Newest Communication technique

Yesterday's blog must have really struck a nerve with the CEO. After hearing about it from the regular readers in his administration, he immediately began making phone calls to denounce the communication of the Blog.

There was nothing posted yesterday that was of a confidential nature and from my perspective, it was a very frustrating meeting with lively discussion and arguments. I share my thoughts and readers can agree or disagree. The blog is open and it serves to keep important issues on the table for accountability.

The tribune published their take on the brief meeting they were allowed to attend in the following article.

http://www.news-tribune.net/local/local_story_150104030.html



The question at the forefront is how much information the public should have related to the financial issues of a county owned hospital. If it were to fail, the county and taxpayers would certainly be affected. The comments in the Tribune about the length of the meetings are accurate and I anticipate the meetings remaining lengthy because little of the information presented to the Board is trusted at face-value. This remains a problem.

I encourage readers to talk to your Commissioners and voice your concerns. Changes still need to be made and complacency is not the answer.

Slow but difficult progress

Frustrating would be the term used for last night’s Board Meeting. Who better to address this would be the reporter from the Tribune who sat outside for probably 2 hours before being allowed into the public portion of the meeting.

Once inside, all he heard was a laundry list of items presented for a vote to approve. There was no open discussion on any of the topics in the public forum. The public meeting took all of seven to ten minutes. This of course is because all of the real discussion occurred the two-three hours before in executive session.

I am sure the reporter wondered what the approval for the “Audit report” really meant. It is not being distributed publicly until it has to be when the auditing firm eventually makes it public.

The other big issue was the supply chain assessment. This continues to be a frustration because up until last night, they have refused to address the issue of staying with VHA as our group purchasing organization (GPO). Many of us believe we have been “ripped off” for years by staying with VHA. We have in the past asked for other GPO’s to be allowed to present their services so we can compare the value or lack of from VHA.

Thankfully, after much discussion and arguing, the board did make a motion to proceed with VHA for now, but administration was instructed to get other GPO’s in for presentations on what value and services they can offer.

The CEO’s long-standing relationship with VHA as well as serving as Chairman of one of their committees in the past has all the markings of a conflict of interest. The board finally did the right thing, but they are about 5 months too late. If this process would have been started in January with the original $11.5 million dollar error, we would now have the information needed to make this decision on the GPO.

With the amount of debt we are in and the ongoing cuts, VHA can no longer be the “sacred cow” it has been in the past. The Board needs to honestly assess VHA by comparing them to other vendors. The CEO’s direction of having VHA audit our purchasing processes is like having the fox guard the hen-house.

May Board Meeting

Tonight is the May Board Meeting for Floyd Memorial. It will be the first time we have seen any financial reports for the past two months.

In addition, the results of the external audit will be presented and we will see what they found. The CEO already stated at the last meeting that they will be recommending better “internal controls” but he did not elaborate on why they would be making that recommendation although when you overstate your revenue by $11.5 million dollars there are obviously problems.

We should also be getting an update on the revenue cycle evaluation and hear for the first time a report on the supply chain.

Receiving accurate information continues to be a struggle as every time we are handed anything, our first thoughts are whether we can trust the data. This makes things difficult when trying to make tough decisions.

A soldiers prayer

Here is a poem to honor our men and women on this Memorial Day.

"I Got Your Back"

I am a small and precious child, my dad's been sent to fight..
The only place I'll see his face, is in my dreams at night.
He will be gone too many days for my young mind to keep track.
I may be sad, but I am proud.
My daddy's got your back.

I am a caring mother. My son has gone to war..
My mind is filled with worries that I have never known before.
Everyday I try to keep my thoughts from turning black.
I may be scared, but I am proud.
My son has got your back.

I am a strong and loving wife, with a husband soon to go.
There are times I'm terrified in a way most never know.
I bite my lip, and force a smile as I watch my husband pack..
My heart may break, but I am proud.
My husband's got your back..

I am a soldier..
Serving Proudly, standing tall.
I fight for freedom, yours and mine by answering this call.
I do my job while knowing, the thanks it sometimes lacks.
Say a prayer that I'll come home.
It's me whose got your back.

