Quality is a function of staffing levels?

 

The question is:

 

I'm seeing a lot of Hospitals cutting staff as a reaction to Health Care reform and related lower reimbursements. What do you think ?

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

Many facilities have had great success, at least with healthcare associated infections, a major cause of readmissions and deaths, more than likely just across the street from a poorly performing facility. More staff does no always equate to higher quality, the knowledge has to be put out there, my wish and advocacy is for these improvement to flow into our Veteran’s hospitals.

http://h-a-i-5.blogspot.com         

 

Just getting back into it, the move down south has been a real challenge and we may well survive. Our kid finished up her tour with the U.S. Peace Corps and will stay in Africa for another year to finish up school and work on a Shea project, we will miss her and I include this stuff for the benefit of all of you U.C. alum working up there in the bay area. Anyway, she sent this picture a couple of weeks ago and asked me if I knew this guy?

 

 

 

 

 

 

 

Now our kid has finished her commitment in the U.S. Peace corps but she will be staying in Ghana to finish her masters and continue her work in the shea industry. A little worried we were last year, one of her tasks under resource conservation was to “organize farmers”, she just sent us this video, pretty cool!

 

http://www.jergens.com/the-jergens-difference/pass-on-the-radiance.aspx

 

"Do not be first, do not be last and never quit"

The advocacy for the prevention of Hospital Associated Infections(HAI) in our Veteran’s hospitals , as with any advocacy, requires energy and focus. Both critical ingredients have been lacking lately due to short term issues, moving our house and business, but forgotten our Veteran’s I have not.

 The debate is raging in the medical community, the answers are there in my opinion and documented on my blog but healthcare professionals far beyond my medical knowledge continue to tune the challenge as I write, the hundreds of thousands of California residents and our Veteran’s,  I am sure, are very thankful.

 My advocacy is dedicated to those who help others due to my lack of  knowledge and thankful I am for the patience of those in the medical community to allow my advocacy to exist but sometimes really odd things happen—

 Here I am, sitting at home using my smart phone to find a solution for the “FBI ransom white screen” malware on my Alienware laptop, my wife hands me the “snail mail” which included the attached note for the Honorable U.S. Senator Dianne Feinstein. Alright, a lot of Jarheads work at the U.S. Post office, “I get it” as far as the move, the house is doing well, the shop, well, my wife asked me how it is going, I said “it will be going better once I get control of my computer but in general, we are going to need a bigger hammer”!  

As far as our Veteran’s are concerned, well, they never gave up on us so I do not see a good reason to give up on them. As for my advocacy, I do not worry about being out in front,  I reflect back to profound knowledge gleaned from those who cared, “do not be first, do not be last and never quit”, Sargent Sanchez, platoon 3086, USMCRD, August 1982.  

 

“hai-five”

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”

 

Ps: again, supporting those who help others, Susan G. Komen Foundation, they may give the term “never quit” meaning to a simple belief in my opinion!

 

"HAI Elimination" via HAI Liaison, CDPH

March 3, 2013

 

Jorge Palacios

California Department of Public Health (CDPH-CHCQ-HAI)

Re: Prevention of Hospital Associated Infections in our Veteran’s Hospitals

 

Dear Mr. Palacious,

 

 Once again allow me the thank you and all of the staff at the California Department of Public Health(CDPH) for all that you do concerning patient safety, I really appreciate it!

 At this time I would like to draw attention to the HAI Liaison program, the technical aspects are most profound, the direction is very encouraging but the logo, “HAI elimination”, as you can imagine, impresses me the most, I do not even know what organization it belongs to but support they will have!

 

http://www.cdph.ca.gov/programs/hai/Documents/HAI%20Liaison%20Program%20Summary%20of%202013%20NHSN%20Changes.pdf

 

The advocacy for the Prevention of Hospital Associated Infections in our Veteran’s Hospitals is dedicated to “supporting those who help others” and has identified the CDPH as a critical component in the healthcare’s effort to create a more efficient and safe, not only for California residents but also our Veterans and healthcare facilities world-wide.

 The following link takes you to an active debate contained Institute for Healthcare Improvement LinkedIn forum:

NatashaUnfollowFollow Natasha

You cannot Monitor improvement without Measuring...

Looking for thought leader’s insight on this. It seems everyone has the same goals to make your organization a better and SAFER place, but how?

