A hospital employee took a simple picture in his/her Emergency Department workspace for a Facebook post. However, the picture also captured his/her computer screen and a patient's personal information.
This simple data breach and HIPAA violation unfortunately has already lead to the patient's identity being used by someone who now has her name, address and social security number. The patient describes this entire incident as a "nightmare", so my guess is that her patient satisfaction scores for the visit will reflect the fear and frustration she is experiencing.
This report initially ran in the local newspaper and, I'm guessing, has created a bit of a public relations mess for the University of Arizona Medical Center, as well.
So lets review the costs to the hospital:
1. HIPAA penalities
2. Potential state fines
3. Lawsuit: Defense costs and settlement/award
4. Damage to brand and recovery costs
5. Additional training costs and potential recruitment costs (to fill a possible vacancy if the employee is terminated)
6. Lower patient satisfaction score and reduction in reimbursement
Hummm, wonder if the employee feels this was all worth a picture that was ultimately removed from his/her Facebook page.
Trevor Wilson, a human resources strategist, recently shared three great tips healthcare leaders can use to foster a culture in which employees are actively engaged. The tips reflect what I have long believed and experienced in the hospital setting.
• Use performance evaluations to learn more about your employees’ strengths, interests and goals. Each employee has strengths and talents that often go unrecognized -- and untapped -- in the workplace. Helping them to identify these and use them at work contributes to their feeling that their work has purpose and results in more engaged, productive employees. “People want to bring all their talents to what they’re doing – we’re happiest when we’re doing what we’re good at it,” Wilson says. “In order to know what those skills, talents, even personality traits are, managers must get to know their individual employees.”
• Do not treat all employees equally. All employees are not equal and treating them as if they were leaves engaged, enthusiastic employees feeling shortchanged and disengaged employees feeling entitled, Wilson says. “Acknowledge and reward employees who are going the extra mile and point out the ways they’re contributing that may not be quantifiable or part of their ‘job description.’ The successful salesman who routinely coaches less successful colleagues is displaying a strength that won’t show up on his sales sheet but is, nonetheless, a valuable contribution to the company.”
• Recognize and reward employees’ demonstration of strong values. Values are part of the human equity that all of us bring to work in varying degrees. Honesty, integrity, compassion, work ethic – our best employees usually have these and other strong, positive values. Business leaders may unconsciously recognize them, for instance, by giving a very honest employee their trust, but they should make a point of acknowledging them publicly as well. “Our values are the foundation of our purpose and an expression of our true selves,” Wilson says. “Employees who are both able to demonstrate their values at work, and rewarded for doing so, having a greater sense of purpose.”
These strategies compliment one of my posts earlier this year on the idea that patients come second. Why? Because you can't have satisfied patients when employees are unhappy, disengaged, non-productive and demonstrating weak values. And, all it takes is one or two to infect the culture and co-workers.
Jobvite has been keeping their finger on social recruiting for the past six years and this year find that recruiting is now marketing. Their latest report shows how social media is proving to be a cost-effective catapult for multi-channel campaigns that, as in marketing, help recruiters target and nurture candidates based on their individual preferences.
Key findings for healthcare employers include:
For those of you looking for a job and wondering what not to post (besides confidential patient information) consider:
The CDC has a new award winning film that is appropriate for staff education and patient and family empowerment. Evidence-based staff training and other resources are available through the One and Only Campaign. There is even an injection safety app and checklist for providers.
Patients and their family caregivers will learn to advocate for themselves and learn what questions to ask to reduce the risk of infection at the time they receive injections.
Several state laws, including California's AB1844, went into effect this week and prevent employers from requiring employees or applications from providing their social media user names or passwords. I had heard of this practice by companies and some hospitals and could only wonder if the human resource leaders or executives truly understood the risk. In this post, I thought I'd just pose a few questions.
1. Shouldn't my personal Facebook page or other social media channels be private? Yes, if I manage the company/hospital's account, I would expect you to have the user name and password in case something happens to me (unexpected illness or leave, death, termination, etc.) But, do you really want to peer into my personal life -- would you peer into my home?