Author Unknown

I lift up in prayer all the brave men and women who currently serve in our armed forces and those who have served in the past. I especially lift up in prayer those who have given the ultimate sacrifice to protect the freedoms we enjoy.

I am proud to acknowledge my son Daniel who is finishing MP training with the Marines and getting ready for his planned deployment to Iraq in January. We pray he and his unit will remain safe and serve our Country honorably.

Car Distractions

As a follow-up to a post a couple of weeks ago about multitasking in cars, here is another recent study by Bridge Ratings. Besides the multitasking we described, drivers are increasingly using satellite radio, MP3 players, cell phones and DVD players in the car.

As you can see, some of the older technology is being used less as newer gadgets are replacing them.

We continue to see teenagers involved in wrecks with the three leading causes being cell phone usage, adjusting the audio equipment and being distracted by friends in the car.

So parents; it would be wise to reinforce these for your teenagers. We know they think it will never happen to them and they are invincible but our experience gives us a different perspective.

The Dating Game

The internet has changed everyone’s life in some way. It is a wonderful tool when used for good but can be very destructive. According to a California researcher, teenagers are now choosing the internet for breaking up with their girlfriends and boyfriends. Sites like MySpace and Facebook are allowing these kids to avoid one on one conversations or phone calls to end these relationships. This is becoming the standard operating procedure for many young adults.

The rejected individual is many times blocked and not allowed to respond to the remarks being offered by the one terminating the relationship.

The scorned individual is finding new ways to retaliate and often uses someone else’s screen name to make postings. It becomes a public display of some very poor word choices and can lead to worsening relationships. It is another example of how we continually choose conflict avoidance rather conflict resolution.

Is this a healthy way to interact?

Post Abortion Syndrome

Rep. Joe Pitts (R-Pa.) has recently introduced HR 1457, the Post-Abortion Depression Research and Care Act of 2007.H.R. 1457: Post-Abortion Depression Research and Care Act of 2007 (GovTrack.us)

This bill has already created uproar with Planned Parenthood and other pro-abortion groups. The studies cited in the "findings" section will read like heresy as it cites evidence of "severe and long-term effects" of abortion on women, including depression, eating disorders, suicide attempts, intense grief, emotional numbness, rage, sexual dysfunction, and relationship difficulties.
"Women who aborted a first pregnancy are four times more likely to report substance abuse compared to those who suffered a natural loss of their first pregnancy," the legislative text reads, "and they are five times more likely . . . than women who carried to term."

This bill uses data and statistics obtained from multiple studies but primarily from a study released in 2006 by David Fergusson, a researcher from New Zealand who calls himself a pro-choice atheist.

Fergusson's findings correlate with many other pro-life researchers at the Elliot Institute and elsewhere. HR 1457 currently has 16 Republican co-sponsors and seeks to have the National Institutes of Health study for the first time the physical and emotional health consequences of abortion, and to issue Health and Human Services--funded grants for the purpose. LifeSite Special Report - Abortion Causes Mental Disorders: New Zealand Study May Require Doctors To Do Fewer Abortions

As most can imagine, this politically incorrect stance has faced tremendous opposition and criticism.

But if the pro-abortion side denies these results, why do their groups offer support services for something they say doesn’t occur? Exhale Exhale: an after-abortion counselling hotline is one such group and it offers post-abortion healing even though they claim abortion does no harm. The group even offers E-cards with statements like. "I think you're strong, smart, thoughtful, and caring," "I think you did the right thing." Another card reads, "There are no words to express my sympathy for your loss. As you grieve, remember that you are loved." Another card invokes God: "The promise of God is to be with us through all of life's transitions. God will never leave you or forsake you. May you find comfort in God's constant love."

There seems to be some mixed messages from this group as well as others on the pro-abortion side including Peace After Abortion. They deny the existence of Post-Abortion Syndrome and attribute abortion fallout to preexisting causes. When that doesn’t satisfy them they blame the negative abortion reactions to such causes like a repressive religious upbringing, an unsupportive boyfriend, or negative societal views of abortion.

It appears studies are only valid to these groups when it supports their ideas but readily refuted when it contradicts them. Their abortion experiences somehow trump all of those women who have been harmed by abortion.

