HealthPartners and American Hospital
Association Partner for National Launch of Joining Forces
HealthPartners Institute for Medical Education and the American Hospital
Association (AHA) have partnered with more than a dozen national
organizations to launch an initiative designed to generate awareness among
medical professionals and others within communities about the challenges --
medical, social and emotional -- that veterans and their families face as
they return home from military service. Through the Joining Forces program
medical professionals will be provided much needed education on dealing
with the medical issues facing our nation’s troops as they return
home from service through a series of online programs.
"Our returning troops have unique medical challenges, which are
sometimes difficult to detect," said Dr. Carl Patow, executive
director of HealthPartners Institute for Medical Education. "This
series sheds light on those conditions so physicians can provide our
returning troops with the best possible care."
HealthPartners first partnered with Twin Cities Public Television, the
Minnesota Army National Guard and Minnesota Department of Veterans Affairs
to create the series in 2007 after learning that many veterans were seeing
their hometown physicians instead of military doctors for treatment after
deployments. After sharing throughout Minnesota,
the groups involved decided to promote nationally in an effort to help
veterans throughout the U.S.
Since that time, the AHA and more than a dozen organizations have signed on
to help spread the word about the program and ensure our returning troops
receive proper care and treatment.
“What began as an effort to educate health caregivers in one
community in Minnesota
about the special needs of returning veterans and their families has grown
into a collaboration among national organizations involving hospitals,
doctors, nurses, social workers, clergy and many others all across our
nation. Like hospitals everywhere, HealthPartners saw a need in their
community and partnered with others to meet that need. And in the best tradition
of community service, they want to make what they did available to every
individual and organization that cares about serving the women and men who
have served our nation in the military. The American Hospital Association
is proud to help make that happen, “said Rich Umbdenstock, President
and Chief Executive Officer, the American Hospital Association. “One
look at the organizations that are coming together to spread the word about
Joining Forces tells an important story about the debt we owe our troops
and the enormous level of support they enjoy back home.”
The four-part series focuses on the most common issues our returning
soldiers face.
The program was based on the award-winning medical conference recognized by
the Alliance
for Continuing Medical Education with the 2008 Award for Outstanding
Collaboration.
Visit www.joiningforcesonline.org for more
information and resources.
Web Link | Return to Headlines
"On-Call Employees Are Increasingly Suing Over
Unpaid Restrictions on Freedom"
National Law Journal (05/19/09) Baldas, Tresa
On-call employees, who claim their freedoms are being limited as severely
as workers in the office, are filing more wage-and-hour class action suits
against their companies, say employment lawyers. Attorneys see more cases
from disgruntled employees who complain about working unpaid overtime and
who demand compensation for time spent answering customers' questions by
phone and time spent on-call but not answering calls. Sweat v. Battelle
Memorial Institute, a case now working through the courts in Utah, involves a
group of lab technicians at Battelle Memorial Institute who claim the
company prohibited them from leaving the premises and required them to be
dressed and available to work even during their lunch breaks. In a similar
case, Walsh v. Apple Inc., a former Apple network engineer claims the
company neglected to reimburse technical support staff for on-call hours.
The practice of using on-call employees to lower overhead costs is
"definitely triggering litigation," said Julie A. Dunne, an
advisor and shareholder for the San Francisco-based employment law office
of Littler Mendelson. "What employers need to do is first of all, take
a look at what restrictions they place on on-call time." Dunne argued
that on-call time comes dangerously close to being paid time if on-call
workers have very few freedoms. She also advised employers to review
restrictions for on-call workers, such a geographic location or how close
they must be to the office or a telephone; response time to phone calls;
and number of calls received while on-call.
Return to Headlines
"California Supreme Court Considers Suit Over
Workplace Spying"
Los Angeles Times (06/03/09) Dolan, Maura
The California Supreme Court heard oral arguments Wednesday in the case of
Hernandez vs. Hillsides, a lawsuit brought by two women against their
employer for installing a hidden surveillance camera in their office.
During their testimony, the women said they suffered emotional distress
after discovering the camera in their office. One of the women noted that
she sometimes changed her clothes in the office before going to the gym,
while the other said she exposed her breasts and stomach to her co-worker
at one point to show how she was losing weight. The employer, Hillsides
Inc., the operator of a residential center for abused children, said the
camera was only turned on in the evenings in order to learn who was looking
at pornography on the women's computers. The company said that it did not
suspect that the women were looking at pornography, and that it did not
tell them about the camera because they "gossiped." It added that
the women were never recorded by the camera. Hillsides Inc. said that since
the employees had nothing to do with the sexual activity, they could not
claim privacy rights--a contention that Chief Justice Ronald M. George disputed.
