Wednesday, August 30, 2006

The Ann Plan

The strategic planning process has begun. This earthquake retrofitting stuff necessitates a new hospital building, so the turf building, fundraising and brainstorming has begun in earnest. The last real CEO we had, Ken Cohen planned heavily, in fact the executive team and the docs retreated deeply into the planning process, they weren’t seen for months. I guess strategy necessitates a secretiveness and withdrawal from the day to day, too many cooks in the kitchen and that sort of thing.

Anyway there’s a poverty of information and no means for working people to watch or participate in the strategic planning process, no union representatives or union members are invited allowed to attend. It’s sort of a Wizard of Oz situation. Since mums the word on the actual strategic plan, and I have to write about something, let me lay out “Ann’s Plan”.

Here’s the deal, a bigger hospital is better. Why ? Well the emergency room backs up onto the streets of Oakland and the numbers of uninsured show no signs of decreasing. Population’s up, car wrecks are up, average age is up, violence is up and last year’s flu season overfilled all the local hospitals. So even ignoring any natural disasters and outbreaks, we need the beds.

More importantly Highland’s currently too small and too resource starved to do the job right. We get the sickest of the sick and we keep them alive and get them going but that’s a far cry from comprehensive management of chronic illness and disability in the poor, and the elderly. What about cancer, TB, diseases of poverty and desperation? We can’t track cancer, we can’t support caregivers and families living with chronic illness, we provide care one crisis at a time. We have to get people out the door as quick as possible because of the long lines of sick people waiting in the Emergency Room.

Without hospital beds we can’t do the elective surgeries and procedures which increase patient’s function and health and ultimately decrease healthcare cost. The County Supes whine and moan about us spending money on chemotherapy, ventilators and cardiac drugs-the outrageous cost of healthcare. They never talk about the flip side: the cost of not providing healthcare; under medicated paranoid homeless people cost my community two small businesses and lots of people sadness and grief. How about angry juveniles who have no skills, no income and no parents because they lost their primary caregiver to a treatable illness? We have thousands of people who cannot function and the pull of their dependence, disease and pain affects us all. See, we’re dealing with the cost of not caring everyday in Oakland and it’s costing us more than the decent healthcare would.

Politicians babble about the breakdown of the family. Yo, bozos how about the breakdown of the public services which support families, there’s a problem you can fix.

I say let’s do it right, build a 200-bed hospital with subacute and skilled nursing beds in it. Take the speech therapists, physical therapists, occupational therapists, and rehabilitation staff from the Fairmont Hospital and use them to optimize function and independence in all patients before discharge. Make the mission of the hospital to make all patients and families independent and functional. If we become the place medical problems can be heard and addressed we can start to fix our county’s disintegrated social services. You cannot cure people without caring for them and we should build a hospital that let’s us do just that.


Anonymous said...


There was a published document regarding the strategic plan for rebuilding the site when Ken Cohen was in charge of the process. Union, physician and staff representatives participated in the planning. So did PwC. It should be available at the Medical Center. The rebuilding included expanded bed capacity, not smaller. This was NOT a secret process and there were many who participated, including union representation from 616 and 250.

Anonymous said...

The plan to rebuild ACMC is a typical Dave Kears/Alameda County hijacking. These same people are the ones who put new clinics on the top floors of expensive hospital space, failed to rebuild the inpatient beds and ICU, and now want to build a smaller hospital. This is the Dave Kears model: treat and transfer. Problem is: not enough beds in the private sector, jamming the Highland ED, and it costs more. This is a job for professionals but they (county) won't listen. Why should they, no seems to be able to hold them accountable for their actions (Cambio, round table CEO/Boards)

Anonymous said...

If anyone can dig a bit, I understand that the consultants that Dave Kears recently (last three years) hired to perform ACMC and Highland rebuild planning studies also recommended building more beds and that they disagree with the County position. Someone should ask for a copy of their work.