Christina's Considerations

What Ails Louisiana - the State's top 10 health problems!

My Louisiana Life magazine arrived and I found a really interesting article that addresses one of the issues I've noticed during my trips home over the last several years.  I've noticed that people tend to be much larger than those I see here along the Central Coast of California or remember from my life in the Great State between the 1960's and 1989.

What Ails Louisiana uses the literary figure Ignatius J. Reilly from the wonderful novel A Confederacy of Dunces for comparison with today's obese and to describe metabolic syndrome and related conditions.  It is worthy reading whether you live in Louisiana -- or not!

SB Community Health Status Report

The Santa Barbara County Public Health Department released the Community Health Status Report for 2009 and identified the casues of premature death, risk factors and prevention steps.  The top three causes are:

• Coronary Heart Disease
• Motor Vehicle Accidents
• Accidental Drug Overdose. 

We have some work to do.  Yes, even here in beautiful Santa Barbara people are obese!

H1N1 Educational Materials for Older Teens and Young Adults

Sometimes it is more difficult to reach out to older teens and young adults on public health issues.  But, UCSB Student Health has some posters for older teens and young adults and an online self assessment of flu symptoms  that might help. 

My favorite is Be Kind to Mankind because if you have the flu, someone else's health will depend upon your actions. 

H1N1 Awareness and Prevention Materials

 

  Below are links to materials that can be printed out, posted on your business Intranet or website, or emailed out to employees and vendors.

Health Alert English and Spanish or English Chinese

Cover your Cough Table Tent

H1N1 Workplace Health Podcast

Don't Spread Germs Flyer

Wash your Hands sign (great for putting in bathrooms)

H1N1 Prevention Tips

The items above and a few really funny and short videos to help get the message across to some employees can also be found at  http://www.cdph.ca.gov/programs/immunize/Pages/RespiratoryDiseasePrevention.aspx.

The great Cough in your Sleeve Video.

The CDC also has a variety of Social Media Widgets and Buttons and a Communication Toolkit,  as well as,

Stop! Do you feel sick?  poster  

Cover Your Cough poster

 Hand Hygiene poster (and a video for patients) 

posters for children

And, if you work with young children there is always Elmo! 

 

 

Business Preparations for a Possible H1N1 Outbreak: Foresee Severe Problems

A recent Harvard School of Public Health Survey revealed concerns about maintaining operations if a significant or widespread H1N1 flu outbreak were to occur.   The concerns center around continuity of operations, absenteeism, sick leave policies, and other employee issues.  Highlights of the data  include:

• Only one-third believe they could sustain their business without severe operational problems if half their workforce were absent for two weeks due to H1N1.
• While 74% of businesses offer paid sick leave for employees, only 35% of businesses offer paid leave that would allow employees to take care of sick family members, and even fewer would allow paid time off to care for children if schools/daycares were closed (21%).
• Just over half of businesses in the U.S. (52%) believe there will be a more widespread and more severe outbreak of novel influenza A (H1N1) in the fall. If such an outbreak does occur, 84% of firms are concerned that it will negatively affect their business.
• Only a third of businesses believe they could avoid having severe operational problems for 2 weeks if 50% of their workforce were absent due to H1N1; less than a quarter (22%) of firms believe they could do so for a month.
• Three-quarters (74% of businesses offer paid sick leave for at least some employees.  Fewer offer paid leave that would allow employees to take care of sick family members (35%) or to take time off to care for children if schools/daycares close (21%).

Employers will want to adopt strategies to limit contact between employees and between employees and customers and flexibility may help in some situations.  In a widespread outbreak, many people may have problems getting to see a physician (and obtaining a doctors note) due to the number of sick individuals.  Employees without sick leave who must take care of children, if they are sick or if schools and daycares, close may face financial troubles. 

Great leaders will plan for how their business will maintain operations and essential services.  This includes plans to slow the spread of H1N1 in the workplace and adjusting operations as absenteeism increases.

Is your business prepared for the 2009 flu season?

The business community, including non-profits, play a key role in the infrastructure of communities as employers and providers of essential services.  As a result, it is really important that businesses are prepared for the upcoming flu season and the impact of the H1N1(swine) influenza.

Keep in mind that the severity of illness appears to be similar to the level seen during local seasonal influenza and most people will recover without the need for hospitalization or medical care.  However, there is the possibility that larger numbers of individuals, especially the young, will become ill or the severity of the pandemic may change. 

Either way, businesses will be impacted and should have a plan to minimize disruptions to operations and essential services.