 Please support the development of some form of “Database of Best Practices for the Prevention of HAI” one process, one outcome!

Sincerely,

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”

 

Robots in the virtual "Super Hospital"!

February 3, 2012    

Jorge Palacios

   California Department of Public Health (CDPH-CHCQ-HAI)

Re: “Database of Best Practices for the Prevention of Healthcare Associated Infections(HAI)”,

                              Another argument!

Dear Mr. Palacious,

 

 

Once again, thank you very much for the good work you and the staff at the CDPH are doing concerning the prevention of healthcare associate infections, as an advocate for the prevention of Hospital Associated Infections in our Veteran’s Hospitals, I really appreciate it!

As healthcare management loses confidence in their ability to develop a culture of safety proactive enough to prevent hospital associated infections(HAI) in our healthcare facilities there will be a race away from incremental improvement to the innovation camp, robots are really flashy but as General Motors found out in the 80s, worthless without a quality culture, the effort is already underway in my opinion. Fast forward thirty years, HAIs are becoming more powerful so perhaps there is a place in the virtual “Super Hospital” for our mechanical friends but without a “Database of Best Practices for the Prevention of HAI” housed at the CDPH, covered by the freedom of information act we may never know, the scope of the demonstrations are just too small to determine the return on investment.

Here is one of the robots--

 http://www.nursezone.com/Nursing-News-Events/more-news/Robot-Fights-Infections-with-Ultraviolet-Light_40885.aspx

 

Here is the question on the Linkedin site Association for Professional Infection Control, I included the hard copy below, the argument is contained with a limited audience. APIC is also listed as a contributor to the CDPH HAI website, “thank you APIC”!  

http://www.linkedin.com/groupItem?view=&gid=1854742&type=member&item=207803999&qid=32d0aa5c-798c-4f5c-9cfe-55fe71416246&trk=group_most_popular-0-b-ttl&goback=%2Egmp_1854742

The argument----

How does APIC feel about the use of UV-C light to disinfect patient rooms with the intentions of reducing HAI? Do you think this technology has a future in the Healthcare market?

 

Mike Johnson •UVc is a proven technique for disinfection of ORs, patient rooms, etc., as long as, there is sufficient dwell time. In discussion with facility directors, they realize the use of UVc portable equipment may cause a reduction in HAIs but are concerned with "shadowing" (UVc will inactivate only what it sees) and the ability of "housekeeping" staff to sufficiently complete the job through manual disinfection. UVc is part of the answer, not the whole answer. Facility directors are looking for ways to reduce costs and improve results; at this time there needs to be a combination of efforts, in sync and working together. UVc is just one piece of the puzzle.

 

Joseph Schulman •I agree with Mike Johnson, UV-C is one part of the total answer, but an important one. Another important part of the answer is advanced air purification technology that can completely "clear" the air, providing air purity beyond the capabilities of HEPA. This is important because, while HEPA is good, and advanced HEPA is even better, they are filters and even the best of them do not capture the smallest particles and it is the smallest of particles that can be tha most dangerous and illness-causing, according to the HArvard School of Public Health study recently released. A few years ago, during the 1990's, NASA devised a bio-conversion technology that was successful in removing all organic matter and VOC's from the air within the hydroponics lab onboard the space shuttles and ISS, (and it is now on display with all the retired shuttles), which has begun to be used in many industires just as successfully here on Earth. It has the capability to clear the air in a room or space of virtually all organic matter, pathogens, allergens, VOC's, spores, bacteria....virtually everything, and to thereby protect patients and staff from airborn threats. IMHO it should be installed in all hospital OR's, ER's and newborn nurseries, to name just a few places within a healthcare setting in which it could be deployed. This is a true breakthrough technology. I am not here to advertise so anyone interested in learning more please contact me privately. JKS

 

   Michael Slavinski •The shadowing, wad up a piece of paper, turn off the lights, turn on the flash light and illuminate every part of the paper, even the inside, non-visible surfaces, not a chance, another wasted “innovation” strategy.
Ok, now have your sanitation engineer tell you how they disinfected the roof? Air filtration sure is not going to hurt either, perhaps even positive air pressure to keep the bugs out.
Look in a clean room at your local chip manufacturer, cool stuff and sometimes we let dogs run through our hospitals?
Pleased support the development of some form of “Database of Best Practices for the Prevention of Hospital Associated Infections”, to be hosted a the California Department of Public Health(CDPH), covered by the freedom of information act.
The “Super Hospital”, if not only virtual, is possible, your ideas on their own may not make it out of your silo but the possible cumulative impact of the right combination will be the answer.
My advocacy for the prevention of HAI at our Veteran’s Hospitals is counting on your input, send your “best practice” here

