A Postcard from D.C.

On Wednesday, members of the delegation from Poweshiek County Economic Development (PowI-80) had meetings with Rep. Bruce Braley, Rep. Leonard Boswell, Senator Chuck Grassley, and Senator Tom Harkin.

Pictured here are the members of the group meeting in Senator Harkin's office. We are advocating for many issues of importance to Poweshiek County. Obviously, one of the biggest issues of the day revolved around President Obama's proposed economic stimulus package. The House of Representatives have passed the package and it now goes to the Senate.

The Senate Finance Committee have reviewed their version of the stimulus package. As you may know, our Senator Chuck Grassley, is the ranking member of that committee and Sen. Max Baucus (D-MT) is the chair of the committee. Over the past few years, both Senator Grassley and Senator Baucus have been working closely on rural hospital issues, including the unfair Medicare reimbursement system for tweener hospitals such as GRMC.

I am pleased that there is a provision in the package to provide assistance to Iowa's tweener hospitals. We are advocating that this and many other provisions of the legislation stay in the final version of the package that will directly benefit Iowa hospitals and the people who rely on them for their healthcare.

Please take a moment, and thank your U.S. Members of Congress and their hard-working staff, for all they do on behalf of Iowans.

We're doing more than keeping our fingers crossed that these provisions will make it to the final version--we're actually on The Hill telling the story for all of us. When I get back from DC later this week, I'll share more with you about what I heard and learned.

A Call to Action!

I thought President Obama’s inaugural address was extraordinary this week. It will be quite interesting to see if he is able to provide the leadership necessary to bring Democrats and Republicans together to effectively address the many challenges facing our nation. I am quite hopeful this will be the case. I was especially struck by his focus on the enduring values that indeed have defined our great nation and his call to action by all of us.

“Our challenges may be new. The instruments with which we meet them may be new. But those values upon which our success depends - hard work and honesty, courage and fair play, tolerance and curiosity, loyalty and patriotism - these things are old. These things are true. They have been the quiet force of progress throughout our history. What is demanded then is a return to these truths. What is required of us now is a new era of responsibility - a recognition, on the part of every American, that we have duties to ourselves, our nation, and the world, duties that we do not grudgingly accept but rather seize gladly, firm in the knowledge that there is nothing so satisfying to the spirit, so defining of our character, than giving our all to a difficult task. This is the price and promise of citizenship.” President Barack Obama 1/20/09

Indeed these words are a call to action as citizens to do what we can, to do what we must to strengthen our nation. I couldn’t help but think about these words in the context of working in a hospital. These same values hold true for the women and men who work hard to meet the needs of the communities we serve. Our challenges have never been greater in meeting those needs and yet we are called to action. Compelled to fight through all the paperwork and regulation, scarcity of resources and government underpayment, complexity and pace of change…why? Simply the desire to make a difference in the lives of those we serve. We do this not grudgingly, but rather gladly, because the opportunity to serve others is our distinct privilege.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Good Bye 2008!

It’s a new year and with it all the optimism that comes with new starts. 2008 was a challenging year in many respects, especially the fight to maintain fiscal success when Medicare and Medicaid reimburse GRMC at only 67 percent of costs. When the dust settles, we will realize about $7 million below what we spent taking good care of these two patient populations last year! Even though we reduced staffing costs through attrition (well over $1.5 million over expenses in 2007) we will still experienced a multimillion dollar loss from operations. Despite this financial black cloud, 2008 had many bright spots because of the dedication and compassion of many committed people. From our volunteers and board members, to our medical staff and employees, people make the difference at GRMC.

A few of the accomplishments of this past year (a year we celebrated 40 years since the merger of St. Francis and Community Hospitals) included outstanding strides in our quality, patient safety, and service excellence journey. Measured in superior patient satisfaction and patient outcome scores, we know the quality of our work is the central focus of what we do everyday. It ranks us at the top of providers nationwide. The work of our quality leadership team was evident with Rapid Response, Condition H, zero central line infections and ventilator associated pneumonias, TeamSTEPPS participation, the new Patient and Family Care Council, to name a few.

