Challenge of the Week: Go Carbon Neutral

The husband and I are in Ashtabula, Ohio this weekend for his baby sister's wedding (Congrats Nicole and Allen!).

The weather is beautiful and crisp, the people warm and friendly, the wedding party is excited, the bride relaxed and the groom only slightly jittery, and the rest of the day should go smoothly.

In the past 4 days, however, just my husband and I (in our relatively fuel-efficient late model Accord) have driven over 9 hours (approx. 1000+ miles).

On Monday I'll purchase a TerraPass to offset our trip (I've written about them before, but also check out this month's issue of INC. Magazine)...

I'll also be purchasing one to offset the flight to Amsterdam in January (and yep Carolyn, I will indeed continue blogging from the Netherlands).

Enviro-consciousness is increasingly a factor in business operations in other sectors (and some healthcare facilities are being LEED certified by the US Green Building Council) - but how far is the hospital industry going? And are we going there fast enough?

So here's the question of the week (and a nifty project for your Decision Support team): What would it take for your hospital (or place of work) to go carbon-neutral?

(Note: It will probably take longer to get a good estimate of your facility's carbon footprint than to purchase the credits to offset it, but firms like Terrapass can also help you calculate this figure).

And how would you communicate your carbon-neutral goal to staff, community members, and other stakeholders? How would you 'sell' the competitive advantage to your exec. staff and Board?

Consider also the tsunami effect; even when your facility achieves carbon neutrality, what time/effort/money would it take to push the initiative out through your web of suppliers?

How much would the hospital have to pay if it offered 'carbon neutrality' as a benefit to every employee as part of the standard HR package (along with PTO, retirement benefits, etc).

What sort of incentives could the hospital offer suppliers (medical equipment, food services, environmental/custodial, etc.) who agree to go carbon-neutral, or at least cover the carbon footprint of sales trips/delivery to your hospital?

An annual eco-awards program would be an interesting next-step as you develop enviro-conscious best practices for your facility.

PS ...

A few more things about my upcoming hop across the pond:

• That's an imaginary internship at BIDMC (for now). Paul, call me...:)
  

• The big Nederland move will happen in January 08.

• If anyone is curious about the healthcare industry over there get in touch via email or the comments section.

Netherlands in the News: Rotterdam Here I Come...

There are times in life when you finally, FINALLY seem to be chugging merrily along, right on track with the goals you've set.

But just as you're patting yourself on the back for steering so brilliantly, God throws you one hell of a curveball.

Here I am, happily cozied up in DC with a rewarding job, challenging volunteer service for several nonprofits and Boards, plenty of interesting schmoozy-type events to go to, and damned if I didn't just find a really great Italian place.

Whammo...husband's contractor secures wonderful new positions in....drumroll please...The Netherlands.

And seriously - I've just finished the oh-so-fun application for an MHSA grad program at a great school, and have been happily daydreaming about my future internship with Paul Levy at BIDMC.

But let's squeeze this challenge until we can wring out a new opportunity...Perhaps I can finagle a joint independent design program with a Master's at Erasmus U, which has an Institute of Health Policy and Management?

Other than the amazingly thrilling opportunity to reinvent my professional self halfway across the globe in two short months, the move will have additional perks.

First - Husband's company is taking care of us...why didn't I go civil service or govt again? Somebody remind me?!

Second - Even when the major deity is throwing me a wicked curve she gives it a nice easy twist at the end.

Low and behold...turns out the Netherlands are a hot spot for healthcare modeling.

HHS Secretary Mike Leavitt is visiting The Hague after a stop in Switzerland early next month.

Check out this piece in today's New York Times, with an interesting introduction to the subject:

The Netherlands are being used as yardstick because the country has "solved two basic problems: moving from an employer-based system to one in which individuals buy their own insurance and subsidizing care for the poor" (W. David Helms, President - AcademyHealth, NYT).

Now, I can choose to be flummoxed by this astounding change of circumstance, or I can choose to be proactive and productive (aka I'll soak up everything I can about gezondheidszorg systeem van Nederland while we're there).

Hmmm....reactive, proactive, reactive, proactive...

That's an easy choice: Carpe diem.

Plus, I hear they have great tulips.

Best Practices: Best Buy Mgmt/Corp. Employees Work Anywhere

If you want to find really innovative best practices, it's often best to venture outside your own backyard.

You can pull plenty from other industries (witness the rise of "Disney" hospital programs and "lean" consultants who palm off kaizen platitudes).

The hot electronics retailer has established a ROWE - Results Only Work Environment - reports workforce.com.

Some staff (the firm is trying to figure out how to make this work with shift salespeople) can set their own hours. Even meetings are virtual.

For Best Buy, it's no longer about the rigorous, repeatable schedule - it's about what gets done.

Is counting the minutes of collective 'company time' as important as what we do for the company?

If the answer is no, doesn't it make sense we can work anywhere as long as we turn in a top-notch performance?

From the slant of my comment (and the fact that I successfully telecommuted and kept a virtual office for over a year) you can probably tell where I stand...but what do you think?

