Category Archives: hospital operations

Bigger, better, faster hospitals are a great idea

Nagoya City University Hospital in Kawasumi

Image via Wikipedia

The other day, I read a tweet from the estimable Matthew Holt in which he summarized what hospitals have been telling him.  In short, they seem to want bigger, badder, newer facilities.  In fact, if I recall correctly, they feel they’re in deep mud if they don’t get these  upgrades and/or new facilities soon.

OK, usually I take such statements with a grain or two of salt. After all, who  — in any industry — doesn’t want the latest and greatest, from the toys we squabble over on up into adulthood?  But in this case, I think we should be taking Holt’s feedback quite seriously.

After all, despite the fact that I’m not an architect, hospital CEO, designer  or any variation on same, I can immediately think of a few very important reasons for a massive buildout of hospitals to improve care and meet today’s process standards:

*  Shared rooms are right out.  There are already a fair number of hospitals (no stats to hand but this IS happening) who are converting all shared rooms to single rooms within their facility.  Their main rationale is infection control, but I think they’re also hoping to streamline the care process by allowing nurses to think rationally, about one patient a time.

*  Older physical plants are a huge liability. When you’ve got a house full of sick people, the last thing you want is a drip from that 20 year old pipe, asbestos to remediate, mold in ancient ducts and so on.  While maintenance will be an issue for any facility, we’ve learned a lot since the first wave of current hospitals were built. Let’s get rid of ’em ASAP.

*  If you’ve ever owned a house from the 70s (and I have) you know that they leak air conditioning and heat out at a ferocious rate.  Sure, you can weatherstrip and insulate and hang curtains to seal out air from the windows, but eventually, it starts to cost so much that it’s a big waste.  A new place — or hospital — is much cheaper over the long run.

*  And while they’re at it, hospitals newly-designed hospitals can be planned with green energy usage in mind — a trick which might not work out in a clumsy plant from decades a ago.  That not only helps to save the earth, it can save big bucks too.  Again, I don’t have a case study handy but Google “green hospitals” and  you’ll find some heartening stories.

* Oh, and I almost forgot…old hospitals can be a nightmare for techs to work around.  Whether you’re talking about simply making sure Wi-Fi gets to every corner of the building or rolling out an EMR, nobody needs to live with design flaws from the 60s.

So, though I’m surprised to say it, it seems to me that bigger, better, faster hospitals are indeed what the doctor ordered.  We’re not talking self-glorifying projects approved by boards to prove they’ve got the juice to make it happen, we’re talking simply about getting with the times.   Let’s hope plenty of hospitals find the means to do so.


The death of the old healthcare magazine? A public challenge


What if healthcare coverage sizzled like this?

With all due respect to the talented people who work (and have worked) at Modern Healthcare magazine, I’m here to kick it in the butt, not praise it.

Now, I have to admit that there’s a reason nobody’s put MH to sleep yet; in short, it’s probably a very successful business.  If nothing else, as an industry figurehead,  it’s deeply entrenched with the “I’m so geriatric I’ve forgotten the names of my colleagues” set.

After all, any new ideas the aforementioned reporters cleverly slip into their stories are buried in an avalanche of dull corporate-speak, and sadly, there’s usually an audience for mind-numbing jargon. I think maybe the corporate-speak makes the pointy-haired bosses feel all important and meaningful.

But tell me, folks, have you ever read a Modern Healthcare story and said “wow!” or “hmmmm” or even “I’m mildly amused”?   Do you ever change your plans based on something you’ve read in this insipid journal of record?  Or do you skim the half-baked parts (again, baked by editors when all is said and done, so don’t blame my editorial colleagues) and just drop your copy of the darned thing?

I say it’s time for a new healthcare industry publication, one which goes FAR beyond this humble blog.  I want to see an industry magazine/Webzine/podcast/TV show/you name it which covers healthcare the way it is — as one of the most critical industries in the world with a hornet’s nest of issues to address.  I want to see color, life, snark, attitude, vigor, curiousity and most of all, passion.

I say we can build such a service for our industry.  In fact, I’m immodest enough to say that *I* and a team of stalwarts can build such a resource, one which would transform healthcare to some modest degree just by existing.  I’m talking Wired and Fast Company and Forbes and Modern Healthcare’s good bits mixed into the insider smarts of the New York Times Deal Book and Heard on the Street.  Yup, you heard me — we’re talking about a paradigm changer.    And if you’re wondering why this editor thinks she can pull such a big idea off I say, with apologies for the obviousness, “Why not?”