Where this Bill goes from here is unknown, but with the democratic controlled congress, it is unlikely to progress far.

Summer Survival Kit

As many of us prepare and plan for summer activities and trips, safety should be a priority.

For anyone planning an excursion to a remote place, here is a list of potential items that may be considered for a survival kit for your car, truck or boat.

Survival Pack: typically plan for 3 days and alter it based on climate

Clothing:
• 3 sets of underwear
• 3 pairs of socks
• change of pants
• 2 T-shirts
• long-sleeved shirt
• waterproof windbreaker
• cap
Food:
• energy bars
• 3 MREs
• salt and pepper
• utensils
• paper plates and cups
• P-38 can opener
• small stove and fuel
• cooking vessels
Water:
• water purification system (or tablets)
• 2 liters in Nalgene bottles
Hygiene:
• roll of toilet paper
• disposable towelettes
• toothbrush and toothpaste
• bar of soap
• liquid camp soap
• shampoo
• razor
• towel and washcloth
• deodorant
• scissors
• hairbrush
• paper towels
• hand sanitizer
First aid:
• first-aid kit
• bug repellent
• sunscreen
Shelter:
• lightweight tent
• Space Blanket
• extremely lightweight sleeping bag
• Sleeping pad
• emergency poncho
Tools:
• flashlight (wind-up)
• wearable LED lights
• fire starter
• knife
• rope
• gloves
• latrine trowel
• FRS radios
Miscellaneous:
• pen and notepad
• tape
• roll of quarters
• spending money
• photo IDs
• ID tag for 72-hour kit
• playing cards or other game

Breaking Bad Habits

How easy is it to really break a bad habit or addictions like overeating, smoking, drinking or spending too much?

The “Just say No”, Cold turkey approach is often not successful long-term unless other things are also done. Unlearning a habit that you've been practicing for 10 or 20 years demands effort and vigilance. Most of these habits are really behaviors you've repeated so often, you now do them on automatically without much conscious thought. Changing the routine adds stress to what is probably an overstressed lifestyle already.

Habits and addictions are closely linked with the latter having some biochemical component. It remains debatable about how much heredity plays in the mix. But without a doubt, many people have been able to overcome even strong addictions.

Helpful ideas in breaking habits and addictions are:

1) Motivate yourself- nobody typically wants to change something that provides them comfort, therefore you have to motivate yourself by creating and setting goals and potential reward for the achievement... There is no growth in the comfort zone and no comfort in the growth zone.

2) Record your habit- keeping track of your actions is monotonous, time-consuming and a nuisance, but it's also a critical step toward helping you change. This is especially true for those who overeat or are trying to lose weight. Your goal should be to keep a log of every time you smoke, have too much coffee, overeat, or indulge in your habit. In addition, you should note the situations that have become linked with your habit as you will find some interesting patterns of behavior.
Don’t’ try to conquer all of your bad habits at once. This is overwhelming and rarely successful. Take each habit one at a time and success is much more likely.

3) Develop a new substitute- Try replacing the bad habit with something that is beneficial or healthy. Rather than smoking or eating, try doing some simple exercise or relaxation technique. Have something healthy to munch on or a sugar-free gum to chew. Most research suggests that cravings last about three minutes and therefore, your goal is to get through the three minutes without falling into the habit trap.

Bad habits are often developed to ease stress in times of anxiety or emotional discomfort and therefore developing another way to deal with that anxiety in a healthier manner is preferable.

4) Get rid of triggers- Most habits are related to triggers. We are similar to the Pavlov dog experiments where certain cues cause certain behaviors. If we can alter our routines and avoid the triggers that stimulate our bad behaviors, we will have a better chance of changing them.

Drug and alcohol counselors tell clients to avoid "people, places, and things" that promote use of the addictive substance. Some people may actually need to make some new friends who don't drink smoke, gamble or overeat.

5) Accept the fact it may not be comfortable- You’ll miss your habit for a while, but the deprivation typically won't kill you. Acknowledge to yourself that you feel anxious and lousy without the “vice”. Then redirect your thinking to something positive and think about the successes.