2. Who exactly will be looking at my social media channels - the hiring manager?
3. What would you do if you found any of the following by looking at my social media accounts?
4. What social media channels will you ask me to access? Twitter, Facebook, LinkedIn? What if I also (or instead) have accounts with Google+, Friendster, Pinterest, Squidoo, Instagram, FourSquare, SecondLife and many others?
5. What does your social media policy say? Is it overly broad, include prohibit organizing communications, or address a publicly-available sensitive issue for the employer?
There are several appropriate things that employers can do to minimize risks around employee social media use and to assess applicants for signs of poor communication or judgement. Prohibiting access to social media channels, or inspecting an applicant/employee's social media channels is short-sighted and a sign that the employer is out of touch with the reality of social media. Unfortunately, it took legislation --- in several states -- to keep these employers from self destructing.
One of my Santa Paula fire-fighting friends has a new blog and I'm hoping some of my readers will go visit his writings on being prepared for a disaster! His first post was about the People Like You video, which is truly a great educational and motivational tool!
As I often say, the best prepared hospitals are those whose employees are prepared at home!
This morning sent out a press release for Tower and also want to also share it with my blogosphere readers. As always, I'm interested in your thoughts and hope you will consider leaving a comment. (PDF Version of Press Release)
The Office of the National Coordinator for Health IT (ONC) and The Centers for Medicare & Medicaid Services (CMS) has released the long awaited final requirements for State 2 Electronic Health Records Incentive programs. Included in the rules is an emphasis on patient engagement.
New rules specific to patient engagement include:
The ONC final rule complements the newly released CMS final rule and reflects their commitment to promote patient engagement and safety.
As hospitals and other providers prepare to comply, they must first acknowledge that this isn’t just an issue for their IT departments to address. Instead, attaining meaningful use of one’s electronic health records/systems for patient engagement will require the collective involvement and collaboration of disciplines from across the organization… clinical, operations, information services and communications/marketing.
“Healthcare leaders will need to be strategic and put every decision in the context of the patient experience. Having an effective patient strategy will lead to happy customers, staff and a healthcare organization exceeding their business objectives” said Dr. Sue Sutton, CEO at Tower, a patient experience consulting group based in Los Angeles, California.
The approach required is one of re-defining patient engagement across all touchpoints, both physical and virtual, to positively transform the patient’s experience – as perceived by the patient. “The research tells us where the patients are going, but institutions aren’t paying attention. If the approach taken doesn’t actually engage patients, the organization won’t meet the meaningful use criteria and they may actually lose some patients to healthcare providers who have implemented more patient-centered engagement strategies“, added Dr. Sutton.
Enterprise portals can facilitate electronic access by making information within existing systems available in a more patient-friendly manner. The portal helps accomplish the goal of compliance with the MU criteria, but it does so at the same time it can accommodate additional features and personalization for enhanced engagement and a better patient experience. Ultimately, this is what will lead to improved outcomes – the ultimate goal of meaningful use.
CMS will audit healthcare providers who are participating in the meaningful use program and will focus in on those who show substantial noncompliance. For detailed information, see
Posted at 10:31 AM in Health Information Exchange/RHIOs, Health Information Technology and Telehealth, Healthy Children and Families, Hospitals, Personal Health Records, Social Media & mHealth, Workplace Health and Wellness | Permalink | Comments (0) | TrackBack (0)
I'm behind on my reading, but did finally finish A Manager's Guide To Virtual Teams. It is a nice blending of team management with communications in a virtual environment. I found the advice on team development, communications, accountability, conflict to be solid and also appreciated the twist for effectiveness in virtual work environments.
As reform of our healthcare delivery system takes place and we experience the challenges related to efficiency and wisely using limited resources, we will experience growing numbers of remote and mobile workers and virtual workplaces. If you are a manager of mobile and remote workers, or new to working in a virtual environment, this is a great book for you. I also think this is a great book for anyone leading teams of people and maybe thinking about going virtual.
The Nursing Alliance for Quality Care (NAQC) released Guiding Principles for Patient Engagement, a list of nine core principles designed to support nurses and other healthcare providers in delivering high-quality, patient-centered care. Patient engagement is a cornerstone of safety and quality and development of the priciples was supported by RWJF.
