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!

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!

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. 

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.

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.

Re-energize in the National Parks

I just scratched off one of the items on my to-do list and feel really great about the accomplishment.  I had a recent trip to Utah and visited Zion and Bryce Canyon National Parks, two magnificent examples of the power of nature.

I've always been fascinated with nature, but in 1981 or 82 I took a geology class at LSU taught by an exceptional geologist and teacher and learned to appreciate and read rocks and earth formations.  These two parks have been at the top of my "must see" list for a number of years and were just as impressive as I expected.

Years of environmental forces have shaped these rocks, much like we are shaped by the environmental forces in our life.  Up close they may not seem very impressive, but step back a moment and look at the whole picture to appreciate their journey!