Wednesday, December 16, 2015

Thank you California Nurses Association!


Deborah Burger, R.N.                                           December 16, 2015

Co-President

California Nurses Association

2000 Franklin Street

Oakland, CA 94612

 

Re: Another Leapfrog Group “A” for Tri-City Medical District

Dear Ms. Burger,

 Thank you and your entire staff and membership of the California Nurses Association(CNA) for all that you do for others, especially our Veteran’s, I really appreciate it!

 At this time I would also like to thank you and your members at Tri-City Medical District(TCMD) for their outstanding work measured in the quality of care given to their customers and recently recognized again by the Leapfrog Group as an “A” level performance, actually, for the fifth consecutive year.

 Recently it was noted that the Neonatal Intensive Care Unit has not had a Centerline  Associated Bloodstream Infection in over five years. One of the comments from a recent auditor from the Joint Commission, “should my family or I need a hospital, this would be the one”!


 How do these accomplishments help our Veterans, according to the U.S. Department of Health and Human Services Healthcare Associated Infections(HAI) are preventable, the closer we get to prevention at any facility the higher the bar is raised for the industry-wide tolerance of occurrences.

 The unique aspect of the accomplishments at TCHD concerning healthcare safety, it is a community hospital, the demographics of its patients are not an attribute, although much improved and committed to delivering quality care its leadership has had its share of challenges, the facility is over fifty years old so the successful component to delivering safe and efficient healthcare, yes, it is a profitable facility, is the staff, your members.

 My advocacy for the prevention of HAI in our Veteran’s hospitals is actually pretty easy, all I have to do is encourage and support the staff at TCMD in the prevention of HAI, the inspiration for this letter of thanks to you, the CNA leadership and membership that populate TCHD and every Veteran’s hospital in our nation.

Sincerely,

Michael Slavinski                                             http://h-a-i-5.blogspot.com/

"If we can improve the quality of care, that will translate into lower cost," Anthem President Pam Kehaly said. "These are real dollars”

Thursday, August 6, 2015

Honorable Senator, thank you for helping our Veteran's


This note to the Honorable Senator, my advocacy, well, the task is to move the argument to the other side of the room to allow those who help others to do just that.

Honorable United States Senator Dianne Feinstein,                                  Date 8/6/15

 

Dear Honorable Senator Feinstein,

 

 Thank you very much for everything you and you staff do for the great country we live in, I really appreciate it!

 Thank you very much for supporting our Veteran's in the Los Angeles area via restricting leases that would not benefit our Veteran's at the Greater Los Angeles Healthcare System(GLAS).

 Over the years as an advocate for the prevention of healthcare associated infections at our Veteran’s  hospitals I have been appalled by the conduct of the staff at the facility.

 The only U.S. employee to criticize my advocacy over the years was GLAS Director Donna Beiter, she had a subordinate call me and told me to stop writing to her and if I did not she would throw all of my communications in the trash, I reminded the subordinate that it was not a problem, the Honorable Senator Feinstein's office has a complete set.  Understandably, at the time, Director Beiter had a very busy schedule, for some reason she seemed to spend a great amount of time in court and I do not believe for recognition of outstanding delivery of service by her unit.   To here lately about the G.A.O.'s findings concerning her living conditions on the facility was of no surprise.

 It is time, in my humble opinion, to investigate the privatization of the VA system, I am quite sure it would benefit our Vets and benefit development of more efficient healthcare for us all. Perhaps there was a good reason to let the regional VA systems run as secretive kingdoms(silos) but everything I have read about the budgetary issues system wide and mismanagement of virtually every aspect of the delivery of service to our Veteran’s.

 A critic I am not but the current tune-up underway at the VA can only be described as a total failure, one man has had little impact on a very challenging situation, the latest, “meetings with union VA staff members in a basement somewhere in the Washington DC area” helped me come to my conclusion.

 Once again, thank you for helping our Veteran's.

