Hamlet from RC Bugolobi, Uganda
Gus Searcy, Identity Theft and Facta Laws
All Officers and Committee Chairs must attend
THE UCLA HOSPITAL SYSTEM, at WVRC on May 14th
LEO TSENG came forward to lead the Pledge. Before that began, he reminded us that he, unlike most of us, was not born an American citizen. He chose that, and it gives him great pride to lead this salute. Thank You, LEO those are thoughts we all should cherish. ED GAULD gave the Invocation: “Loving Father, Some of your people are hurting. They have problems that are very hard to solve. Many are sad; many are poor; many are rich, but sad inside and poor. And many don’t have a single friend. Please help all of these people, Father, and show us how we can share your love with them.” ED, as usual and expected, Well Done! And then, who else but LENNY came forward to lead us in America a rousing success, of course.
PP STEVE DAY continued his delivery of new Paul Harris pins, reminding us that he has the exact amount that you need to move up a notch. It turns out that PP PETER MORE, for a mere $28.00, can achieve a multiple jeweled Paul Harris, for example. President SEAN then asked how many in the club were over 75 years old? Several hands went up - mine included and he then announced that we had a member who is celebrating his seventy fifth WEDDING ANNIVERSARY! That had to be HENRY TSENG and ANNIE, and next week he may be nicked for a fine.
We had no Visiting Rotarians, but there were guests. SUNNY was with LENNY, and Special Guest Andrew Kim was introduced by PP STEVE SCHERER. WARREN DODSON brought PAT, and JOHN HEIDT again introduced his Special Guest, Madison Goritsan. And in support of our Speaker today, Ian Jipp was present and reminded us all that he conducts personal tours of the Ronald Reagan Medical Center. (This is a sharp guy when I spoke to him after the meeting, he said, “Oh, yes, I remember you from the Tour last year!”) Somewhere in here the Head Table was introduced, but I missed their pronouncements. I will blame this on the no-fine policy after all, if what they say is free, it can’t be worth much…
Under the title, Mexican Oysters, MARK BLOCK provided the following Inspirational Moment: A big Texan stopped at a local restaurant following a day roaming around in Mexico. While sipping his tequila, he noticed a sizzling, scrumptious-looking platter being served at the next table. Not only did it look good, the smell was wonderful. He asked the waiter, “What is that you just served?” The waiter replied, “Ah, Senor, you have excellent taste! Those are called Cojones de Toro, bull’s testicles from the bull fight this morning. A delicacy!” The cowboy said, “What the heck bring me an order.” The waiter replied, “I am so sorry Senor. There is only one serving per day because there is only one bull fight each morning. If you come early and place your order, we will be sure to save you this delicacy.” The next morning, the cowboy returned, placed his order, and that evening was served the one and only special delicacy of the day. After a few bites, inspecting his platter, he called to the waiter and said, “These are delicious, but they are much, much smaller than the ones I saw you serve yesterday.” The waiter shrugged his shoulders and replied, “Si. Senor. Sometimes the bull wins.”
We had THREE Irish dates to remember! On today’s same 14th of May, but in 1755, George Barrington was born in Maynooth, County Kildare. He was famous as a well-dressed pickpocket who ‘Worked’ in churches and the Houses of Parliament, but was arrested and transported to Australia. Later, he became Australian high constable, and is famed for the following quote, “True patriots all; for be it understood We left our country for our country’s good”. And on that same day in 1893, George “McIrish” McElroy was born (three years before my Dad) in Donnybrook, County Dublin. Serving as an infantryman in WWI, he was gassed and brought home. However, flight training came along, and he ended up as Ireland’s highest Ace, with 47 victories within 40 weeks. Gadzooks, think what he could have accomplished with a little more training! But I digress. Harking back to this same May 14th, in 1923 William Butler Yeats received the Nobel Prize for Literature. He was born in Dublin in 1865 and spent his childhood in County Sligo, where his parents were raised. His work after 1910 was strongly influenced by Ezra Pound. Yeats was one of the founders of the famous Abbey Theatre *(National Theatre of Ireland) in Dublin.
PEGGY BLOOMFIELD introduced our Speaker, Dr. David Feinberg, who is the Ronald Reagan UCLA Hospitals CEO and Associate Vice-Chancellor. Dr. Feinberg graduated cum laude in economics from UC Berkeley, then with distinction from the Chicago Medical School. Along the way he earned an MBA from Pepperdine, and he is triple board certified in the specialties of child and adolescent psychiatry, adult psychiatry and addiction psychiatry. He is a professor of clinical psychiatry in the David Geffen School of Medicine at UCLA. Prior to his present post, he was the medical director of the Resnick Neuropsychiatric Hospital at UCLA.
Dr. Feinberg began with an overview of the UCLA Health System. The includes all the hospitals owned by UCLA 3 miles west is the Santa Monica UCLA Medical Center and Orthopedic Hospital, which joined UCLA after the 1994 quake. The I.M. Pei designed Ronald Reagan UCLA Medical Center, which includes the Resnick Neuropsychiatric Hospital and the Mattell Children’s Hospital is at UCLA. Many pediatric specialties are in Santa Monica. There are about 2,000 physicians on staff, 200 of whom are listed among the best doctors in the U.S. . Their outpatient facilities receive an average of five patients a day by helicopter, and UCLA is the number one organ transplant hospital in the U.S. They expect to do their first brain transplant within the next two months. Ronald Reagan has 800 beds, all single rooms, and treats about 45,000 patients annually. They are ranked number three among 6,000 hospitals in the U.S, which is based on expected mortality. Among their firsts is the first diagnosis of AIDS, inventing the Pet Scan, and originating Reception, the foremost treatment for breast cancer.