Business can expect increased employee absences due to personal or family illness or public health containment measures, but there is also a great deal they can do to minimize the prevalence of illness and absence among their workforce, customers or partners.  Some resources to aid in your planning for continuity of operations include:

CDC Business Guidance  

Preparedness Guide for Small Businesses 

Flu.gov Business Planning   

Santa Barbara County Pandemic - Business Planning 

Over the next few weeks I focus on a couple of specific actions you can take to prepare.  If you need some help, explore resources in your community.  I'm also available to assist businesses with the assessessment and improvement of their continuity of operations plans.

Santa Barbara Healthcare Forum

I noted in earlier posts (Evolution of the US Healthcare System: A Process and  Baseball and Health Reform) that I had been invited to join a panel of physicians and a health insurance broker to discuss the need for reform to the healthcare system.  It was taped and video of the highlights are now available on YouTube (Part II) .

The doctors were truly the stars of the evening and their comments so important to this debate.  I urge you to listen and consider their perspectives as you form your own opinion on the subject.  I also invite you to leave your thoughts on this post, especially those of you with an interest in the role of health information technology and exchange.

Hospital H1N1 -Seasonal Influenza Preparedness Checklist

The California Hospital Association has been producing some really great tools to help hospitals be better prepared for any emergency that might strike, but the latest is rather timely. 

The Hospital H1N1 - Seasonal Influenza Preparedness Checklist can help facilities and their leaders identify any gaps that may exist, so steps can be taken now to fully prepare what could be a significant event.  I highly recommend that you and your leadership team complete the checklist and take action to address any improvement needs. 

I'm somewhat of a freelance hospital administrator at the moment so let me know if I can help.

Southern California Health Care Summit

I'm attending the Southern California Health Care Summit on October 29, 2009 from 9 am to 3 pm at the Marriott Ontario Airport.  This year's program should be a good one given the healthcare system reform issues we face.

I like the line-up of speakers and am especially pleased to see the involvement of local elected officials.  This summit is an example of how those involved in the healthcare system and policy makers need to come together for dialog and debate so that the true gaps and real priorities can be identified and addressed.

The added bonus or lagniappe is Category I ACHE credits!  Let me know if you are planning to attend and we can connect face-to-face! 

Hospital Administrator Bloggers

I've followed a couple of hospital administrator's who have blogged over the years, but in writing my book on use of social media in healthcare I found a few more.  I also know there are administrator's blogging on secure networks, like their Intranet.

Since there now seems to be more of a hospital administrator blogger community, I thought I'd start a list of hospital Presidents & CEOs who blog and it can be found on my side-bar under the title "Hospital Administrator Bloggers".  If you want to recommend a blog, just add a comment to this post or send me a link.

For those of you who may be wondering, I've left Nick in this list even though he is a former hospital President/CEO, because he is the first one I found back in 2005.

Healthcare System: Full of Fraud?

Hummm!  The President said the "healthcare sytem is full of fraud" last night and I'm a bit miffed about the statement.  I've worked in the healthcare system and seen a few people be brought down by the scams they brought on themselves and know there are probably a few more individuals out there who are headed toward a career in Federal prison.  I'm all for catching thieves and throwing them under the jail!

However, I can't say the system is "full of fraud".  It makes me a bit disappointed because the people I've always worked with were really trying hard to bring quality care to the patients we served.  We struggled within the system we had and I think in the long run, didn't do so poorly with the tools we were handed.  I resent the statement that the system is "full of fraud" -- like this will somehow pay for a system we can't afford. 

Now, maybe I shouldn't be putting myself out on a limb -- given my unemployment status.  But, at some point we all need to stand up and call a sham, a sham.  The bottom line is I don't trust the federal government to run a healthcare plan for the general public without having an advantage.  And, I certainly don't think they can run a healthcare system any more efficiently that what a private  enterprise can.  I've worked in both private and public healthcare and can point to specific examples.

What I want to see is a government that is looking for the best solution(s)  to increase access to care for everyone and willing to work with our best and brightest minds to find the solutions that will make a real difference.  I don't see any movement in that direction and am saddened that Washington DC can't seem to put their individual interests aside for what is best for the sustainability of our democracy and this country's future.

The system we have didn't happen overnight.  It is the result of missteps over many years and sometimes the learning process.  Lets move away from the blame game and get it right this time!  We need a leader, not someone to throw fuel on the fire!

The wrong way to reform the health system

Paul Levy shares an example of how not to reform our healthcare system .  This is an example of not thinking through the process and the impact it will have on other costs.  Those who are not familiar with the process, because they have never worked in it, should not be making this type of a blind decision.

Zits: For Moms and Sons

Over the weekend, I read a comic and shared it with my son.  When I asked what he thought about it, he replied with a smile that he liked it.  I think he may have noticed the familiarity of the situation.  Sometimes they do really get it after-all!

