Intermountain Healthcare has a webpage for kids that is pretty cool. You can watch some short videos, print posters that tie to the videos, and play games all focused on educating kids on health and wellness. Share it with the kids you love!
The May/June 09 issue of Healthcare Executive is all about healthcare greening beyond recycling bins. However, I noticed that a few of my favorite opportunities were missed, or perhaps are not realized by the writers. So, I'm adding my thoughts on a few of my favorites that go beyond the more obvious reducing waste and recycling.
1. Motion sensitive light and other switches - Do you realize how many lights are in a hospital and run 24 hours a day/seven days a week? A lot, even in the smallest of hospitals and the increasing cost of electricity adds up to a tidy sum. Have your hospital electrician, or a contractor, switch them out and then watch your electric bills decrease. Lagniappe: This is also one less place for those nasty bugs to hide and it may help your infection control efforts! :)
2. Lighting retrofit and new bulbs - there is a cost, but usually there is a return on the investment after just a couple of years if you replace ballast and switch to the new energy-efficient bulbs.
3. Boilers, HVAC, ice machines, fans, freezers, refrigerators, and other major equipment - how old is your equipment and can you recover the replacement cost after a couple of years with the energy savings you will realize? I think it is worth looking into, especially if you aren't in California and don't have to send the project through OSHPD for approval.
4. Unused phone lines - over periods of years, hospitals usually wind up with a lot of old phone and modem lines that could be cut off to save the $20 or so monthly line charge. Maybe, there isn't a significant energy savings to this one, but there certainly is a cost saving.
5. Expired medical supplies and old medical equipment - there are several organizations that accept donations or purchase old medical equipment and supplies (like Direct Relief) to provide needed healthcare in developing countries. It may result in a minimal recovery of some cost, but more importantly it will result in a recycling of equipment and allow you to avoid throwing some unused supplies in the trash.
6. Reprocess one-time use items (think ortho surgery) - some vendors will reprocess and re-sell certain one time use items to you at a lower cost. They guarantee the quality/performance of the item and you save money. Ask your vendors if they have re-processing programs. If they don't see if their competitors do!
7. Mercury - again, I don't know if there is a significant cost savings, but have you had your staff hunt through drawers, cabinets for old equipment containing mercury? If you do try this, don't be surprised if someone finds an old thermometer or other mercury containing item -- even if your staff have searched before. Make it fun and give out a prize to anyone who finds something!
8. Patient belonging bags - switching from plastic to reusable patient belonging bags was mentioned in the magazine and there is an associated cost increase. However, imagine all of those patients shopping and walking around town with your logo on the bag. Think of it as going green and use some of your public relations funds to help support the additional cost.
9. Promote carpooling, walking and bike riding to work. Identifying a place to shower and bike lockers/racks will help motivate some to get healthy while helping with the green. In addition, it might even help relieve some of that parking problem your staff have been complaining about.
10. Cleaning the hospital is really important and I for one don't want to sacrifice cleanliness for green. However, if you can find green cleaning products that save costs and help the earth and still clean, then make the switch.
11. Foam soap - this one is a great one because it is just as effective and more fun that slimy hand soap -- and it saves a lot of money.
12. Change the filters in your air exchanges often to improve air quality in your facility and reduce illness in your employees.
13. There is a balance between using glass & china or paper plates and cups. Look at the cost of water in your community to help with your decision. It makes more sense to use glass/china in Louisiana and paper in California.
14. I think solar farms will be a great opportunity for hospitals in small and rural communities where you are most likely to have some wide open space. Keep an eye out for any funding that will help with the up-front costs.
15. Look at your patient accounting functions and consider adding online bill payment options and electronic communications to reduce postage and paper.
16. If you are in the market for new printers, consider the new double-sided printers to help save on paper.
17. Look into for alternatives for your generator fuel (methane, biodiesel, ethanol, hydrogen),
Another bit of lagniappe for some of the energy efficiency initiatives listed above may mean your generator fuel goes farther in a disaster!
There is help available for some green efforts ,usually in the form of rebates and assistance with up-front costs. Check with your utility companies and see if there is a Joint Powers Authority addressing energy resources in your community. The example I'm most familiar with is Ventura County Regional Energy Alliance. Another resource is the Local Government Commission.