So, are you going to help me?  Do you want to have a voice in changing how healthcare looks at itself?  I know for sure I can’t do it alone, and I doubt anybody could.   I need money, yes — details on request — but as much as anything I need people to decide that our current way of covering healthcare just doesn’t cut it.

If you’re with me, let’s go for it.  Call 571-484-4056 or write to me at I’m ready to move if you are.

Did hospital “kidnap” patient who wanted to leave?


Hospital? Or prison?


OK folks, I don’t know any more about the following story than you do, but if true, it’s an absolutely insane breakdown in hospital systems — one, I’d argue, that might not have happened in a hospital which had its, uh, finances and operations together.

The beginning of the tale sounds pretty routine. Apparently, Joseph Wheeler and his wife Felicia Ann, both in their mid-40s, were in a car accident in June and brought to Cheverly, MD-based Prince George’s Hospital.  In theory, this should have been a relatively simple case, as neither was gravely injured.

Now, let’s take a pause. Prince George’s is part of the Dimensions Healthcare System, a financially troubled institution which brought on a new CEO and an interim EVP  last month. The system, which has been forced to accept funding from the state in the past, expects to begin a restructuring plan in coming weeks.  It’s also looking for capital sources, natch.

So, back to the Wheelers.  Joseph Wheeler spent the night of June 23rd at the hospital, being treated for blunt torso trauma without other acute injuries.  The next morning he wakes up, finds a woman’s ID badge on his wrist, and is told he’s getting surgery “to have a potentially cancerous mass removed from his chest,” according to ABC News.   Need I tell you that he freaked out?

Well, all hell broke out at that point, according to the Wheelers, who have since filed a $12 million lawsuit against the hospital for false imprisonment, assault and battery and infliction of emotional distress.  According to Mr. Wheeler, he couldn’t get hospital staff to take an interest in the fact that the badge was for a woman 13 years younger than himself, so he and his wife decided to leave. 

Unfortunately, when they tried to leave the campus, they were accosted by security guards with a big chip on their shoulder. Two guards cursed the two out, then beat Mr. Wheeler severely, while attempting to take the incorrect ID bracelet away from him, the suit claims.  Ultimately, the facility let him go when Wheeler signed a form admitting he was leaving against medical advice.  He was treated at a nearby hospital with several new injuries, his suit recounts.

So, is this just an unbelievable aberration?  Has the financial strain the hospital faced left it with scared, poorly trained employees who simply got out of control?  What do you think?

Hospitals: Can you afford to ban big drug company payouts?

A hospital's best friend?This week, a very interesting (and important) question courtesy of the indefatigable  Can hospitals afford to shut down the lucrative relationships doctors have with pharmas?  To quote his blog:

“A recent case at Boston’s Brigham and Women’s Hospital [has] raised some eyebrows. Apparently, an asthma specialist was so dependent on drug company money, that he chose to quit the hospital [rather than give up extra income]. According to the Boston Globe, “Out of thousands of US doctors hired by drug-maker GlaxoSmithKline to talk about its products, [this physician] was the highest paid during a three-month period last year, the company recently disclosed: He made $99,375 for giving 40 talks to other physicians last April, May, and June, almost one every other day.

When it comes to hosptials like Brigham and Women’s, which have the kind of resources and reputation many others would kill for, it’s not likely there will be any lasting damage to the organization.

But what about community hospitals?  Can they afford the hit?  What if a single invasive cardiologist took their patients with them to a rival hospital next door?

After all, according to a study done earlier this year by Merritt Hawkins, that invasive cardiologist typically generates $2.2 million per year, a sum few hospitals can let go lightly.  And if you really want to cringe, look at the other top specialties and what they bring in each year. For a smallish hospital this is a VERY scary game.

Looking a chess move ahead, does this mean that pharmas can play hospitals against one another, or even hospital systems, if they  play the right incentive games?  Not sure where it all ends, but it’s not pretty.