Social Media: Disruptive Force in Medicine!

You betch'a social media will be a disruptive force in medicine and healthcare.  Glen at the Healthcare Blog does a great job addressing one of the biggests risks.  However, their is already great risk in how we conduct our personal life (make choices) and the potential impact upon our professional life. 

My book on use of social media in healthcare is now in the hands of the publisher and being prepared for its release.  I'm really excited to have this opportunity to share my knowledge on the topic with my administrator peers and my vision for the future of social media in healthcare.

King of the World - Flu Fighting

Sometimes it would be nice to be king of the world an see if I could really make it a better place.  Well, I've found at least a virtual world where I can practice.  The Great Flu is a game that allows a person to step into the shoes of the role of Leader of World Pandemic Control and it is up to you to prevent serious threat to the world population!

• Find and prevent an outbreak

• Distribute antivirals

• Assign research teams

• Close schools and markets

• Find a vaccine

If you play the game, remember, the fate of the world depends on you!

For anyone who is waiting for the book, it should be out in January!  Visit Health Administration Press to learn more as we near the release date. 

Here we go... RHIOs are Connecting!

I've known since 2004 that we would see the day when RHIOs began to find others who shared the same vision and they would pool their resources and collaborate for a sustainable future.  It seems the first to do this are three RHIOs in Indiana and Ohio -- Healthbridge, Indiana Health Information Exchange and HealthLINC.  This pioneering example of interconectivity is just one more (big) step forward as we bring all of a patient's health information to the point of care.

Congratulations to the leadership at Healthbridge, Indiana Health Information Exchange, and HealthLINC!

Hospitals Sustain the Economy

Those of us working in hospitals have realized our role in supporting local economies.  Many towns and cities, and now, States rely on their financial contributions to the economy.  It was a pleasure to read the article Hospitals Help Sustain Louisiana Economy. 

However, I'm well aware that some of the care being provided is to treat preventable or at least manageable chronic conditions.  I hope we can reduce these costs by improving our lifestyle choices.

Trust, Sharing and Managing Health Information

I been wanting to add a couple of documents related to health information exchange (HIE) to my blog since I read the Spring Issue of the Journal of Health Information Management.They are all worth reading in their entirety.

Crying Wolf:  Consumers May be more Willing to Share Medication Information Than Policymakers Think:  While the subtitle of this article says it all, the study revealed that participants almost universally chose to share their medical information with the providers, however, they didn't always understand as a whole the possible consequences of their choices. 

The Next Step in Health Data Exchanges:  Trust and Privacy in Exchange Networks:  The idea that it is no longer efficient for a RHIO to negotiate a separate data exchange agreement with every one of its exchange partners is explored.  The paper explores the use of multi-party trust agreements and their crucial components.

• Common goal to improve clinical patient care

• Stakeholder input

• Mechanism to establish trust

• Protecting exchanged information

• Allocation of liability risk

Best of Breed Strategies:  Hospital Characteristics Associated with Organizational HIT Strategy:  Of the hospitals surveyed, 65% indicated a single-vendor; 29% indicated a best-of-suite; and 10% suggested a best-of-breed strategy. 

• The single-vendor strategy was more common in small, stand-alone, for-profit, non-teaching and/or non-JCAHO accredited facilities.
• The best-of-breed strategy was most common in system affiliated and JCAHO-accredited hospitals.
• The best-of-suite strategy was most common among very large, system affiliated, teaching and JCAHO-accredited hospitals.

Elmo says "Wash your hands!"

Elmo, as usual, has some great advice when it comes to washing your hands and covering your cough to avoid getting the flu.  Please share this with you young children.

Yeah for Teen Hospital Workers!

Teens in Boston are getting a peak into what it is like to work in a hospital and Brigham and Women's Hospital is being recognized for their effort with AHA's NOVA Award. 

I started my career as a candy striper (hospital volunteer) and at 16 was offered a job in the hospital (business office) along with several other kids who had parents working at Lakeside Hospital.  It was a wonderful experience that lead to my decision to make healthcare a career.

OK, so I didn't like the idea of blood and stuff and I believed my skills would fit better on the administrative side.  I've never regretted the move even after a couple of challenging times (DRGs, managed care, California's fiscal crisis). 

There is no better way to attract young people to the healthcare workforce than to expose them early.  I'm saddened when student worker programs are the first to be cut, because that is a potentially powerful pool of future healthcare professionals.  So congratulations, Brigham and Women's Hospital for taking the next step and exposing your neighborhood kids to a career in healthcare.  I hope you and the teens reap the rewards for years to come.