Reality Check

James R. Teeter
President and CEO
Arkansas Hospital Association

I think there's no tougher job today than that of a hospital chief executive officer. The CEOs with whom I'm best acquainted spend at least 65 hours a week trying to procure and retain high quality healthcare services for their communities while guiding their hospitals through the most turbulent changes in the history of American medicine.

It's easy, in the midst of all this, to lose sight of something vitally important--the public's perception of hospitals and healthcare. This brings us to a massive 1996 research project by the American Hospital Association, the product of which is Reality Check: Public Perceptions of Healthcare and Hospitals. This publication and an accompanying video are a "must read/see" for hospital execs.

Unfortunately, the news from Reality Check is not good. But, it can be constructive if we listen, then act to improve the caregiving process. Here are some of the more troubling public perceptions that leap from the pages of Reality Check:

-- Quality of care has declined. Almost no one believes that quality is improving.
-- The key measure of hospital quality of care is the RN, a superb caregiver who is being systematically replaced by poorly-trained, low-paid aides who perform routine medical tasks one minute and quasi-janitorial tasks the next.
-- Hospitals place a higher priority on profit than on a commitment to caring. However, there is uncertainty whether this is hospital-driven or caused by greedy insurance companies interested only in fatter profits for themselves.
-- Insurance companies have taken control over critical decisions about patients' medical care. Consequently, physicians and hospitals have ceased being advocates for patients' needs. Patients feel left out and want to be included in medical decisions which pertain to their own care.
-- Hospitals are disorganized, impersonal, and offer little emotional support; physician and hospital instructions for post-hospital self-care are lacking, making patients feel frightened and poorly prepared to go home.
-- The cost of healthcare is unnerving. If waste and fraud were removed from healthcare, hospitals could provide better care at more reasonable prices.
-- $10 Tylenol tablets, complicated and error-filled bills, and the way hospitals communicate with patients are inexcusable and are sources of great frustration.
-- Hospital mergers and consolidation of services stem from business and profit considerations rather than improving quality of care.

Out of a possible 100 points, hospitals scored 65 with the public in 1996. That's frighteningly close to an "F." In 1995, we scored 72, a low "C." Reality Check's message is clear: despite all the great things hospitals do every day, many of them are losing the public's trust. They must regain it. How can this be accomplished?

Why not start by designing an accounting system that simplifies hospital bills and realistically prices items like the $10 Tylenol tablets which have been a hospital public relations disaster for years? Why not explain the necessity of hospital profits, and how they're used? Why not communicate the high quality of care that prevails in our hospitals? Why not work to make patients feel more involved? Why not better explain the societal and financial forces that are changing healthcare, and how those changes can benefit patients and the community? Why not?

Summersett Arkansas' ACHE Regent
James A. Summersett III, FACHE, president and chief executive officer of Conway Regional Medical Center, has been elected to the Council of Regents, the legislative body of the American College of Healthcare Executives (ACHE). Summersett, who succeeds Steven Lampkin, FACHE, senior vice president and administrator of Baptist Medical Center in Little Rock, was elected in March during the ACHE's 40th Congress on Healthcare Management in Chicago.

As Regent, Summersett will serve as the ACHE's official representative in Arkansas and will work with the membership within his jurisdiction to implement ACHE programs, services, and activities. Summersett, who has 17 years of healthcare administration experience, has served in his present capacity at Conway since 1993. Prior to this, he was president of Kissimmee Memorial Hospital in Kissimmee, Florida; administrator of the George W. Truett Memorial Hospital in Dallas; and executive director of Baylor Medical Center in Gilmer, Texas.

Editor's Note: The statistical information that follows was compiled by AHA senior vice president Paul Cunningham based on information from the American Hospital Association.

Hospital Indicators Per 1,000 Population

Source: American Hospital Association

AHA Educational Calendar

-- June 24-25 -- North Little Rock
Competency-Based Appraisal for Allied Health Professionals

-- July 24-25 -- Little Rock
The Continuum of Managed Care

-- August 12 -- Little Rock
Management of Information

-- September 15-16 -- Little Rock
JCAHO Environment of Care Standards

-- October 12-15 -- Little Rock
AHA 67th Annual Meeting and Trade Show

Call 501-224-7878 for programming information

Arkansas Newsmakers and Newcomers
Randall Fale, president and CEO, of St. Joseph's Regional Health Center in Hot Springs, has been elected to a three-year term on the Arkansas Foundation for Medical Care (AFMC) board, succeeding Franklin E. Wise, administrator, Fulton County Hospital in Salem, who has represented hospitals for two full terms on the board and was ineligible for re-election. By virtue of the AFMC board appointment, Fale also succeeds Wise as a member of the Arkansas Hospital Association board of directors.

Sister Judith Marie Keith, president and CEO of the St. Edward Mercy Health Network in Fort Smith for the past 27 years, retired July 1 to pursue new ministry options within the Sisters of Mercy religious community. Sister is a past-chairman of the AHA and is a current board member representing the Arkansas Valley District.

Edward L. Lacy, MHA, CHE, has accepted an offer to become administrator of the McGehee Desha County Hospital and Southeast Arkansas Home Health, succeeding Bill Conway, who will retire upon Lacy's arrival.

Harry P. Ward, M.D., chancellor of the University of Arkansas for Medical Sciences (UAMS), was named the March of Dimes 1997 "Citizen of the Year" and honored at the March of Dimes annual award dinner in Little Rock March 20.