 

Respectfully,

 

 

February 13, 2012

 

Donna M. Beiter, R.N., M.S.N.

Director

Department Of Veterans Affairs

Greater Los Angeles Healthcare System (GLAHS)

11301 Wilshire Boulevard

Los Angeles, CA 90073

 

Dear Ms. Beiter,

 

 Please allow me to offer you a very warm “thank you” for your letter in response to my advocacy for patient safety (691/90), your efforts are very much appreciated. Although there are certainly no shortage of vendors in the field of HAI, my advocacy is “pro-bono” with the inspiration deeply rooted in the article in the L.A. Times and the profound statements from Ms. Pam Kehaly, President, Anthem Blue Cross, contained within.

 My advocacy has led me to the top to see where I could help to assure our veterans are receiving the benefits of the efforts underway in the private healthcare system only to find out that the “top” is watching for “best practices” being employed by the 50 states.

 The unlikeliest of advocates I am but as a veteran, ratepayer, business owner and taxpayer, HAI seems to be a small part of healthcare, for me, my top priority!

 My advocacy will depend on input and support from professionals like yourself, Ms. Kehaly and her staff set our efforts ahead a few months in a short meeting, five professionals with 116 years in the healthcare field, “HAI-Five”!

 Other than manufacturing components for ventilators for the past decade in our humble machine shop I have no financial relationships with any entity that would benefit from my advocacy, just trying to give a little back and help out a few vets.

 One thing I have learned is that a V.A.P. free facility should now be the “norm” not the exception, I have recently solicited both the California Senate and Assembly Healthcare subcommittees and T.J.C. of my intentions, Kimberly-Clark has provided a web-based site where I have posted my interests. http://hai.soundenterprises.com/pg/profile/Michael

 President Barack Obama, Senator Dianne Feinstein, Senator Barbara Boxer, all of my state representatives, GLAHS,  Anthem Blue Cross, Kimberly Clark, in my opinion, we are all looking for the same thing, safer, more efficient healthcare.

 Once again, thank you so much for all that you and your organization do for the people who gave the most for the great country we live in! If you do not mind I will send you updates from time to time as my advocacy begins to find more focus.

 

Sincerely,

 

Michael H. Slavinski                                                  Continued on page 2

 

  page 2

 

cc:

 

Honorable President of the United States Barack Obama

 

Honorable United Stated Senator Dianne Feinstein

 

Honorable United States Senator Barbara Boxer

 

Honorable Governor Edmond G. Brown Jr.

The Great State of California

 

Honorable California Senator Ed Hernandez

Chair, Senate Health Committee

 

Honorable California Senator Sam Blakeslee

 

Honorable California Assemblymember William W. Monning

Chair, Committee on Health Care

 

Honorable California Assemblymember Katcho Achadjian

 

Honorable Supervisor Frank Mecham

San Luis Obispo County Board of Supervisors

 

Ms. Pam Kehaly

President, Anthem Blue Cross

 

Mr. Eddy W. Hartenstrin

Publisher and Chief Executive Officer, Los Angeles Times

President and Chief Executive Officer, Tribune Company

 

Veteran's Service Officer Dana Cummings,

San Luis Obispo County

 

Staff, Anthem Blue Cross

 

"If we can improve the quality of care, that will translate into lower cost," Anthem President Pam Kehaly said. "These are real dollars."

  

Sunday, July 26, 2015

Veteran's, Efficient and safe healthcare


Deborah Burger, R.N.                                           July 26, 2015

Co-President

California Nurses Association

2000 Franklin Street

Oakland, CA 94612

 

Re: Efficient and safe Healthcare,

 

Dear Ms. Burger,

 

 Once again thank you for all that you and the entire membership of the California Nurses Association (CNA) does to help others, as well as our Veterans.

