CEO Corner

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Josef Spencer

Josef Spencer

05.21.14 by Jeff Ferenc HFM Senior Editor

Renovation of ED at Lincoln Medical and Mental Health Center pays dividends

The ED at Lincoln Medical and Mental Health Center doubles in
Patient Safety
05.21.14 by Jeff Ferenc HFM Senior Editor

Weekly reports to hospital leadership lead to sharp cuts in Acinetobacter baumannii infections

Jackson Memorial Hospital, Miami, finds a way to nearly
05.21.14 by Maxine Levy

Parkland Hospital’s building project close to completion

Under construction since October 2010, Dallas' sprawling 2.5 million-square-foot, Parkland Hospital complex is attracting national attention for its sheer size and number of technical innovations.

On a 60-acre site just north of the downtown hub, the 17-story, $1.3 billion public hospital will have 865 private rooms, 27 operating rooms and 96 individual neonatal intensive care rooms as well as 12 intensive care beds in the Parkland Burn Center. The health care project consumes enough drywall to cover 200 football fields.

With substantial completion scheduled for August and the opening slated for May 2015, the new facility replaces the nearby existing and outdated Parkland Hospital that was built in 1954. Various clinical and commercial uses for the existing facility are being considered.

"This is the single largest hospital construction in the country," says Walter Jones, senior vice president, facilities planning and development, Parkland Health & Hospital System. Linked to the metropolis via a new Dallas Area Rapid Transit light rail station, the totally wireless facility incorporates many cutting-edge clinical, operational and structural innovations.

For example, every high-tech, high-touch VoIP telephone has a camera and a screen. When a nurse answers a patient's call, the two will see and hear each other. By streamlining patient care and benefiting clinical efficiency that promote improved patient outcomes, the advanced communication system could also aid teaching and learning for medical students and faculty at the adjacent University of Texas Southwestern Medical Center.

"The chief medical officer wanted clinicians, students and other clinical professionals to be able to consult, see patients and watch operations in real-time without all being in the same place. This enables that," says Lou Saksen, senior vice president of new construction at Parkland. To ensure their privacy, patients provide prior authorization. "It's not like Big Brother peeking in on everybody," says Saksen.

Likewise, to promote patient safety and sanitation, an expansive network of 16-inch sealed pneumatic tubes will transport trash and recyclables rapidly and cost-effectively from strategic collection sites throughout the building to the dumpsters parked at the loading dock. Computer-monitored and controlled, the pneumatic tubes travel at speeds up to 60 miles per hour. Jones says this sophisticated system "helps to keep the units cleaner, since little trash storage is needed." He adds that the system aids patient-focused care efforts because it allows hospital personnel to remain on the unit; thus, reducing the time riding the elevator to take out the trash.

Finally, for patients arriving via helicopter at the hospital's 18th-floor helipad, two custom-constructed, super-smooth elevators, each measuring 7 feet by 11 feet, will travel at 700 feet per minute, efficiently transporting the 17-person trauma team to the hospital's street-level emergency room in only 31 seconds. These high-speed "Megavators" are in the building's controlled-access core area, reserved for patients and authorized personnel.

The heated helipad and the Megavators provide the complementary capabilities to ensure that critically injured patients can be transported successfully even during severely inclement weather.

Says Ron Anderson, M.D., Parkland's former long-time chief executive officer, "The best thing would be if Parkland becomes the hospital of choice, not of last resort."

By Maxine Levy, a Dallas-based freelancer who specializes in health care-related topics.

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05.21.14 by Jeff Ferenc HFM Senior Editor

Standard room design for patient, exam and operating rooms offers many benefits

Advocate Health Care uses standardized room designs in its new projects.
Monday, 26 May 2014 00:00

Stand-Alone Outpatient Facility

Web Exclusives: Planning
05.27.14 by Paula Crowley

Stand-alone outpatient facilities help hospitals stay relevant

Although the decision to renovate or replace a health care facility is one with which hospital leaders

New payment models depend on metrics—especially outcome measures—so the nation's health data infrastructure needs to be bolstered, the report noted. Help needs to be provided to overcome technical barriers—particularly for small medical practices, it noted.

Friday, 23 May 2014 00:00

Top 10 Rules of Engagements


Welcome to the first of many blogs on subjects that interest me. Through this ongoing format, it is my aim to provide a clear understanding of my project management ethos, a communication path to appreciate the beliefs that guide me and an awareness of my approach to IT management, specifically as it applies to project management in the healthcare arena.

In 1996, John Kotter wrote his seminal book on change management entitled, "Leading Change." As an information technology executive, I was significantly impacted by the book, and discovered the close kinship between project management and change management.

It's easy to discern that change management is critical to leadership of transformative projects that involve people, process and technology; however, change management must simultaneously occur for any "green-lighted" project whose key goal is to generate a return on investment.

A singular focus on project management attributes (timeline, scope, quality and budget) is a worthy collection of multi-related objectives; however, combining project and change management optimizes the realization of the higher goal of attaining overall benefits, and generates a firm foundation for those benefits to endure.

Kotter's Eight Steps to Leading Change:
Step 1: Establish a sense of urgency.
Step 2: Create a guiding coalition.
Step 3: Develop a change vision.
Step 4: Communicate the vision for buy-in.
Step 5: Empower broad-based action.
Step 6: Generate short-term wins.
Step 7: Never let up.
Step 8: Incorporate change into the culture.