It may take three weeks to three months to break a minor habit and longer for something more intense. The cravings for some addictions may never go away.

As with many other things in life, persistence pays off. Few people succeed on their first attempt, so don't give up!

Good news for the Male slugs

Very good news guys. There is now scientific evidence to support being lazy couch potatoes while the women work. A new report out by German cancer researchers finds that doing regular housework significantly reduces breast cancer risk and especially in younger women.

The study is published in the journal Cancer Epidemiology Biomarkers & Prevention. The study shows that pre-menopausal women who performed regular housework reduced their risk of breast cancer by about 30 percent and post-menopausal women by 20 percent.

The goal of the study was to try and determine a link between exercise and breast cancer. This link was found and attributed it to the regularity of doing housework compared with the irregular exercise routines. We all know exercise is not done regularly for the average American.
I guess the women will want a study looking for a link between prostate cancer and the regularity of remote control use by men watching TV.

Short Man, Strong Arm

Well the CEO is at it again. He has once again sent out a letter to the middle management about contributing to the PAC’s (political action committees).

He no longer puts in writing what the expectation is, but directors and managers have been told they are expected to contribute $50 dollars at the manager level and $100 dollars at the Director level.

This really places a burden on some of these workers who have families, single parents, and kids in college etc.

This was discussed in 2005 at the Board level and the CEO knew that this was not something the Board condoned and did not feel should continue. Since there are new Board members who were not present in 2005, he is once again challenging the direction of the Board.

Rather than risk putting the mandate in writing, he has carefully worded the above letter so that it does not directly tell them what is expected. But they all have been informed verbally what the expectation is.

The hospital receives a list of everyone who contributes and those who don’t have gotten a reminder telephone call in the past.

With the financial strains, lack of raises and bonuses for some of these middle management personnel, this continues to show the CEO’s lack of understanding and concern.

It is coercive, unfair, and shows a complete lack of compassion for the struggles of the middle management.

New Study on Grief

In a recent article published in the Feb. 21 issue of the Journal of the American Medical Association researchers from Yale University School of Medicine are questioning some beliefs about what has been felt to be the normal stages of grief.

They found that after the loss of a family member from natural causes, grief indicators typically peak in the first six months, and contrary to the stage theory of grief, disbelief was not the dominant emotion in the family members who continued to score high on grief indicators.

Paul K. Maciejewski, Ph.D., of Yale University School of Medicine in New Haven, Conn., and colleagues conducted a longitudinal study of 233 bereaved individuals who were assessed for indications of the five conventionally accepted stages of grief (disbelief, yearning, anger, depression and acceptance) in the two years after a loss.

The study found that the initial, dominant grief item was not disbelief, but yearning, which peaked at four months after the loss, compared to one month after the loss for disbelief. Anger and depression peaked at five and six months post-loss, respectively. The final stage, acceptance, increased steadily over the 24-month follow-up period.

They did conclude that regardless of how the data are analyzed, all of the negative grief indicators are in decline by approximately six months post-loss. They felt that persistence of these negative emotions beyond six months is likely a reflection of a more difficult than average adjustment and suggests the need for further evaluation.

Since the study looked at “natural causes” of death, these results may have been skewed or biased. Taking all causes of death, may have resulted in the more common grief stages. Further studies will probably be performed.

European Healthcare

Most European countries have achieved universal coverage for their citizens; but how exactly are they doing it?

We hear people talk about the Canadian model of single-payer financing to create universal coverage, but this is not the typical way it is done in most European countries.

Only Canada uses the pure Canadian model where there is a single payer, no private insurance plans and all health insurance coverage is paid solely from the general tax revenue of the country. It is also worth noting that per capita healthcare costs in Canada are now the fifth highest in the world, exceeded only by Luxembourg, Norway, Switzerland and the U.S.

Canada, Cuba and North Korea hold the distinction of being the only three countries in the world where it is currently illegal for an individual patient to buy healthcare services directly from a doctor or hospital in the country.

Austria, Belgium, Germany, Switzerland and the Netherlands all use mixed public-private models that involve individual mandate laws where citizens are required to buy coverage. In addition, there are public and private health plans competing to sell health coverage to their customers, there is a "guaranteed issue" requirement that necessitates private health plans to sell a basic level of coverage to all people regardless of their health status, and there is a very strong government subsidy to help low-income people buy their health insurance.