Jorge.Palacios@cdph.ca.gov

The CDPH is doing a great job concerning the prevention of HAI, their web site and resources are improving but they can only do so much without your input in my opinion!

http://www.cdph.ca.gov/programs/hai/Pages/default.aspx

Once again, “thank you”!

Sincerely,

Michael H. Slavinski

HAI robot—the movie

http://www.youtube.com/watch?v=MShAH2ILrcg


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

Quality statement via U.S. Peace corps, some things translate very well!

For those of you number professionals, SAP is very active in the shea industry, providing mobil access to markets and pricing to very hard working people!

http://www.youtube.com/watch?v=pWkuaPdXUB0

 

Ps: UCSF/CDPH, just because the Niner’s are getting smoked, no reason to turn off the lights!

"Super Bugs" hit "Prime Time"

 Last year I do believe someone at the World Health Organization claimed that Hospital Associated Infections(HAI), sooner than later, will be the demise of the modern hospital if nothing is done. I guess the national media here in the U.S.A. ran out of stuff so in 8 seconds of inspiration for the masses it is a headline for today anyway but them again, I think I heard it is on 60 minutes tonight as some form of profound new discovery!
Actually, this problem is accelerating due other factors in the U.S.A., not just antibiotics, due to all of the alternatives to our hospitals they now house once the very sick, patients unable to fight the infections.
O.K., I know little about healthcare but the whole “doom and gloom” never did much for me and it turns out I am not alone, stuck in a silo near you are the answers, some of them are pretty impressive and there is a way to share all of these known processes with all healthcare professionals in California by encouraging the California Department of Public Health(CDPH) to host some form of “Database of Best Practices for the Prevention of HAI”, here is the first one with a really impressive 7 years without a CenterLine Associated Bloodstream Infection(CLABIS)---
http://www.youtube.com/watch?v=G6JbNIhubCg

The CDPH has a pretty good HAI resources section and getting better all the time

http://www.cdph.ca.gov/programs/hai/Pages/default.aspx

If you have any “best practice” you think would be an asset send it here---

Jorge.Palacios@cdph.ca.gov

Here is a very promising program currently underway featuring collaboration between the University of California Medical System and Anthem Blue Cross—

http://www.bizjournals.com/sacramento/news/2012/11/14/uc-anthem-blue-cross-health-care-focus.html

Even more, here is California’s “Let’s get healthy California” program—

http://www.chhs.ca.gov/Pages/HealthCalTaskforce.aspx

The good news is that the currently funded surveillance system at the CDPH, provided a single process for the prevention was practiced on a large scale, could be used to do P.D.C.A. (Plan, DO, Check, Action) rather than focus on penalizing poorly preforming facilities utilizing one of the thousands of indigenous processes responsible for tens of thousands of deaths annually in the state of California!

ps: couple of more happy customers at the tree nursery courtisy U.S. Peace Corps! A friend, many years ago, told me of folklore, "only three things you can do will survive you, write a book, have a kid and plant a tree", pretty cool watching this stuff!

More culture from Africa, you rarely see a kid without a smile, not an Xbox in the place!

http://www.youtube.com/watch?v=3iK82NkybOk

Honorable California Assemblyman Achadjian!

 

January 24, 2013

 

The Honorable California Assemblyman Katcho Achadjian

35th Assembly District

1150 Osos Street #207

Sam Luis Obispo, CA 93401

 

Regarding: January 23, 2013 meeting

                   Advocacy for the Prevention of Healthcare Associated Infections(HAI)

                   in our Veterans Hospitals with Ms. Vicki Janssen, District Director,

                                 35th California Assembly District

 

 

Dear Assemblyman Achadjian,

 

 Please allow me to humbly thank you for all that you do for the great state we live in, I really appreciate it.

 Thank you for the opportunity to present the interest of the advocacy for the prevention of HAI in our Veteran's Hospitals to Ms. Janssen. Due to the complexity of the current healthcare industry concerning the prevention of HAI it has taken a year and a half to get anywhere near a vision of an actionable position.