But the justices were also skeptical of the women's claim that they had
suffered serious harm as the result of the surveillance. The case is
expected to be decided within 90 days.
Return to Headlines
"Doing More With More?"
Modern Healthcare (05/25/09) Vol. 39, No. 21, P. 26; Blesch, Gregg
U.S. Sen. Barbara Boxer's (D-Calif.) new bill calls for a number of
initiatives long sought after by nurses, including minimum nurse-to-patient
ratios. Three unions--the California Nurses Association/National Nurses
Organizing Committee, the United American Nurses, and the Massachusetts
Nurses Association--turned out to support Boxer's bill when it was
announced during a May 13 rally on Capitol Hill. The 150,000 members of the
"superunion" and the Service Employees International Union's
(SEIU) 2 million members are united together for "the first time . . .
[in support of] the same thing," said UAN Secretary-Treasurer Jean
Ross. If passed, the bill would mandate nurse-to-patient ratios of
one-to-five in medical-surgical units and one-to-three in emergency rooms.
Boxer's legislation also prohibits mandatory overtime for nurses, requires
lift teams to do heavy lifting usually done by on-duty nurses, and
establishes whistle-blower protections for nurses reporting on employers
who are not adhering to the rules. The American Nurses Association stands
firmly against mandatory nurse-to-patient ratios. "All of the
healthcare facilities, they are tapped--they are maxed out," said
ANA's Janet Haebler, who believes the ratios would take away shift
flexibility. "But when we look at healthcare reform, we have to look
at the workforce issues" such as staffing, violence, lifting, and
overtime. By addressing these issues, hospitals are better able to attract
and retain nurses, thus mitigating the nursing shortage, Haebler added.
Return to Headlines
"Hospital's Job Shadow Program Improves
Teamwork"
Health Facilities Management (05/09) Vol. 22, No. 5, P. 7
Silver Cross Hospital in Illinois embarked upon a pilot project that
enables securities officers, shuttle bus drivers, and other workers to
shadow hospital workers from other departments to learn other duties that
will help them assist patients check-in to the hospital or find their way.
The program already helped the hospital identify the need for additional
volunteers in its lobby. Valet attendant John Allen says the program helped
him learn the duties of service ambassadors, enabling him to help patients
when those other staff members are assisting another patient or visitor.
The hospital may expand the job shadowing program to include other
departments in its efforts to improve teamwork and patient satisfaction.
Return to Headlines
"Scare Tactics"
Asbury Park
Press (NJ) (05/26/09) Willis, David P.
Experts say that workplace bullying is on the rise, due to the slumping
economy and the fears it has created. In addition, the tight job market has
made some supervisors take the attitude that they can treat employees
however they want, since it is easy to find a replacement for someone if
they quit, said Gary Namie, the director of the Bellingham, Wash.-based
Workplace Bullying Institute. The increase in bullying has had a number of
negative effects on businesses, including lower morale, said Alan Cavaiola,
an associate professor at Monmouth University and the co-author of
"Toxic Co-Workers: How to Deal With Dysfunctional People on the
Job." Experts say there are a number of things employees should do if
they find themselves being bullied. For starters, bullied employees should
stand up to their bullies, since doing so will often put a stop to the
harassment, according to Red Bank workplace coach Donna Coulson. If the
bullying does not stop, workers should begin keeping a diary of what they
experience so they have a record of the problem they can give to human
resources. If necessary, bullied employees should take their case to the
highest-level official in the company who is not pledged or related to the
bully. Employers also need to do their part in recognizing the need to
address bullying, said Kathleen M. Connelly, a lawyer at Lindabury,
McCormick, Estabrook & Cooper in Rumson, N.J. "Employers have
dropped the ball in not recognizing that an essential element of being a
supervisor is managing people, and that means being able to do that in a
respectful manner," she said.
Return to Headlines
"Employment and U.S. Health Care Reform"
Journal of the American Medical Association (05/06/09) Vol. 301, No. 17,
P. 1811; Sessions, Samuel Y.; Detsky, Allan S.
One key goal of healthcare reorganization is to lower costs while promoting
job growth in a sector that employs 10 percent of working adults in the United States.