 In my humble opinion the California Nurses Association has recognized the correlation between staffing levels and safe and efficient healthcare.  Educating your members and supporting proper staffing levels has helped improve safety and reductions in healthcare associated infections(HAI), a set of preventable and often lethal diseases impacting not only patients but your membership as  well.

 


 

Large scale budget cuts are on the table and the historic tactics of the U.S. Veteran’s Affairs(VA) leaves little room for innovative solution to large scale improvements:   

 


 


 

 Scientific methodology does not seem to be part of the equation, I have little confidence the VA will be investing in improvements that are underway in other healthcare facilities here in California, and I am advocating for the CNA to do your best to highlight what is possible rather the just accepting the inevitable for our Veteran’s.

Apparently the VA has been listening to grievances from organized labor in a basement somewhere in the D.C. area, hopefully the CNA is addressing the issue, a critic I am not and I will say no more.

 However uncomfortable my advocating for the prevention of HAI in our Veteran’s hospitals may be, The CNA has the ability to influence change on many levels in my humble opinion and should do so as your profession mandates, I do not.

 Once again, thank you and your entire staff for all that you do for others, I really appreciate it!

 

 

Sincerely,

Michael Slavinski     

 

 

 

Tuesday, June 9, 2015

Bugs in the rug!


Deborah Burger, R.N.                                           June 9, 2015

Co-President

California Nurses Association

2000 Franklin Street

Oakland, CA 94612

 

Re: Healthcare Associated Infections & the CNA

 

Dear Ms. Burger,

 

 Once again thank you for all that you and the entire membership of the California Nurses Association (CNA) does to help others, as well as our Veterans.

 In my humble opinion the California Nurses Association has a focus on patient safety and is in a positon to influence change. The battle to keep our acute healthcare facilities free of evermore deadly infections is evident in your website:

 


 Efforts such as the CNA’s interest in Ebola protection demonstrates your ability to influence change, fortunately, other than the chaos created by a false alarm and poor communications Californians did not have a single, Healthcare Associated Infections(HAI), thousands of California residents will lose life or limb “this year” with little fanfare.

 The tools are there:

 


Centerline Bloodstream Associated Infections, some hospitals in California, at least one hospital I know in California has not has an occurrence in over eight year leaving me to believe many will suffer needlessly.

All forms of HAI are preventable, adequate staffing is one of the critical components, attitude is perhaps the key to preventing HAI on a large scale, again, in my humble opinion.

 Our Veterans are running out of time, the  wars are now a distant memory for the public, how to do more with less is difficult to accomplish when budgets are cut and hence my advocacy for the prevention of Healthcare Associated Infection in our Veteran’s Hospitals which the CNA is present in every one. Ebola and MERS are dangerous but are over-published minor threats  in our communities.

As a manufacturing community member I do share your objection to the Fast Track proposal, describing who will benefit from it seems to be a major challenge, “if we do not do it China will” offers little comfort to those of us with a vested interest. In exchange for my support, your members are doing great at Tri-City Hospital concerning patient satisfaction but I need that place to be “way over the top”, the routine “A” rating from Leapfrog gives me a lot of hope in your members competency, Quality objectives are a challenge to us all, should your office be able to contribute to the effort I would sincerely appreciate it.

 

Once again, thank you!

Sincerely,

Michael H. Slavinski

 


 

Sunday, May 3, 2015

"A" for Patient(customer) satisfaction?


Deborah Burger, R.N.                                            May 5, 2015

Co-President

California Nurses Association

2000 Franklin Street

Oakland, CA 94612

 

Re: Another Leapfrog Group “A” for Tri-City Medical District

Dear Ms. Burger,

 Thank you and your entire staff and membership of the California Nurses Association(CNA) for all that you do for others, especially our Veteran’s, I really appreciate it!

 At this time I would also like to thank you and your members at Tri-City Medical District(TCMD) for their outstanding work measured in the quality of care given to their customers and recently recognized again by the Leapfrog Group as an “A” level performance.

