Get A Grip
James R. Teeter
President
Arkansas Hospital Association

On September 22, 1997, Arkansas executive Sharon Burleson ended a long day at the office and a three hour evening meeting by stopping at Dillards at Park Plaza to buy some items for the next day's work. As she left the Little Rock mall just before closing, two thugs forced her into the passenger seat of her Mercedes and drove off with her.

For several hours, one man held a gun to Burleson's head as the other drove to at least five automatic teller machines where she tried to withdraw money for them. Her ATM card, however, had never been activated and wouldn't work, which angered the men. They weren't satisfied with the $400 cash she had given them. And they felt she had "insulted" their intelligence when she offered to write a check.

So, they decided to kill her. They told Burleson they were going to find a quiet, dark place to commit the act. They told her repeatedly that she would die face down. As the driver headed down a desolate Saline County road, his partner with the gun told him, "Don't stop here, there's too many people who could hear the shot."

Finally, they stopped, tied Burleson's hands behind her back and dragged her out of the car, down an embankment, into a ditch and through a wooded area, where they forced her to her knees and tied her feet. They then threw a shirt over her head. "I just thought, 'This is it,'" Burleson recalls. She waited for the fatal gunshot. Instead she heard the men drive away. Burleson freed herself and walked a mile to a house, where police were called.

A few weeks ago, a 30-year-old Little Rock man with a long criminal record--the gunman in this crime--was sentenced to life in prison plus 40 years after a Pulaski County Circuit Court jury heard Burleson's testimony. He was linked to the crime through a call he'd made to his home on Burleson's car phone. His 20-year-old co-defendant is awaiting trial. Burleson says the ordeal "has changed my entire life." One can only imagine.

Richard Carlson, in his best-selling book, Don't Sweat The Small Stuff, lends perspective to life-threatening and life-changing encounters like Burleson's. Writes Carlson on page 245:

When are you going to die? In fifty years, twenty, ten, five, today? I often wonder, when listening to the news, did the person who died in the auto accident on his way home from work remember to tell his family how much he loved them? Did he live well? Did he love well? Perhaps the only thing that is certain is that he still had things in his "in basket" that weren't yet done.

The truth is, none of us has any idea how long we have to live. Sadly, we act as if we are going to live forever. We postpone the things that, deep down, we know we want to do--telling the people we love how much we care, spending time alone, visiting a good friend, taking that beautiful hike, running a marathon, writing a heart-felt letter, going fishing with your daughter, learning to meditate, becoming a better listener, and on and on. We come up with elaborate and sophisticated rationales to justify our actions and end up spending most of our time and energy doing things that aren't all that important.

Carlson recommends that we live each day as if it is our last on this earth. He offers this not as a prescription to be reckless or to abandon our responsibilities, but to remind ourselves of how precious life really is. That life is too brief and uncertain to take too seriously. That we should keep our careers and personal lives in proper perspective. That we should never, ever sweat the small stuff. And that in the grand scheme of things, it's all small stuff.

Arkansas' New Hospital Construction

Ashley County Medical
Center's New Hospital
Ashley County Medical Center's new $12.5 million facility in Crossett opened June 14. The hospital, first discussed in 1994, has been under construction for the past 20 months. It was financed by bonds supported by a one-cent sales tax passed by the voters in Ashley County. The Ashley County Health Foundation added another $335,000 for furnishing rooms and waiting areas.

About $3 million of the total facility price went toward equipping the hospital. Included in the new equipment are state-of-the-art patient beds and delivery/postpartum beds, diagnostic heart catheterization equipment, and new equipment for the hospital's radiology and laboratory departments.

Baptist Memorial Medical
Center Builds New Facility
The $90 million replacement facility for Baptist Memorial Medical Center in North Little Rock is on schedule to open in mid-1999. The new 320,000 square-foot hospital will focus on outpatient and primary care, with four times as much space for those services, and also contain 135 inpatient beds, as opposed to the old facility's 224 beds. The medical campus will include the hospital, medical offices, a diagnostic center, an outpatient cancer treatment center, and administrative and support services.

St. Vincent Building
Sherwood Hospital
St. Vincent Health System of Little Rock broke ground in July on a new 84-bed acute care facility that will be located in Sherwood. The new hospital is being built on the same campus that holds an outpatient facility, ambulatory surgery center, and rehabilitation hospital currently operated by the system. Together, the four facilities will be known as St. Vincent Medical Center/Sherwood. The 93,000 square-foot facility, which carries an estimated cost of $30 million, is scheduled to open in late 1999. Plans are for the hospital to operate 56 beds initially, and eventually expand to the full 84-bed capacity.

WRMC To Build
Maternity Hospital
Washington Regional Medical Center (WRMC) in Fayetteville, which delivers about 2,000 babies a year, announced plans July 9 to build a $10 million, 50,000-square-foot women's hospital as part of a series of projects on 80 acres it is developing at North Hills Medical Park. Pending city and state approvals, construction of the Regional Women and Children's Center could begin this fall and will take about 11 months. The new hospital, which will concentrate on maternity care, will have 18 delivery rooms, four surgery suites, eight recovery rooms, and 12 patient rooms. The two-story center also will include regular and intensive-care nurseries, as well as 18 physician offices. WRMC already has a free-standing surgery center at North Hills and is developing a 64-bed assisted-living center in the medical park.

Arkansas Newsmakers and Newcomers

The UAMS Area Health Education Centers recently honored Curtis Shipley of Fayetteville and Tom Byrne of Texarkana as recipients of the AHEC Volunteer Service Award. Shipley, a member of the board of Washington Regional Medical Center, is also immediate past president of the Arkansas Association of Hospital Trustees. Byrne is the retired administrator of St. Michael Healthcare Center in Texarkana.