Kotter's "spot-on" philosophy influenced me and sparked a decision to reassess my approach to project management. I applied and interwove Kotter's "Eight Steps" with my experience, knowledge and areas of expertise, and developed guiding principles that work extremely well in my profession. I term these guiding principles:

Spencer's Rule of 10:
10: Succession Planning Ensures Returns on Investment is achieved
9: Measure for ROI, User Readiness and Reassess Continuously
8. Negotiate Before, During and After the Project
7. Mitigate and Focus only on the big stuff
6. Team build and Celebrate Continuously
5. Manage the Critical Path
4. Know when to push and Push very Hard When it is Time
3. Get the Right People on the Bus, Put the Rest in Storage
2. Communicate, Communicate, Communicate (Kotter, 1996)
1. Establish a Sense of Urgency (Kotter, 1996)

I will share my thoughts on these principles in an effort to engage your interest in, and understanding of, the significance of the union of project and change management.
Next installment: Succession Planning Ensures Results!



Researchers evaluated more than 2,500 U.S. hospitals on five categories, including death rates among heart and surgery patients; readmissions (an event for which hospitals are now subject to penalties by the CMS); overuse of CT scans; the incidence of hospital-acquired infections; and on effective communication to patients about medications and discharge plans. Each hospital received a score between one and 100. The average was 51.

“That's just not good enough,” said Dr. John Santa, medical director of Consumer Reports Health. “These are major, preventable causes of death and suffering. We think they should be at the top of the list of priorities for hospitals.”

Among the hospitals scoring well above the average; Miles Memorial Hospital in Damariscotta, Maine, scored a 78; Oaklawn Hospital in Marshall, Mich., scored a 77; and Aurora Medical Center of Oshkosh in Wisconsin scored 75.

Among those who scored the lowest: Harris Hospital in Newport, Ark., and Lake Cumberland Regional Hospital in Somerset, Kent., both scored a 20; Tulane Medical Center in New Orleans scored a 19; and Bolivar Medical Center in Cleveland, Miss., scored an 11. Several of the low-rated facilities responded, saying their ratings do not necessarily reflect the recent progress they have made in addressing safety.

The data that was taken into account has a “considerable lag,” said Dr. Rusty Holman, chief medical officer for Life Point, which owns and operates Bolivar Medical Center, the lowest ranked hospital on the survey. Since that hospital system got involved in 2012 with the Hospital Engagement Network, a part of the CMS Partnership for Patients program, he said Bolivar Medical Center has seen significant improvements in quality and safety measures, including a 45% drop in mortality rates and a 9% reduction in readmissions. “These improvements are happening in real time,” Holman said, “and we expect they are going to be reflected in future publications.”

A representative from Harris Hospital, ranked third from the bottom, said it has also instituted changes during the past calendar year.

“We have seen significant progress in … reducing infections and (improving) communication with patients about their medications. This success will be reflected in future updates to public reports,” a hospital spokesperson said, noting that it is already being recognized for its efforts. “Last October, our hospital was recognized as a top performer on key quality measures by the Joint Commission, based on our effective use of evidence-based clinical process shown to improve care for certain conditions.”

Santa said Consumer Reports uses the most current data from the federal government. For this particular rating, it obtained CMS data on blood, surgical and catheter infections from April 2012 to March 2013; avoiding readmission from July 2011 to June 2012; avoiding medical mortality from July 2009 to June 2012, avoiding surgical mortality from July 2010 to June 2012; communication from April 2012 to March 2013; and on overuse of brain scans from January 2011 to December 2011. It is quite possible, Santa said, the low-scoring hospitals may have more current data that had not been reported to the federal government.

“We're in a tricky and awkward phase in terms of how hospitals are being evaluated,” said Santa, who also noted that various reports—Leapfrog, Hospital Compare, the Joint Commission and the hospitals themselves—all have different models.

“The science of performance management is still in the early stage and we have not all come together and agreed on an evaluating system.” There are many dimensions to hospital safety and no single measure captures everything, he said.

The new report also found that only 35 hospitals earned a top rating in terms of ensuring that a patient admitted for a heart attack, heart failure or pneumonia did not die within 30 days of admission; 66 hospitals received a low rating in this category. One hundred and seventy-three hospitals scored highly in reducing surgical mortality, but 288 received the lowest rating. For every 1,000 surgical patients who develop serious complications in a top-rated hospital, 87 or fewer died, compared to 132 deaths in low-rated hospitals.

“The differences between high-scoring hospitals and low-scoring ones can be a matter of life and death,” Santa said. He also noted that simple policy changes can make a significant difference, but leadership has to make safety a priority.

“In high performing hospitals, I often find the CEO has made it clear this is priority No. 1,” he said. “If the CEO makes this a top priority, it happens, if they don't, it doesn't.”

Tuesday, 20 May 2014 00:00

Code Standards

Codes and standards
05.21.14 by Mike Hrickiewicz HFM Editor

Checklist features items related to new and proposed codes and standards and resources on new or pending regulations

CMS proposes adopting 2012 editions of two NFPA codes

Tuesday, 20 May 2014 05:00


05.21.14 by Jeff Ferenc HFM Senior Editor

A calendar of health care industry events


3–6 | 51st American Society for Healthcare Engineering Annual Conference and Technical Exhibition; McCormick Place,

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