 The stunning aspect of our meeting was the in-depth appraisal of the evolution of my humble advocacy and a few very detailed talking points that could have only been raised by a professional who has followed every detail of my advocacy for some time.

 My presentation was somewhat challenged, this is the second presentation I have engaged in since the beginning, to leave the meeting with insight and clear direction was far beyond my expectation. Ms. Janssen's offer to collaborate with the Honorable California State Senator Monning's office regarding the prevention of HAI in general was very much appreciated and hopefully will help gain momentum in the Honorable California Governor Brown's "Let's get healthy California" impact on our state.

 From what I have learned there is a bright future in healthcare, my confidence comes from engaging professionals like Ms. Janssen, providing inspiration to continue to advocate for preventing fiscal waste and the tragic and needless harm done by HAI to not only our healthcare system but our Veteran's as well.

 Once again, "thank you"!

 

Respectfully,

 

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

 

                                                                               continued on page 2

 

                                                                                                                                     

                                                                             Page 2    January 24, 2013

 

Honorable Governor Edmond G, Brown Jr,

The Great State of California

 

Honorable California Senator Ed Hernandez

Chair, California Health Committee

 

Honorable California Senator William Monning

 

Diana Dooly,

Secretary,

California Department of Health and Human Services

 

Ron Chapman, MD, MHA

Director,

California Department of Public Health

 

Pam Kehaly,

President,

Anthem Blue Cross

 

Sophie Harnage, RN

Clinical Manager of Infusion Services

Vascular Access Team at Sutter Roseville Medical Center

 

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.”

The picture, judgement day a the tree nursury courtsy U.S. Peace Corps, the grant is in for next years crop and should be a legacy for one really proud U.C.R. grad!

 

Database of Best Practices for the Prevention of Healthcare Associated Infections, "road trip"!

Vicky Janssen                                             January 23, 2013

District Director

Honorable California Assemblyman Achadjian

35th Assembly District

Thank you for your invitation to present my advocacy to prevent Healthcare Associated Infections(HAI) in our Veteran’s Hospital’s interest in the development of some form of "Database of Best Practices for the Prevention of Healthcare Associated Infections" at the California Department of Public Health(CDPH).

The "need", California’s healthcare system is currently expensive and dangerous, HAI is a very large part of the expense and the cause of tens of thousands of serious injuries and deaths in California annually.

The "root cause", currently every healthcare facility in California is responsible to develop their own HAI prevention program and the catastrophic results are clearly stated in the currently funded surveillance system at the California Department of Public Health(CDPH). Due to the thousands of indigenous processes the surveillance system can do little more than identify and penalize poorly performing facilities. Training and turnover without some form of standard process is beyond my comprehension.

The "practical solution", adopt one proven process to be made available to all California healthcare facilities, hosted at the CDPH and covered by the freedom of information act, continually improved due to large scale implementation and feedback from the current surveillance system at the CDPH. The improved efficiencies of the participating healthcare facilities should encourage further participation.

Enclosed you will find a brief description of something close to a "Database of Best Practices for the Prevention of HAI" from the CDPH website, the inclusion of the process to prevent Centerline Associated Bloodstream Infections(CLABSI) that successfully prevented CLABSI for seven years is a significant step further in my opinion and should be the first "best practice" adapted be the State of California.

The inclusion of Anthem Blue Cross’s "Patient Safety First" program demonstrates the effective development and use of standardized processes on a large scale, now the University of California’s Medical system and Anthem Blue Cross have a plan to "collaborate" to further improve healthcare efficiencies and patient safety, "who will have access to these gains"?

The U.S. Department of Health and Human Services is awaiting and sometimes funding "best practices" being developed at the State level, the origin of the term "Best Practice" Funding is also available at the World Health Organization, their opinion "HAI will sooner than latter be the demise of the modern hospital"!

What to do? Could your office please deliver my request to the Honorable Governor Brown and corroborating information to the Honorable State Senator Monning and Honorable Governor Brown? "Let’s get healthy California" is a good start, California is far behind other states concerning the prevention of HAI, to help our Veteran’s, my advocacy will not breach the gates at the V.A. but good science will!

Michael H. Slavinski


The picture, Christmas with a U.S. Peace Corps kid, all hand made and a sory of their own1