Christina's Considerations

CAeHC webinair on FBI's Cyber Program

Those who are interested in health information exchange (HIE) privacy and security may want to check out the next CAeHC webinar on Tuesday, November 10 at 1:00 PST.  The speaker is Special Agent James Harris, supervisor of the FBIs Sacramento Cyber Program.

I'll be driving back from an interview and hopefully (if the mountains don't get in the way) can listen.

H1N1 Mis-information and Flu Film Festival

Someone from a local college sent me an email that is circulating among the faculty and students with some prevention advice for the flu.  While it might sound like it could work, one of our public health medical directors reported that there is no evidence of effectiveness for the techniques described. 

My advice is to refer to information from the CDC, Flu.gov or your State or local Public Health Department and...

• Wash your hands often
• Stay away from people with the flu or symptoms (coughing, sneezing, etc)
• Stay home and rest if you get sick

Or, view the videos from the California Department of Public Health Flu Film Festival and vote for your favorite by November 12th!

Geaux Saints!

Wow!!!  Another football game that kept me  on the edge of my seat all the way through.  I don't know if my heart can take another Saints game.  Last night -- two heart attacks!  Huhhhh!  Breath!

I am really proud and excited to see the Saints doing so well this year.  They all look great and the team is performing --- not just a couple of individual players.  The jumps, leaps and falls were amazing and beautiful!  It reminded me of the ballet!  No, these aren't the Saints of old!

I've already called my sister to make a reservation at her house if the Saints make it to the Superbowl. Now, that will be a time to be in the city -- visiting the places of my younger life.  I can't wait for a quick trip home, especially since it will be oyster season.

Ok, enough!  I'm getting hungry and homesick all at the same time!

Looking for a great new boss!

Jury duty (all six weeks of it) is over, final edits are being made on my book and the big push to get California's strategic plan(s) completed for accessing the ARRA HITECH funding is over.  I'm still working with the Public Health Department and will serve on California's Health Information Exchange Committee, but these aren't enough to fill my days.

So, I'm looking for a great new boss (or more) and scheduling interviews again!  

I'd love to find a full time hospital or other healthcare administrator job within commuting distance of Santa Barbara, but also realize this could take a few years.  As a result, I'm also looking for projects or interim assignments that will allow me to utilize my strong leadership, governance and operational expertise.  Some ideas include:

• advisor and coach for performance improvement, compliance and health information exchange projects
• providing interim leadership during recruitment and hiring periods
• initiating operational, financial or strategic turn-around
• disaster/emergency and continuity of operations planning and response
• review and recommendations for revenue cycle, supply, security, and customer (patient) flow processes and systems
• workplace and employee health assessments and planning and implementing health status improvement strategies
• objectively evaluating and monitoring organizational and workforce performance
• governing body orientation, education and performance assessments
• writing, reviewing, revising, and consolidating policies, procedures, protocols, guidelines, job descriptions and plans
• community and public heath assessments and planning and implementing health status improvement strategies
• identifying  and facilitating the removal of obstacles to change
• planning and initiating change strategies (only if leaders are committed to constructively managing and resolving the conflict that will arise)
• facilitating planning and implementation of social media strategies
• safety assessments and recommendations for improvement
• establishing metrics and outcome monitoring and reporting processes
• planning to establish "meaningful use" and access ARRA and HITECH funding

This is just a start and I'll add more as the ideas flow, or let me know if you have a specific need.  But, most importantly, if you are a great boss looking for a star worker, call today to schedule your interview!

Disruptive Behaviors in Healthcare Environments

I'd like to suggest that one important piece of health reform is the elimination of disruptive behaviors by healthcare professionals, because it ties in directly with transparency, adverse outcomes (quality & safety) and cost(s).  We need to educate and hold all of our leaders accountable for eliminating the barriers to dealing with unprofessional behaviors -- especially the politics.

The Studer Group has researched the impact of disruptive behavior by healthcare professionals and included an insert in the 2009 report on the Best Places to Work in Healthcare titled Creating Great Places to Work by Eliminating Disruptive Behaviors.   I've written a little on my experience at Speaking up, Staying put or Getting out  and the Joint Commission has two new leadership standards dealing with disruptive behavior.  Lets bring it all out in the open and deal with it so we can move on with the real work at hand - improving the quality and safety of care while reducing the cost.

H1N1 Public Service Announcements: California

The California Hospital Association has released some PSAs on H1N1 for children and adults in English and Spanish.  The PSAs feature hospital emergency room physicians who describe the typical symptoms of the H1N1 flu virus, as well as the warning signs of a more severe case of the illness.

Below is the adult English PSA.  Please visit the CHA website at http://www.calhospital.org/h1n1spots for the others..

 

 

Workplace Health and Wellness: H1N1

I've been monitoring the traffic to my posts and am happy to report that there are more searches for information related to "business" and "workplace".   Please visit my last post on business and workplace responsibilities.

I've posted on my concerns about obesity a few times (one example) and now it seems it is a high risk condition for the H1N1 flu.  This could be due to the existence of other chronic conditions like diabetes, or perhaps compromised lung function is increasing the risk of respiratory distress.

Even though the strain isn't so severe, be prepared for the impact on your business and encourage your employees to stay home and rest if sick.  They should call their doctor and/or go to the hospital if they are vomiting or have difficulty breathing.

Just having the flu isn't a reason to go to the emergency room!

