Like most people, I do not like being sick. There is nothing fun about staying home and watching bad daytime TV. So what can I do to stay healthy when everyone else around me is sick? I asked Dr. Long Hoang of Keystone Family Medicine in Simpsonville. Here’s what he had to say.

First, Dr. Hoang suggests getting the flu vaccine. He also recommends frequent hand washing and adequate rest. And lastly, if you are sick, stay home! (This is probably the toughest rule to follow, especially when the alternative is hours upon hours of bad daytime TV.)

If you are sick, Dr. Hoang says you should drink plenty of fluids. He also recommends a liquid/bland diet if you’re suffering from a GI illness, as well as over-the-counter medicines for upper respiratory illness or fever. (If you’re concerned about which medicines to take, consult your doctor or pharmacist.)

According to Dr. Hoang, you should see a doctor if you are experiencing any of the following: severe cough or shortness of breath; high fever with body ache, fatigue and/or sore throat; unable to tolerate fluids due to severe nausea or vomiting; having dizziness/lightheadedness and significant weakness; or any other concerning symptom.

If you need a doctor, you can find one on our website: www.ghs.org. Just click on “physician finder” on the left hand side. And if you need a doctor at night or on the weekend, visit one of our two MD360 Convenient Care locations (www.ghs.org.md360).

So, did any of Dr. Hoang’s advice surprise you? It sounds pretty similar to what my mom tells me every year. Perhaps it’s time for me to admit that mom is always right …

The ladies from Cafe and Then Some are at it again. They are a very funny and somewhat irreverent comedy troupe from Greenville.

They pushed it a bit with the New Jersey humor, but if you have a couple of minutes, take a look at page 37 on the attached link. There is a video that made me chuckle and cringe!

http://emag.fetegreenville.com/

I do want to make one point or correction, lest something think I went back on my word. When we started publicly speaking about the School of Medicine, one of the core principles was we would not seek money from the legislature to support the School of Medicine in Greenville. The School of Medicine in Columbia and the Medical University of South Carolina, appropriately receive money from the state to support their schools. In fact, I promised the President of MUSC, Ray Greenberg, from the beginning that we would not look for that support from the state. I may be from New Jersey, but keeping that commitment is important to me!

Finally, as an aside, for those of you that live in Greenville, there is often a misconception that we receive tax revenue from City of County Tax to care for the uninsured or underinsured, we do not. We do it because it needs to be done.

I have written before about the pitfalls of reporting systems and grades for hospitals. Here is an article I just read from a newsletter I received from PHTS – a risk management organization that we belong to. I was tempted to delete the last sentence, but I think this is a critical point. Self-reporting has some limitations and inherent conflict of interest, in that it can be self-promoting.

Leapfrog measures fall short. Hospitals that comply with safety standards pushed by the Leapfrog Group, and endorsed by the National Quality Forum, don’t necessarily have lower mortality rates or lower incidence of hospital-associated infections, report researchers in Archives of Surgery.

The authors reviewed outcomes in a nationally representative sample of level I and level II trauma centers. They report that neither the total score on the Leapfrog Safe Practices Survey, nor full implementation of computerized physician order entry, nor full implementation of intensive care unit physician staffing led to lower mortality or fewer hospital-associated infections.

“We did find, however, that a hospital disclosure policy for informing patients and families of systems failure or human errors leading to unanticipated outcomes is associated with lower mortality,” the researchers reported.

Earlier research on safe practices also turned up equivocal results. For instance, researchers found that computerized physician order entry and ICU physician-staffing levels improved outcomes for heart attack patients but not for patients with congestive heart failure or pneumonia. Another study found no correlation between a high score on safety practices survey and lower mortality.

Dr. Laurent Glance, who led the work, told Reuters Health the findings don’t indicate the safety practices aren’t effective. It could be the Leapfrog survey is falling short. “You can’t just rely on what the hospital executive says. You’d probably also need to have some sort of auditing in place,” he noted.