The engagement principles that they hope will be integrated into programs and practices include:
CHCF/NEHI has released a list of 11 emerging chronic disease technologies to watch and they include some familiar applications. Each has the potential to reduce costs and improve the quality of chronic disease care in California, and elsewhere.
The full report is at Getting to Value: Eleven Chronic Disease Technologies to Watch. It includes barriers to technology innovation and adoption.
Posted at 12:44 PM in Health Information Technology and Telehealth, Healthy Children and Families, Hospitals, Social Media & mHealth, Workplace Health and Wellness | Permalink | Comments (0) | TrackBack (0)
TechNewsWorld interviewed me not long ago for an article looking at specific issues related to personal mobile devices in healthcare environments. The article is Part 2 of a series, so I also recommend reading the first one, which addresses the general issue of mobile devices and the need for encryption.
As it relates to healthcare, here are some more specific thoughts.
Dr. Ken Cohn is one of my virtual friends and like me, a writer and blogger. He lives on the East Coast and at one time did live here in Santa Barbara, however the Internet has facilitated our connections and collaborations on topics of shared interest. As in the case with some of my other virtual friends, I'm sure one day we will meet in person -- most likely at an ACHE Congress on Healthcare Leadership.
Last year his latest book Getting It Done was published. He and his co-editor, Steve Fellows, have pulled lessons learned from some of the best and brightest in the healthcare profession on a broad range of topics. I enjoyed the stories, ideas and peaking inside a little unfamiliar territory. Here are a few of the chapters and concepts that struck me.
Disaster Preparedness for Healthcare Professionals Important reminders:
Overcoming Rural Healthcare Challenges - The complexity that sometimes leads to the marginalization of rural hospitals and in many cases their one and only general surgeon.
Launching and Innovation Revolution in Healthcare - Great examples of breaking out of the old. I especially like the red zones and Chocolate Cafe'!
Documentation as Destiny: A Tool for Survival Why physician documentation is the key ingredient in the determination of payment.
Building a Functional Operating Room Culture Hummm!! I can see how the best candidate for OR medical director is "a retired surgeon or anesthesiologist who likes surgeons and has a background as a high school teacher with a degree in psychiatry." This wonderful chapter also includes the quote "The best way to predict the future is to invent it." (Kay 1989)
Innovations to Address Disruptive Physician Behavior Comprehensive approach and series of progressive interventions and ongoing monitoring, but don't forget docs aren't always the hospital's bully. Use this guidance to address them all for safe and high quality care.
Coaching Healthcare Teams to Improved Performance Breakdowns in communication and poorly managed conflict drive suboptimal team performance and undermine the quality and safety of patient care.
I thought today would be a good day to remember our veterans who fight to save the lives of those fighting for our freedom. My dad was a corpsman who worked in a naval hospital during the Vietnam War and I wrote about my tour of Midway's hospital ship last year.
A few years ago, I also had the honor of touring the Field Medical Training Battalion at Camp Pendleton and their field hospital -- ER, OR, recovery and unit tents. I took pictures and am shocked I can't seem to find a post about it on this blog. As soon as I can find them, I'll add them to this post.
So, thank you to all of our military corpsman, doctors, nurses, pharmacists, administrators and other healthcare professionals!
The Doctors have been focused on exercise this month and I thought I'd share this video clip as a reminder to all doctors to have those conversations about weight and exercise with your patients. I, too, also hope it helps inspire a few readers to get up and exercise.
I don't watch The Doctors (too busy working), but I do love Richard Simmons and think I'll go for a walk now!!!
A few of the 13 secrets being revealed on the show are:
The Acting General Counsel of the National Labor Relations Board released a second report on outcome investigations involving social media that were submitted by regional offices and it underscores two main points:
I share this because I'm not sure how many of my readers even saw the first report (Wonder if they tweeted it!). In this report there were/was:
These cases aren't limited to healthcare, but they will be helpful as your organization's human resource department monitors it's policies with the rapidly evolving new media. For more, visit a related post on social media risks.
By the way, does your organization's social media policy address managers "recommending" employees on LinkedIn? Can you think of reasons why it should?