Twenty-seven percent, or approximately 3.6 million, of these jobs are
clerical, a significant figure considering 4.4 million jobs already have
been lost. However, U.S.
workers remain wary of job-creation programs that hint at 'socialism' and
prefer job retention over mandatory job creation. If the healthcare sector
shoulders most of the job losses, it could result in hundreds of thousands
of highly specialized medical workers being dumped back into the employment
pool without the skills to survive in a non-medical field. To remedy this
problem, some have recommended reducing physician reimbursements for
doctors in the highest-income group, lowering shareholder returns, and
moving away from specialized care to a primary care physician model.
Moreover, experts recommend separating products from services, noting that
patients need medical services, but pharmaceutical subsidies merely
increase product costs and should be eliminated. Additionally, some
healthcare workers could be shifted to other sectors in need of additional
manpower, including geriatrics, primary care, and long-term care fields.
Return to Headlines
"Assessing Witness Credibility in Workplace
Investigations"
Business Management Daily (05/25/09) DiLorenzo, Louis
Rather than bringing a workplace investigation to a halt, HR investigators
can take several practical steps when they meet with contradicting
witnesses and evidence. Investigators must recognize their own biases and
maintain a calm, objective mindset when conducting interviews and taking
notes, which should reflect observations and not conclusions. Having
another investigator present for the interviews can provide assistance and
another perspective of witnesses' accounts. How the witnesses present themselves
can help determine the truth of a story, as does comparing the consistency
of a witness's account with those of others. Determining a witness's
truthfulness may be easier when there is a definite chronology of events,
with physical evidence such as e-mails, notes, and expense reports.
Investigators also need to examine witnesses' possible motivations,
including bad blood between the witness and the accused or complainant
based on incidences in the past.
Return to Headlines
"A Solution's Evolution"
Human Resource Executive (05/09) Vol. 23, No. 7, P. 35; Corsello, Jason
Though roughly half of all employers now rely on some kind of talent
management strategy, many still have no way to measure the results of
talent management initiatives, making enterprise-wide adoption elusive. The
movement toward a single-provider "suite" that encompasses
multiple platforms for employee recruitment, interviewing, and training is
losing steam. On the other hand, social collaboration or Web 2.0 is gaining
popularity as a platform for connecting, sharing, and collaborating with an
employer. According to Knowledge Infusion, social collaboration--as seen on
blogs, forums, and social networking sites--enables and heightens
productivity and engagement at all levels of an organization. HR experts
believe social collaboration will dwarf talent management as a pivotal
undertaking among employers. Organizations that build a comprehensive and
adaptable platform centered around business strategies and not limited by
IT demands will do well, experts say. HR leaders should be involved in
assembling stakeholders and the formation of compliance and governance in
an employer's social collaboration strategy. The safety of social software
platforms are a main concern among employers, particularly in terms of data
leakage and reduced productivity.
Return to Headlines
"Retain Your Knowledge During Layoffs"
IndustryWeek (04/09) Clarke, Mary
Baby Boomers are closer to retirement, and organizations across a variety
of sectors are suffering financial losses in relation to the economic
recession. With few new workers to replace exiting Baby Boomers,
organizations need to devise ways to retain and transfer knowledge. The
first step in this process is for organizations to identify their
"knowledge custodians," those workers that know the
organization's business and processes inside and out and are often consider
as a source of reliable information by other workers. Knowledge development
programs are the second step in the process, which will require the
administration of periodic worker evaluations to measure knowledge,
competence, and confidence. These evaluations will provide leaders and
managers with an overview of what workers know and what knowledge they are
confident in using. These evaluations also can play a role in tough
economic times when cutbacks must be made and workloads are redistributed.
In addition to improving current training programs, assessment-based
knowledge development programs can bolster employee productivity and reduce
mistakes and employee turnover. According to a Cognisco survey of 400 U.S. and U.K. firms, more than 60
percent of respondents with these programs reported fewer human errors and
lower turnover rates and 50 percent reported increases in productivity,
improved safety and health records, and fewer data policy breaches.
Return to Headlines
"If Only Health-Care Payments Could Be Like
Retail Payments"
Digital Transactions (05/01/09) Vol. 6, No. 5, P. 23; Giesen, Lauri
There is a growing movement toward the real-time adjudication of payments
in the healthcare industry. This trend is being fueled by a number of
factors, including the desire among healthcare providers to reduce their
costs by charging patients for services as soon as they are provided,
instead of sending out several statements later. In addition, real-time
adjudication of payments is becoming more necessary because patients are
increasingly responsible for paying more of their healthcare bills.