One of the requirements of a Medical Staff is to meet annually. In addition to fulfilling the responsibility outlined in the bylaws, it is also a good event for social interaction and education. I am usually given some time to give an update of some sort. The following is a copy of what I intend to speak to the group about. The level of physician leadership and involvement at GHS has steadily increased over the years. This talk gave me pause as I read it….I am struck by how engaged our physicians are. Perhaps it is one of the reasons this past year that, as a group, our physicians scored in the 99th percentile of engagement in our annual survey administered by Moorehead.

• Acknowledge
o Governor Tom Ridge, keynote speaker
o Medical Staff Officers
• Chris Wright, MD -President
• Marty Lutz, MD – Vice President
• Bruce Snyder, MD – Immediate Past President

• Thank Lee Van Voris, Shirley Crawford and all the staff responsible for tonight’s event.

• My assignment: Offer brief comments about the state of our system.

• Start with our goals – both the multi-year and annual goals. They offer a framework for understanding where GHS is heading – both near and long-term.

o MULTI-YEAR GOALS….Our Five Big Ideas:
1. Become a Total Health Organization.
2. Transform core organization structures and processes into a highly integrated delivery system.
3. Become an Accountable Care Organization.
4. Improve care and delivery and workforce development through innovation in academics.
5. Ensure a sustainable financial model that supports our vision and mission.

• …and our Annual Goals which center around six pillars of excellence:
1. People
2. Service
3. Quality
4. Growth
5. Finance
6. Academics

• Not enough time time to move through them one-by-one; but let me talk about one important theme that emerges for me when I think about these goals.
11-17-11

• Theme: The Role of Physician Leadership/ Engagement at GHS

o Highest level of physician engagement here at GHS compared to any other health care setting I’ve known.

o Examples
1. At the senior-most levels of the organization
• CEO Staff Meeting (Youkey, Taylor, Sinopoli)
• President’s Council (Youkey, Taylor, Sinopoli, Marshall, Diller)
• Operations Council (All Clinical Chairs)

2. At the unit level
• Physician/Nurse Manager partnerships addressing work-unit specific operational goals

3. In Practice Settings
• Physician leadership is critical – nothing new here
• In concert with the vision and larger goals of the system – that’s different today than ten or twenty years ago.

o What’s been possible as a result?
1. Consistently high results related to quality of care – CMS All Care Measures

2. Improvements in our culture of safety – still room to move forward here.

3. Year-over-year growth
• Access to care
• Volume
• Outpatient activity accounts for more than half of our revenue today

4. Strong system-level financial results in a very challenging economy
• Credit goes to the hard work of the Operations Council led by Greg Rusnak and Jerry Youkey
• Clinical Chairs and Campus Presidents working together to sort through difficult decisions
• Finance team willing to reinvent itself in collaboration with physician leadership

5. Measurable evidence of high levels of physician engagement
• Our employed and closely aligned physicians rank in the top decile of all health care works across the country – Morehead Workforce Commitment Index

6. Collaboration and innovation within the system and across the community
• YMCA PATH program focused on coordinated intervention for chronic conditions such as diabetes
• ITOR – bringing private sector research together within the delivery system…a vision of translational research and personalized medicine
• Nurse-Family Partnership – an evidence-based community health program
• Our Total Health philosophy influences many of these partnerships…

7. Significant movement toward higher and higher levels of system integration
• Care coordination throughout the system
• Information systems
o EMR
o Centralized Scheduling
o Acknowledge the growing pains…that are being felt across the country

8. Accreditation of the USC School of Medicine – Greenville
• The energy behind this achievement belongs to Drs. Youkey and Taylor and several others who were driving this process
• Our ability to even entertain the idea of a four year medical school was predicated upon the exceptional commitment to teaching and academics that exists within the GHS physician community – we had the foundation and it was you!

o These are just a few examples of what we’ve been able to accomplish with physician leaders who are highly engaged and aligned with the GHS vision and mission. There are many more examples.

• Thank you for what you do to put patients and families at the center of all we do; for the contributions you make and for your commitment to our mission to heal compassionately, teach innovatively, and improve constantly.

