Planetree Conference 6 Part 1 of 3

Day 3 of conference proper consisted of a series of keynote address.

James Canton, Phd – Futurist, Title: Extreme Future of Healthcare

- Question: is it possible to transform healthcare to become cost effective and high quality care?

- Key trends – asymmetric risk

• Eg. Alzheimer will affect 1/3 men over 70 years old

- At least 50 companies at working on retrieving memories in the brain

- Yesterday Wall Street Journal reported that the State of Pennsylvania will publish all quality data for all hospitals in Penn State

- We are in the era of consumer genomics – what we can do, what insurance co can do, government can do with the data is still largely unexplored

- Hospital can becomes the arbiter of information (overload) – we (hospitals that is) are already trusted to cure/disease management, why not extend the continuum

- With all these data and information, can we move to Predictive Medicine, instead of Reactive Medicine?

- Population is aging, different buckets of demographics uses technology different [important as we think about how to employ technology for patient-centered healthcare]

o 25% Gen Y (> 1976), 10% Gen X (1965-1975), 40% Boomers (1946-1964), 25% Mature (<1946)

- Health 2.0 – everything digital about healthcare, that’s where everyone is focus on right now

- 7 Characteristics of Healthcare in the near future

• Patient centered, humanistic (personalization)
• Predictive
• Preventive
• Wellness vs Disease focus
• Self-care & Personal Responsibility
• High Tech, High Touch
• Social networking

- What medical model will we be using?  We have a rare opportunity to re-think the healthcare model.  Can we take advantage of it?

- Early detection made possible through genomics, data warehousing, epidemiological data, all sorts of wonderful invention in predictive power, are we doing enough to take advantage of it and advance healthcare?

- Diagnostic future – patient wants more information

- Wellness Centers – the younger the demographic, the more they want to know the extent of probability of something happen to them

- Regenerative medicine – next big thing!

- Medicine will be personalized

- New class of pharmaceuticals coming up, personalized, targeted

- Personal bio-detection – do you know what that is?

- Design evolution for drugs, surgical devices, diagnostic equipment

- Tiger Woods have Lasik twice to have better than 20/20 vision

- Telerobotics – not just DaVinci, have you heard of nano surgical robots?

- Conquering disease at the atomic scale – the next frontier

• If we know how disease works on the atomic level, don’t you think the intervention will be different too?
• More than 100 companies working on this now

- Synthetic biology – merging engineering and biology – grow new limbs, new kidney, new heart?

- Designer genes – already coming

- The future of healthcare, can be summarize in 3 Ps

• Predictive
• Prevention
• Health Promotion

- Hospital is already a social network for the community regarding health

• How do we empower the patients?
• how do we partner with them to prevent disease?
• we need to think health management vs disease management
• somehow we have to integrate all these together, does your hospital know how?

- Every industry is moving to Cloud Computing, because it’s always on, anywhere, anytime

- Technology is a good thing, it integrates, it is cost effective, the biggest resistors are doctors unfortunately

- We can now move information faster, have better access to data warehouse, leverage all the extra information to provide better care

- Cloud computing means collaboration

- Did you know that there are 100s of medical apps for iPhone currently available

- Nutra genomics - Individual groups response to medical intervention

• Greek study – Normal way to lose weight did not work for them. Genomics research discover potatoes help them lose weight, not what you expect. 
• Only Europe is doing all this pioneering work, not happening in USA
• Speaker sees prime opportunity in helping people manage their health in pre-diabetes stage

- Insurance companies are like dinosaurs, still want to manage disease, we need to manage health

- Can we give people a glimpse of their future, use lifestyle information we have today, we can do it, could we do more?  It can be a source of new revenue!

- We are already patient-centered care for Planetree hospitals, we are already halfway there

- Look up this term, “Intuitive Awareness”, [I have no idea], googled it!

- Electronic Health Records – who owns them?

• It appears that hospital just need to ask permission from them to store it for them.  Ownership will need to be defined better. [we need to think about this when we go EMR, do our patient agreement covers use of data in EMR database?]
• this is a great opportunity to use the data for greater quality of care
• raise awareness of these trends to doctors
• link/collaborate with those working on it
• hospital as “trusted advisors” help navigate patient through all this.  The emerging role of patients in their health management will be dramatically change

- We are still medieval.  Why is it none of us know when we are going to die? Why??!!  Will all this information available, we still leave it to chance

- Insurance can play a different role

• Eg. His brother has retinal detachment due to genetic predisposition, but he himself has the same thing 15 years ago.  So there is greater genetic predisposition, but nobody tell him.  Information is there, we need to link it and use it. 
• Eg. If you are predisposed to renal failure, why not work with patient to put away $10 a month, and get ready to pay for a new kidney 15 years from now.  Hello insurance companies?  Isn’t this a better way?