Another highlight of 2008 was the amazing financial support from the community. In a year marked with historic economic hardship in our country, our annual fund drive established a new record with over 1,100 donors and $313,000 in gifts; a 35 percent increase over 2007! This follows the wildly successful capital campaign that concluded in 2007 and raised a whopping $8.3 million. The Auxiliary kicked in over $30,000 more in support for equipment purchases last year. Without this outpouring of support and generosity from the community we certainly could not be the hospital we are today.

On the medical staff front, we added two new anesthesiologists (Drs. Whipple and Emge), a new pain specialist (Dr. Pavlovic), a new family physician for Deer Creek Health Center in Toledo (Emil Pecholt) and a new internal medicine physician (Dr. Lindgren). In addition we added three new physician assistants: Kristin Leonard, Sarah Fedderson, and Jarrod Phelps. Each of the above has excellent training and clinical skills and the personality focused on caring, compassion, and teamwork. A great year in medical staff recruitment in deed.

Another highlight for the year included articles in the Des Moines Register about our efforts to stimulate community supported agriculture; Modern Healthcare regarding the “Tweener” Medicare issue; the Cedar Rapids Gazette touting our efforts to raise $16,000 for employees from St. Luke’s Hospital that lost their homes in the spring floods; and USA Today extolling our integrated medicine programs! It is fun to get state and national recognition for the efforts of our employees to make a better world.

Finally, the acts of kindness, the hallmark of our efforts to fulfill our mission of service, to the community were evident daily. Despite the financial challenges, I am proud of my colleagues that call GRMC home and refuse to let government payment get in the way of caring and curing!

2009 will no doubt have its own challenges; however I am convinced we will not only meet those challenges, we will make it a better year financially with resolve, commitment, and an attitude of service to the communities we serve.

On a personal note, 2009 marked a change for me as I hit my 15th year at the helm of GRMC. It will be a year without my friend and colleague Todd Nelson. After 18 years, Todd was recruited to provide leadership at the Healthcare Financial Management Association in Chicago. His devotion to a job well done; his commitment to integrity; his amazing work ethic; and his determination to make GRMC the best it could be will be missed. I wish him well and look forward to working with him in his new role in advocacy and policy development for healthcare CFOs across the country. He will be extraordinary in this role and the country will be better off for his efforts. Here is the candy bar poem we wrote him as he left:

Our time together has been (Good & Plenty). Over the last 18 years you have been a (Life Saver) to us, and not a (Milk Dud).

Before you hit the road, we wanted to (Take 5) and give you some helpful advice:
-Don't be an (Airheads) in your new job.
-Be a (Red Hots) financial advisor to all those CFOs.
-Please, please never stop acting (Nutrageous).
-Treat everyone like a (Sweethearts) and not a (Dum Dum).
-Don't let the $ slip through your (Butterfinger).
-Work hard and Fridays will be a great (Pay Day).
-Leave the (Goobers) in your nose.

Do all these things and your new coworkers will love you to (Pieces). (Kisses) Your friends at GRMC.

Sparky, now that you hit the (Big League), don't go on a shopping (Spree)! Remember we had (Mounds) of (Snickers) mostly because you're such a (Nerds). Honestly, we think you're worth a (100 Grand) and we even asked Nate and Thad and they said their (Pop Rocks)!!!

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Being Todd Linden

Have you ever gone to the search engine Google and typed in your name?

Try it sometime. You might be surprised at what comes up.

Here are a few I found:

Todd Linden, professional baseball outfielder
"Linden had a monster game last night with the Giants."
That could be a fun morale booster. There was even a phrase referring to someone who "pulled a Todd Linden." From the context, that didn't seem like a positive thing to do, however.

Todd Linden, MD, clinical instructor, New York University gastroenterology section.
Now, let me think...a gastroenterologist...I think I'd rather play one on TV.

Todd Linden, NASCAR PR associate
Not bad. I enjoy car racing. Have you been to the Iowa Speedway in Newton yet? It's awesome.

Todd Linden, 2006 Teleplay Sitcom Winner, Austin Film Festival
Now that has some real appeal!

Alright, fantasy over. I'm Todd Linden, hospital administrator for Grinnell Regional Medical Center and that's just who I want to be. I get to work with a great group of people, some of the best anywhere, dedicated to making a difference in the lives of others.