What a great few days of learning it has been here at The Beryl Patient Experience Conference. The video below sets the stage for how we healthcare workers are the patient experience. Below the video are some key quotes/thoughts from the last couple of days.
The Annual Healthcare IT Conference of the SoCal Chapter of HIMSS is coming up quickly on April 4th in Los Angeles. It is a great networking and learning event for healthcare professionals, but it is also a wonderful opportunity to meet some of those who are new to the health IT workforce.
The HBR blog has a post titled, Reward Value, Not Face Time and it brings me back around to the idea of managing a mobile workforce. I really do see more mobile healthcare workforces as an opportunity for hospital leaders to become more effective and efficient with the management of their limited and constrained resources.
Like Tony, I too realized that the more autonomy I give people, the more confident and expert they became in their domains, the more ownership they took of their results and the happier they were at work.
I don't want to harp on this subject. Instead, I'll just end by sharing a quote from the article that sums it all up perfectly.
The job of a leader or a manager, I've concluded, isn't to tell people how to get their jobs done, or when and where they do their best work. Rather, it's to free, fuel and inspire them to bring the best of themselves to work every day.
I'm a big fan of the AHRQ's tools and have a new one to share. I realize that some people aren't impressed by some of the tools, but overall I think that they are good -- and they are free. If for no other reason, they will help stimulate ideas among providers who that then improve upon the resources they provide.
The latest tools are part of the “Questions Are the Answer,” a new public education initiative that encourages patients and their clinicians to engage in effective two-way communication to ensure safer care and better health outcomes. An added benefit, or as we say in Louisiana a little "lagniappe" is the contribution improved safety and outcomes has on the patient experience.
To promote safer care and the importance of Patient Safety Awareness Week (March 4–10), AHRQ offers these free multimedia tools that health care providers can use with their patients:
For more information, go to www.ahrq.gov/questions. To request free copies of the DVD, brochure and notepad, email AHRQpubs@ahrq.hhs.gov or call 800–358–9295 and include the following reference numbers: DVD (AHRQ Pub. No. 10-(12)-0094-DVD); brochure (AHRQ Pub. No. 10(11)-0094-A; notepad (AHRQ Pub. No. 10(11)-0094-1).
I was recently interviewed for an article in Healthcare Finance News about the cost of protecting workers against violence. It came about because of a ANA survey looking safety concerns in the workplace and the report that healthcare facilities are not doing enough to keep nurses safe. While we often think of the hospital, workplace violence can, and does, also occur in nursing homes and ambulatory or private practice settings.
Healthcare worker violence is an issue related to security, which falls under the broader umbrella of hospital safety. From a general standpoint, healthcare security is important, but competing priorities sometimes get in the way of organizations doing more to secure access to the facility or expend additional resources on training. Most hospitals and some other healthcare settings do have security staff. However, security staff can't be everywhere at once and just adding more isn't always the best answer.
The best person to identify when something isn't right (a safety or security risk) in their environment, is the person who works in that environment on a daily basis. The result is that we must rely on employees and others in the organization to notice and report any suspicious behavior and to be more defensive in their contact with patients, families, visitors and even other staff. Unfortunately, as an industry we have tried to create warm and inviting environments for the public and healthcare workers have historically been too caring and trusting.
The risks to employee (and patient) security and safety are continually evolving and expanding. I believe our healthcare organizations must create policy that mandates reporting of any suspicious behavior, threats, and/or violence. But, they should also create a culture where staff feel safe in doing so. Organizations can also do more to educate their employees of the evolving risks and help them gain skills to identify risks and respond to difficult situations.
As it relates to our patients (or their families), they are sicker than they have ever been before and unfortunately the ER is sometimes used as a dumping ground for individuals who belong in other settings. We need to help our staff become better at identifying threatening behavior sooner and support them with response from other clinical or security staff. Our organizations also have to develop strong relationships with law enforcement and other community leaders to address concerns as they arise.
As for the investment cost of security ... it is so much less than poor employee morale, high turnover and absenteeism rates, negative media coverage, investigations, fines, litigation, worker's compensation claims, and higher insurance costs. But, keep in mind that a balanced approach is best.