 The linkage of quality of care and healthcare efficiencies are well documented and from recent comments from Board of Directors Members at TCMD and related financial statements the dividends of delivering a high quality product are quickly becoming a cultural reality for the entire organization in my humble opinion.
 From what I have learned in our industry and the teachings of Mr. Deming, quality is not achieved as a fixed goal, due to human nature and the laws of physics(entropy),  quality in improving or regressing, hopefully what we are witnessing at TCHD is just the beginning of a bright future for safe and efficient healthcare, I believe the Honorable Governor Brown may have finally found what he is looking for and hopefully this culture of quality will finds its way to our Veteran’s Healthcare system.

 In a few weeks we will be having another Patient Partnership Council Meeting at TCMD, this meeting has been advertised to have a focus on Patient Satisfactions, complete with statistics. Comments from staff were positive in the discussing as the agenda was forming but the customer feedback participation size was disturbing and support from related governmental agencies is apparently non-existent in such a critical fiscal consideration as well as a quality measure.

 Once again, thank you for your valuable time and should there be an opportunity for the California Nurses Association to support and focus on Patient Satisfaction I would appreciate it very much.

Best regards,                                                              

Michael H. Slavinski                                                                                  http://h-a-i-5.blogspot.com

 

"If we can improve the quality of care, that will translate into lower cost," Anthem President Pam Kehaly said. "These are real dollars”

Wednesday, April 15, 2015

Patient experience and why it matters?


Patient Partnership Council                                                                                 April 15, 2015

Tri-City Healthcare District

Oceanside, California

Council members,

 Today, 4/15/15, I found the conversation concerning patient satisfaction surveys at Tri-City Healthcare District’s(TCHD) Patient Partnership Council  meeting  most interesting. Perhaps the most profound input was presented by Dr.  Stuiver “over the past few weeks there have been very few complaints concerning patient satisfaction”, a statement of the quality of the professionals and volunteers working hard on a very critical issue in my humble opinion.

 The reported fact that the response rate is around six(6) percent at TCHD and can influence the fiscal situation by up to thirty percent in the days of the Affordable Care Act perhaps is why it will be on the agenda for our next meeting.

 Many times at the Board Meetings at TCHD there is almost a side note interest in improving the patient experience and most weeks I badger the California Nurses Association about  the leadership role they should assume on the issue, perhaps they had something to do with the improvements Dr. Stuiver described so I included them on the cc, thank you CNA.

 The disturbing part of the conversation is that the agencies(US) collecting and analyzing the survey are offering no feedback as to how to increase response rates so I cc to them as well, the California Department of Public Health is not the U.S.D.H.H.S. but do have a stake in an obviously failing system.

 Just to start the argument, no matter where the delivery(new Guide book is an option), be honest and ask for help:

“Your input will influence our community hospital and the quality of care we provide 

“How can you help”

“Why should you help”

“Your experience will directly influence”

“Patient satisfaction is a critical part of our funding cycle”

 

Psychological Approach

The psychological approach relies on heuristic factors such as reciprocity, helping, compliance, and selectivity as a way to increase response. Reciprocity is the behavioral norm that says people should treat others as they have been treated

 


 

Best regards,

Michael Slavinski

 

Ps Please feel free to challenge my opinion, that is the point, the reason why patient satisfaction is a “side note” at the honorable TCHD Board meetings is the multi-million dollar investments in capital equipment and technology to  improve “quality”  is the current trend, healthcare has finally made it to the 1980’s.

 Six percent, that is disturbing,  is the ACA really failing that badly, what could you possibly learn from 6% responding patients?

 

Sunday, March 29, 2015

Workplace safety, Healthcare Associated Infections


Deborah Burger, R.N.                                            March 29, 2015

Co-President

California Nurses Association

2000 Franklin Street

Oakland, CA 94612

 

Re: Workplace safety, Healthcare Associated Infections

Dear Ms. Burger,

 Thank you and your entire staff and membership of the California Nurses Association(CNA) for all that you do for others, especially our Veteran’s, I really appreciate it!

