Thanksgiving is my favorite holiday. Not just because so much care goes in to the preparation and the gathering of family but because it is the one holiday that all Americans celebrate. It is a day that our forefathers created to make us purposefully stop and think about all the things that we have to be thankful for and especially for what people gave up to start this most amazing country.
I have been following the posts on Facebook of my friends who have taken a pledge of giving thanks for something each day. Some of them are serious, some of them are funny, some are memories of loved ones lost and some are thankful for the bounty they have been given. So, I thought it would be fun to start a thankful list on the blog. It could be big or small but I would ask that you try and relate it to something or someone you are thankful for at Children's Specialized.
For me, I have so much to be thankful for. Children's Specialized allowed me to jump onto this amazing wave that you had going. Seven years ago when I got here, you were a couple years into a strategic plan that envisioned growing outpatient services and building a new hospital at the same time implementing values that would help us through good times and bad. As I look back seven years later, we have done much of what was in that plan. We have had great people join our ranks; over 300 new people have come to CSH in the last seven years. We have said goodbye to some friends and welcomed some back. The days are filled with both a lot of hope for the future and a lot of work to be done. I am thankful that I was selected to come into the CSH family and allowed me to be part of the amazing work that we do.
And you?
Wednesday, November 17, 2010
Friday, November 5, 2010
Sharing the Changes of Healthcare
There are times when the healthcare industry is in an uproar and I may only share information with you sporadically. Partly because maybe I am trying to not make you worry or maybe it is because I assume if I am hearing these things, you are hearing them too. This year we did not make the Best Places to work from Modern Healthcare. From the comments on the Modern Healthcare Survey, it is clear that we need to do a better job of communicating what is going on in our hospital industry. So here it goes - Here are some of major changes that have happened in the 2010 in the hospital industry that have affected many hospital employees and people who receive care.
RWJ Rahway in July of this year reduced management’s salary by 10% across the board and all other employees by 5%. They took back a week of vacation from all management employees and have stopped the hospitals contribution to the 403B plan.
RWJ Hamilton and St. Peter's Hospital in New Brunswick were forced to lay off 200 employees each or not fill positions that were currently open due to their decreased census. St. Barnabas announced the sale of all of their long term care services, impacting 600 employees.
Many hospitals throughout the state have frozen wages and have stopped any contribution to their 403 B plans.
State employees had to agree to seven furlough days, (meaning they can’t work, nor will they get paid for that day) In addition, a new law requires an increase in their health benefits contribution.
Beginning January1, Medicare will reduce its payments to NJ acute care hospitals by $1 BILLION a year, each year, for the next 10 years.
Economists say that the recession is over, but the financial growth may never reach the levels of before September 2008.
The State of the NJ is facing a $12 BILLION loss in 2011. The Governor has committed that he will not raise taxes and this loss is after his difficult reductions made in last year’s budget.
So why do I tell you all of this? There will be more hard times ahead for the State of NJ and for all of the healthcare industry. Besides continuing to deliver high quality care and make wise management decisions, we must continue to distinguish ourselves with our positive culture, delivery of high quality care and your commitment to our children and their families. It is being able to live our values each and every day, even though there may be chaos and tumult going on all around us. As much as we can, this Senior Leadership team is going to work hard to mitigate the pressures of the outside world but we are going to need to make changes in order to do that.
In 2010 we began an effort to systematically review every thing we do - every process, every contract, every thing to ask our selves are we doing this in the most efficient way for our families and our staff? There have been great things that have come out of that review, and we have uncovered many opportunities to make more improvements. That work will be part of what we do each and every day - not a one time project. It is much like the changes we have made in reference to quality improvement. This process is not to make “more” money for the organization but knowing that our reimbursement is going to be flat or reduced, we need to make sure we have money to continue to meet increased salaries, health insurance and reward employees for your superior work.
So what does this all mean for you? It means that the work that we have done to date, improving the quality of care we give, including our families in helping solve problems, being focused on becoming the most efficient organization we can be, all are a strong foundation for the challenges that we will face. I am absolutely confident that we will come out the other side of these challenges an even stronger organization, more resolute on doing all that we need to for our kids.
