What are the reasons that people seek care at a certain hospital? Where their physician practices, where they have been before, what type of insurance they have, and what type of medical condition are factors that are a part of that decision. However, to really earn the trust and support of a patient and their family, it does boil down to how they are cared for during their interactions with the hospital. How they are acknowledged, how we introduce ourselves, how we explain how long things will take and what we are doing, and then thanking them when we are done go a long way towards making our patients and their families feel like we truly care. We know this practice as AIDET. The patient and their family call it caring. It is the one thing that we at VMH must always strive to excel at. It is a set of actions that help set us apart from other facilities our patients could choose to get their care from.

VMH operates in a relatively small market. Each patient is important to us, and being able to get the care they need close to home is important to them. While we have done well in the Press Ganey survey area, it has also pointed out some areas that we can improve on. It is important that we look at those areas and work on them.

Each and every day I see people demonstrating the principles of AIDET. From thanking the patients to explaining to them what is happening to them. From the bedside to the various clinical areas, you have all taken the time to make sure the people we serve feel cared for.

Thank you for your efforts in this regard. You can go anywhere to be treated. You all help make this a place they feel cared for.

How ironic is it that Congress finally did something about the budget by once again being unable to do anything? While still failing to see that the emperor has no clothes, there has finally been meaningful progress towards addressing the $16.5 trillion deficit. To those in office who say there is no spending problem it must be asked how we have then ended up owning so much money? It has always seemed to me that if cannot afford something, you either don’t buy it, or you look to reduce the expense of what you are spending money on.

Looking at our recently completed budget process, we allocated money towards those things of which we can afford to sustain, and that provide the greatest benefit to those we serve. Yes it might be nice to have the latest of everything in terms of technology, and to have an unlimited supply of people to call upon to work. However, given that VMH lives on what it makes we cannot do that. Sometimes tough decisions are made as to where the money is spent. We allocate the money in a fashion that rewards growth and quality so that we can continue to expand those things. Areas that struggle or would not support growth or care for our patients are not given more money, but looked at to see how they can become more productive or to shut down. After awhile you find that the productive areas stay productive, and end up being the only programs left. Perhaps the members of Congress should come and learn how things are done here.

Well the ads are done, the numerous calls are done, and so is the election. For some it is a time of relief that their candidates won, and for others a time to regroup because theirs didn’t. Now begins the time where all those who ran on promises will be in the spotlight. In every campaign, there are promises made, and promises broken. This election showed no easing of the partisanship that has paralyzed decision making at the Federal level, as the campaign rhetoric and advertisements continued the fighting from the halls of capitol buildings into the homes of all Americans.

Now the talk is over and action is needed. The last four years have seen increasing national debt at a rate never seen before. It has seen fights on everything from health care to taxation, and now we sit at a point where some agreement is needed to address these issues. There is no hiding from them as we are poised as a nation to officially spend more than we make in just a little over 10 years. A nation that once drove the world’s economy is facing living check to check in just a few more years.

No more infantile displays of “getting along” as with the last State of the Union address. No one cares who sits with who, but they do care about who works with who to get things done. Getting things done to fix the deficit spending while still making sure that we can defend, care for, educate, and feed our country is what is needed. Now we need those who have been elected by a majority of the registered voters to do their jobs.

As a nation we will watch these people as they tackle the issue of Medicare, Medicaid, and Social Security which in the not too distant future will account for over 50% of the nation’s budgetary expense. Combine that with the fact that 10,000 people per day are turning 65 for the next 19 years, and it is not hard to see the scope of the problem. The question becomes what are the elected officials willing to do, and what are the people who elected them willing to take.

There is no more kicking the proverbial can forward to fix things in the short term. The meter is running and the tab will get no cheaper. In health care we await to see what can be done as more and more people join the Medicare era, and the ACA proposes to put more people on Medicaid. For those who want the government to not be in the health insurance business, let them explain that to the Medicare and Medicaid beneficiaries.

The health care industry is ready to be at the table for discussions on how to assist in reducing the increase in health care spending, but there needs to be receptive people to work with. The issues will not go away, they cannot be passed on to future generations, and the people of this nation should not let that happen. Those campaign slogans of making a difference or moving forward need to have action associated with them. The nation awaits your actions.

There are some alarming numbers coming out of Washington this year. Many of them point to the rising cost of healthcare in the United States. Right around the year 2020, Medicare, Medicaid, and Social Security will make up all Federal spending.  This coincides with the current trends of the United States on a course to spend as much as it makes during that same time period. There will be hard choices, and hard decisions for all of us to make going forward.

Already there is a move to promote wellness and focus on outcomes that are positive rather than paying for the treatment of disease only.There are penalties for readmissions, lower quality, and lower patient satisfaction being proposed. This is a decided change from the way payment has been done in the past. It was based on doing more tests, keeping people in the hospital, and focused more on disease care rather than health care.

VMH has started preparing for these changes. Partnering with other community services to look how we can together improve and enhance the health of people of all ages, getting out and testing for higher blood pressure, higher blood sugars, that can lead to chronic illnesses later in life. You can see it in our workforce where we are encouraging healthier behaviors by changing what we offer in our dining room, participating in Live Healthy Iowa programs, and wellness testing.

Changes in how we eat, exercise, and care for ourselves does not  come over night, but we are becoming part of a team that can help all of us achieve a healthier lifestyle that allows us to remain active and productive for many years.

While there are many challenges as we look to the future, it is exciting to think of what we can accomplish as we work together to enhance the lives of the people we serve.

As the election heads down the final stretch, it is almost a full time job figuring out all of the claims and counter claims by the people running for office. Romney now says he would not repeal all parts of “Obamacare”. Of course, this is on the heels of him trying to defend his version of the very same thing that he implemented when governor of Massachusetts. What is interesting, and perhaps a little sad is that do any of the words by any of the candidates mean anything? Apparently what you are for or against depends on what the latest polls say rather than what they truly believe. In the rush to dismantle the Accountable Care Act (Obamacare) there are have been no viable alternatives proposed. It should not be acceptable to return to the days of non coverage for preexisting conditions, not paying for wellness exams, or young adults struggling to have health coverage. Those things should be areas of concern heading into the election. So while Obama attempts to steer away from a dismal economic record, and Romney attempts to steer towards whatever subject might earn him votes, do not let either of them steer the voters away from the basic concepts of fair and decent health care coverage.