Britain uses a mixed model with the National Health Service, or NHS, providing basic care for everyone. Primary-care physicians are paid by the government based on the number of patients in each doctor’s “panel. A number of competing private health plans sell private market insurance coverage to British citizens who don’t want to wait in queues for certain types and categories of hospital care or NHS-funded specialty care.

In Germany, the health plans are called “sickness funds”. They have been in place since Chancellor Otto von Bismarck ruled the country more than a century ago and there are nearly 300 competing plans.

There are roughly 30 competing health plans in the Netherlands and everyone gets his or her care through one of those plans.

In France, the government provides a basic Medicare-like insurance plan for all citizens, and then 90% of the citizens buy supplemental coverage from several dozen competing “mutualisms” (mutual aid societies) and private insurers. Those plans look a lot like the private Medicare supplemental plans in the U.S.

A number of countries, including Belgium, England, France and the Netherlands, also offer private insurance plans that provide coverage for care not paid by the basic government plan.

European countries fund universal coverage primarily through payroll taxes. In most European countries, there is a mandatory payroll deduction or income-linked contribution required of each worker and it averages in the 3% to 9% range. The employer is also required to make a matching contribution in the same general range in several of the countries.

In the Netherlands, employees pay 6.5% of their pretax income, plus a nominal annual fee, toward health insurance. Employers reimburse the income-based contribution.

In the U.S., typical employer costs run from 8% to 11% of total worker payrolls and employee healthcare costs run in the 5% to 10% range.

Many American workers actually spend a lower percentage of their pay for health insurance and direct costs than many European workers.

So what we Americans presume to know about European healthcare is probably inaccurate. Rather than comparing ourselves to what we think the European countries have, we need to decide on what our needs are and figure out how best to meet them.

There does not appear to be a simple solution or a single program that will work for everyone. We will need to use a combination of individual mandates, subsidized coverage and a mixed public-private models to create universal coverage that meets our needs and we will need to place individual responsibility as a high priority.

Walmart Legislation

Remember the so-called “Wal-Mart Bills”. This is where states have taken different measures to force employers like Wal-Mart into providing more of its employee’s healthcare. They may be coming to an end.

With employer-sponsored coverage continuing to erode, states had begun seeking new ways to encourage, coerce or downright force businesses to pick up more of the growing cost of covering the working uninsured.

It began in Maryland when legislators passed a first-of-its-kind law in January 2006 forcing retail giant Wal-Mart to pick up a greater share of its workers’ health insurance costs. It was soon followed by many other states as “the model”.

Earlier this year, these employer coverage mandates was thrown into question when a federal appeals court upheld a lower court ruling that struck down the Maryland law. The 4th U.S. Circuit Court of Appeals in Richmond, Va., ruled that the state’s Fair Share Health Care Fund Act ran afoul of a 33-year-old federal statute governing private employer-sponsored benefit plans.

This ruling will likely lead to further challenges in many other states and any state contemplating a (coverage) mandate on business will likely think twice before proceeding. The court’s ruling seemed very clear that these kinds of statutes are pre-empted by federal law.

You can bet that attorneys will find new and innovative ways around this temporary roadblock, but for now, these companies may have a short reprieve. It seems clear that targeting certain companies based solely on their size doomed this legislation from the start.

This Maryland ruling may still be appealed and the Attorney General has not made the final decision.

Hawaii's law is the only state that has a mandate for companies to cover employees and it was passed before these other Federal legislations and therefore won a special exemption from Congress.

Mother’s Day Thoughts

God could not be everywhere and therefore he made mothers.
Jewish proverb

Youth fades; love droops,
the leaves of friendship fall;
A mother's secret hope outlives them all.
Oliver Wendell Holmes

The mother's heart is the child's schoolroom.
Henry Ward Beecher

The joys of motherhood
are never fully experienced
until the children are in bed.
Author Unknown.