Christmas Spirit

It was the night before Christmas, and all through the hospital, not a creature was stirring, not even a mouse…now that is not exactly true! First of all there are no mice and second there is a lot of stirring. There are nurses and doctors, lab and radiology techs, housekeepers and dietary staff…the list goes on and on. Although it is a little quieter than the average Wednesday, there are plenty of us here on Christmas Eve and Christmas Day. Disease and injury know no special dates or times. We are here 24/7 and ready for whatever may come. We will even be ready at the Fly High Fitness Studio and the Paul W. Ahrens Fitness and Rehab Center for exercise after all the eating that seems to come with the holidays!

This year Suzanne Cooner (vice president of operations) and her husband Russ decided to help with a special Christmas Day lunch and dinner at the hospital. With financial help from many others, and the support of our nutrition services department, a festive holiday meal is planned. Now this is nothing new for our employees working on the holiday, we often have special meals for them and their families. However, this year we invited any of our employees that may be alone for Christmas or may be struggling a bit financially and would appreciate an opportunity to break bread with other members of our team. Last I heard we are expecting around 75 to a 100 people!

Then there is the story of the family of six headed out to Washington State and involved in an accident. They wrecked their car, fortunately no major injuries, but now stranded in Grinnell. This family is having a tough Christmas…lost both their jobs and home in Indiana and so decided to sell everything and take a small U-Haul with what was left of their belongings out to stay with family all the way up near Spokane. Then the car gets totaled…now what? They found themselves in a place where good ol’ Iowa hospitality is alive and well. Iowans rally to their cause of course. They help with food, hotel bills, and ultimately a bank kicks in to fly them out to their relatives. I heard one of our staff members talking about the fact that the family sold the Christmas gifts to help pay for the long car trip out west. Next thing you know, folks around here start raising some funds and Brenda Peck and Lisa Cowan (two of our employees) headed out to buy some gifts! They said the kids jumping up and down would bring a tear to the eye!

People making a difference in the lives of others…whether it’s life saving medical treatment or in this case just good neighborly care and compassion for a family of strangers in need of a big Iowa hug.

For me it is pure joy to be associated with so many caring and dedicated people. If that doesn’t get you in the Christmas spirit, I don’t know what will. I would like to wish a Merry Christmas and Happy Holidays to your family - from ours.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

When Disaster Looms Large

Disaster…a word that can elicit a shot of adrenaline for most folks! For those of us who work in a hospital, the word “disaster” is often a call to action. Over my 20 years as a hospital CEO, there have been plenty of disasters…most are natural disasters. As I write this we are experiencing a winter storm that began with ice, turned to sleet, and is now snow. I am not sure exactly what I will find in the morning. The phone may ring before the night is over.

This storm brings back memories of one disaster in particular: the ice storm of 2007! I first realized it was going to be a very long day when I was awakened by the sound of cracking limbs. My two large soft maple trees were literally tumbling down around my house. An inch of ice covered everything. It took a half hour to free my windshield of ice so I could begin my 25 mile journey to the hospital.

Suzanne Cooner, one of our vice presidents and the administrator in charge of any and all disasters, had already initiated our disaster protocols and set up a command center. (Interesting factoid: Suzanne is trained at the highest level of incident command…a very reassuring thing to have someone so skilled when it comes to disaster. In fact we call her the “Queen of Disaster”!)

We had three priorities for us that day:
• Deal with the widespread power outage.
• Get enough staff to the hospital to meet the needs.
• Reach out to those with special medical needs in the community.

It was cold, and warming shelters were needed. Those who rely on electronic medical equipment to maintain their health needed shelter with electricity. Eight couples with such needs took up residence in our OB unit while they waited for power to be restored to their homes.

The conference room at the hospital became the incident command center for the county. Volunteers and staff made welfare calls on thousands of people in rural Poweshiek County. Public safety officers would be dispatched to bring those who needed help to shelters. It was a massive effort with multiple agencies working together, just like we had practiced through drills many times before. In fact, Governor Culver and Adj. General of the Iowa National Guard, Ron Dardis, stopped by to see the operation in action and declared it a model for all counties.

