Sunday, July 30, 2017

A New Alchemy in Healthcare; A Periodic Table for Healthcare Delivery ©

Chemistry and action;
Second law of thermal dynamics, Law of Entropy
Order to chaos

Complexity builds with discovery
Discovery in this sense meaning a new and perhaps unrecognized requirement or variable that when understood and applied creates conditions necessary for a positive outcome be it clinically, experientially, regulatory or financially.
Healthcare delivery in the aggregate has historically dealt with ever increasing complexity in a variety of ways in the search for  “goldilocks” conditions, not hot not cold, just right.

One can posit that every healthcare “discovery” created essential elements or necessary conditions which described those factors, there interdependencies and relationships; a periodic table for Healthcare. Lets check out the elements;

1) Co
Positive clinical outcomes, starting with “first do no harm” is the key element in the healthcare periodic table. This is the element to which all others must “interrelate” and without it, no other sustainable structure can be created. It incorporates; safety, human factors and high reliability
2) Pe
Patient Experience
            Patient > and = Customer

3) Fp
Financial Performance
            Positive margins

4) Ee
Employee Engagement
            A staff that derives meaning from there work and translates that into the             patient experience

5) G
            Ease of access,
            a sub element; maturity as an organization

6) Msh
Market Share
            A strategic approach to serving more

7) Ca
Competitive Advantage
            Differentiated “destination” programs

8) Ca2
Clinical Alignment
            Medical Staff, & Clinical Enterprise, strategically and economically

9) Pm
Payor Mix
            An understanding of the delicate balance of this “catabolic” element in your             market is essential

10) L
            If you can choose it you can influence G, Msh & Pm

11) R
            Essential component of Ca not found in most cases without AcM

12) GL
Governance & Leadership
            The wrong group of alchemist can turn lead to gold or gold to ash

13) AcM
Academic Medical Center
            A critical component for many of the elemental structures noted if you are             fortunate enough to have it as part of your Periodic Table

If the elements come together in just the right order you may have those
Goldilocks Conditions previously noted:
Integrated healthcare delivery platform
Safe, positive clinical outcomes
Clinical staff; quality providers
Academics, medical school, research & pipeline of clinicians
Market relevancy
Differentiated services & indispensability
Aligned clinicians & clinical enterprise
No silos, synergy throughout
Low cost structure, low debt, low age of plant, net assets &reserves
Positive margins

Richard Gannotta NP, DHA, FACHE

Sunday, July 23, 2017

Healthcare 2018 early predictions & areas to watch

My thoughts on a few areas of keen interest for 2018 and beyond. 
Patient care, healthcare policy, delivery, technology and economics sure to be impacted by these examples with more to come…

1) Medication & Pharma
I am still a believer that genetic, genomic and nanotech will have a tremendous influence on health and disease in the future, right now watch;
           PCSK9 Inhibitors, a very promising class of cholesterol lowering drugs

2) Augmented Reality for Healthcare
The applications in healthcare delivery are endless, the tech companies that are exploring this arena  are absolutely worth looking into.
For a better idea of what I am referring to, click on the University of Maryland site below, a “glimpse of things literally right around the corner;

3) Artificial Intelligence
From Google to Watson the future of healthcare delivery is being changed by AI. Nothing more to say…

4) In home care (not to be confused with home healthcare)
Care in the home,  from what historically would be found in an inpatient general med surg 
unit to ICU care will increasingly be “pushed out” of hospitals. Coupled with a well developed clinical infrastructure and advanced by remote technology it can be a safe and economically favorable alternative to inpatient care (think disease specific and operative bundled payments)…

5) Social Media
One of the most, perhaps singularly influential and game changing areas that will impact consumer driven healthcare. 
From a market perspective, ignore this sector and its opportunities at you own “peril”.

Tuesday, July 4, 2017

Individual & Organizational Well Being & Inspired Leadership for Healthcare and Business

Individual & Organizational                                                July 4th 2017
Well Being & Inspired Leadership for
Healthcare and Business

Here are some potential benefits of several “key” practices that can;

Align individual aspirations and organizational mission.

The result: Increased performance, positive outcomes &
Inspired Leaders


Its benefits;
            Acceptance & Non Judgment

Mindfulness means paying attention in a particular way;

•On purpose
•In the present moment
•Non - judgmentally


Works as a renewing agent

Decreases stress levels and improves overall effectiveness; the experience of compassion will set in motion restorative mental, emotional, and physiological processes.

All of this leads to a more positive environment which research has shown affects how that organization actually performs.

This infers a powerful business case for compassion.

In addition, caring relationships are the key to arousal of the PSNS which
Can lower blood pressure, enhance immunity, and lead to overall better health.

Healing environments

Facility design
Minimize stress, remove barriers, equals an efficient healing environment

Personalized relationship between staff and customers.  In healthcare between caregivers & patients, consider care delivery proximity and space

Integrative /Complimentary & Alternative Medicine
Increasing the availability and use of complimentary therapies in the inpatient setting may be beneficial

Inspired Leadership

The inspired leader, any position and level in the organization, puts all three practices in motion; Mindfulness and Compassion creates a Healing Environment.

Final thoughts & practices to consider;

Listen & become “People whisperer’s”

Compassionate & Honor Spirit

Self-defined and aware


Takes Sabbath seriously

Is servant vs. manager

Attitude of courage, gratefulness

Sunday, June 25, 2017

NYU Research

Really happy to report that research with my friend and colleague Dr Tom D’Aunno
is progressing well with many interesting insights!!!

Tom and I are looking retrospectively at disruptive “game changers” in healthcare over the last 30 years, all sectors.
This will lay the ground work for more “precise” forecasting and futures…
Look for further reporting this summer.

Sunday, April 12, 2015

Pocket Guide for Mindful Moments in Healthcare

Pocket Guide for Mindful Moments in Healthcare
Rick Gannotta

Paying attention mindfully with awareness to what is happening in the dynamic clinical (or personal) situation and setting you are in, for the changes that continue to unfold and evolve in patient care, with your team, and within yourself, in the “moment” may allow you to become more present for the patient and the task in front of you.

This may positively influence and improve clinical outcomes and patient satisfaction.

Here are seven opportunities for mindful moments in healthcare delivery;
  • During patient report
  • While hand washing
  • During the physical exam
  • Medication administration
  • Site marking
  • During operative or procedural “time outs”
  • When your stressed, distracted and or feel overloaded

These three steps may assist in optimizing mindful attention;

1) Identify
       This is a high reliability situation
        I am called upon to perform a task, with the team or independently
2) Awareness (enhance)
            Ground yourself in the moment via cues;
                        Hand washing,
                        Touching the doorknob prior to entering the room,
                        Taking patients hand

            Breath & Breathing (one or two consciously)
            Bringing focus intentionally onto the 
            breath, observing without reacting

3) Mindful Attention (shift)
            Being “aware that you are aware” may improve focused attention
            and limit distraction

Some potential benefits and applications of mindful awareness in a high reliability organizations and situations* such as those found in healthcare delivery include;

Better recognition and management of your stress reactivity:
Mindful Breathing and “checking in” to how you are feeling frequently throughout the day.

The clinical environment its distractions and the context you are working in:
Mindful hand washing, mindful listening, and purposefully noticing your surroundings.

Bring mindful awareness & attention to your actions:
In high reliability situations such as dispensing medications, prepping and procedures, checking vital signs and instruments, taking and reading orders.

*High reliability Organizations:
A complex working environment that operates safely and reliably in the face of hazards that can harm hundreds or thousands of people.
      Roberts, K. Organizational Science, 1990

Richard J Gannotta copyright 2015 All Rights Reserved