During some research last week, I came across an example of one of my suspected uses for the new social networking communication tools and want to share the link to Innovis Health's YouTube Video. This small hospital and clinic system in Fargo, ND used their blog and Twitter to communicate with employees and medical staff, the media, their patients and families, and the public during recent floods.
I congratulate them on being an innovator and happy they were able to continue to support their community during this challenging time!
I'd also like to invite anyone to provide me with additional examples. I'm writing a new book and want to include some exceptional examples. Just leave a comment or send me an email.
Health Management Technology had a great article on Health Improvement Technology and I want to share a few of the highlights below. I also want to call my readers attention to developments related to regional healthcare improvement efforts around the country. These collaborative organizations are forming as regionally-based, multi-stakeholder organizations that are working to improve the quality and value of health care delivery. A national coalition, NRHI, of these organizations has formed and their site makes it easy to identify those in your area. The work of these organizations (towards a value-driven coordinated care delivery system and severity-adjusted episode-based or comprehensive payment system) fits in nicely with HIE efforts and I recommend that you include them as a stakeholder.
Our current delivery system, as well as, the information systems that run them, were never designed to expertly manage chronic disease or improve population health. (They were designed to treat acute illness, injuries and perform procedures.)
Consumers are effectively disengaged from their own health and not in the habit of proactively improving their health habits and making value-based decisions or managing their own health risks and conditions. (Many still want the healthcare system to take care of them.)
Neither hospitals nor physicians are rewarded for keeping patients healthy or preventing chronic disease from developing in the first place. (They are rewarded for treating disease.)
We can't afford this any longer and change is needed, starting with collaborative team processes between payers, providers and consumers. We need:
to digitize, re-design and commoditize the collaborative processes driven by people and teams that erase inefficiencies, drive down operational and medical costs and improve personal and population health.
a focus on collaborative processes and consider data and information merely as valuable inputs to those processes, but not the end goal.
technology to follow providers and consumers wherever they go and adapt to their analog and digital worlds.
Sometimes my family and friends are grossed out by my work in healthcare and this post won't let them down. Things like people peeing in the pool are important and I'll address the reasons and present six tips for healthy swimming. Once you stop laughing, read on...
In the world of Public Health, water quality is really important because many people can quickly and easily be exposed to some really bad germs that cause illness. Water is a nice vehicle for germs to float around in until they find you, or your child. So, the preventative handwashing you did in the restroom could easily be undone if you walk out and jump into a dirty pool.
The stats are that 84% of Americans believe their fellow swimmers participate in unhygienic pool behavior and they are right. The Water Quality and Health Council surveyed 1000 adults nationwide and found that 47% admit to one or more behaviors that contribute to an unhealthy pool.
Peeing in the Pool?: 17% say they have done it.
Showering?: 35% pass the shower without stopping
Proper chlorination plays a key role, but swimmers also have a responsibility for healthy swimming and that means:
Don't swim (or let your kids swim) when you have diarrhea.
Don't swallow (or let your kids swallow) pool water.
Practice good hygiene and shower with soap before swimming and teach your kids to do the same.
Wash your hands after using the toilet or changing diapers and teach your kids to do the same.
Take your kids on bathroom breaks or check diapers often
Change diapers in a bathroom or a diaper-changing area and not at poolside
Wash your children thoroughly (especially their bottom) with soap and water before they go swimming.
Most importantly, don't pee or poop in the pool and teach your kids not to do so either.
If using a public pool (or maybe even a friend's) ask about their policy on chlorination, listen to see if you hear pool cleaning equipment at work and perhaps use test strips. Look for clean, clear and blue water and smooth clean tiles. If you see slime or smell odors that is a bad sign.
Press Ganey (PG) is known for their stakeholder (customer, emplyee, medical staff) satisfaction survey services. Now, PSQH reports on their recently released Safety Culture Pulse Report which assesses the correlation between medical errors and the culture impacts within the heatlhcare provider workplace.
PG analyzed data collected from 42,378 health care employees who were given the opportunity to report on their perceptions of their facilities practices that affect safety culture. Key findings included:
hospice and outpatient staff reported the highest perception of safety, while emergency department and anesthesiology staff report the lowest perception.
employees of government-run hospitals report a focus on safety prevention that is considerably lower than tax-exempt hospitals, especially faith-based facilities.
the perception of safety in the employee's hospital steadily decreases as the size of the facility increases
employees who work 20 hours per week report the highest level of focus on safety, while those who work 60 or more hours each week report increasingly lower perceptions of safety in their hospital
employees who have worked in healthcare for 6 to 10 years report the lowest sense of safety in the workplace and those who have worked for less than a year report the highest level of safety focus.