NYC’s shame: Psychiatric nightmare continues


Alan Aviles: Don’t stay in his psych ward

 Since psychiatric patient Esmin Green died, ignored, on the floor of King’s County Hospital in 2008, I’ve repeatedly argued that far too few heads have rolled.  If it were in my power, I’d particularly like to show the door to Alan Aviles, head of the city’s Health & Hospitals Corp.  But some may have thought I was too quick to condemn Mr. Aviles, who, admittedly, has one hell of a job on his hands.  

Now, tell me again that the psychiatric mismanagement and patient violence at King’s County are nobody’s fault.  

It’s 2010, and the leadership at King’s County has allegedly been shaken, stirred and rocked. But once again, staff have again been found to have hidden very seveve deficiencies in their behavioral health unit. Need an example? Here’s an ugly one. One particularly unlucky patient was left alone long enough, often enough, to attempt suicide, get sexually assualted and attempt suicide again.  

In theory, these things shouldn’t be able to happen any more. When HHC settled a suit brought the the U.S. Department of Justice, it agreed to be supervised by a judge for five years. Perhaps the judge and Aviles are old golfing buddies?  Seriously, folks, this just isn’t funny.  

Anyway, don’t take my word for it:  read this well-researched piece  from the New York Daily News and tell me why there’s a single senior manager still in place at HHC, much less King’s County.  While it was published in April,  somehow I doubt things have changed much. I’d be embarassed to work there.

Tweet roundup: Data loss at Thomas Jefferson, med records found in dump

Happy weekend!  Here’s a group of tweets from the past few days that might be worth a second look.  If you have tweets you’d like to see in our roundup please feel free to share them.


Anne Z.

Tweets for the week of 8/8/10

> @idtexpert #Medical #IdentityTheft Alert: Huge loss of patient data at Thomas Jefferson #University #Hospital in #Philadelphia ;

> @drchrono patient med records found in a Boston dump! sounds like yet another good reason to get an EMR: #emr

> @hcapr Regional Med Ctr of San Jose Uses Pocket-Sized Handout to Improve Quality Scores: #HCA #hospital #cms #healthcare (Hey, I’m intrigued; how about  you?)

> @ShigeoKinoshita RT @ingagenetworks: 3 ways to increase engagement and revitalize your healthcare system #hcsm #health20

> @AndrewPWilson: CDC Gateway to Health Communication & Social Marketing Practice #gov20 #health20

> @HealthYRc Lone bedbug sends Kings County Hospital ER into fumigation lockdown – #New #York #Daily #News#Hospitals#Health >

> @HealthYRc It’s easy to buy babies at govt hospitals – #Times #of #India#Hospitals#Health > (ED: Sounds outrageous but check out the story)

Come on, hospitals! Put the social media pieces together!

Today, in the Baltimore Business Journal, we learn that Charm City hospitals are doing a great deal more social media outreach than they had in the past.  Take health system LifeBridge, the paper says:

The LifeBridge Twitter account and Blogspot blog is updated regularly and provides health care information to patients while its Facebook page is used as a job and career board. LifeBridge also has its own channels on YouTube and ICYou, an online health video source.

These all sound like good initiatives which use the various social media channels appropriately.  It’s clear that LifeBridge is trying to reach out and touch consumers; that it wants patients to be healthy;  that it’s making sure people have access to its job listings and that it’s making an effort to keep people up to date on its activities.

All of which means, well, just about zero if I’m a patient hoping to decide where to have an elective procedure.  Nada. Zip. Job listings?  Meh. Tweets?  Well, I’m willing to be called on it if I’m wrong, but I’m doubting they start thoughtful conversations with consumers.  Health information on video?  Well, I’ll add a few points for the video, as it’s a pretty compelling way to educate people, but just a few.

Bottom line?  Even if they are using the right content for the right pieces, these are a bunch of loosely-connected initiatives that can’t do much to make patients feel safe, comfortable and welcome on their own.  Doing that takes not only a change in content, but also in approach.

It’s time to build social media efforts around a central goal, that of making your key audiences feel connected to your facility. Not informed about what you’re up to (most people who read don’t care about your new parking tower), not educated (there’s a place for that and it’s usually called WebMD) but connected.

That would take a bunch of effort, time, study of what patients, clinicians and staffers want and some serious trial-and-error experimentation. But it would be worth every penny. Try it — I dare you!  You won’t be sorry.