The Best Hospital in America
In a few weeks Advance for
Respiratory Care Practitioners, the magazine that I started off with in 1988,
will be celebrating its 20th year. This made me think back to the
times in my life when I was a caregiver and the many different places I worked,
including:
- Mary
Lanning Memorial Hospital, Hastings, NE
- Kirksville
Osteopathic Hospital, Kirskville, MO
- St.
Mary's Hospital, West Palm Beach, FL
- Blessing
Hospital, Quincy, IL
- Mt.
Sinai Hospital, Hartford, CT
- St.
Charles Hospital, Oregon, OH; and
- Vencor
Hospital, St. Louis, MO
While I learned many things (both good and bad) at many of
these places, two of them are special because they were the places that formed
the core of my beliefs about what is both good and bad in the health care
professions.
St. Mary's Hospital in West Palm Beach, Florida, was located
minutes away from Riviera Beach, a popular spot for tourists and a place where
thousands of "snow birds" sought respite from the cold climate up north.
The hospital was a 350 bed facility and it was run by a religious order that
cared a great deal about meeting its calling to provide care for the suffering
and disenfranchised.
It was there, as a therapist, that I practiced my very best
respiratory care as a clinician. I worked with neonates, attended deliveries,
went on transports, worked in the emergency room, and hung out for long
stretches in the ICU and CCU. At one time a fellow therapist, a lovely young
lady named Victoria Parks, taught me that it was easy to make iced tea in a
graduated cylinder, and we frequently walked through the ICU drinking our tea
from the same type of receptacles that nurses emptied their Foley bags
into.
We made sure never to leave one in a patient's room,
however. We were probably too cute for our own good, but even today that memory
makes me smile. But it wasn't all fun and games: Vickie and I worked a lot of
18 hour days in that ICU, and did a lot of good with a lot of people. St.
Marys' was the place that made me proud to be a therapist, and I wept like a
child when the day came to move on.
Blessing Hospital, in Quincy Illinois, was the hospital I
went to after St. Marys, and it was where I learned to be a manager. I had
expert tutelage from Harry Wolin, my vice president, and eager assistance from
my second-in-command, Rebecca Bean. What made Blessing such a great place to
work (other than the two people just mentioned) was its focus on what was good
for the patient - not just in terms of medicine. If you wanted to raise the
cost for a procedure, you had to justify it, and it had to be approved by a
board committee before being implemented.
The board at the hospital constantly sought to keep health
care costs down - a far cry from what many boards do today. Blessing was the
best hospital I ever worked for, and probably at that time the best hospital in
America. It owed that to a man named Larry Swearingen, who was the CEO and who
ran the organization like it was personal to him. It was never just a job to
Larry. He cared, and everyone who worked for him knew it.
So here's the legal angle to all of this. Great
organizations, that are well managed and encourage the best in performance from
their clinicians and staff, these are the facilities that are rarely sued, and
even more rarely, will a jury render a verdict against them. This is because
juries like people who try to do their best for the patient, even if they might
accidentally make an error now and then. I always say the best insurance policy
is a good patient relationship, and Blessing proved that over and over
again.
On the plaintiff side of the aisle we say that unless the
jury likes your client, they won't help your client. The same is true on the
other side. If the jury doesn't dislike the defendant, they are less apt to
make a finding against them. When an organization cultivates a culture of
excellence like St. Mary's, or a culture of community trust, like Blessing, the
payoff is never visible in the balance sheet as a separate line item. But it is
very much visible in the bottom line.