However, there are a number of obstacles standing in the way of widespread
real-time adjudication of patient payments, including insurers' use of
legacy systems that are not capable of processing insurance claims individually.
In addition, it can be difficult for healthcare providers to bill patients
for all the services they receive because some services, such as certain
tests and procedures, may be billed by a third-party provider. But efforts
to address such problems have allowed some companies to begin offering
real-time payments for healthcare services. Among them is Visa, which
recently partnered with the Texas-based electronic payment and
transaction-processing services provider Preferred Health Technology to provide
a service that will allow healthcare providers to verify patients'
insurance eligibility, adjudicate claims, and accept payment cards for
payment when the service is provided or at a later date.
Return to Headlines
"Putting Benefits Plans Out to Bid May Reap
Savings"
Workforce Management (06/09) Speizer, Irwin
Forcing health benefit providers to compete openly for corporate contracts
naturally drives down prices, as was the case at Florida Power & Light
(FPL), the state's largest energy utility. To pare down over-the-top
spending, FPL initiated a bidding process in 2004 and forced dental,
vision, and other providers to offer lower prices for the company's
business. Without expanding its HR department, the utility has managed to
save approximately $1.1 million a year on its health benefit plans. FPL
hired HighRoads, a benefit-plan procurement firm, to handle the competitive
bidding process. HighRoads officials say many employers that force
competitive bidding for health benefits experience high cost savings
because they tend to renew their plans each year instead of doing full,
competitive bidding. HighRoads recently carried out an internal study of
its 4,700 benefit plans under 137 major employers and found that health
benefits spending at almost all of these employers fell once competitive
bidding replaced automatic plan renewal. Companies with self-insured plans
increase their cost savings by approximately 16 percent by forcing
competitive bidding on the component health coverage plans, and
fully-insured companies save about 18 percent, HighRoads stated.
Return to Headlines
"In the Pink of Corporate Health"
Claims (04/09) Vol. 57, No. 4, P. 14; Quinley, Kevin
Employment wellness programs designed to prohibit or encourage workers from
using nicotine, promote weight loss, and bolster gym membership tread a
fine line between keeping health costs down and tramping on workers'
rights. Employers that implement these programs are advised to seek the
help of legal counsel to avoid costly litigation from employees who believe
they are being discriminated against by workplace rules that infringe upon
outside activities. For instance, an employee with Scotts Miracle-Gro in Massachusetts who
was let go after testing positive for nicotine later sued his employer,
even though company policy prohibited smoking on or off the worksite. A
group of Michigan
firefighters sued their local fire department for requiring workers to obtain
periodic cholesterol tests, claiming this was a violation of their
Constitutional rights. One move in the wrong direction and even the
best-intended wellness program could violate the Americans with
Disabilities Act (ADA), Health Insurance Portability and Accountability Act
(HIPAA), or the Civil Rights Act of 1964, in which Title VII prohibits
discrimination based on age, sex, or race. Additionally, 29 states so far
have passed "lifestyle discrimination" laws that make it illegal
for a company to punish a worker for engaging in any legal activity while
off the job. A veteran workplace law attorney will know where potential
tripwires are, because a company cannot save on employee benefit costs when
on the defensive against discrimination lawsuits.
Return to Headlines
"Consumer Watchdog Urges Crackdown on Hospitals'
Discipline of Doctors"
Healthcare IT News (06/02/09) Merrill, Molly
A recent Public Citizen report reveals that nearly 50 percent of hospitals
in the United States have not referred at least one physician's name to the
National Practitioner Data Bank (NPDB), which was created by the Health
Care Quality Improvement Act of 1986 (HCQIA) to review providers'
professional credentials. The HCQIA requires hospitals to report physicians
to the NPDB when hospital privileges are revoked or restricted for more
than 30 days. Rather than the estimated 5,000 cases expected, hospitals
have reported a mere 650 annually. Public Citizen says nearly 1,000 doctors
with at least two adverse privilege reports to the NPDB were not subjected
to licensure board disciplinary action. "Our report shows there is an
urgent need for the Obama administration to step in and hold hospital
administrators accountable as well as ensure that hospital medical staffs
hold their own physicians accountable for patient safety," says Sidney
Wolfe, Public Citizen's acting president and director of its health
research group. The group suggests combating the strong culture among
physicians not to "snitch" on one another and to close reporting
loopholes that allow doctors to be disciplined while avoiding reporting
requirements.