This week, Tom Newton, director, Iowa Department of Public Health, stopped in for a discussion with all those involved in emergency preparedness in Poweshiek County. Tom and I serve together on the University of Iowa College of Public Health Advisory Board. I have been impressed with his leadership. He is a great public health leader and I appreciate his effort to get out into the state to see firsthand how we prepare for emergencies.

Many of our local public safety agencies were represented at the meeting with Tom, like Police Chief Jody Matherly and Fire Chief Dan Sicard; Mayor Gordon Canfield and State Senator Tom Rielly; EMS and County Emergency Management leadership; and of course many of our hospital staff. The meeting was led by Chad Nath, GRMC emergency preparedness director. (Incidentally, I call Chad our MacGyver – one of the handiest and ingenious guys I know!) He gave a presentation about the ice storm and what a magnificent job we all did working together to meet the needs of our community. Director Newton declared that our work in Poweshiek County was indeed a model for the rest of the state. IDPH Deputy Director Mary Jones was also on hand for the meeting. Mary is responsible for the trauma certification system in Iowa and she praised our trauma system from the onset of the rating program through to present. She said that if she were in an accident in the State of Iowa, GRMC would be one of the hospitals where she would want to receive her care. We were actually the first hospital in Iowa to go through the certification process a decade ago. I am very proud of all the dedicated women and men at GRMC who put the lives of others first in the face of disasters.

The truth is we really never know what tomorrow is going to bring: a chemical spill from an 18- wheeler on I-80; a tornado or major wind storm; a massive explosion or fire at one of the industrial sites in the area; or a senseless act of violence against innocent victims. What I do know is that the hospital, working hand-in-hand with many other agencies, stands ready to jump into action to serve others. We tuck our families into the basement and head to the hospital in the middle of summer storms. We work 24- and even 36-hour shifts until the job is done. We deploy our practiced skills and talents in the face of danger and personal risk, all in the service to others.

Being one of the best in the state doesn’t just happen. It takes dedication, education, and training; reaching out to other agencies; a desire to serve; and a little sense of adventure. Fortunately, we have all those things and I am proud of the team at GRMC and all our colleagues in Poweshiek County. I know I will sleep well tonight even with Mother Nature up to her old winter tricks, because I know we are ready. Can’t wait to see what will happen when winter officially arrives next week!

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Stress, stress, and more stress

Stress, stress, and more stress. The life of a rural hospital CEO can sometimes be rather stressful. This week, the focus has been on dealing with the difficult financial challenges we are facing. Thirty-five percent below cost Medicare payment, a very tough economy and lower patient volumes all contribute to a big negative bottom line! We are determined to keep our focus on our mission because we know the work we do is vital to individuals, families and the community as a whole. We also know that it is our employees, physicians, volunteers, and board members that make that difference. The work we do is fundamentally about people interacting with compassion and skill. It is deeply personal. So too the business side of a hospital can’t lose sight of the people. I take my job seriously when it comes to the people who work here. I know they depend on the hospital as an employer. And the hospital depends on our people to bring our mission of service to life. It is really that simple…but often stressful trying to make it all work.

I use HeartMath, a routine massage, a glass of good wine and good food, time with family and my faith to help with this load. I also look for humor in my day! This week, I spent a few hours with Mark Doll (our facilities management director) working on our waiting rooms. It seems chairs had been mixed about and the spaces simply looked a bit disheveled. We moved things around and both felt much better about the spaces we have people waiting in at GRMC. We did find two really old, and I mean ancient, patient room lounge chairs in one of our lobby spaces. They were really ugly. We were going to simply retire them. Then we had a brainstorm…let’s put them in someone’s office. We headed to our imaging director, Kevin Kincaid’s office and removed his side chairs and replaced them with these two “vintage” and/or “classic” chairs with a message of congratulations. Well, when I went to my car this afternoon, on a tip that I had a low tire, the picture here is what I found! What a belly laugh…thanks Kevin for adding to my stress management program. By-the-way, I bet you didn’t get that up on my car by yourself! Mark…

I am very confident we will make it through this challenging financial time – simply because we have great people at GRMC. I am proud to stand side by side with them! (Even the jokers in the crowd.)

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.