What I need from you are your thoughts on how best to engage all of you in this constant change that is going on. I truly want you focused on continuing to do great work but I know you need a context to understand why we are doing the things we are doing. Please give me your suggestions on how best to connect with you and make sure we are doing the best job possible to align all of our goals with the realities that we are facing.
RWJ Rahway in July of this year reduced management’s salary by 10% across the board and all other employees by 5%. They took back a week of vacation from all management employees and have stopped the hospitals contribution to the 403B plan.
RWJ Hamilton and St. Peter's Hospital in New Brunswick were forced to lay off 200 employees each or not fill positions that were currently open due to their decreased census. St. Barnabas announced the sale of all of their long term care services, impacting 600 employees.
Many hospitals throughout the state have frozen wages and have stopped any contribution to their 403 B plans.
State employees had to agree to seven furlough days, (meaning they can’t work, nor will they get paid for that day) In addition, a new law requires an increase in their health benefits contribution.
Beginning January1, Medicare will reduce its payments to NJ acute care hospitals by $1 BILLION a year, each year, for the next 10 years.
Economists say that the recession is over, but the financial growth may never reach the levels of before September 2008.
The State of the NJ is facing a $12 BILLION loss in 2011. The Governor has committed that he will not raise taxes and this loss is after his difficult reductions made in last year’s budget.
So why do I tell you all of this? There will be more hard times ahead for the State of NJ and for all of the healthcare industry. Besides continuing to deliver high quality care and make wise management decisions, we must continue to distinguish ourselves with our positive culture, delivery of high quality care and your commitment to our children and their families. It is being able to live our values each and every day, even though there may be chaos and tumult going on all around us. As much as we can, this Senior Leadership team is going to work hard to mitigate the pressures of the outside world but we are going to need to make changes in order to do that.
In 2010 we began an effort to systematically review every thing we do - every process, every contract, every thing to ask our selves are we doing this in the most efficient way for our families and our staff? There have been great things that have come out of that review, and we have uncovered many opportunities to make more improvements. That work will be part of what we do each and every day - not a one time project. It is much like the changes we have made in reference to quality improvement. This process is not to make “more” money for the organization but knowing that our reimbursement is going to be flat or reduced, we need to make sure we have money to continue to meet increased salaries, health insurance and reward employees for your superior work.
So what does this all mean for you? It means that the work that we have done to date, improving the quality of care we give, including our families in helping solve problems, being focused on becoming the most efficient organization we can be, all are a strong foundation for the challenges that we will face. I am absolutely confident that we will come out the other side of these challenges an even stronger organization, more resolute on doing all that we need to for our kids.
What I need from you are your thoughts on how best to engage all of you in this constant change that is going on. I truly want you focused on continuing to do great work but I know you need a context to understand why we are doing the things we are doing. Please give me your suggestions on how best to connect with you and make sure we are doing the best job possible to align all of our goals with the realities that we are facing.
Friday, September 24, 2010
Face to Face
Thank you all for your posts on my previous blog here and for the conversations we have had off line. To keep us on track - the goal of the meetings are to provide an update on how we did during the previous year on meeting our corporate goals, what the new goals are and how they may relate to what you do every day, for information on current issues to be shared and for you to be able to ask me anything you want about the organization and decisions we have made.
In an honest assessment, some of those goals have been met, some of them haven't. I have heard you clearly that the face to face is important, but maybe they don’t need to all be done in an eight week period. Also, that we should make use of the technology to provide an opportunity for those who are unable to be there.
Given all of that, I will continue to do the "State of the State" in the February through April timeframe so the goals can be reviewed and have someone video a session and we will get it on the intranet. The second meetings I will stagger throughout the year, committing to getting to all sites and programs, but not trying to squeeze them all into the tight time frame. For this Fall, I will get to all sites by year end.
Thank you for your feedback. I appreciate the time you took to share your thoughts.
In an honest assessment, some of those goals have been met, some of them haven't. I have heard you clearly that the face to face is important, but maybe they don’t need to all be done in an eight week period. Also, that we should make use of the technology to provide an opportunity for those who are unable to be there.
Given all of that, I will continue to do the "State of the State" in the February through April timeframe so the goals can be reviewed and have someone video a session and we will get it on the intranet. The second meetings I will stagger throughout the year, committing to getting to all sites and programs, but not trying to squeeze them all into the tight time frame. For this Fall, I will get to all sites by year end.