Return to Headlines
"To Nap or Not to Nap? Residents' Work Hours
Revisited"
New England Journal of Medicine (05/21/09) Vol. 360, No. 21, P. 2242;
Blanchard, Melvin S.; Meltzer, David; Polonsky, Kenneth S.
To improve patient care at teaching hospitals, a subcommittee of the
Institute of Medicine (IOM) recently proposed further cuts to the duty-hour
limits in residency programs that the Accreditation Council for Graduate
Medical Education (ACGME) enacted in 2003. A study sponsored by the IOM
examined the costs associated with strictly observing the 80-hour work
week, five-hour naps during long shifts, a 16-hour limit on shifts with no
naps, and a lighter workload. Researchers projected a cost of $1.1 billion
to $2.5 billion to change the standards. The challenge lies in gauging the
impact of the recommendations on the frequency of adverse events. Many errors
occurring in teaching hospitals happen as a result of an equipment or
system failure and do not account for physician fatigue, though reduced
hours could lead to more hand-offs, which would nullify the benefits of
reduced hours. Some postulate that a patient may be better served by a
doctor who has worked more than 16 hours but is familiar with the patient's
condition and treatment than by someone just starting their shift. The
physicians who studied the recommendations do not believe they should be implemented
immediately, despite the wishes of the IOM.
Return to Headlines
"Cost Implications of Reduced Work Hours and
Workloads for Resident Physicians"
New England Journal of Medicine (05/21/09) Vol. 360, No. 21, P. 2202;
Nuckols, Teryl K.; Bhattacharya, Jay; Wolman, Dianne M.
Despite limits on work hours by the Accreditation Council for Graduate
Medical Education (ACGME), unease about physician fatigue at teaching
hospitals remains. Researchers Teryl Nuckols, Jay Bhattacharya, Dianne
Wolman, Cheryl Ulmer, and Jose Escarce examined the Institute of Medicine's
(IOM) new recommendations to adhere more closely to the shift limits
established in 2003, grant naps during long shifts, cap shifts with no
extended breaks to 16 hours, and lighten workloads. Public information was
used to gauge labor costs associated with transferring additional work from
residents to support staff, and sensitivity analyses were then employed to
measure the effects of these estimates. Relying on a probability model to
reflect the costs of labor, mortality, and adverse events, the researchers
determined that primary teaching hospitals would pay a net cost of $1.1
billion to $2.5 billion to implement the changes. A hospital that
experiences a 10 percent decrease or a 10 percent increase in adverse
events would pay an average of $99 or $183 per admission, respectively. A
10 percent decrease or increase would cost insurers and taxpayers an
average of $17 or $266 per admission, respectively. The research team concluded
that implementing the recommendations would be expensive, and the costs
would likely remain high for teaching hospitals. If the recommendations
proved effective, they would help reduce the number of adverse events,
though researchers were unable to conclusively link IOM recommendations
with patient safety improvements.
Return to Headlines
Management and Leadership
"Alignment, Action, and Accountability"
Healthcare Financial Management (06/09) Vol. 63, No. 6, P. 52; Studer,
Quint
The economic downturn has shaken the leadership of many hospitals as they
struggle to pay for capital improvement projects, continue to provide
quality care, and generate revenue. Evidence-based leadership--which calls
upon managers and executives to align goals and behaviors for the purposes
of accountability--is gaining ground, and leaders scoring below 50 on this
scale must improve their execution of this strategy. Alignment between
organization and leadership performance are essential to ensure resources
and talent are not misplaced or misused. With finances becoming a major
concern, leaders must sufficiently manage their time and think
strategically and critically about financial resources. Leaders also should
take the time to cultivate relationships with department heads and
understand how core missions and objectives are being implemented and who
has helped in the process. The hiring process should include behavior-based
questions during peer interviews; ensure that performance is measured and
workers are meted out into categories; and take care that high performers
or top talent are recognized in more than one way, including personalized
notes. Communication with patients, families, and others should adhere to
the fundamentals of AIDET--acknowledge, introduce, duration, explanation,
and thank you. Additional referrals can be generated by boosting patient
loyalty, which can be accomplished by increasing nurse rounds, calling
patients in advance of their surgeries or hospital stays, and making
discharge phone calls.
Return to Headlines