- 50% of lumps we will know the timing of when it will turn cancerous.  Knowledge is available, are you using it?

• Repeat one last time, we need a different model of healthcare

I know there’s a lot here.  Each of the keynote speakers were great.  Hospital cannot stand still.  Time to think differently.

Enjoy reading…

Planetree Conference 5

Keynote address for Day 2 evening session:

Joe Tye, Values Coach, Inc, author of The Florence Prescription.

- If you have a job, you could lose it, but if you have a calling, you can lose it

- address open with a vide of a baseball being hit to the left field, the left fielder decides that the ball is too high to be caught.  The ballgirl, standing right out the boundaries, using her feet, climbing nearly 10 feet and caught the ball.  Have to see the video to believe it.  Then she shrugged and sits down on her chair waiting for the next ball.  Now who has a job, and who loves the game?  Who do you want to take care of you when you are admitted to the hospital?  The ball girl or Jake the outfielder?

- The left brain counts and the right brain matters

Nordstrom – they don’t have rules – one statement “in all situations, use your common sense, there are no more rules”

Left Brain	Right Brain
bean counter	poet
measured	seen
rules	values
plans	inspires
hardwire	softwire
what you do	what you are
boring	chaos
count beans	plant beans

I really like the comparison table, it summarizes what we are doing perfectly

- the invisible architecture we allowed to evolve haphazardly

- The foundation of the hospital is your core values, the spiritual side of our workplace

- What value do you think your senior leadership valued the most? Productivity or Compassion

- Values are not good intention, they are skills –> teach it!

- Corporate culture is the superstructure of the Invisible Architecture of the organization

- Culture eats strategy for lunch! –> any time, every time

- Emotional climate is the interior decor of your Invisible Architecture

- Where’s our blueprint for the Invisible Architecture?

we have masterplan for physical construction, now we are starting a masterplna for services, how about a masterplan for the Invisible Architecture – the culture of the hospital

- Spark plugs/zombies/vampires

Spark plugs make up about 25% of the staff, they are the ones engage

Zombies are on auto-pilot, still doing the work, but it’s a job, 60%

Vampires suck the life out of everyone they touch, the disengaged staff, about 15%

- BMW Club – bitching, morning and whining people

- Negative emotion is physically harmful, if we allow this in our - workplace, for our caregiver taking care of our patients, that’s medical malpractice!

 

8 values

1.  Commitment – a lightning strike and two delayed weddings.  Someone build a barn to hold weddings, a lightning strike it and burn it to the ground.  Because of what he represented, two weddings are postpone, the to-be-wedded couples help re-build the barn so that they can get married.  the barn builder does not have a job, he has a calling!

2. Engagement – how long does it take to finish a road?  Paul Newman’s film, where they decided to own the chain-gang work while in prison. 

Leaders are Storytellers.  Speaker is continuously amaze that so many leaders are not good storytellers, simply because they haven’t bother to learn the skills.  each leaders speech must have SEX (sic) with the audiences. SEX – significant emotional experience

3. Passion – nothing great was ever achieved without enthusiasm (Ralph Waldo Emerson)

Texas Roadhouse – have pep rally and singing the company song “I Love My Job”.  They realized that every store can have great food, but the customers will come back if they have fun, and they will only have fun if the employees have fun

4. Initiative – the antidote to learned happiness – “PROCEED UNTIL APREHENDED” – key phrase by speaker.  You can’t empowered people until they empowered themselves

5.  Stewardship – at home, at work, in the world

6. Belonging – fear excludes and creates enemies.  Courage includes and creates friends

7. Fellowship – put the cheer back into leading.  James O’Toole book “Leadership A to Z”, CEO stands for Chief Encouragement Officer

8. Pride – the classic icebreaker opener, “What do you do?”.  the most horrible answer, almost always given, “I’m JUST…”  why do we say that?

example: Industrial ventilation system company called High Volume Low Speed (HVLS) Fan Company.  sales was normal, and customers being calling it a different name, so they decided to adopt the name, Big Ass Fan Company.  Sales double every year!  They adopted a donkey mascot and started selling hats, t-shirts and pants.  They proceed goes toward – get this – Orphan Donkey shelter.  They have fun!