Thank you for your feedback. I appreciate the time you took to share your thoughts.
Thursday, September 16, 2010
Redefining Employee Meetings
I am going to ask for your thoughts again on an issue that I am struggling with. For the past six years, I have been doing employee meetings twice a year. It turns out to be about 32 meetings trying to get to all sites, different shifts and each program. It takes about eight weeks trying to make sure that everyone gets the same information about the same time. If you happen to be on vacation or not working that day or just get busy at work, you may not get there. At the bigger meetings, very few questions are asked because people feel intimidated to ask tough questions in front of 100 people. We do solicit questions before the meetings, but honestly I don’t get many questions that way. At the end of all the meetings, the presentation is posted on the intranet, but people have told me it is not the same.
So, here’s where I need your help - Is there a different way to do these meetings that still gets information out? I love the meetings. It is a chance for me to get face time with each of you but if I am absolutely honest, I may get more out of these than you do.
Right now, I need to own up to the responsibility to do exactly what we have been doing throughout the organization - look at everything we are doing and ask - "does this project/process add value, or do we do it because we have always done it?"
Now I am not looking for you to make me feel better about this and justify keep doing something I like. The truth is, are they really effective in the current form?
Here are some options to consider that I know other companies, who have multiple sites, including in other countries have used.
• A video is posted on the intranet for everyone to look at on their own time. Questions following that video are asked on the CEO blog and answered for all to see, not just the people at your meeting.
• Have one meeting, announced ahead of time that is videoconferenced and telephonically conferenced for all to participate, if they choose to come in at that time. It would be like our clinical grand rounds. This would still allow people to ask questions during that meeting, so it would be more interactive. Also it could be taped and posted for those who didn’t attend.
• Abandon the twice a year meetings schedule and schedule for me to be at each site throughout the year. Don’t have a formal presentation at the meeting but do a more meet and greet over coffee and people can bring up any issues. The written presentation of an update on our goals can still be posted on the intranet but not presented.
• Have Site Directors and Managers present the information with the thought that there would be more interaction with people you re more comfortable with and create a different "ask the President" vehicle.
Your thoughts would be helpful.
Amy
So, here’s where I need your help - Is there a different way to do these meetings that still gets information out? I love the meetings. It is a chance for me to get face time with each of you but if I am absolutely honest, I may get more out of these than you do.
Right now, I need to own up to the responsibility to do exactly what we have been doing throughout the organization - look at everything we are doing and ask - "does this project/process add value, or do we do it because we have always done it?"
Now I am not looking for you to make me feel better about this and justify keep doing something I like. The truth is, are they really effective in the current form?
Here are some options to consider that I know other companies, who have multiple sites, including in other countries have used.
• A video is posted on the intranet for everyone to look at on their own time. Questions following that video are asked on the CEO blog and answered for all to see, not just the people at your meeting.
• Have one meeting, announced ahead of time that is videoconferenced and telephonically conferenced for all to participate, if they choose to come in at that time. It would be like our clinical grand rounds. This would still allow people to ask questions during that meeting, so it would be more interactive. Also it could be taped and posted for those who didn’t attend.
• Abandon the twice a year meetings schedule and schedule for me to be at each site throughout the year. Don’t have a formal presentation at the meeting but do a more meet and greet over coffee and people can bring up any issues. The written presentation of an update on our goals can still be posted on the intranet but not presented.
• Have Site Directors and Managers present the information with the thought that there would be more interaction with people you re more comfortable with and create a different "ask the President" vehicle.
Your thoughts would be helpful.
Amy
Thursday, September 9, 2010
Keeping Our Kids Healthy
So I need your advice.
What should Children's Specialized do if we know that employees are intentionally putting our children at risk? Now that is definitely a loaded question and the first reaction is that we must do everything to protect our children. Ok, but what if the risk is that employees refuse to get flu shots free of charge? By not doing so - put our children at risk.
Okay - I can see the eye rolls as I write this. "Why doesn’t she just give this up already? We are already double the percentage for most hospital employees why can’t she just leave well enough alone?"