The study found that assessing blame for errors rather than addressing system failures as the root cause of errors is the primary impediment to improving error prevention and creating a culture focused on safety. And, they found that the hospital's administrators' involvement in the issue presents the greatest opportunity to improve the culture and perception of safety.
Administrators must take an active role in patient safety processes and I believe it starts with truly understanding the perceptions of employees. As a result, I encourage all effective hospital leaders to gain a better understanding of the culture and atmosphere of safety in your organization and exhibit a sincere interest in preventing errors and adverse events. Aside from being your job, it is what your patients and other stakeholders expect!
I don't mean to beat a dead horse with a follow-up to my post on grace in the workplace. However, an article in Chief Executive magazine is worth sharing, because Want Better Performance? Say you're sorry! presents an apology as a less costly alternative. I especially enjoyed reading the sidebar about the Pearl Outlet research that showed that customers who were willing to say "I'm sorry" earned more than those who rarely or never apologize.
In addition to going a long way towards earning the respect of employees and customers, an effective apology may be the difference between keeping or losing your job and your company being truly transparent. In addition, those of us who have worked in risk management have long known that an sincere apology goes a long way in helping to minimize the risk of legal action or the amount of the award.
I'll close with a line I found recently in my horoscope that seems to fit in nicely with the results of an effective apology. "Precious gems are created by extraordinary pressure." Yes, there is sometimes extraordinary pressure on the leader who is about to make an apology. However, the outcome is most likely to be a precious gem and worth the effort!
The 2009 Statewide Medical and Health Functional Exercise Guidebook is now available for the drill on Thursday, June 18. The drill scenario will be based on a pandemic influenza outbreak in Southeast Asia that progresses to laboratory confirmed cases in CA. Communications, Medical Surge and Intelligence/Information Sharing and Dissemination will all be tested.
I'm providing this information as follow-up to my posts over the last couple of week on hospital preparedness and don't think California will mind sharing the resources with hospitals in other states.
Once again we have fire in Santa Barbara in the mountains above our community. I can see the fire from my office and will keep a close eye on it today. We are just outside of the evacuation warning area and no hospitals are involved. However, this is probably a good time to share a few things from my current work on the topic of hospital evacuation.
It is important to have a clear understanding and the role of your local EMS agency described in the plan. Make sure you have had conversations with each other prior to an event to avoid any gaps or misunderstandings. Then clearly document the key points in your plan so it can be implemented by anyone who finds themselves in the role of Incident Commander.
While it is ideal to coordinate access to resources with your local EOC, be prepared to initiate an evacuation on your own if they are overwhelmed by the incident or cannot be reached. You will want to shelter-in-place as long as possible, but be prepared to get out on your own if needed.
Security during and after an evacuation is important for safeguarding assets and helping to ensure that every is removed from unsafe areas or the facility. Also be prepared to secure and shut off utilities as appropriate or as the sections of the facility are evacuated.
When evacuating patients, plan for the transportation of needed medications, supplies, equipment and staff, even if your destination is another hospital. Some patients can be removed from medical gasses and equipment during the evacuation period, but will need this support at the destination. The receiving facility will be in a surge mode and resources may be limited initially.
If you have electronic health records, how will you access patient information at the destination facility or alternate site. What minimum set of records should be printed out if time permits for each patient?
In advance of an evacuation, identify holding areas (safe areas for patients awaiting transportation) and staging areas (for loading patients onto transportation that has arrived.) Consider different holding and staging areas for different patient types and transportation needs (ie. critical patients are evacuated through the ER via ambulance, ambulatory patients are evacuated through the main entrance via bus, non-ambulatory patients are evacuated through the side entrance via wheelchair vans and ambulances, etc)
Keep track of patients, but also the evacuation of employees and visitors.
Plan for demobilization, recovery and re-entry soon after the plans for evacuation begin. Establish criteria
Outline key tasks and responsibilities for each of the HICS roles that you expect to be initiated in an evacuation event. Train staff and conduct drills that test their response to the six critical areas of emergency management: