Many challenges in 2010

The Post-Standard asked me a couple questions for its annual Progress Edition, which appeared last week. The paper set a 75-word maximum for each question. There were ten of us who participated in the Q&A involving ten economic sectors, and we more or less complied with the word rationing.

I didn't see the Q&A in the newspaper's print edition, but it did appear online. Here's what I said:

What key challenge or trend will health care face in 2010?

Hospitals face many challenges -- pressures to reduce lengths of stay, infections, and other complications; payers that reimburse hospitals below our costs; state taxes on hospital revenues; the high cost of sophisticated technology; an aging Central New York population; and an aging medical community.

How will that affect your own institution in 2010?

We have many initiatives: controlling infections and other complications, managing length of stay, and reducing costs. For clinical improvement, we have a new Orthopedics Center of Excellence; the city's most active daVinci robot; and a growing bariatric service. We've received honors for prostate surgery, maternity services, and orthopedics (HealthGrades); for low infection rates (Consumer Reports); and for spine and joint surgery (Excellus). To avoid duplicate investments and achieve more efficiency, we're exploring a merger with Crouse Hospital -- the larger operating scale would help us work with physicians on common challenges.

Soup for the soul

Last week Community thanked its volunteers for their work and dedication by serving "soup for the soul."

Hospital staff served the volunteers as they took their lunch breaks during Volunteer Appreciation Week. In the photo are (from left) volunteers Ed Klein, Carolyn Terrell, and Bill Thorpe.

Community has some 350 volunteers. To each of you, the patients (and staff) thank you for every hour of service and for every act of kindness.

A best friend and lifelong neighbor

Jean Yeiser was a founder and friend of Community General Hospital. She knew all about the hospital, just as a best friend and lifelong neighbor would.

Jean was a charter member of the Auxiliary (from 1962), and she was a lifetime Auxiliary member. She was Auxiliary President (1979-1983), and she served on the hospital board during that period. Jean started the holiday lights program more than two decades ago. She was chairperson of many Auxiliary committees over the years, serving notably as the chair of volunteer services for many, many years.

Jean was herself an active volunteer, and you could find her on Monday mornings on the main desk . . . until she passed away, February 20. She was 90.

In all her years in up here (that is, "he-ah"), Jean never lost her North Carolina accent -- nor the direct and friendly way she engaged and assisted others. What a dear and impressive woman. What a friend and colleague.

We are proud and thankful that Jean was such a part of the Community general family. Our sincere condolences to the Yeiser family and to her many friends.

We miss her.

Duly noted

Following my posting on best practices, David Rothman, Community's blogging librarian, chided me this week with a copy of "Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomized controlled trials," an article by Smith & Pell from BMJ several years ago.

The article concluded:

As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to a rigorous evaluation by using randomized controlled trials. . . .We think that everyone might benefit if the most radical protagonists of evidenced based medicine organized and participated in a double blind, randomized, placebo controlled, crossover trial of the parachute.

Satire duly noted.

Return of MASH Camp

My appreciation to County Executive Joanie Mahoney (left photo) and to Excellus Central New York President Dr. Art Vercillo (right) for their welcome of the MASH Campers to Community General this week.

There were 30 junior high school students at this year's MASH Camp -- that may be a new record. See MASH Camp in 2008 and 2009.

During busy days, the scrub-suited young people learned about hospitals and health careers through hand-on experiences.

MASH (Medical Academy of Science and Health) is run by the Central New York Area Health Education Center (CNYAHEC) with funding from Excellus.

My thanks, as well, to the professionals at Community who designed the workshops and interactive experiences that kept these active and curious young people so engaged.

He practically invented orthopedics here

After Dr. Robert Lockwood completed a total hip replacement on my mother (some 25 years ago), she observed, "It's my best part." Mom has also been known to say (to this day) what a gentleman is Dr. Lockwood and how much confidence she had in him.

A few days ago I was reminded of Dr. Lockwood's work and accomplishments when I saw him, as trim and fit as ever, standing in Community General Hospital's new Center for Orthopedics. He was visiting a patient there.

It was Dr. Lockwood who performed the first joint replacement surgery at Community General, decades ago. He performed the first rotator cuff surgery, and he was the first to use a halo device (surgeons at Upstate Medical Center would borrow the frame).

Dr. Lockwood was Community's chair of orthopedics from 1975-1982. He recruited to the hospital younger doctors who went on to play significant roles: Dr. Joe Smith succeeded Dr. Lockwood as chairman of the department, and Dr. Perry Cooke went on to lead Syracuse Orthopedic Specialists.

After he retired from private practice in 1988, Dr. Lockwood continued working as the Director of the Orthopedic Clinic at University Hospital in Syracuse. He had been a faculty member at Upstate Medical Center (now, Upstate Medical University) since 1953. That was the year he graduated from orthopedic residency at Northwestern University in Chicago and began his practice in Syracuse. At Upstate he was promoted to a full professor in 1988, and he didn't retire from there until -- last October!

A curious, energetic, and active man, Dr. Lockwood was legendary for climbing the Himalayan mountains (four times!) and for scuba diving in the Dead Sea. He traveled to Jordan on a medical mission and worked in a small hospital in Jerusalem. In China he once taught for a month at a medical school in Kunming (there was no heat, electricity, or running water at the time).

Dr. Lockwood skied, he swam, he hiked, he rowed, and he played tennis. He still cross country skis . . . and hikes . . . and rows.

As he concluded his practice at Community, I asked a photographer to accompany Dr. Lockwood on his last OR case. Afterwards I sent him several prints (see one, at right). "You have earned the respect of your colleagues and coworkers," I wrote him, "and the gratitude of your many patients -- including my own mother."

Click here for safety

At a recent hospital management meeting, we discussed the importance of patient safety. I promised to collect various patient safety postings from this blog. These collected messages are now at a special address, accessed by the patient safety button (above my picture) or through the Community General home page.

The messages demonstrate the importance of patient safety – and its visibility – with Community's senior management . . . and me personally. This morning I emailed all managers to suggest they use these tools to reinforce patient safety messages within their departments.

Consumer Reports: no infections

Sue Chamberlain's phone started ringing last evening. Several doctors asked if she had seen the current issue of Consumer Reports. No, she had not.

By this morning Sue had a copy of the magazine showing Community General Hospital as one of nine New York State hospitals having no central line infections in 2008, the most recent year for which Consumer Reports had comparison data.

Sue is the director of Community's infection control program, and she and her colleagues take infections personally. But infections aren't prevented by Sue and her colleagues alone. They are prevented by the careful work of nurses, physicians, and other clinicians, following standard precautions and procedures. They are prevented by environmental services and other support personnel paying attention.

Low infection rates are something for everyone to be proud of.