Friday, April 15, 2011

Readers Sound Off on EMTALA, ACOs and the Future CEO

Today, in what will become a regular H&HN Daily feature, I'm handing the blog over to my readers and their thoughts on recent blogs, articles, podcasts and videos:

Robert Sigmond responds to Emily Friedman's recent piece on the 25th anniversary of EMTALA and its long-term impact:

"When I started working with hospitals in the 1940's on the Pennsylvania Hill-Burton plan, none of the hospitals that I remember ever charged for service in the Emergency Department. When I took my wife to the Emergency Department at the hospital of the University of Pennsylvania in the middle of the night with a terrible toothache back then, there was no way that I could pay for the care. The staff explained that they were not allowed to take tips! By the 1950's, Hill Burton requirements and the rapid growth of prepayment plans and the early insurance offerings had started to change all that, even before Medicare and Medicaid in the 1960's."

Debra Gerardi, R.N., writes in response to How to Build an Effective Accountable Care Organization, written by Abe Levy, M.D., Aric Sharp and Scott Hayworth, M.D.:

"Adopting a proactive approach to conflict management and improving conflict competency among leaders will be a necessary component of any successful ACO. In addition, the Joint Commission has required this as a component of accreditation and as such it is an invitation to leaders to think of conflict management strategically as a core component of achieving overall safety and high quality care for patients."

On Don't Use That Kind of Language Here, a blog I wrote about the importance of clearly written signage, pamphlets and forms for patient communication, Cheryl Allen, R.N. writes:

"I've been an R.N. for 30 years, and sometimes when I go to the doctor I have no idea what they're asking. The form says have you ever had any of the following...Rash, well who hasn't had a rash? Do they want me to put yes—even though it only lasted three days or do they want me to put no because it wasn't significant?"

Scott Mason responded to Dan Beckham's article CEOs Under Scrutiny, about the changing expectations hospital boards have for their CEOs:

"Rather than punt to a health system in the absence of a thoughtful strategy or simply put off succession planning, progressive boards may be required to embrace non-traditional models in the selection of their future leaders. It has long been the model in healthcare for CEOs to come up through operations. This has worked to a point. But it is my observation that operations has very little to do with strategy; there is almost no crossover. Future CEOs in healthcare, as Dan noted, must be strategic. And to the extent that operations is important, it may be more a need for familiarity with physician practice and freestanding ambulatory operations (growing) rather than just hospital operations (shrinking). At the same time, we should not forget that ‘culture eats strategy for lunch.'"

And finally, Daniel Fell, from Chattanooga, T.N., responded to How CIOs Can Stay Relevant, a podcast interview with Spencer Hamons, corporate project manager for the Yukon Kuskokwim Health Corporation in Alaska, on the importance of CIOs in smaller markets:

"I think one way CIO's can break out of the IT silo is to collaborate with departments like marketing who have a shared interest in IT solutions. Marketing also brings a broad market and customer perspective that can help IT to be more successful in its planning and implementation efforts."

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H&HN Daily

H&HN Daily extends the conversations that readers began in other health care management publications and media. Each daily e-newsletter contains at least two topics with exclusive insights from high-visibility, recognized names in health care. All comments are welcome and may be posted to the blog. Comments may be edited for clarity or length.


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H&HN Senior Online Editor

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H&HN Managing Editor

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H&HN Senior Editor

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