The heart of a mother is a deep abyss
at the bottom of which you will always
find forgiveness.
Honore' de Balzac

Women know the way to rear up children (to be just). They know a simple, merry, tender knack of tying sashes, fitting baby-shoes, and stringing pretty words that make no sense. And kissing full sense into empty words.
Elizabeth Barrett Browning

Making the decision to have a child is momentous. It is to decide forever to have your heart go walking around outside your body.
Elizabeth Stone

A mother is the truest friend we have, when trials, heavy and sudden, fall upon us; when adversity takes the place of prosperity; when friends who rejoice with us in our sunshine, desert us when troubles thicken around us, still will she cling to us, and endeavor by her kind precepts and counsels to dissipate the clouds of darkness, and cause peace to return to our hearts.
Washington Irving

All that I am or ever hope to be, I owe to my angel Mother.
Abraham Lincoln

My mother was the most beautiful woman I ever saw. All I am I owe to my mother. I attribute all my success in life to the moral, intellectual and physical education I received from her.
George Washington

A mother is not a person to lean on, but a person to make leaning unnecessary.
Dorothy Canfield Fisher

At work, you think of the children you have left at home. At home, you think of the work you've left unfinished. Such a struggle is unleashed within yourself. Your heart is rent.
Golda Meir

Few misfortunes can befall a boy which brings worse consequences than to have a really affectionate mother.
W. Somerset Maugham

Biological possibility and desire are not the same as biological need. Women have childbearing equipment. For them to choose not to use the equipment is no more blocking what is instinctive than it is for a man who, muscles or no, chooses not to be a weightlifter.
Betty Rollin

Women do not have to sacrifice personhood if they are mothers. They do not have to sacrifice motherhood in order to be persons. Liberation was meant to expand women's opportunities, not to limit them. The self-esteem that has been found in new pursuits can also be found in mothering.
Elaine Heffner

All that remains to the mother in modern consumer society is the role of scapegoat; psychoanalysis uses huge amounts of money and time to persuade analysis and to foist their problems on to the absent mother, who has no opportunity to utter a word in her own defense. Hostility to the mother in our societies is an index of mental health.
Germaine Greer

All women become like their mothers. That is their tragedy. No man does. That's his.
Oscar Wilde

The moment a child is born, the mother is also born. She never existed before. The woman existed, but the mother, never. A mother is something absolutely new.
Rajneesh

A suburban mother's role is to deliver children obstetrically once, and by car forever after.
Peter De Vries

It kills you to see them grow up. But I guess it would kill you quicker if they didn't.
Barbara Kingsolver


I remember my mother's prayers and they have always followed me. They have clung to me all my life.
Abraham Lincoln

If the whole world were put into one scale, and my mother in the other, the whole world would kick the beam.

Henry Bickersteth

There is only one pretty child in the world, and every mother has it.
Chinese Proverb

The heart of a mother is a deep abyss at the bottom of which you will always find forgiveness.
Honore' de Balzac

Mama exhorted her children at every opportunity to 'jump at de sun.' We might not land on the sun, but at least we would get off the ground.
Zora Neale Hurston

A mother is a person who seeing there are only four pieces of pie for five people, promptly announces she never did care for pie.
Tenneva Jordan

A man loves his sweetheart the most, his wife the best, but his mother the longest.
Irish Proverb

Maternity is on the face of it an unsociable experience. The selfishness that a woman has learned to stifle or to dissemble where she alone is concerned, blooms freely and unashamed on behalf of her offspring.
Emily James Putnam

Strange Diet

Deer have been known to eat some weird things, but three deer killed on the Fort Polk Military base in Louisiana were found to have a stomach full of old bullets and shell casings. There were two bucks and one doe checked in with the strange stomach contents.

It was speculated that the bullets had been on the base for years and had gotten sodium or other salt built up on the outside which prompted the deer to consume them.

They recovered a total of 64 bullets and did not feel the deer’s diet posed any threat to the hunters who planned to eat the venison.

Survey shows For-profits less satisfactory

A national customer-satisfaction survey recently found that consumers would be better off with privately held health insurance companies rather than publicly traded giants like UnitedHealth Group, whose national presence is set to grow, yet again, with its $2.6 billion bid to purchase Las Vegas-based Sierra Health Services. Many in the Las Vegas area where this acquisition is to take place have major concerns and are very wary because they know from experience it will disrupt service, payments, and create an overall decline in satisfaction amongst patients and providers.

