Discussing the issues at Town Meeting- BWH Bulletin - For and about the People of Brigham and Women's Hospital
Discussing the issues at Town Meeting- BWH Bulletin - For and about the People of Brigham and Women's Hospital
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June 26, 2000
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In This Issue:
Discussing the issues at Town Meeting
Summer Incentive Program
Celebrating a leader in education
BWH PeopleSoft University
Preparing for JCAHO
Blood Donor Ceremony
Otten completes term as MHA chair
Pike Notes
BWH President Jeffrey Otten opened last Tuesday's Town Meeting with a discussion of several crucial topics currently affecting the health care industry. The audience of BWH employees, staff, and volunteers then engaged Otten, Chief Medical Officer Anthony Whittemore, MD, and Chief Operating Officer Matthew Van Vranken in a dialogue on topics ranging from the cost of care at BWH, to parking and shuttle service, to supply issues. The following are excerpts from that discussion: Q: I’m happy that you’re going to expand the shuttle service from Ruggles station to the hospital, but there’s not a marked shuttle stop at the back of 221 Longwood. Is creating a stop there an option? A: Art Mombourquette, vice president, Support Services: BWH recently agreed to lease 300 spaces at the Renaissance garage, which is adjacent to the Ruggles station. Since BWH is the sole user of that garage, we’re also going to be the major user of the shuttle. We are working with the city and (Cont. on p.4) (Cont. from p.1) MASCO to find an area near 221 Longwood to add another shuttle stop, and the area outside the Vanderbilt gates is a possible site. Also, the shuttle service is expanding tremendously because we’re going to have more ridership. There are new schedules, and the service is more frequent and it runs throughout the day—from 5:30 a.m. to 9 p.m. Q: A couple of weeks ago, it was reported that the health care costs in Massachusetts are much higher than the United States’ average, and that teaching hospitals were driving that costs. Although the care we deliver is top-notch, it’s more expensive than other places in the U.S. Does that cause a problem when we try to get the state legislature or the federal government to give us some financial relief? A: Jeffrey Otten, president: We’ve done some analysis of why our costs tend to be higher than those of the rest of the country. Forty percent of admissions in eastern Massachusetts are in teaching hospitals, as opposed to 14 percent around the country, and teaching hospitals tend to be more expensive, which is why Medicare pays us a higher rate of reimbursement than they do community hospitals. The way that expenditures are calculated includes all our research and total expenditures, but does not consider the fact that 6 percent of our patients are from outside the New England area. If we adjust for those factors, BWH is at or below the national average for cost of in-patient care. Anthony Whittemore, MD, chief medical officer: It is an extraordinary tribute to all of you that we’re able to keep our costs down given the challenges we face. I hope that the $21 billion that President Clinton has said he’d pump back into the budget will provide some real relief; and that the budgetary constraints we face going forward won’t be as draconian as they appear to be on the surface. Matthew Van Vranken, chief operating officer: We aggressively benchmark our costs against other institutions, and we subscribe to a pretty sophisticated benchmarking approach that the university hospital consortium has organized. That, along with HCIA-Mercer, which puts us into the Top 100 for the seventh year in a row this year, really shows us that when we compare our productivity and efficiency, we actually fare well against other like institutions across the country. Q: My question relates to what my nurses and I see as a critical problem with supply. When my nurses have to send the PCA or the facilitator off the floor to go either downstairs to get the supply, or go to another pod to borrow supplies, we’re losing facilitator and PCA time. So I am wondering—as we look at our contracts with our suppliers, do we have some kind of quality monitor of how well we’re doing? Is there a way that once in a while we could do refresher training on how to use the system and how the system is supposed to work? A: MVV: I appreciate the fact that not only did you present us with a problem, but you’ve also given us a couple of opportunities for solutions. These relationships with vendors like Owens and Meyer are really cast in the light of a partnership, which basically says that they’ve got a lot at stake in our operations. I think that we need to engage folks like yourself in finding specific opportunities for improvement. AW: Again, I want to emphasize the generic issues that we’re all facing here. The acuity is up and average length of stay is only 5.2 days, very short for an acute care hospital. We have a 6 percent increase in volume every year and over 100 nurses positions that are available and funded and that we’re actively recruiting for, and there are no signs that things will slow down. We’re having growing pains, and we rely on your input and listen to it to make improvements. AM: We’re starting to look at how we can better measure how our vendors are doing. In terms of a partnership with them, I don’t think we’ve done all we can to maximize our relationship with them. Part of what we pay them for is our access to their expertise and distribution systems, in helping us set par levels, in helping us manage supplies on the floor, and we’ve challenged them to come to the table and give us the full value for the premium we pay.