Lyndon Finney, director of communications, Baptist Health, has been appointed to the Kidney Disease Commission by Governor Mike Huckabee for a term which will expire June 14, 2001. He replaces Patrick Flynn of Fayetteville.

Roger D. Feldt, FACHE has been named CEO at Saline Memorial Hospital in Benton. Feldt previously served as CEO of Crawford Memorial Hospital in Robinson, Illinois, and COO of West Medical Center in Scottsbluff, Nebraska. Feldt succeeds Terry Whittington, who resigned to accept a CEO position in Louisiana.

Among Arkansas Business' 1997 Top 100 Women in Arkansas are hospital executives: Maura Walsh, president and CEO, Columbia Doctors Hospital, Little Rock; Jan Burford, CEO, CARTI, Little Rock; Sister Judith Marie Keith, president and CEO, St. Edward Mercy Medical Network, Fort Smith; and Diana Hueter, president and CEO, St. Vincent Infirmary Medical Center, Little Rock. Other Arkansas healthcare leaders honored are: Linda Hodges, Dean, College of Nursing, UAMS, Little Rock; Sandra Nichols, M.D., director, Arkansas Department of Health, Little Rock; and Sharon Allen, executive vice president of enterprise networks, Arkansas Blue Cross Blue Shield, Little Rock.

Robin "Rob" Lake has been named chief executive officer at Harris Hospital in Newport. He previously served as CEO of Columbia Medical Center in Carlsbad, New Mexico. Lake succeeds Timothy E. Schmidt who served as interim CEO and Ronald T. Seal who had been CEO at the hospital before accepting a position as CEO of Marion Memorial Hospital in Marion, Illinois.

Cindy Hall has been named administrator of Eastern Ozarks Regional Health System in Cherokee Village. She had served as director of nursing since 1992, and has been associated with the hospital for 15 years. Hall succeeds Norman Steinig.

Nominations Now Open for 1997 AHA Awards
Nominations are open for the 1997 Arkansas Hospital Association awards program. The A. Allen Weintraub Memorial Award, Distinguished Service Award, and Statesmanship Awards will be presented during the Association's 67th Annual Meeting in October. The Diamond Awards, cosponsored by the Arkansas Society for Healthcare Marketing and Public Relations, will be presented at the same time.

The A. Allen Weintraub Memorial Award, named for the beloved Allen Weintraub, long-time administrator of St. Vincent Infirmary Medical Center in Little Rock, is the highest honor bestowed upon an individual by the AHA. Those nominated for this honor should be hospital administrators who are contributing to their hospitals and communities in much the same manner as did Allen.

The AHA's Distinguished Service Award is presented to individuals who, while not necessarily AHA members, have promoted a cause of the healthcare industry, thereby becoming entitled to special recognition. Examples of those eligible for this award are physicians, nurses, trustees, auxilians, and other deserving individuals.

The Statesmanship Award is presented to a legislator or congressman who has worked diligently on healthcare issues and is, therefore, entitled to special recognition.

The 1997 recipients of the Weintraub, Distinguished Service, and Statesmanship Awards will be chosen by the AHA Board of Directors from those nominated. Nominations, accompanied by documentation of the nominees' accomplishments, must arrive at AHA headquarters no later than Friday, September 5. A list of previous award recipients and award requirements is available by calling the AHA.

The 1997 Diamond Awards will honor outstanding achievement in healthcare public relations and marketing, and will be presented in several categories, such as publications (internal and external), billboards, and radio, print, and television advertising. Two awards (for hospitals of 175 beds or less, and those of more than 175 beds) will be presented in each category at the ASHMPR annual luncheon held in conjunction with the AHA's Annual Meeting in October. Award recipients will be chosen from entries received no later than Friday, August 15. Detailed entrance information and forms are available from the AHA.

Hospital ICU Infections Rise
The rapid increase in antibiotic-resistant bacteria is complicating the treatment of intensive care unit patients, according to researchers speaking during the Society of Critical Care Medicine's Educational and Scientific Symposium. Hospital-acquired antibiotic-resistant infections might result in prolonged hospitalizations, and require increasingly more toxic and expensive antibiotics. About one-third of those patients die as a result of their infections, researchers said. One study estimated that a surgical intensive care patient who contracts a bloodstream infection will be hospitalized an average of 24 extra days at an additional cost of $40,000.

Arkansas Tough With Docs
When it comes to the number of serious disciplinary actions per 1,000 physicians, the Arkansas State Medical Board is among the nation's toughest, according to the Public Citizen Health Research Group. The group issued rankings showing disciplinary actions against physicians by each state. Arkansas ranked the 15th toughest with 4.61 serious disciplinary actions per 1,000 physicians.

According to the researchers, state medical boards are improving, but most fall far short when it comes to protecting patients from "bad" doctors. "It doesn't make sense that you can cross a state line and find a doctor who would not be allowed to practice in your own state," says Sidney Wolfe, the group's director. The report finds New York, Maine, and Rhode Island are most improved, moving up from 49, 46, and 50 in 1991 to 18, 17, and 25 in 1996, respectively.

Medical boards "are doing a better and better job with the resources they have," said Dale Austin of the Federation of State Medical Boards. But, he says differences in state laws and policies make state-to-state comparisons impossible.

Community Hospitals By Bed Size And Control
Arkansas And The United States

Source: AHA STATISTICS, 1996-97