Case Study:

Tucson Medical Centre – Emergency Department was one of the worse place to work.  Speaker conducted focus group, and CEO authorized the entire report to be given to every single staff of the hospital.  Staff were told, fix the problems, don’t wait. 

- maintenance says they don’t have time to paint for the wards, the nurses went out, bought the paint and started painting, maintenance department suddenly have time to paint for them. 

- no security guard at ED, nurses called the Police Chief to help out with security at ED, suddenly security has the extra personnel to help

- they were taught Proceed Until Apprehended

- CEO directed all senior management staff to round the hospital from 8 to 10am every morning.  No senior mgt staff is allowed to check their  email, or a phone call before then

 

Empowerment is helping others be better than who they are

 

visit www.joetye.com/blog for free download on culture of ownership, invisible architecture, keeping people, values training, presenting yourself with power.

 

visit www.healing-tree.com.  can’t remember for what reason!

 

- end of day 2 keynote address report -

Planetree Conference 4

Only attended one workshop today.

The first keynote address of the day talks about the soul, which i thought was a bit New Age, so decided to work on my emails instead.

First workshop of the day talks about impact of Color in Healing Environments.

Husband and wife team, over 30 years experience in design acute care hospitals.  Husband was with US Navy (I think), lived in Bangkok for a few years building a hospital for the US Navy. familiar with South-east Asia.  Volunteer to give us any resource if we need help.  Good contact.  Barbara Huelat and Joseph Parimucha.

- Science haven’t been able to explain our emotional response to colors, but experientially there’s an impact, many books written about color psychology but not a lot of scientific evidences as yet

- the color schemes that will be easy on the eyes and last longer with jading the eyes are nature colors.  A very common method I see with all the interior designers here, is to use a photo (literally) of the local scenery, and match a palette of colors to the design.  Very effective.  This was also demonstrate to me by the firm that Loma Linda uses, Aesthetic, Inc.  The industry term is nature fractal

- Use colors by the 3 Ps – Palette, Placement, Percentages

1. Palette – monochromatic (do not recommend), analogous, complementary, double complements, neutral and full spectrum-balanced.

2. Color Placement – background should be light neutrals, ceiling for be light neutrals, flooring should be mid-tones, secondary accents – mid-tones and primary accents must be limited

3. Color Percentages – ceiling is usually the lightest color, primary accents limited to 2 to 5%

Other things to consider – avoid fashion trends, keep a balance between warm * cool, consider the function, adjacent color scheme, lighting, color reflectance, color temperature, getting close to the right color match is not good enough, the the science, nature, culture and emotion of color.

Quote” It’s a goo thing that when God created the rainbow he didn’t consult a decorator or he would still be picking colors” Sam Levenson.

 

Made contact with Hackettstown Regional Medical Centre (part of Adventist Healthcare system), they are working hard on Planetree ideas.  HRMC gave a workshop on shadowing program, bringing high schools student through the hospital during school holidays and hopefully interest them to become healthcare works.  Works very well, part of their ‘giving back to community’ project under Planetree initiatives.

 

Drove to Washington D.C. to see International Finance Corporation (IFC), the private sector financiers for World Bank.  Highlights:-

- Investment arm continuously match projects with investors, we can play both roles

- when IFC lend, they become active partners, whether as lenders or equity holders, this is a good thing because they can bring to bear their consider resources in best practices for financing

- The South-east Asia desk person-in-charge was not available, so I spoke with the South Asian officer.  She was very keen to know whether we have interests in Bangladesh, Sri Lanka, India or Pakistan.  Just 4 months ago, she had investors looking for a hospital management company to take up a project

- I spoke about setting up a for-profit entity, possibly in Singapore, raise funds from private equity, capital market to invest in the region.  She said she will source a resource person from their Private Equity Division to work with me on how to structure such an entity.

- Overall, they were very positive, and was sold on our philosophy and approach.  Their familiarity with Washington Adventist Hospital helps.

- I offer for them to meet with GC Health Ministries Department.  I will be in GC on Thursday morning, will see if I can dropped by to see Dr. Landless and make an introduction to IFC officers.  I also explain to them a little bit about AHI, Loma Linda.  I’m not sure if these will lead us anyway, but we never know would we?