 As a pro-bono advocate for the prevention of Healthcare Associated Infections(HAI) in our Veteran’s Hospitals I signed your petition to support the California Nurses Association effort to gain proper protection for healthcare workers concerning Ebola protection nationwide.


Ebola is no longer in the headlines, last week I heard our local hospital board discuss the catastrophic consequences here in California of a reported(negative) Ebola case , perhaps some of the panic could have been alleviated should the proper protection been available?  

 As a pro-bono advocate for the prevention of HAI in our Veteran’s Hospitals I supported the successful organizing of our local Veteran’s Hospital, the impact of a collective voice should improve the situation in my humble opinion.

 


Also, the correlation of patient to R.N. has not escaped the attention of my advocacy, thank you for that as well.


Much like Ebola, in my humble opinion, HAI does not make the headlines very often, unlike Ebola, HAI , a preventable set of diseases, will needlessly cost thousands here in the state of California their life or limb this year, next year and every year after should it remain an acceptable cost of poor and very dangerous practices at our healthcare facilities, some of which in understaffing.

 How to help our Veterans, awareness is the key, the Association of Critical Care Nurses has set the standard for websites and focus.


The California Department of Public Health(CDPH), at times, has been an industry leader, supporter and resource for the prevention of HAI and your link to it included in your RN resource page is much appreciated. The  Honorable Governor has also commented on the catastrophic fiscal damage caused by HAI but unfortunately the lack of input concerning the resent HAI outbreak at U.C.L.A. medical highlighted the conflict of interest between the UC medical system and the CDPH. In my humble opinion, the CDPH is responsible for the prevention of preventable diseases, not protecting state assets, There efforts concerning the prevention of HAI have been dormant for a while now and I believe the CAN membership may well pay a price for their dormancy on the issue.


 As noted, the CNA is pushing for positive change in our healthcare system and hopefully   you will continue to do so and should the CNA take a leadership role in the prevention of HAI, as a veteran, a rate payer and a tax payer, I would appreciate it very much, once again, “thank you”!

Best regards,

Michael H. Slavinski  

 

Sunday, March 8, 2015

California Wellness Plan 2014



Deborah Burger, R.N.                                            March 8, 2015


Co-President


California Nurses Association


2000 Franklin Street


Oakland, CA 94612


 


Re: California Wellness Plan 2014


 


Dear Ms. Burger,


 


 Once again thank you for all that you and the entire membership of the California Nurses Association (CNA) does to help others.


With all of the challenges facing healthcare today  it is easy to be a critical which always presents a challenge to my advocacy for the prevention of healthcare associated infections in our Veteran’s Hospitals. My time and resources are limited, your website section titled “Nurse Resources”  led me to the California Department of Public Health which in turn led me to the “California Wellness Plan 2014”, there we go, something positive, thank you for that!


 


http://www.cdph.ca.gov/programs/cdcb/Documents/CDPH-CAWellnessPlan2014%20(Agency%20Approved).FINAL.2-27-14(Protected).pdf




A big fan I was of “Let’s get Healthy California” along with the Honorable Governor Brown, the genesis of “California Wellness Plan 2014”, the potential of what healthcare could be in the State of California gives me hope for the care we could someday provide to our Veterans.
In my humble opinion programs like the “California Wellness Plan 2014” only exist if organizations like the CNA support them, our Veterans could use the help, perhaps someday healthcare associated infections will make the list, hopefully the next positive thing for me to write to you about.


 Once again, thank you!