Is a results-only policy idealistic, realistic, or a little bit of both?

Of course, size and organizational complexity will greatly influence whether or not some employees can work offsite...if you have a large corporate HQ these staffers can more realistically work from anywhere than if you're a small community acute care facility with a relatively flat exec team.

But the question is still worth asking: could a similar strategy work in the hospital/healthcare setting?

Not yet - we're so behind the tech revolution that we'd be hard pressed to operate in a virtual world without physical constraints.

Even if hospitals were interested in transitioning to some part time/hourly telecommuters or 'consultant' positions, how would they start?

The good news is that there's a logical genesis...with a total transition to EMRs/EHRs, your Medical Records, coders, billers, etc. could all work from anywhere as long as connections were secured and files backed up using an outsourced provider like Carbonite (or back up files using onsite servicers, wherever they're hosted).

Challenge of the week: If you had to put a plan to move 10 percent of your workforce to telecommuting in the next annual plan, how would you do it? Bonus points if you can figure out how to move 25% ...

Hospital Administrators: Required Reading

McKinsey offers great newsletters with juicy content at a great price (who can beat gratis?).

If you're not already signed up (or if everyone in Decision Support isn't peeling through this weekly source for nuggets of wisdom), sign up here.


This innovative management piece by Gary Hammell and Lowell Bryan is a MUST read.

Without a doubt, it's the best coverage on today's innovation challenges (and how to actually prioritize, plan, test, retest, and roll out) I've seen.

Read the article and then examine how your organization is harnessing the wisdom of crowds by tapping into invididual, non-exec talent.

Hint: If the answer is "I don't know," you'll need more help than this article...

When I was an analyst/consultant for a startup think tank, in our early stages we were all 'home' based telecommuters who communicated via email and Instant Messenger.

IM allowed for the instantaneous sharing of ideas, the speed of our 'conversations' and decision-making time-limited only by how fast we could type.

Did we waste time chatting? Sure - just like we sometimes do in the office environs. Did we save time bouncing ideas off each other? Of course.

We saved so much time, in fact, that analysts were able to do things like complete 40 page best practice studies in 3 days....imagine the revenue per employee in that firm.

One metric I used to track performance informally was whether each employee made back their salary each year, failed to generate their own paychecks, or blew the payscale out of the water with the funds they brought in (either via research that gained us new members or selling the concept of our services to new members).

If you had to break revenues generated per employee, how would you do it? Is it an impossible task in our market?

Patient Perspective: What I Want to Wear in the Hospital...

Click here to read about snuggly, single-use Bair Paws gowns...mmmm!

No more alienating my nurses by requesting 50 layers of heated blankets fresh from the warmer...for those of you who've been under general anesthesia you know there's almost nothing worse than waking up feeling like you've emerged from surgery in the middle of the next Ice Age.

From the press release on eMediaWire.com (and if you're not using eMediaWire, well, what's your excuse?):

"Using a handheld controller, patients can adjust the temperature either warmer or cooler, depending on their personal preference.

Just the fact that we prewarm every patient ensures the speediest recovery we can give them,” said Leslie Decker, O.R. Supervisor at the Surgery Center on Soncy in Amarillo, Texas.

“They’ve been prewarmed with the Bair Paws System in pre-op and we keep them warm during the surgical procedure with it.

With its clinical capabilities, the Bair Paws warming unit offers prewarming benefits before surgery and can also be used for comfort warming in both pre- and post-op settings. In addition, the gown is fully compatible with Arizant’s Bair Hugger warming units for the demanding clinical needs of the OR and recovery."

If parent company Arizant Healthcare Inc. is publicly traded I'll be looking into buying more than their blankets...

Career Changers: Consider Home Health...

According to Forbes, the future of students interested in home health looks bright. The question is - how do we get students interested in home health?

Click here to read the article.

The Bureau of Labor Services estimates 350,000 additional positions (a 56 percent increase) in the sector by 2014.

For those of us who abhor being stuck in a cube at a 9-5 job, the relative freedom and variability of a home health position offers an economically viable alternative to desk-jockey-land.

It's also a good transition point for mid-career jumpers joining the medical field and pursuing advanced degrees in medicine/nursing/healthcare administration...flexible schedules provide the chance to gain industry experience and earn a paycheck while still in school.


In the home health field, time spent with each patient may well be more than new graduates would gain in a hospital setting. Additional interaction time can help increase confidence levels prior to joining a fast-moving, highly stressful acute care team.

The aging active boomer population, with increasing consumer purchasing power, may see home health as a more desirable choice than extended hospital care after surgical procedures.

The growth of personal concierge type services is a trend crossing sector lines into healthcare - personal doc agencies who make house or office calls operate on the fringes of a consumer-driven movement.

We want our healthcare, like other services, to be accessible to us wherever and whenever we desire.

Although many hospital systems have home health agencies, these organizations face the same succession planning challenges as larger systems - and it may be even more difficult to recruit home health aides and nurses, as well as administrators willing to take on the logistical challenges involved in running such a group.

Anyone need a job?