All in all, a good meeting besides recovering from the shock of paying $15 for parking!

 

Back to Baltimore for the second Keynote address of the day.  Details in the next summary.

 

Right after, attended a gathering for the International delegates.  Spend a bit of time with the key officers of Planetree, who also happen to be Griffin Hospital officers, they are the sponsoring parent body, based in Derby Connecticut.  A must visit hospital if we are serious.  They have hosted 700 hospitals visit since they started.  The President/CEO Patrick Charmel gave a personal invitation to tour their hospital.  www.griffinhealth.org, www.planetree.org

 

- end of Day 2 report -

Planetree Conference 3

Highlight from first day Keynote Speaker, country singer fame, Naomi Judd.

First question is on who we are.  Do we know who we are? Be a detective on ourselves.  Unhappiness is because we do not know who we are.

“Pain is inevitable, but suffering is optional”

Planetree hospitals knows that there may not always be a cure, but there’s healing.

Mark Twain says that the only people who likes change is a wet baby

Human beings are hardwired to socialize, [but why so many problems expressing, communicating, relating etc]

Read Blair Justice book, how the sick stay well

FEAR – false evidence appearing real – when confronted with deadly disease, find out all you can about it

Dr Lisa Randall (?) says we live in 11 dimensions, and we only know of 4 so far, most already struggle with 3.  All the studies on physics, cosmology, biophysics actually proves the existence of God.

we are supernatural beings living a natural life

Read Eckhart Tolle – getting rid of ego – EGO stands for edging God out

All our behaviours driven by our emotions

Co-dependency taught her how to step back and observe how their behaviours affected her, then set healthy boundaries to cope

Like 12-step AA, say the serenity prayer everyday

When you change, others who see it will want it too, you will become the change agent

We all become a victim ONE time, after that we volunteer!  understand?

When we BLAME, it’s Be Lame

Illness means something out of bound

MOM upside down spells WOW :)

It’s not about what happen to us, but what we do with the information (in respond to her family secret)

“When we offer ourselves to someone broken, we make yourself whole.

Integrative medicine is the future. touch therapy, acupuncture, pet therapy.  music is very powerful – first sense to develop in the uterus.

Very important to detox

8 characteristic from American Psychiatric Association

1. Spiritual – faith factor, Dr. Dale Matthews (read his books and research)

2. Support System – people live longer nowadays

3. Sense of Humor – endorphin producing

4. Nature – nature is a healer

5. Having a purpose

6. Diets

7. Exercise

8. Open belief system – read the story of infection/sterility, invention of stethoscope

Change her name to Naomi at 30 because she wants to remember a retarded girl in her grade school.  Her real name is Diana.

My comments: Very interesting talk, we don’t have agree 100% with her, but she sure gets you to think seriously about things.

Planetree Conference 2

Day 1 Conference

· I asked hospital executives here regarding Studer Group.  They said it’s good, but it’s very much process based.

· Many recommend Values Coaches, Inc, Joe Tye, who I met last night, works on the soft-wired side, that’s attitude, values and personal ownership of core values.  Very interesting perspective from him.  He’s working on a project in Hanoi (first trip to Asia).  He has a few Asians working as coaches for him.  He explains it as Studer work on the Left Brain, he works on the Right Brain

· 5 certified Planetree architects and planners exhibiting here, their products are awesome.  Dare I say it, even better than TAHPI

· The designation process helps wrap JCI, Malcolm Balridge, HCAHPS, IHI, methodology like Studer, around a patient-centred framework/perspective

· I was thinking, Adventist should be leading the charge here.  We promote wholistic care, but others has done a much better job.  140 US hospitals are into this now.  Loma Linda, Washington Adventist leading the charge, but Florida hospital nowhere in sight (a very curious thing)

· Heavy promotion of aromatherapy, pet therapy, touch therapy, acupuncture – not just for patients, for staff as well (very important aspect)

· Planetree has design consultancy service led by an architect (I met her, and she will give us a proposal on how it usually happens).  She is also LEED certified

· All Planetree hospital aims for Open Chart, patients has a right to see their chart anytime, some even allow patients to write their own notes attached to the chart!  Not necessary part of the official chart, but it gives a way for patient to counter check the care plan, and also gives opportunity to correct errors, or if plan were not followed correctly by nurses

