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Hippocrates
Said…
Allen Greenway, MBA
Vice President of Finance
In ancient Greece, Hippocrates taught the art of medicine
to his students under the spreading branches of a great tree.
He taught that the healing ethic should encompass the idea of
first do no harm, benefit only. Today, the mission, vision, and values of most healthcare
organizations generally suggest caring about patients.
However, in reality, most are planned, organized, staffed,
directed, and controlled around the schedules, expectations, and
needs of clinicians and staff. This is an operational perspective, not a marketing
perspective.
The marketing perspective asks the customers – in the
case of ACT, these would be our patients, their families, and our
facilities – what they expect from the services provided.
Organizations with a marketing perspective determine what
these expectations are, how the customers experience compares to
their expectations, and then design their processes to meet the
expectations. Employees
of these organizations are held to standards of performance that
meet or exceed these expectations.
When the patient experience runs contrary to the patient
expectation, management is expected to find out why and implement
plans to resolve this issue.
What does all this have to do with the organization,
management and delivery of care for ACT?
A large body of research on this topic concludes that
operating from the marketing perspective (versus the organizational
perspective) is effective in reducing health care costs.
One study of hospitals that utilized this approach reported
shorter lengths of stay, the use of less pain medication, higher
patient satisfaction, and less serious complaints.
But even more important is that studies have shown
organizations with this perspective have far less employee turnover.
Since most people enter the healthcare profession to help
people, a greater congruence of values within this type of
organization leads to greater commitment to the organization.
This strategy is win-win. Your
customers get what they want. Your
employees feel good about where they work and want to stay.
Implementation of this process is far less costly than one
might expect. Think
about this for just a moment. You
respect your customers in a fundamental way, thus making them happy.
You make your employees happy.
You do it less expensively.
You build a brand. Using this model to position ACT has led to increased market
share. Improvements in
this process will lead to more market share and improved brand
image. According to the
American College of Healthcare Executives’ Futurescan 2004,
a new generation of resourceful customers demands more and more
respect. With the
efforts of all of us, ACT will “live long and prosper.”
Is Hippocrates all that different than Mr. Spock????
Excerpted
from articles in the April 2005 HFMA Magazine
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DIABETES MELLITUS
Catherine Morgan
Primary Care Support Nurse
ACT Medical Group
Diabetes is a costly epidemic in the United States. There are
some 18 million Americans with this disease and one third remain
undiagnosed.2 As healthcare providers it is important
that we continue our work to prevent and control this chronic
disease. We are fortunate to have the opportunity to provide
excellent quality care in long term care facilities during this time
of ongoing research and improvements in the care and prevention of
diabetes. In the nursing home population alone as many as 26% have
diabetes and 30% have glucose intolerance. The enormous cost of care
for these patients is estimated at $6 billion annually.3
People
with diabetes have blood glucose levels above normal due to the
inability to convert food to energy. Normally the hormone insulin is
secreted by the pancreas; however, individuals with diabetes do not
make insulin or their insulin is not effective.
Classic symptoms of diabetes
include unexplained weight loss, excessive hunger, excessive thirst,
frequent urination, fatigue and sores that do not heal. Today,
screening for diabetes is done more often and a prediabetes
diagnosis may be made when blood sugar levels are high but not high
enough to have a diabetes diagnosis. These individuals remain at
high risk for developing diabetes occurring most often in overweight
individuals over the age of 45.4
There are several categories of diabetes however the two main
types are referred to as Type 1 and Type 2 diabetes mellitus. Type 1
diabetes is an autoimmune disorder that occurs when there is no
insulin produced by the pancreas. The cause is complex and may
include genetics and the environment but it is not completely
understood. People with Type I diabetes must take insulin every day
to live.4
Type
2 diabetes is the most common type and it is diagnosed when the body
cannot effectively use the insulin it does make. This metabolic
dysfunction ranges from complete insulin resistance to mild
impairment. Type 2 diabetes is associated with adulthood but it has
become more prevalent in children and adolescents.2 Lifestyle
changes that include weight loss and physical activity reduce the
risk and help control Type 2 diabetes.4 The
most recent exciting news is that in June of this year a new Type 2
diabetic medication, Byetta, will arrive on the market. Byetta has
just been approved by the FDA to treat Type 2 diabetes. It is the
first medication that will mimic the action of the hormone GLP-1 to
spur insulin production after a meal. This will decrease the risk of
experiencing hypoglycemia that can be a problem with other
medications currently used to control Type 2 diabetes.1
Long
term complications of uncontrolled diabetes mellitus occur due to
damage to vital organs over time. This damage to nerves and blood
vessels often leads to heart disease, stroke, blindness, kidney
disease, nerve problems infections and lower extremity amputations.2
It may be possible to
prevent the worsening of complications and stop new ones from
developing with frequent focused interventions in the plan of care.
Individualized treatment goals include managing blood glucose
levels, managing cholesterol and blood pressure. Regular monitoring
of weight and blood pressure is important as well as ongoing
education and counseling with adjustment of medications as needed.
Regularly scheduled dental, eye and foot exams are also part of the
management plan.3 Although
the population of patients in nursing homes and assisted living
facilities present challenges due to complex multi system medical
complications, management efforts by our team of clinicians is
making a difference in the quality of life for many. This is a
practical effort for the health of these patients as well as for
controlling the enormous healthcare costs.
Even
though there is a great challenge ahead to continue finding ways to
understand the cause and the complications of diabetes through
research, there have been enormous strides in recent years. This
promising news is helping in the management as well as in early
detection and prevention of diabetes. Education, better diagnostic
monitoring and ongoing addition of new medications will provide the
opportunity for a bright and healthy future for our diabetic
patients and for those at risk of developing diabetes.2
References
2) Gerberding, J. (2005).
Diabetes: Disabling, Deadly, and on the Rise. Center for Disease
Control. Retrieved April 30, 2005 from, http://www.cdc.gov/nccdphp/aag/aag_ddt.htm.
3) Pandya, N. (2003).
Diabetes Management in Long-Term Care. Caring
for the Ages. Retrieved March 4, 2004 from, http://www.amda.com/caring/february2003/diabetes.htm.
4) U.S. National Institute
of Diabetes and Digestive and Kidney Diseases of the National
Institute of Health. Retrieved April 30, 2005 from, http://www.diabetes.niddk.nih.gov.
ACT
Anniversary Dates:
- Gretchen
Belovicz
5 years
- Sara
Schneidmiller
5 years
- Karen Fulwood
3 years
- Martha Wright
2 years
- Kerry Rush
1 year
- Russell Thomas
1 year
- Dan Earnest
1 year
Birthdays:
- Deborea
Winfrey
5/10
- Michael
Lefaive
5/18
- Gail Kissner
5/26
- Bryan
Patterson
6/5
- Jacqueline
Marquis
6/6
- Doug Smith
6/9
- Paul Clarke
6/10
- Sara
Schneidmiller
6/14
- Jennifer Sapia
6/17
- Cheryl Reigle
6/22
- Dante Langston
6/23
New Hires:
- Jennifer Sapia,
PhD Psychologist
- Dante
Langston, Physician Assistant
- John Reilly,
GST Member
- Catherine
Morgan, Clinical Support Manager
- Paula Bruner,
Physician Assistant
- Jeff Stewart,
Staff Coordinator-Psychology
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