American Hospital Association Investiture Speech
April 10, 2011
Presented by John W. Bluford, chairman
First, let me say that it is a tremendous honor to stand before you as the chairman of the American Hospital Association, especially at such a dynamic and even turbulent time in health care. Right here today you are the people who are transforming communities by delivering ever-better health and wellness and, as a result, better opportunities for people to prosper and thrive.
Also, before me in this room are some of the people who have personally helped me prosper and thrive—to grow from a kid obsessed with basketball and biology to find a profession that provides me with so much fulfillment— including the unwavering support of my mother Augusta Jones, my godmother Della Mae Burke, my cousin and national poet Tom Siebles, my first hospital mentor Robert Shakno, my leadership team colleagues and board members from TMC [Truman Medical Center], and particularly two colleagues who have collectively shared careers with me of 26 and 31 years, respectively, Mr. Allen Johnson and Ms. Catherine Disch. And, of course, my loving, supportive wife and best friend of 41 years, Joanne. Also, I am very proud to recognize my son and daughter John and Jennifer, and Jennifer’s husband Mr. Chris Watkins.
You have heard Millie Edwards Nottingham, one of my favorite Jazz vocalists, who is also an inspirational activist and educator in Kansas City. It’s no secret to those who know me that I love jazz. And I have found that in life, as in jazz, a fantastic score is imperative . . . but so is collaboration, improvisation, and yes, the occasional grace note…. (I’ll explain that later.)
As hospital executives and staff, we are fortunate to have such a very powerful score, and that is the mission and vision of the American Hospital Association. You’ve seen this mission and vision statement a thousand times, maybe tens of thousands, but listen…
“The AHA vision is of a society of healthy communities, where all individuals reach their highest potential for health. Our mission is to advance the health of individuals and communities. The AHA leads, represents and serves hospitals, health systems, and other related organizations that are accountable to the community and committed to health improvement.”
I hope you noticed how often the word “community” appears in those few, well chosen lines? It is no accident. Hospitals are, and must be, collaborative enterprises. That means that we, as hospital leaders, must assume a moral and professional role as community leaders.
So what does that REALLY mean?
It means we have to show up and really get to know our communities. As the great KC jazz saxophonist Charlie Parker once said, “If you don’t live it, it won’t come out of your horn.”That is to say, knowing our communities is not a responsibility we can delegate. We have to see it, feel it, and understand it!
Every community, from the most urban to the most rural, has social and health disparities. It’s our job to know our communities, our schools, our community gathering places, our churches, and in general the overall human circumstance of our neighborhoods so that we can address those disparities with passion. We can’t do that hemmed in by our four walls.
I am talking about the kind of tough, messy problems that will take generations to fix. So, with apologies to Paul Simon, “Hop on the bus, Gus.” Or spend a day or two taking an exit off the highway that you have never taken before.
For example, I have put forward the idea that in my community of Kansas City, violence is a real public health concern. And that violence doesn’t stop at the door of my emergency room. It is an impediment to all kinds of healthy behaviors. Violence keeps children from playing outdoors, sometimes from going to school, and often times can inhibit their performance in school. Violence kills jobs and critical businesses and commerce like grocery stores. And violence creates tremendous stress—for everyone!
So, in our community, I think we need to address violence if we are going to be able to improve the health of our community. Maybe you don’t work in the center city, safety-net hospital like I do, but your community has its own dynamics that create its own barriers—solid walls that stand between people and the healthcare that will allow them to achieve their full potential.
Tearing down those walls will be painfully slow. But we will never get to the destination if we don’t start the journey. Or as my friend and fellow AHA board member Dr. Ron Anderson will tell you, “If you have to eat a frog and keep putting it off, then the frog only gets bigger.”
A second aspect of community that we cannot afford to overlook is our own people—our workforce. If we don’t take care of our own, how can we expect them to take care of the community in a credible way? Cookie-cutter approaches don’t work here, either. AHA’s “A Call to Action: Creating a Culture of Health” demonstrates a wide variety of creative programs from HCA’s wellness assessment to Geisinger’s free prescription program to the volunteer wellness program at St. Elizabeth’s Medical Center in Wabasha, Minn.
At Truman Medical Centers, we have gone after this issue on several fronts. We have an active employee wellness program and have come up with some novel approaches to pay for it, but we don’t stop with our employees. We go on to support their families, as well. We provide a variety of continuing education and life skill classes for staff and their families—and recently we began offering tutoring classes for the children of our employees who need additional support in their school work.
We hold a farmer’s market so that staff and the community have a convenient source of fresh fruits and vegetables in a community setting that does not provide many food store options. In fact, within the next 18 months, we hope to open a full-fledged grocery store in the community. These are just a few “out of the box”—or should I say “out of the bed”—ideas that are helpful in making a difference in the well-being of our community.
To affect truly sustainable change—whether inside our hospitals or throughout our communities—we need to adopt what I like to call the point guard strategy. It’s not enough to anticipate the next move; we’ve got to look at the move after that. And then we’ve got to put in place mechanisms to measure whether we guessed right. And ultimately we need to score—meaning, make a difference—in the lives of the people we serve.
That will be our scoreboard!
Here’s another example. We all know that better management of chronic diseases like diabetes, asthma, emphysema, COPD, sickle cell anemia, hypertension, and heart disease will not only improve lives in the new health reform environment, it will also improve our financial health as well, thereby allowing us to do more for our communities.
So Truman Medical Centers has improvised. We introduced a program called Passport to Wellness. Passport is targeted towards our affectionately known “frequent flyers”—those people who show up over and over again in our emergency room and inpatient settings. We are taking some creative actions to help these patients and their families make lifestyle changes that will in turn help them better manage their health, resulting in fewer hospital visits.
At TMC, our results have been truly phenomenal. Our sickle cell readmission rate has been reduced by 26 percent. Our asthma patient cohort in this program has experienced a collective 25 percent reduction in patient days and their ED visits have been reduced by 217 days (23 percent). These results were created by guided protocols and case management through team-based care, including a physician, nurse, pharmacist, and social worker. And the design of the services included feedback from community advocates.
Through education and a coached approach to lifestyle changes, this care team of health professionals is helping patients better understand their illnesses, teaching them firsthand how to manage their illnesses, and guiding them to become their own advocates in managing their diseases. The care team also works to remove barriers that prevent patients from following through with their care plans, like transportation problems, preparing for appointments, or general health literacy. And we make sure that every member of the care team communicates effectively. It’s patient centeredness with “touch” and understanding the total picture. That’s the grace note.
And by no means am I implying that TMC is the only hospital exploring and executing these types of creative solutions. They are happening at:
- San Francisco General Hospital
- Rochester New York Medical Center
- The pediatric asthma program at Sinai Health in Chicago
- The patient rounding program at McLeod Regional in Florence, South Carolina
- The Healthy Futures program at Munson Healthcare System in Traverse City, Michigan
- The Tao’s First Steps program at Holy Cross Hospital in New Mexico, and
- One of my favorite programs, the Charter School in Oklahoma City, started by the Integra Healthcare System in Oklahoma.
The two points I want to emphasize here is that (1) we can all learn best practices from each other, and (2) that ultimately our institutions will not only be judged by the care administered within our walls, but by the health status of the community we serve.
Down the street from your office, there is probably a blue sign with a big “H” on it. If I can leave you with one thought today, it will be this: The meaning of that H should not be limited to “hospital.” We must accept the fact that H stands for “health.”
My job, your jobs, our jobs—come with a big soap box. Use it. Work with your staff, your community, and your AHA colleagues to share knowledge and build a collective healthier community.
Publication Date: Wednesday, November 06, 2013