All these facts are important, but to Dr. Feinberg the critical question is how you are treated while at the hospital. Until recently, he feels they had lost their way in emphasizing patient-centered care. Of the top five Johns Hopkins, Mayo Clinic, Cleveland Clinic, Mass. General and UCLA, we are the only NEW facility. We only opened in 1955. Historically, the NPR has about 40% involuntary patients that is, those who are either homicidal, or suicidal. He is proud of the fact that 90% of all NPR patients would refer UCLA to a friend when they were discharged.
When Dr. Feinberg assumed control of the entire operation, he began spending much of his time roaming the halls, and knocking on patient doors. He introduced himself, and then asked, “How is your care here?” He heard many wonderful things for example, literally taking a liver and giving it to two children, thus saving their lives. He also heard that the food was never hot, nobody introduced themselves, the room was not kept clean, care was disjointed, air conditioners didn’t work. In spite of performing miracles, two years ago patients would not refer UCLA to a friend. As he walked the halls at both UCLA and Santa Monica, he found the patients were from every nearby community but NOT from Beverly Hills, Brentwood, Westwood, Malibu or Santa Monica. The reason is they were going to St. Johns or Cedars, because there the care was considered to be more patient-centered. Again, when patients were asked if they would refer UCLA to a friend, and where we rated on a 1 to 10 scale, we came out at the 35th percentile!
It didn’t make sense to Dr. Feinberg that we were rated #3 nationally, but had all these strikes listed. When he was the CEO of the Resnick NPR Hospital, they had a 90% rating, and yet they had elevators that didn’t work, air conditioners that were inoperative, rooms that weren’t always clean, etc. So he gathered his entire management staff and challenged them to get out and talk to patients. They contended that they didn’t have time, and he drew on his MBA training, in which there is an emphasis on knowing your customers. You will find, he said, that the customers will tell you what’s wrong. Out of their staff of 7,500, there are 2,000 doctors, 1,000 volunteers, and 1,500 Residents. He suspects that about a third of the people he was talking to thought he was crazy why did they hire a psychiatrist to do this job? A second third were on the fence, and the last third came to him, saying this is why we went into health care, and we’re happy to be part of your team.
One of the biggest problems was the ER at UCLA, with a 12% approval rating. The staff at Santa Monica, which had a 25% approval, said they wanted to take over the ER at UCLA. He called them together, said you can go ahead and if you aren’t up to at least 75% soon, you are both out of a job. One immediate change was to direct trauma patients to immediate care, with less serious problems waiting in line if necessary. Upon study, they learned that 4/5ths of ER patients don’t need a room they can be treated and released. So even before the move to the new facility at UCLA, they hit 99% in patient satisfaction! Overall, UCLA came up to 75% and Santa Monica rose to 87%, so the new systems were working.
Before these changes, all meeting started with the financial report. This was entirely changed, so meeting started with each participant required to tell a patient story - leading to some wonderfully instructive moments. Before, this, Dr. Feinberg learned that most staff would not bring their own family to UCLA. This had to change, and it has. They are now the only hospital in California that has every staff member in uniform. On average, nineteen people come into your room every hour so this helps to identify who is who, which means you soon know who to ask for what kind of service. When patients arrive, no matter what time of day, they are greeted by name. They now have a personnel interview system that focuses on determining if applicants are serviceminded. As a result of this 2 to 3 hour interview, they have found that almost 50% of those that might otherwise have hired do not meet their service standard. As a result, staff turnover is remarkably low there is a nursing shortage in California, but at UCLA there is a waiting list for nurses jobs. Thus creating a standard that emphasizes service has reduced their staff turnover.
On June 29th, 2008, a Sunday, all patients at the old medical center were moved to the new facility. This was five years in planning, and cost millions of dollars, but it went off perfectly. They started at 0500, used thirty ambulances, and completed the move two hours ahead of schedule! Within three hours of moving into the new hospital, they delivered their first baby, did their first liver transplant, took out a kidney, and an appendix. Since then, the UCLA hospital has achieved a 96% approval rating from an independent evaluating firm, and several departments are at 99%! Our lowest unit functions at the 88% compared to other hospitals across the country. Cedars and St. Johns, as comparison, run around the 65% level.
What are our problems? They have perhaps underbuilt the new hospital. The usual average is 85% occupancy, and they first aimed at 90%. Yet in the last four months, we have operated at just OVER 100%! This includes about a dozen patients who are in the ER overnight (I was one of those, in October 2008 but the fish entrée made up for everything!), another dozen in a holding area, not really designed for overnight occupancy but people do want to come! Where possible, they are moving facilities from UCLA to Santa Monica to eliminate this overcrowding.
Eventually, a new NPR structure will be built, the patients today occupying the entire fourth floor at Ronald Reagan. NPR as such is a cheaper structure to build than a regular hospital, since they do not need the labs and operating rooms for their patients. The Santa Monica facility is about 1/3 completed, and is expected to be fully operational in another year and a half. Currently they turn away about fifty requests for rooms every week, so new facilities are in real demand.
Dr David Feinberg, you have shown us why you are so enthusiastic about the UCLA Health System. We thank you.
But we must not forget those closing words of wisdom:
A clear conscience is usually the sign of a bad memory, OR
Love may be blind but marriage is a real eye-opener.