Mark Cain, CEO of Southwest Hospital in Little Rock, has announced a change in the facility's name to Southwest Regional Medical Center (SWRMC). SWRMC was recently purchased by Hospital Management Associates, Inc. of Naples, Florida.

Joe Jirinec has assumed the position of interim administrator of Delta Memorial Hospital in Dumas, succeeding Rodney McPherson, who resigned to pursue other opportunities. Jirinec is the former administrator of Chambers Memorial Hospital in Danville, and the former COO at Central Arkansas Hospital in Searcy.

Ed Lacy has been named administrator of Baptist Medical Center Heber Springs, succeeding Harrell Clendenin who resigned to pursue personal business interests. Lacy is the former administrator of McGehee Desha County Hospital in McGehee.

David C. Laffoon, president and chief executive officer of Central Arkansas Hospital in Searcy, has been re-elected to a two-year term on the national board of governors for the Federation of American Health Systems (FAHS). Laffoon, who is also a member of the AHA board, has served on the FAHS board of governors since 1982. Thomas P. Harlan, CEO, Select Specialty Hospital, Little Rock, was elected to a one-year term on the FAHS board.

Rick Daugherty has been named administrator of Baptist Memorial Hospital Forrest City, succeeding George Fray who has entered private business. Daugherty has served as administrator of Hillcrest Hospital in Calhoun City, Mississippi, and Whitwell Medical Center in Whitwell, Tennessee.

Rex Jones, assistant administrator of DeQueen Regional Medical Center, has been named administrator of Howard Memorial Hospital in Nashville. Jones succeeds Lynn Crowell who resigned to pursue other opportunities with Quorum Health Resources, Inc., the hospital's management firm.

Andy DeYoung has been appointed administrator of St. Bernards Behavioral Health Center (formerly Greenleaf Center, Inc.) in Jonesboro. DeYoung succeeds John Hart.

Harry Hutchison, chief financial officer of Arkansas Methodist Hospital in Paragould, was elected president of the Arkansas Chapter of the Healthcare Financial Management Association (HFMA) at the association's annual meeting. HFMA is one of 20 allied and affiliated organizations of the Arkansas Hospital Association.

AHA president Jim Teeter was named the 1998 recipient of the Ken Graves Memorial Award, the highest award bestowed by the Arkansas Society of Association Executives (ASAE), during the organization's annual conference July 24-25 in Eureka Springs. The award is presented in recognition of excellence in association leadership. The ASAE membership comprises the state's premiere trade associations and professional societies.

Arkansas PRO Saves Medicaid Dollars

By encouraging hospitals and physicians to perform fewer repeat Cesarean deliveries (C-section), the Arkansas Foundation for Medical Care (AFMC), the state's HCFA-designated peer review organization, saved Arkansas Medicaid nearly one quarter million dollars in 1997. Through a collaborative project initiated by AFMC, hospitals throughout Arkansas have successfully reduced the rate of C-sections performed for Medicaid recipients by 11% statewide. With estimated costs of C-sections typically around $2,000 higher than vaginal deliveries, cost savings to Arkansas Medicaid could top $250,000 per year as more hospitals take part in AFMC's C-section project.

At the core of this project was the increased use of vaginal birth after C-section (VBAC). Contrary to traditional views advocating "once a C-section, always a C-section," studies indicate that 60%-80% of pregnant women who attempt to deliver vaginally after one or more previous C-sections succeed. AFMC's efforts to promote the increased use of VBAC were highly successful. Hospitals participating in the project showed a 51% increase in VBAC, while hospitals who chose not to participate showed a 2% decrease.

According to the U.S. Department of Health and Human Services, C-section deliveries carry a higher maternal mortality rate, two to 26 times that of vaginal delivery. Yet, C-section rates have increased nationally since 1965 with no evidence of improvement in the health of mothers or children. The U.S. Public Health Service has recommended a maximum C-section rate of 15% nationwide as part of its "Healthy People 2000" initiative, a national strategy to improve the overall health of Americans, primarily through preventive care. At the start of AFMC's project in 1995, Arkansas' C-section rates were higher than the national figures with around 23% of Medicaid deliveries being C-section. With approximately 40% of all births in Arkansas being to mothers covered by Medicaid, the success of this project makes a notable statewide impact. However, its success also points to further quality improvements and cost savings for public and private arenas of healthcare and cost management outside Medicaid.

Frazier, Nichols Resign as Health Directors

Two high-ranking Arkansas State government health officials resigned their posts in June. Lee Frazier resigned after one year as director of the Arkansas Department of Human Services (DHS), the state's largest agency with almost 8,000 employees and an annual budget of more than $2 billion. And, Sandra Nichols, M.D. left her position as director of the Arkansas Department of Health (ADH).

Frazier, who had a close working relationship with the Arkansas Hospital Association and the state's hospitals, was able to achieve some major accomplishments in his year as director of DHS, including implementation of the ARKids First healthcare insurance program for children of the working poor. The program has received national recognition and serves as a model for other states trying to structure similar programs.

During her tenure, Dr. Nichols enjoyed a good working relationship with the governor, the state legislature, and most organizations that the department regulates, including hospitals. She has accepted a position as medical director of United Health Care Corp. in Little Rock.

At press time, neither position had been filled with a permanent director. Richard Weiss, director of the Department of Finance and Administration, was named interim director of DHS, and George Harper, deputy director of the Health Department, was named interim director of ADH.