Showing posts with label Henry Ford Health System. Show all posts
Showing posts with label Henry Ford Health System. Show all posts

Wednesday, May 08, 2013

Tales of the Wayfaring Generic Manager - from Ritz Carlton Hotels to Henry Ford West Bloomfield Hospital to Cancer Treatment Centers of America

In 2006, we wondered what a former hotel manager, Mr Gerard van Grinsven, admittedly known for putting the "wow" back in the Detroit Ritz-Carlton, would be doing as a hospital CEO.  This seemed at the time like a real "wow" example of how generic managers were taking over health care.  Mr Grinsven had extensive experience in the hospitality field, but no known background in health care. 

Organic Local Produce, "Wellbeing Centers," Gourmet Dining, Wedding Receptions, and Corporate Functions

Over the next few years, Mr van Grinsven's Henry Ford West Bloomfield hospital did make a name for itself.  In 2009, Becker's Hospital Review reported on some of Mr Van Grinsven's innovations. 

First, he lead an apparent change in the hospital's mission from acute care to recreating:

the hospital experience into one focused on promoting wellbeing and healthy living. The hospital has already begun to realize its mission statement, which reads 'to take health and healing beyond the boundaries of imagination.'

The new hospital apparently was designed to look like a luxury hotel:

The hospital is located on 160 acres of woodlands and is designed to resemble a Northern Michigan lodge. The facility also features a retail 'main street' which looks like an actual main street in a Northern Michigan town and includes stores focused on sleep, pregnancy, organic food and healthy cooking as well as a pharmacy.

Apparently it is now a favored site for weddings:

The hospital also holds free concerts for the community and has already received nine wedding inquiries. 

It had a "wellness center"

Henry Ford West Bloomfield also features a unique, integrated wellness center called Vita. Vita offers acupuncture, therapeutic message, yoga and relaxation classes, an aqua therapy suite, a spa and health coaches who provide lifestyle and exercise consultations. In addition to offering one-time services, the hospital offers memberships to community members to encourage frequent use of the center.

What really stood out was its food service:

Henry Ford brought in top Michigan chef Matt Prentice to transform traditional hospital food service. The hospital features 24-hour room service for patients, all of which is served by the hospital's on-site gourmet, organic restaurant, Henry's. All food served in the hospital is organic, promotes sustainable agriculture and, in many cases, is procured from local farmers.

A 2011 article in Fortune noted that

the hospital is on track to generate millions of dollars a year hosting and catering functions for companies and community groups.

It all sounds great, if it were describing a luxury hotel.

The Fortune article ended with the gushing summation:

While it will be years before anyone can say whether this model works, there's no question that it captures a spirit of innovation that just might be a cure for what ails so many organizations. We are living today through the age of disruption. You can't do big things if you're content with just doing things a little better than everyone else or a little differently from how you've done them in the past. In an era of intense competition and non-stop reinvention, the only way to stand out from the crowd is to stand for something special. Originality has become the acid test of strategy.

Neither it nor the Becker's rather uncritical discussions dealt with what any of this had to do with the fundamental mission of a hospital, to care for the sick, what it has to particularly do with quality of care, especially care of severely acutely or chronically ill patients, traditionally those whom hospitals were meant to serve.  Would a patient desperately sick from a myocardial infarction (heart attack), stroke, sepsis (bacterial blood stream infection) or the other major ills that bring people to hospitals really care that if he or she were to survive without major sequelae, organic, locally grown food would be served in the hospital's fancy restaurant?  Is there any evidence that provision of any of these fancy hotel amenities would affect important clinical outcomes for such patients?  Could the funds needed for all these fancy hotel services be better spent to improve patients' the the population's health?

On to a More Ethically Challenged Environment

We may never know.  But what we do know is that Mr van Grinsven, having brought "wellness" centers and organic, locally grown, gourmet food to an acute care hospital, is now moving on.

Crain's Detroit Business just reported:


Henry Ford West Bloomfield Hospital President and CEO Gerard van Grinsven has resigned from the position effective June 1, according to an internal email sent Friday to employees from Henry Ford Health System President and COO Bob Riney.