But consumers don’t usually have much choice in health insurers as they remain at the mercy of their employers who typically purchases insurance from the lowest bidder. Entities like these giants can underbid virtually everyone else in the area until they can no longer survive financially.

J.D. Power & Associates, in its first national consumer survey of big health-insurance plans, found that customers give “notably higher” grades to private, not-for-profit insurers like Harvard Pilgrim Health Care, and independent Blues plans than they do investor-owned giants like UnitedHealth or Aetna. These healthcare giants received the lowest scores of any of the 13 companies surveyed in the region.

The average overall national score was 739 and several large, publicly traded insurers fell well below that benchmark. The survey showed Aetna scored just a 698 in the West while UnitedHealthcare scored only 729 which are well below the national average. Privately held companies consistently were the high scorers in all geographical locations.

Healthcare in the United States will continue to be problematic if giants such as these are allowed to remain unhindered all while placing more and more restrictions on patients and providers. Their continued denials, restrictions, and rules allow them to practice medicine without the same risk of consequences. Stock holders remain their primary interest.

Trampoline Ups and Downs

Many people have strong opinions about trampolines. Some advocate them for physical activity while others want them banned from use because of potential injury.

There are potential injuries that can occur with their use and families need to understand the inherent risks.

The National Electronic Injury Surveillance System reported approximately 921,000 trampoline injuries from 1990 to 2002. The vast majority of these cases occurred in children younger than 18 years, and over 80% occurred on a home trampoline.

In 1999, the American Academy of Pediatrics issued guidelines recommending the elimination of trampoline use at home, at school, and at the playground. (American Academy of Pediatrics Committee on Injury and Poison Prevention and Committee on Sports Medicine and Fitness. Trampolines at home, school, and recreational centers. Pediatrics. 1999; 103:1053-1056). Other recommendations were that in supervised settings or training programs, no one younger than 6 years old should be allowed on a trampoline and that only one person at a time should be allowed on the apparatus.

Various types of injuries occur and correlate with the age and mechanism of the injury.

The lower extremity is the most common body region injured in both children and adults on any type of trampoline. On mini-trampolines, children younger than 6 years were more likely to sustain a head injury usually resulting in a laceration. Older children and adults were more likely to sustain a lower extremity sprain, strain, or fracture.

Fractures of the extremities occur frequently, but involvement of the trunk and pelvis is uncommon. Groin injuries occur in 5% to 9% of high school athletes from a sudden acceleration-deceleration or directional change during sporting events.
The rare but most severe injury associated with trampoline use is damage to the spinal cord, especially the cervical spine that results in paraplegia or quadriplegia. The majority of these injuries are incurred during improper execution of a somersault.

The treatment of trampoline mishaps is injury-specific.

Parents and children should be warned of the potential dangers associated with trampolines and aggressive cheerleading maneuvers.

Clear as Mud- the CEO definition of transparency

Our “illustrious” CEO who continually touts the transparency of the organization has done it again. He along with the acting CFO decided on a policy change and he announced to the management council that it had been decided to decrease the discount for prompt pay from 20 percent to 10 percent.

Different people have heard differing comments about whether employees would continue to receive the 20% discount for paying their entire bills while the rest of the public would only get a 10% discount.

This is being done without Board knowledge when it is clearly a fiscal issue related to the hospital’s finances. Why the Board has not been informed of this will need an explanation, but I’d be willing to bet this wasn’t an unintentional oversight but a way he will be able to disavow it when he realizes it is another poor decision as well as a public relations nightmare.

Trying to nickel and dime those patients who have a tough time affording healthcare anyway is an example of “short”-sighted thinking.

This will not solve the financial dilemma at Floyd that occured under his leadership. It will create an ever larger chasm those patients feel has developed over the past two years.

Not showing financials at the last Board meeting and now doing this without Board involvement shows just how transparent the organization is under his leadership.

Maybe transparency at the administrative level has a different meaning than everywhere else!

Is it too late??

