Thursday, May 13, 2004

Highland Consultants Cut Waste and Fat

Cambio did it; they found the fat and waste. They announced their long awaited lay-off list. Cambio’s cut list spared the bloated middle management structure. They concentrated their efforts mostly on laying-off clerks, housekeepers, and patient care providers.

The emergency room will lose all its nursing assistants. I guess we’d rather pay an RN or MD to push a gurney to a broken elevator and wait there to take the patient to their room. It can take up to an hour to get a patient from the emergency department to a room and we’ve just doubled or tripled the salary of the staff that will perform this task. Then I suppose the doctor will come back and clean the equipment for the next patient. But hey, there is an upside with Highland’s highly unreliable elevators it’s probably is safer to have a registered nurse or doctor riding them at all times.

They also hit housekeeping hard-that makes sense, patients often complain that Highland’s just too clean. Maybe it’s that excessive cleanliness that results in so many patients with multi-drug resistant infections. I’m sure the cost of excessive cleaning has driven many businesses into financial ruin. Isn’t that what happened with Enron?

Medical clerks, there’s another huge waste. Why do you need someone on a nursing floor who can decipher physician’s orders or coordinate admissions and discharges. It just takes all the fun out of medicine. Nurses should just guess what the doctor wrote, and since they can’t read the signatures either, just guess who wrote it. As for discharges, well if they go slow enough patients will learn to get themselves home. Admissions, well that should be less of a problem because now that doctors will be doing transport and equipment cleaning we’ll be expecting far fewer admissions.

You just have to give it to those consultants and many of the staff would like to, but you just can’t find them. One was spotted last week scurrying up the backstairs.

8 comments: said...

Are these consultants worth all that money?

boomito said...

Hey, with all the dirt flying around here, I've been wondering why someone hasn't done a blog. Thanks!

As for the layoff list, it seems so sloppily prepared and poorly documented that I think we have to look at it as an initial bargaining position. Remember, G.W. Bush wanted an idiotic $300 Billion tax cut, and he got it by demanding $700 Billion and letting the Dems "negotiate" downward.

We need to pressure the trustees to hold hearings, dept. by dept., to assess the impacts on patient care and demand that cambio and CEO M. Burroughs substantiate the claim that services won't be impacted.

More dirt: Burroughs explained to managers on 5/13 that building new revenue often means investing $$ in improvements and waiting for the investment to pay off. Then he said we don't have time for that, so we mainly have to work on expense reductions. He asked "What is our biggest expense item?" and everyone groaned in unison: "Labor."

Lynne Behr RN said...

Yes,Cambio is brilliant. Who else would be able to convince the intellectual giants (our Board of Trustees) to give them more money when they didn't even fulfill the first part of their contract. I would always trust a group of liars and theives to run my medical center and ensure my patients safety, NOT. Let me clarify for those not familiar with Cambio's less than stellar track record. You know, the stuff they don't post on their website. They have a long track record of asking for more money than was in their original agreement. An example, Columbus Community Hospital, and they were in Chapter 11 bankruptcy. Also, there was that US history making Medicare and Medicaid fraud settlement paid by Cambio's parent company for $840 million dollars. Jim Braily, Cambio's project leader at HGH had a very good response to the BOT's inquiries about these allegations,"it's all a matter of public record".Three cheers and more money for Cambio!!

Anonymous said...

Hey, who says Cambio doesn't have a conscience? They just keep it in the closet behind their sheets. YEE-HA!
Also, some say I may be a coward for not signing my name. But with today's technology maybe they can spend
some of that money they stole from the community and track me down. In closing, some may say I'm a coward
for not signing my name, but in the words of Bob Marley, "He who lives and runs away, lives to fight another day". While running, be mindful of people who's most significant accomplishment is mastering the art of walking upright. Just ask the staff member they backed over. Hey Cambio,my love to Cletis and Bubba! Bring me a squirrel sammich next time y'all are
in town. Peace!

Silverchief said...

Let's face it, ACMC is experiencing the results of at least ten years of CEOs' and financial staff who were totally unqualified to lead the hospital in the 1990s. We are considered the most backward public hospital west of the Rockies. There are some very good health care managers in the public hospital sector who refuse to work for Alameda County. The reason being, ACMC is seen as a throw still thinks it is the 1970's when MediCal patients had no choice but Highland. Now they can be seen at Summitt and Alta Bates.

What do I mean by backward??? We failed ten years ago to move heaven and earth to do whatever was needed to make us the provider of choice for MediCal patients. This meant the new building should have been built nearly fifteen years ago. It also means Dave Kears should have been lobbying in Sacramento to increase the dollars for CMSP coming to this county the minute Gray Davis sat in the governor's chair. Had we made a bigger stink about the uninsured, we too, like Los Angeles could have been given bailout money for uninusured patients for since 1995. A lot of highly paid people have been asleep at the switch for far too long.
We need to clean up our act financially and due to the unqualified CEO's we have had, with the exception of Ken Cohen, there will have to be significant cuts in labor that can be purchased more cheaply by contracting out. It is sad, but the pain will have to be borne.
Granted, Cambio works from a set formula or playbook no matter where they go; however, when it comes to cleaning up billing practices, they are not that bad. The big problem with Cambio is that they do not listen and learn about the client insitution's diffferences from the Cambio playbook.

Silverchief said...

When is Cambio going to start bringing in more money to ACMC. They are doing the easy stuff.....cutting staff. They should be asked to find new sources of revenue for ACMC. They need to see if we can get paid at cost for MediCal patients seen at ACMC the way nearly every other public hospital in an urban area does.
They need to find ways we can cut the cost of care by using new methods proven to reduce unnecessary visits. They need to show us how we can run our clinics more efficiently with fewer staff...not just say cut staff. I want to see those high priced consultants in a clinic improving patient flow patterns. Cutting is easy. Doing the bidding of the Board of Supervisors is easy, leading a bunch of neophytes to public hospital management/financing (BOT) to make short-sighted decisions is easy. Truly making the place more efficient with the financial and patient care outcomes to prove it is really what I want my tax dollars to pay for.

Anonymous said...

Here! Here! Perhaps in the finite wisdom of the current consulting menace, there might be a page in the playbook for oh, I don't know, MARKETING this institution to private insurance companies. AND maybe learning how to actually bill in a 7 day or less turn around time to insure payment of at least a portion of our costs. AND maybe keeping caregivers on staff to actually fulfill the demands of the patients who come here. Oh yeah, perhaps actually looking for qualified executive staff that have real hospital-based management and administrative experience and saavy to lead us beyond the 70's decade.

Anonymous said...

Calling all MEDIA...We MUST get public attention to the REAl problems that have caused Highland hospital to fail. The minute anyone gets close to the truth, another "interm CEO" gets hired and the prior one gets his "hush money" to go away quietly. Is anyone able to look any deeeper than laying off staff as a viable means to keep the hospital afloat? ....more on this later...shhhhhhhhhhh