Be aware and prepare at home and work!

Macro trends in possible healthcare legislation?

Mark Frisse shares his thoughts about some possible macro trends in healthcare legislation and I agree that these are needed and likely.  I especially believe there needs to be more dialog and a closer link between payer intermediaries and decisions at the point of care.  Too many layers and being too far removed increases the risk of undesirable outcomes.

The trends:

1. A shift from plan exclusion of pre-existing illness to controlling expenditures of covered members
2. Rising health care costs
3. More dialog between payer intermediaries and decisions at the point of care
4. More capitation and risk relationships with providers
5. More dynamic provider networks based on a variant of social networks and preferences
6. A shift in the delivery of health care services from physician-based practices to networks of clinicians with varying skills practicing in a wider range of accessible settings
7. A shift in "ROI" from short-term return to long-term value
8. A shifting responsibility from intermediaries to individuals
9. Administrative simplification
10. Pricing and quality transparency

How 'bout them Saints?

I've been watching Manning quarterbacks for many years and really enjoy the games of the two younger ones.  However, when it comes to a Manning vs. the New Orleans Saints, I'll always choose the latter.

We are off to a great season with today's win!

Do hospitals need to enter the world of social media?

I've been following Tony and Hospital Impact for several years now and it is great to see he is having success with the contributor format.  One of his contributors posted on whether hospitals need to enter the world of social media and I'm sharing it because it is yet one more voice on the subject and a nice example.

For those of you who want an example of what people are posting about the hospitals in their community visit the link to GWU Hospital Horrible.  I wonder if GWU knows about the post! 

Most Severe Cases of H1N1

The SBCPHD has a new press release that includes some stats I'd like to share.

• Over half (58%) of the 26 Santa Barbara County residents hospitalized with complications of H1N1 since late June were younger than 19 years old and 75% of those placed in intensive care units due to H1N1 complications were 16 or younger.  To date, the only death in the County has been a teenager with multiple medical conditions.
• Pregnant women are at increased risk of complications and death from the H1N1 flu and nationally, over 25% of pregnant women who were hospitalized for H1N1 flu have died.  Although the actual number is relatively small (28 as of 10/1/09) the concern is great.

H1N1 Most Severe Press Release H1N1 Most Severe Press Release -- Spanish

Please prepare to limit the risk to your family by being aware of the symptoms outlined and taking steps to reduce the risk of exposure.  If you do get sick, call your doctor or a clinic. 

Po boy's & Muffuletta's

Leidenheimer has been making bread for po boy's and muffuletta's since 1896 in New Orleans and I've been missing their french and muffuletta bread.  So, I went online and found their site and want to share a little lagniappe with my readers.  In addition to being able to purchase these two unique breads, you can also download a Po boy Screen Saver.  What I don't understand is why the po boy's are not dressed!

I just can't imaging eating a soft shell crab or oyster po boy that isn't dressed!  Can you?

Where Healthcare Workers Work

Hospitals and Health Networks Magazine had a great diagram and article summarizing where healthcare workers work in their September 2009 issue.    I'm sharing it here because it also demonstrates the communication needs that we hope to address with health information exchanges. 

Think of the patient who visits their family physician and is referred to a surgeon for an outpatient surgery and is referred to the hospital for further treatment based on some pathology findings.  At discharge the patient is referred back to the surgeon and family physician for follow-up care and to a home health program, or possibly a skilled nursing facility, for support during their ongoing recovery period. 

It will be really great when each of these providers can easily access the patient's records without waiting for the copy service or courier to deliver constantly changing paper records to multiple sites.

Santa Barbara County H1N1 Information Line

If you live or work in Santa Barbara County and have questions about H1N1 flu (swine flu) you can call the Public Health Department Information Line (1 888 722-6358) and speak with a nurse in English or Spanish.  For more information about the information line or to review or post the press releases go to:

2009-10-07 H1N1 phone line

2009-10-07 H1N1 phone line (Spanish)

H1N1 Flu (Swine) and Santa Barbara County

We had our first death from H1N1 flu this week here in Santa Barbara County -- an adolescent girl with complicating factors.  I've also noticed a lot of traffic to my recent posts on H1N1 Awareness and Prevention Materials and Educational Materials for Teens and Young Adults. 

While the traffic to these posts is great, I'm not seeing much traffic to my posts on Is your business prepared for the 2009 flu season or Business Preparation for a Possible H1N1 Outbreak.  Given a recent conversation, I suspect that my community's businesses (especially small ones) will not be a prepared to respond to the impact of a significant H1N1 event.  And, this may be true for your community, as well.

Hospitals and other healthcare and first responders have been preparing for months, but we still need the business community to help keep our local and national infrastructure moving forward.  We have chosen a capitalist economy, so that means we can't expect the government to be there to provide all of the services we now receive from businesses this flu season.  Just as we expect our government and healthcare communities to prepare, we should also be expecting our business leaders to fulfill their responsibility to prepare for disruptions and minimize the risk of an adverse impact on our daily lives. 

Hospitals and healthcare providers will only be able to accommodate the expected surges if the business community understands the importance of their role and is prepared to take definitive steps to continue to providing essential services, equipment and products needed for daily living. 

My recommendation:  ask the businesses you frequent and your business partners how they have prepared for a significant H1N1 event.  If they don't have an answer, prepare to obtain your food and essential supplies and services from businesses that have a plan.