I have been intrigued by a company called Accenture. They are a global management consulting, technology services and outsourcing company, committed to delivering innovation.

They work with all sorts of industries and believe that many companies wait too long to attempt transformations. They believe most companies only do so when the signs of trouble have become obvious and by that time it is too late.

They state that high performers, by contrast, change before they must, knowing that the best way to transform is from a position of strength.

I don’t think anything could sum up better the past few years at Floyd. We waited too long to make needed changes and we are now paying a heavy price. Our position of strength has collapsed and we are now in survival mode. The administration missed many opportunities for collaborative efforts with physicians and are now competing directly with many of them.

The new Chairman has instituted some changes, but there are still many necessary changes still needed and hopefully they will not be too late!

Bike Rentals

I ran across this in a magazine recently and thought it was a great idea for a city like New Albany. I like the idea of bike transportation in small cities and have visited places like Davis California and Stevens Point Wisconsin where they take bikers more seriously and actually build things with bikers in mind. I do not bike regularly now, but have enjoyed my biking vacations with my family in the past.

With the new YMCA and river front projects, this or a similar idea could be a nice idea. Biking is certainly one of the best ways to exercise and stay healthy.

Rehab Floor Closing

After months of speculation, worry, and emotions, the administration finally made the recommendation to the Board to close the rehab unit at Floyd Memorial Hospital. Many of the employees had already left because of the uncertainty and there was just a skeleton crew remaining. It eventually became a financial decision as they could not justify the ongoing losses in the face of the other financial problems. So even though it added non-monetary value for patients and physicians, it needed to close to help solve the other fiscal problems facing Floyd.

There will be mixed emotions but at least having a final decision gives the remaining employees some closure and will allow them to move forward.

It is the intent of Administration that Floyd will do everything possible to find positions within the hospital or at Southern Indiana Rehab so these employees can maintain their seniority and benefits.

April Board Meeting

The Board met last night and discussed several ongoing issues as well as making the recommendation on the selection of the new CFO. We were informed that the offer was made and the CFO did accept it. He will begin his new duties on June 1, 2007.

One interesting note from the meeting is that with all the financial problems facing Floyd, there were no financial numbers given for the previous month. When questioned about this, the answer given was that the audit was underway and the audit firm thought it best to hold the release of any more numbers until the audit is completed.

We were told last month that the hospital has been really busy and the financials should be good this month. Whether this turns out to be true is still to be determined, but when no numbers are given, it certainly makes you wonder. When I asked direct questions related to the issue, very indirect answers were given.

The financials are very important as it relates directly to staffing and as Vice Chief of Staff, I along with other members of the medical staff are still very concerned about our staffing situation and lack thereof. Morale in some critical areas is worsening and many of us fear we will be losing more good nurses and other personnel.

It is difficult to give any specific answers to employee's questions on the financial situation because of the ongoing selective release of information. The final audit report is supposed to be completed by the end of may, but when administration makes comments like "they (the auditing firm) will be recommending better internal audits", it makes you wonder what else is not being said. Trust remains a key concern regarding information received from administration.

The only reassuring aspect of this whole situation is that the Chairman appears to be truly in charge. This gives many of us a sense of reassurance, but I still do not believe he is getting all of the information. As I have stated before, I believe people make the right decisons when they have all the information.

A new source of Organs

Should inmates get time off their sentence if they donate an organ? This question is being raised in South Carolina.

There is currently a proposed bill from South Carolina State Sen. Ralph Anderson that would grant prison inmates time off of their sentences if they donate organs or bone marrow.

There have been many comments related to the proposal including the following:

“Repugnant,” “grossly unethical” and “taking lessons from the Chinese” are some of the things being said about the proposed legislation.

The bill arises from a federal law that allows up to 180 days “credit” if an inmate saves a prison guard’s life. Therefore, extrapolating this law further, Anderson figured they should get time off if they help one of the 573 state residents waiting for a kidney.

The desperation for organs is high but this avenue would certainly raise questions and potentially affect the donor pool as incidents of hepatitis and other problems are higher among prisoners.

People who donate outside of prison don’t get time off and typically expect nothing in return. They do it out of love most of the time.