That was true in the past, but now most hospitals have achieved a 74% vaccination rate among their clinical staff. So we are not any better than the national average. There are now about 45 hospitals and heath systems that require mandatory influenza vaccination and a recent CDC survey of 1,500 health care workers indicated that 1 out of 10 employers required mandatory vaccination. The fact remains that unless we get a vaccination rate of over 90%, our patients will remain at risk from influenza.
We have surveyed our non vaccinated staff about why they refuse the flu vaccine. The most common answer is “I never get sick.” However, it is well known that health care workers may become sick from influenza but have such a mild case that they still come to work. That does not prevent them from transmitting the virus to their patients. For our children with chronic health conditions contracting influenza may cause significant complications and even result in their death. So we need to think about our patients health and get vaccinated to help protect our patients.
Not only do we need to get vaccinated against influenza but there is another disease out there that is making a major comeback. The answer may surprise you - Whooping cough (pertussis). Seven infants have died in California because adults had whooping cough, and transmitted to children. Adults who get pertussis don’t get whooping cough; they get the cough that never seems to go away and typically lasts about 6 to 8 weeks! But when babies and young children get pertussis they get whooping cough which can be deadly. The infants who died in California could not fight the infection because they were too young for the vaccine to be effective (pertussis vaccine (part of the “DPT”) is a series of three shots given at 2,4, and 6 months of age and a booster at 18 months). Infants don’t have immunity until they complete all three shots. The problem is compounded by parents who refuse to have their children vaccinated. Politicians have inserted themselves into this debate and said that we should allow parents to make their own decisions for their children - but what happens when their free choice impacts the rest of us? Adults who were vaccinated against whooping cough as children need to be revaccinated as adults and this can now be done when you get your tetanus shot But for those who opt out - the result may be deadly for our kids.
So what should we do? Right now we make influenza vaccination one of our corporate goals. We provided the shots free of charge and will virtually do them any time day or night. Our highest percentage of employees who get the shots are actually the administration employees who may never see children - such as all of our employees on Route 22. The employees who have the least vaccination, sadly our EIP employees who are most vulnerable because they are walking into people's homes each day. There is no environmental services staff there to make sure they are safe and things are clean.
We have talked about allowing staff to opt out but for clinical staff who are not vaccinated they would have to mask and gown before they were allowed contact with a child in the event of an influenza or pertussis outbreak. At RWJ they put a dot on their ID card to distinguish between those who have gotten their flu shots and those who haven't.
Your advice/comments would be welcome. How can we increase the number of CSH employees who receive their flu or whooping cough vaccine?
The truth is that with whooping cough starting, other diseases of the “past” may not be far behind. When the vaccination rate against polio dropped off in several countries in Africa, polio came back with a vengeance. As an organization we lived through that crisis once - it would be a sin to be faced with it again.
What should Children's Specialized do if we know that employees are intentionally putting our children at risk? Now that is definitely a loaded question and the first reaction is that we must do everything to protect our children. Ok, but what if the risk is that employees refuse to get flu shots free of charge? By not doing so - put our children at risk.
Okay - I can see the eye rolls as I write this. "Why doesn’t she just give this up already? We are already double the percentage for most hospital employees why can’t she just leave well enough alone?"
That was true in the past, but now most hospitals have achieved a 74% vaccination rate among their clinical staff. So we are not any better than the national average. There are now about 45 hospitals and heath systems that require mandatory influenza vaccination and a recent CDC survey of 1,500 health care workers indicated that 1 out of 10 employers required mandatory vaccination. The fact remains that unless we get a vaccination rate of over 90%, our patients will remain at risk from influenza.
We have surveyed our non vaccinated staff about why they refuse the flu vaccine. The most common answer is “I never get sick.” However, it is well known that health care workers may become sick from influenza but have such a mild case that they still come to work. That does not prevent them from transmitting the virus to their patients. For our children with chronic health conditions contracting influenza may cause significant complications and even result in their death. So we need to think about our patients health and get vaccinated to help protect our patients.