· 24 hours open visitation hours – no kidding

· Nutrition plays a big part – again here Adventist healthcare should be leading the discussion, but we are not

· Lights, colours, use all five senses, artwork, all plays an important role

· I met the interior designer for Marriott hotels, she said she’s not as expensive as we might think.  She just finished Tokyo Disney for 9000 piece of artwork, all without traveling from her Chicago office

· Music therapy is very big deal – I got a free example, very cool for pre-op surgery, dental surgery etc.  their research shows dramatic improvement in patient calmness and outcome

· Met the aesthetic designers for Loma Linda, saw the storyboard for loma linda new centre, it was better than anything I have seen out of TAHPI or Sylvia for that matter.  Met the director, they already doing Sonora, Glendale, Bollingsbrook.  You don’t have to explain Adventist Healthcare to them!  They will interpret our concept of wholistic health for you, imagine that!

· Planetree just established an international network, it’s at the pioneering stage.  Now is the time to get involved.  The big players are Brazil, Netherlands, Japan, Canada.  I meet one of the assessors, they love to go big in South-east asia, will talk to them about a pilot hospital project, we should get there before Singapore or Hong Kong does

· Met Wendy Leebov, computer self-directed learning materials for patient care and patient customer service.  I thought the materials were very good, comprehensive, useful to help our nurses.  Googled wendy leebov to see for yourself

· Meet Sharp Coronado Chief Nursing Officer, one of the first Planetree Designated hospital in the country.  We can visit them anytime.  Good contact, very generous with her time

Planetree Conference 1

Things I learned today from my hospital visit…

- learn from the best.  Bayhealth hospitals are award winning hospitals, it’s a Studer hospital as well.  We can learn a lot from them

- heavily promote what Planetree advantage is for the patients in public areas

- Planetree is about distraction for patients, using colours & senses, in addition to good customer service initiatives etc.  Lots of natural light, keep hallway and rooms bright

- hospital created their own distraction booklet

- create space for personal therapy for staff (Planetree is not just for patients)

- getting patient involve in their own care

- every service unit has a patient resource center

- encourage everyone to think about patient centered care and staff wellness, i guess goes hand-in-hand

- patient/family advisory council

- open chart (wow!)

- name their corridors! (i like this)

- rehab floor was awesome, lots and lots of space, has mock apartment to learn how to cope when go home, patient also learn things because at hospital everything is provided for like handrails, specially designed toilets etc

- all care is deliver in the patient room, like physio

- touch therapy, pet therapy very widely practice

- aromatherapy for maternity patients (optional of course)

- labour, delivery, recovery, discharge LDRC (forgot the exact acronym) in one room for maternity patients

 

source: Milford Hospital, Bayhealth System, Delaware

The Role of Finance

Key Thoughts:-

Once in a while, an article that summarizes my thoughts. Here’s one I just read. The article mainly mentioned the CFO specifically, but I think no one person can do a job, it’s a whole team. So I believe it’s applicable to all of us.

Summary:-

The article opened with a declaration that Finance bring a unique view to the table – ‘a broad, objective perspective on costs, cash, and capital, with the long-term best interest of the organization in mind.’

However, near-term pressures to ‘reduce costs, better manage cash and working capital, and monitor capital expenditures’ cause some Finance function to shift focus.

Areas Finance should focus on includes:-

1. Information Management. Management is about making decision, and we can’t make decision if we have no information. Or if we have bad information, we make bad decision. The need for greater accuracy and control over the ‘development and use of information’

2. Enterprise Risk Management. Awareness of risk means that the risk management processes will require greater, broader, and more frequent effort.

3. Cash Management. A recent survey shows that the CFO’s agenda has shifted from ‘value preservation’ to ‘value creation’. Needs to be front and center in discussions of growth opportunities. The need to develop scenarios planning means we need competencies in cash forecasting.

4. COO’s area of responsibilities. The consolidation of COO role in some hospitals means more areas come under Finance, facilities management, human resources performance management, regulatory affairs, and general operations.

My Comments:

It’s heartening to note that at PAH, Finance is already doing a lot of the area listed, this serves as a reinforcement that we are on the right track. What we need is increase the effectiveness of what we are contributing.

Reference: Finance Needs to Sit At the Head Table, Edward J. Giniat. HFM, May 2009, pg 80-82.