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by Lynn McVey
For this month's blog post, I planned to continue my theme of expensive variations in healthcare management, particularly the variation in executive salaries between for-profit and nonprofit facilities.
Conservative estimates demonstrate the median for-profit CEO salary is around $300,000, while the median nonprofit CEO salary ranges around $600,000. Setting the national standard at the for-profit median could mean a $1.5 billion drop in healthcare spending. I now join the ranks of those writers who recently called this variation the "800-pound gorilla."
However, a personal journey I took throughout our healthcare system this week interrupted my blogging plan--when my 92-year-old father entered three hospitals via three ambulances in three days for life-saving interventions.
Because I worked in all three hospitals and my smartphone contains a priceless list of healthcare contacts, I navigated the system for him. When the cardiologist said he couldn't get table time until the next morning because the staff was leaving I talked to that hospital's CEO, who made it happen. My smartphone also contained numbers for ambulance drivers, nurse managers, clergy and hospice; all of whom I texted for help in navigating my Dad's life-saving interventions.
I slept (not really) in a chair next to his bed for six nights in the intensive care unit. Besides the crick in my neck, I also got an insider's view into what a well-oiled healthcare machine could look like. Yes, I weighed the fact that I am a hospital CEO. I took that into consideration.
My vision is for a 1-1 nurse/advocate to inpatient ratio. One nurse who has a contact list similar to mine. One nurse who will navigate care coordination. One nurse to take blood, obtain vitals, give medications, order food, recite patient allergies, repeat patient history to anyone who asks. One nurse to transport the patient to radiology and back again. One nurse who, by this close association, can advocate and protect the patient from errors. Even at my dad's side, even as this facility's CEO--I intercepted an incorrect lab test.
I haven't calculated the financial impact and not every patient needs this 1:1 ratio. But for the elderly, alone and critical patients, I wonder how many expensive errors, unnecessary tests, infections, falls, extended days and deaths this 1-1 approach could prevent. It is crystal clear to me that we built a healthcare model that is too complex to fix. If any of us had the opportunity to rebuild healthcare from scratch, it would never look like it does today.
After a roller coaster ride that included catering a repast menu, it now looks like my dad will come home. I am profoundly grateful for this healthcare system and I will never forget the raw kindness everyone showed my dad and my family. But after an insider's view, I'd love the opportunity to architect a system that works this well each time for every patient, not just the CEO's dad.
Lynn McVey serves as CEO and president of Meadowlands Hospital Medical Center, an acute care, 230-bed hospital in New Jersey
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