Not only do we need to get vaccinated against influenza but there is another disease out there that is making a major comeback. The answer may surprise you - Whooping cough (pertussis). Seven infants have died in California because adults had whooping cough, and transmitted to children. Adults who get pertussis don’t get whooping cough; they get the cough that never seems to go away and typically lasts about 6 to 8 weeks! But when babies and young children get pertussis they get whooping cough which can be deadly. The infants who died in California could not fight the infection because they were too young for the vaccine to be effective (pertussis vaccine (part of the “DPT”) is a series of three shots given at 2,4, and 6 months of age and a booster at 18 months). Infants don’t have immunity until they complete all three shots. The problem is compounded by parents who refuse to have their children vaccinated. Politicians have inserted themselves into this debate and said that we should allow parents to make their own decisions for their children - but what happens when their free choice impacts the rest of us? Adults who were vaccinated against whooping cough as children need to be revaccinated as adults and this can now be done when you get your tetanus shot But for those who opt out - the result may be deadly for our kids.
So what should we do? Right now we make influenza vaccination one of our corporate goals. We provided the shots free of charge and will virtually do them any time day or night. Our highest percentage of employees who get the shots are actually the administration employees who may never see children - such as all of our employees on Route 22. The employees who have the least vaccination, sadly our EIP employees who are most vulnerable because they are walking into people's homes each day. There is no environmental services staff there to make sure they are safe and things are clean.
We have talked about allowing staff to opt out but for clinical staff who are not vaccinated they would have to mask and gown before they were allowed contact with a child in the event of an influenza or pertussis outbreak. At RWJ they put a dot on their ID card to distinguish between those who have gotten their flu shots and those who haven't.
Your advice/comments would be welcome. How can we increase the number of CSH employees who receive their flu or whooping cough vaccine?
The truth is that with whooping cough starting, other diseases of the “past” may not be far behind. When the vaccination rate against polio dropped off in several countries in Africa, polio came back with a vengeance. As an organization we lived through that crisis once - it would be a sin to be faced with it again.
Thursday, July 8, 2010
Words of Wisdom for Graduates
So, next Saturday morning at 9 am I will be standing before 600 graduates at Dover University giving a commencement speech. This is a two year school with the largest majority of students graduating in the health care profession of some kind. Some will go on to 4 year schools others will not. Many held full time jobs, have kids and a home while going to school full time.
I’d really like to offer these graduates some honest and useful advice. Who better to ask then our CSH family of employees? Many of you have sat through graduation ceremonies either as a recipient, parent or relative.
Is there anything you would recommend that I make sure I mention as I send these folks out into the world?
I’d really like to offer these graduates some honest and useful advice. Who better to ask then our CSH family of employees? Many of you have sat through graduation ceremonies either as a recipient, parent or relative.
Is there anything you would recommend that I make sure I mention as I send these folks out into the world?
Tuesday, July 6, 2010
Thank You Fridays
In my last wrap up, I mentioned that we are designating summer Fridays as “Thank You Fridays” You can wear jeans every Friday through the summer, but in exchange, you need to thank someone you work with who you appreciate and who has helped you in some way. I LOVE this idea because there is nothing better than showing appreciation for each other. It doesn’t have to be the "you saved my life" thank you but the little things people do each day.
We will do it on the honor system, but my only request is you have to thank someone different each week. You may also post your thank yous here on my blog.
Can't wait to see the blogs or hear the stories! Thanks, James Marotta, for the great idea!
Here’s an example of a thank you I received from Geetha Bharathan - Geetha, sent me a small embroidered pouch. In the pouch it contained "worry dolls" the legend is that if you "give your worries" to these dolls each night, you will be able to start each day anew. She was concerned about how much I worried about each of you and our children and she wanted me to have some relief. I was so touched by her kindness and as a way of trying to relieve my stress.
Please share your words of gratitude below.
We will do it on the honor system, but my only request is you have to thank someone different each week. You may also post your thank yous here on my blog.
Can't wait to see the blogs or hear the stories! Thanks, James Marotta, for the great idea!
Here’s an example of a thank you I received from Geetha Bharathan - Geetha, sent me a small embroidered pouch. In the pouch it contained "worry dolls" the legend is that if you "give your worries" to these dolls each night, you will be able to start each day anew. She was concerned about how much I worried about each of you and our children and she wanted me to have some relief. I was so touched by her kindness and as a way of trying to relieve my stress.
Please share your words of gratitude below.
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