or nurse may be very good, but the organization is a goliath and often impersonal. Their values are all about being the biggest and the best but many forget the compassion and the fun that are our hallmarks.
We are given the opportunity to care for and become involved with families as they face some of the most challenging times in their lives. That relationship is tremendously personal and we see it as a gift that we have a chance to try and make the lives of their children better, in whatever way we can. Whether it is as a physician, therapist, or in billing or dietary, wherever we sit we know that we have a chance to offer a solution with a warm smile.
We are far from over on our journey to fulfill our mission to be the best pediatric rehabilitation hospital in the country but each and every day we get one step closer because of your efforts and your dedication to our children.
As part of this new blog, you are able to leave comments about the blog and answer questions I may pose to you. Here’s my first attempt to hear what you are thinking… Please comment.
What do you think the future will look like?
Are there things that you dream of for Children's Specialized?
I know what that the future will be filled with opportunities to continue to build on our strong foundation and continue to strive to fulfill our mission of being the best pediatric rehabilitation hospital in the country.
It is my honor to be part of the Children's Specialized Team.
As an organization, you had gone through so much change. In 2001 you had instituted a new mission, a new vision and new values for the organization. You had bold plans about how much we were going to grow and of course the plans to build the new inpatient hospital. Now what seems like a blink of an eye, here we are five years later. I will join Pam Radel who will be celebrating her 35 year at Children's Specialized Hospital, and 200 more employees who will be honored at the this year’s employee recognition event on May 9.
The last five years have flown by. We have seen many firsts - the first time we have had more than 1,000 employees, the first time we were ranked top children's hospital by NY Magazine, the first time we have ever raised $33 million in one campaign, the first time one donor ever gave us $5 million, the first time kids in NJ will have access to acute care, rehabilitation, on an academic medical school campus with the opening of our new hospital, and been ranked as a top NJ employer three years in a row with this year being ranked number 1.
While all of those accomplishments are so very important, it is personal memories I have had the privilege of sharing with many of you that are my reflections over the last five years.
It is watching one of our little girls in LTC walk with a walker for the first time. It is the excitement over the lung transplant that has since allowed one of our little guys to go home and live with his family, it was each of the “beach balls” and having a chance to let down our hair and spend personal time together. And is all the many tears of both joy and sadness that our kids have allowed us to partake in.
Our success comes from our commitment to our mission and our values. The pursuit of excellence, with the commitment to our values, is what makes Children's Specialized so unique. There are many places in the country that are the best in their fields in health care – the Mayo Clinic, the Cleveland Clinic, Texas Heart, Johns Hopkins. All of them have that drive for clinical excellence but it is how they provide the care that is so different than what we do. You are literally one of hundreds and the relationships you develop with your individual physician or nurse may be very good, but the organization is a goliath and often impersonal. Their values are all about being the biggest and the best but many forget the compassion and the fun that are our hallmarks.
We are given the opportunity to care for and become involved with families as they face some of the most challenging times in their lives. That relationship is tremendously personal and we see it as a gift that we have a chance to try and make the lives of their children better, in whatever way we can. Whether it is as a physician, therapist, or in billing or dietary, wherever we sit we know that we have a chance to offer a solution with a warm smile.
We are far from over on our journey to fulfill our mission to be the best pediatric rehabilitation hospital in the country but each and every day we get one step closer because of your efforts and your dedication to our children.
As part of this new blog, you are able to leave comments about the blog and answer questions I may pose to you. Here’s my first attempt to hear what you are thinking… Please comment.
What do you think the future will look like?
Are there things that you dream of for Children's Specialized?
I know what that the future will be filled with opportunities to continue to build on our strong foundation and continue to strive to fulfill our mission of being the best pediatric rehabilitation hospital in the country.
It is my honor to be part of the Children's Specialized Team.
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