Another one of my posts that addresses the culture of safety and the CEO's role may also be of interest.
Not long ago I posted on a shocking example of un-compassionate healthcare. An agency employee made fun of and posted a picture of the patients medical records on his Facebook pages. Worse, he refused to see is error or accept responsibility for violating the patient's rights and privacy.
So, last week I ran into a friend of mine who is the Executive Director of Adventures in Caring Foundation, a nonprofit organization that cultivates and teaches compassion in healthcare. Their volunteers visit hospital and nursing home patients and are often undergraduate students who will pursue a healthcare career. They also teach and train staff on delivering compassionate care and having those difficult conversations.
We discussed this shocking example of un-compassionate care and wondered if it is possible that this employee isn't managing their stress -- leading to poor judgement and actions. In other words, is this employee letting the pressures of caregiving and life wear him down to the point that he exhibits self-destructive behaviors?
I'm especially interested in the thoughts of those of you in direct care roles, or who work and support caregivers.
A new report Social Recruiting Activity Report from Bullhorn examines the activities of recruiter use of social media for executive and job recruiting and it reveals that LinkedIn drives more views than Facebook and Twitter combined. And, recruiters that post jobs on LinkedIn are likely to receive more applications (9 times more than Facebook and 3 times more than Twitter).
Other interesting data includes:
The reports authors and I both believe we will see an increase in use of Facebook and Twitter over time, but it may be a bit slower for conservative healthcare leaders. So, for now invest your time in LinkedIn.
For those of you who are considering or preparing for a career in health management, visit the resources on the ACHE webpage for students, those in transition and career counselors.
Mobile Health (mHealth) also involves managing the mobile workforce, but I don't often hear this administrative function being discussed. In our efforts to increase access and the quality of healthcare and reduce costs we are moving beyond COWs (computers on wheels) and leveraging and adopting more mobile technologies, such as, tablets and smartphones. So, lets see what kind of discussion this blog post will generate.
A few months ago I read the book Managing the Mobile Workforce and appreciate the guidance on leading, building and sustaining virtual teams. I was especially happy to see a couple of examples drawn from healthcare environments. One of these examples caught me a bit by surprise. It involved looking at employees who spend most of their workday out of any office (or nursing station) and on the units attending to patients. Or those in ancillary and support roles who move from department to department or drive between clinics or other sites throughout their workday.
My first question is have we, as healthcare leaders, really thought about the new workforce paradigm and our ability to communicate with and supervise workers who are increasingly on the move during the day?
I do believe that effective healthcare leaders will begin to recognize the strategic value of more flexible work arrangements and this will include virtual and remote workers. Telemedicine technologies are facilitating access to clinicians at a distance and remote coders and IT support are becoming more popular. But, there are other functions that can easily be performed from a distance with today's technology -- at least a portion of the time. Traditionally, hosptials and other providers have expanded their real estate to house these workers, rather than turning to "telecommuting" arrangements.
My second question is are healthcare leaders beginning to recognize that mobility can actually increase productivity and will they follow other industries who are turning to remote and virtual workers to stay competitive? If so, have they really thought through how to develop motivated and engaged virtual teams?
A new, more mobile workforce in healthcare will also require thought about the type of person needed to fill the job that needs to be accomplished. And, it will require that supervisors learn strategies to train, support, motivate and manage the performance of teams that include both onsite and remote workers.
My third question is do healthcare supervisors and managers recognize the importance of trust and how to build it with workers across vast distances?
A final question focuses in on the technologies that are improving our ability to even consider the idea of expanding the remote and virtual workforce.
Do healthcare managers, especially high-level ones, know what the tools can do, and what their limitations are, so they can manage their teams more effectively?
In December, I came across 5 considerations for hiring remote workers and I believe they are an ideal starting point for healthcare leaders who are beginning to reflect on mobility in their workforce. These five considerations set the foundation for starting to create your organization's strategy for managing a mobile workforce.
1. Create Common Goals
2. Set Individual Goals and Expectations
3. Develop Trust and Accountability
4. Overcome Isolation
5. Plan Regular Communications