The University of South Carolina v. Florida is over for this year and USC came out on top. This is a game where at home, my position is to lay low. My wife Susan is a Gainesville Florida native. Susan and her family has attended, worked for and lived near the University of Florida for generations. We even have season tickets for UF football. We do not go very often, but we do make a lot of our relatives happy by giving the tickets away. I often joke that she is the Gator and I am the Gator-in-law. Truthfully, it has been a lot of fun to be a Gator these last couple of decades – on and off the field. Our daughter Clare, however, is a Gamecock….now do you see why I lay low? It has been fun to see those two navigate the love and competition that comes with college football and baseball.

College football is serious in the south…at least that is my experience. It can divide us and unite us – at home, office or in the stadium. What I want to talk about today is an example of how it unites.

Several weeks ago, one of the Vice Presidents at GHS, Howell Clyborne, entered the hospital after a time of quiet, prayerful reflection. He asked for some guidance on what he could do to make a difference today. As he entered the lobby, he met someone involved with hospice and palliative care. Hospice care is how we gracefully transition from a place of fighting illness with medical interventions to allowing the natural process of surrendering to our mortality. Done well, this is invaluable for the patient and the family during difficult times.

What Howell heard was the story of a man with cancer in hospice care. As it turns out, he was a huge Gator fan…not a majority position in the Upstate. After a brief conversation, there was a connection made to my wife Susan (Gator) and me (Gator-in-law) and whether or not we knew anyone in Gainesville. Howell spoke to me and I called a friend of mine Tim Goldfarb, CEO of Shands Healthcare, which is the Academic Medical Center at the University of Florida. I told Tim the story and he said he would get back to me. Over the weekend, I received a call from the loading dock that a box from Fed Ex was delivered with my name on it. One of our pharmacists signed for it and kept until Monday.

So, what was in the box? A helmet signed by Will Muschamp, the head coach of the University of Florida! Later that week the helmet was brought to the patient’s home. He was speechless, grateful and there were a few tears shed. For my part, I will always remember my friend Tim in Gainesville and how grateful I am to be a Gator-in-law. Football is just a game and so much more…..Go Gators, Go Cocks.

Mike

These last few days I have been at the annual AAMC (Association of American Medical Colleges) Meeting. The AAMC consists of 136 Accredited, allopathic (MD granting) Medical Schools in the US and Canada. Approximately 4,000 people attended the conference and they represented many different subgroups of the AAMC. One of those groups is the COTH (Council of Teaching Hospitals) and I serve on Administrative Board with 15 other Hospital CEO’s and staff. I have been part of the COTH since my time in Chicago and I have been on the Board for the past three years and have just agreed to another three year term.

Another group is the Council of Deans (COD) made up of all the Deans from the 136 Medical Schools. What was different at this AAMC meeting for us? This year, the newly appointed Dean of the University of South Carolina School of Medicine Greenville, Dr. Jerry Youkey, attended – his first meeting. In the past 30 years only 11 newly accredited allopathic Schools of Medicine have started. In the last year only 1 was accredited and that was us. What has emerged in Greenville was a natural topic of conversation for many at the meeting. And, just as we saw in South Carolina there were enthusiastic supporters and there were a few detractors. I am grateful for both.

It was at this meeting and last week that the magnitude of this accomplishment dawned on me. In the modern era, we have been working on this for over 2 1/2 years. My point in saying modern is to recognize that this dream and hope was present in Greenville for the last 6 decades in the physician and administrative leaders at what is currently called Greenville Hospital System University Medical Center. We built upon what made sense these last 6 decades and we executed the strategy and tactics to accomplish the goal.

I truly believe that the approval we recently received to start accepting students for the Fall of 2012 was a “through me” experience. We were the conduits to bring this school to the Upstate and to Greenville with the University of South Carolina. Some have referred to it as a sort of “manifest destiny” and I appreciate the simultaneous nature of that as we surrendered to what needed to happen and did the work to make it happen. I believe we will look back on this school in the decades to come and marvel at the impact we have had on the region, state and country.

What happened last week was that Dr. Youkey hosted a small party to celebrate the accreditation decision by the LCME (Liaison Committee for Medical Education) for a group that was integral to making this happen. We gathered for a toast at his house with friends and spouses and for me, it was the first time I relaxed enough to celebrate and enjoy what we have been working on for these past years. It was fun and emotional and exciting. I was again filled with a sense of gratitude and appreciation.

Through Us,
Mike