Sincerely,


Michael H. Slavinski


 




 



Sunday, March 1, 2015

California Nurses Association: Workplace safety


Deborah Burger, R.N.                                            March 1, 2015

Co-President

California Nurses Association

2000 Franklin Street

Oakland, CA 94612

 

Re: workplace safety

 

Dear Ms. Burger,

 

 Please allow me to thank you and your membership at California Nurses Association(CNA) for all that you do to help others, I really appreciate it. My humble advocacy for the prevention of Healthcare Associate Infections(HAI) in our Veteran’s Hospitals has led me to the great work of the CNA concerning patient safety, supporting your efforts at the San Diego Veterans Healthcare System brought to light the value of a collective voice, thank you very much!

 Just the other day I was at a meeting which included senior nursing staff and clinicians at our community hospital concerning the proposed patient guide book, it has a focus on patient safety, including the identification of the value of hand washing, I asked the group “how do doctors respond when a patient asks if they washed their hands”, the response was, no comments, blank expressions.

 Bits and pieces I learn in support of our Veteran’s, what to do with what I learn is a challenge, I do know that the CAN is at our community hospital, they actually talk to me there, the Veteran’s do not.

 Your website is focusing more and more on patient and workplace safety, I really appreciate that.

How can the CNA help our Veteran’s in my humble opinion? Our community hospital would be a great example for the Veteran’s system to learn from as a HAI free facility and that can happen with the support of the CNA.

 Little do I know about the medical industry so my advocacy is dedicated to supporting those who help others and that would be you and your entire membership.

 

Sincerely,

 

Michael H. Slavinski

 

Ps thank you for including the good work of the California Department of Public Health’s HAI program as a nurse resource on your website, I have been very impressed with their efforts concerning the prevention of HAI, the VA has access to their efforts as well. 

 

 

 

 

 

 

To: The Board of Directors                                                   February 25, 2015

        Tri-City Medical Center-Administration

        4002 Vista Way

        Oceanside CA 92056                        

 

Re: Quality commitment

 

Dear Honorable Board of Directors,

 

 Please allow me to thank you and the entire staff at Tri-City Healthcare District(TCHD) for your commitment to provide safe and efficient healthcare to our community, I really appreciate it.

 Recently two comments from Honorable Board members give me hope for a bright future for healthcare, “what is preventing TCHD from becoming one of the top rated hospitals in the country” and “it would be good to add an extra board meeting to spend more time on quality issues”!

 TCHD, already is one of the top rated hospitals in the country says the Leap Frog Group, a consistent “A” quality rating speaks for its self in addition to numerous awards received from the Joint Commission.

   A new facility would be a good start but, as with other industries, anything less than a “holistic” approach to quality will always be challenged by entropy. Your financial commitment to providing quality care is clearly stated in recent investments but, in my humble opinion, “culture” should not be overlooked. Culture is easily identified, the question, “how do your fellow  staff members respond when a patient ask if they have washed their hands”. To clearly identify your interests, that question should be the first questions asked in any employment interview.

 Cedar-Siani, one of the safest facilities in the country, had a Healthcare Associated Infection(HAI) issue a few years ago, a comment from a doctor there, “HAI is un-acceptable at our facility”.  Adding the cost/waste associated with re-admissions and HAI occurrence to your monthly financial report should impact your investment strategies and theoretically improve your bottom line.

 HAI, thousands will lose life and limb in addition to the catastrophic fiscal damage in the state of California this year from a completely preventable set of diseases, our Veterans are not faring any better  due to staff members routinely get offended when asked if they have washed their hands.

 Can organized labor help create a safe work place, are the Fed’s in, how will the California Department of Public Health respond to your efforts to be one of the safest and efficient medical facilities in the country, hard to say but I would really like to find out and pass the information on to our Veteran’s care providers.

 Is there a need, time or support for more meetings concerning safety and efficiencies here at TCHD, that I would like to learn as well.

 Once again, thank you for all that you and the entire staff here at TCHD do for others, I really appreciate it!

 

Respectfully,

 

Michael H. Slavinski

 

 

http://h-a-i-5.blogspot.com/