WASHINGTON — Attendees at the American Hospital Association's Annual Membership Meeting this week voiced concerns about a wide array of issues.


Here's what some people had to say about three of those issues:

Rural Health

Noting that too many programs affecting rural hospitals depend on Congress authorizing periodic extensions rather than finding permanent fixes, Jennifer Boyer, senior health policy adviser to Sen. Pat Roberts, R-Kan., said, "We need to have a much broader discussion. We don't know what we want from rural health care anymore. What does it mean? How do we maintain it? But every time extenders come up, they become the focus. We don't get to have those deeper conversations."

Responding to critical access hospital CEOs' concerns that the government is considering ways to restrict the program, Nick Bath, health policy adviser to Sen. Tom Harkin, D-Iowa, said, "The future of the CAH program depends on its ability to define itself as a value-based program."

Boyer agreed: "If you are going to convince people in Washington why you are important, you can't just say you're providing access. You have to show that your patients are getting the same quality of care as patients in other areas."

One executive complained, "There's a rural bias at CMS. It's staffed by people who live inside the Beltway and commute to work. They don't get it."

John Supplitt, senior director of the AHA's Section for Small or Rural Hospitals, said rural hospitals might be able to help educate the Beltway crowd. "The Kansas and Nebraska hospital associations host a preceptor program in which staff from HRSA and CMS go out to rural hospitals. They get a real feel for what the issues are." He suggested other state associations might want to consider similar programs.

Diversity in Health Care

In her investiture speech on Sunday, AHA Chair Teri Fontenot expressed pride in the diversity of the association's leadership. Fontenot noted that she's the fifth woman to serve as AHA board chair and then pointed to her colleagues on stage, immediate past chair John Bluford, an African-American, and chair-elect Benjamin Chu, an Asian-American.

In an open forum later, an attendee asked what advice they would give other hospitals and hospital associations to encourage diversity.

Fontenot: "First we look for leaders with the skill sets and the mindsets to get the job done."

Bluford: "We're consistently talking about the need to diversify," both at Truman Medical Centers, where he is CEO, and at the AHA. "We want new views, different views, and we want to reflect the population.

"It's a tough job," Bluford admitted, "but we're determined to find that talent, and where there's not that talent, to create it."

Another attendee swept her hand around the largely baby boom audience and said, "We've got to find out how to get younger people involved in leadership roles in this organization and in our hospitals."

AHA President and CEO Rich Umbdenstock concurred. "We definitely need to connect with our younger members." He noted that the AHA's personal membership groups, representing professions ranging from environmental services to human resources, have 42,000 members and many of them are from Generations X and Y. "We make sure these PMGs provide input into the overall strategic plan of the AHA."

Umbdenstock also pointed to the AHA's Institute for Diversity in Health Management, which sponsors a Summer Enrichment Program for minority graduate students. The goal is to help young people from a variety of backgrounds move up the leadership ladder. Click here to learn more.

Engaging Staff to Transform Care

In a session called "Reducing Costs by Improving Quality and Patient Satisfaction," three hospital executives said building true partnerships with employees is the key to making care better and more efficient.

"You have to show [staff] how any changes we make improve the care we deliver to patients," said Sallye Liner, R.N., chief clinical officer of Novant Health in Winston-Salem, N.C. "That's the goal that motivates them — not that we have to cut $300 million in operating expenses."

Liner said an "authentic relationship with staff" means giving them "a voice and a choice" in process changes.

"Culture trumps everything," said Gary Meyer, CEO of Schneck Medical Center in Seymour, Ind. "You have to build trust, be open and honest. Leaders must be accessible to everyone in the organization. We even share the financials every month."

Nancy M. Schlichting, CEO of Henry Ford Health Care in Detroit, said "partnering and collaboration are a core competency" for her employees. So is innovation. "We build innovation into everything we do" and it's an excellent way to engage and encourage staff. "The most important word in my vocabulary is ‘yes,' " she said.

Nearly every speaker emphasized the need to collect and analyze data, and then to share it with employees. That enables them to measure their progress on specific goals and compare how the organization as a whole, their department and themselves as individual staff members are doing.

"Nobody goes into health care to do bad work," one speaker said. "Physicians, nurses and the rest of our employees take real pride in caring for patients. Data is the tool for improving the care we deliver."

Send your comments to Bill Santamour at bsantamour@healthforum.com