Van Grinsven is leaving the hospital to become the president and CEO of Chicago-based Cancer Treatment Centers of America, Riney said in the email. He will oversee the CTCA's five hospitals and medical centers in Illinois, Pennsylvania, Oklahoma, Arizona and Georgia. The CTCA is expected to announce van Grinsven's new position later today.

Henry Ford Health System CEO Bob Riney saluted van Grinsven thus,

'Gerard's leadership talents and his tremendous global experience made the transformation of this innovation and distinctive vision a reality,' Riney told employees in the email.

He did not apparently mention anything about the quality of care for acutely and chronically ill patients.  The press release from CTCA proclaimed

'Gerard's arrival is an exciting and dramatic step in the evolution of our leadership that will herald new opportunities for all of our talented Stakeholders and the thousands of patients we serve,' said [executive chairman and former CEO Stephen B] Bonner. 'Our expertise in Patient Empowerment Medicine® and track record implementing change is unparalleled. Nothing we do today is the same as we did two years ago. Gerard is uniquely qualified to provide the leadership required to advance our commitment to patient-centered care in all we do,' concluded Bonner.

Of course, there was nothing about how van Grinsven's expertise in wellness centers and organic produce would be useful to an organization supposedly devoted to cancer patients, whose care may involve risky treatment choices and who may become desperately ill.

There was also nothing about how van Grinsven's background would help CTCA to avoid new ethical misadventures.  Earlier this year, we posted about issues involving CTCA making unsubstantiated survival claims; promoting "integrative" treatments that are unsupported by evidence; and manipulating survival statistics, in part by turning away patients with poor prognoses.  Of course, it is not clear that given van Grinsven's background he would even understand why such behavior is unethical. 

Summary

As a physician, it is hard not to laugh at all this, at least to keep from crying.  As we have noted frequently, health care has been taken over by generic hired managers.  At best, while well meaning, many of them seem clueless about the nature and context of health care, and health care professionals' values.  At worst, the manager's coup d'etat has turned managers into manager-kings, queens and nobles, while driving up health care costs, and sacrificing the health of patients and the public.  The depth of this phenomenon is demonstrated by the absolute lack of skepticism about the worthiness of a former Ritz-Carlton executive to run either a community hospital or a system of cancer treatment centers.

I say once again that true health care reform would put in place leadership that understands the health care context, upholds health care professionals' values, and puts patients' and the public's health ahead of extraneous, particularly short-term financial concerns. We need health care governance that holds health care leaders accountable, and ensures their transparency, integrity and honesty.


Friday, April 22, 2011

Henry Ford Health System Decides Meaningful Use Not That Meaningful

The CMIO for inpatient services for Henry Ford Health System discusses the Michigan system's decision to hold off on applying for meaningful use funding in 2011, and what that means for its long-term vision of connecting clinical goals with IT support. April 15, 2011. Podcast running time: 3:58 (link to podcast).

Excerpts:

“The clinician experience of delivering care has never been more complicated. Implementation and adoption of these Electronic Health Records seems to be to many people an end in itself—and that’s unfortunate.

The implementation and adoption of EHR is a means to an end and one of those ends is better patient care and another one is clinician efficiency or better and more effective care. And that part feels to me that it gets lower priority and gets overlooked for the sake of adoption and implementation especially now with the federal requirements coming on.

Now we must adopt, adopt, adopt. And the clinician experience is left behind. The complexity of being a physician is almost overwhelming both in the hospital and clinic setting and that’s one of my great concerns.”

- John Frownfelter, MD CMIO, Henry Ford Health System


Health IT in its present poorly usable form only makes being a clinician more overwhelming. As I wrote at "Meaningful Use Final Rule", meaningful use initiatives before "meaningful usability" has been achieved have put the cart before the horse.

Henry Ford, inventor of the assembly line, would probably have approved. An assembly line is appropriate for building identical widgets, but inappropriate for the implementation of health IT in the extremely complex, poorly bounded, conflicted, highly variable, uncertain, high-tempo work domain of hospitals, especially if the implementation is just for implementation's sake.

-- SS

Friday, March 31, 2006

Putting on the Ritz?

According to an article published by the Detroit Chamber of Commerce, Gerard van Grinsven, who was appointed General Manager of the Dearborn Ritz-Carlton in 2002, has put the "wow"back into the hotel. Among other achievements, van Grinsven succeeded in having the hotel ranked number 1 for customer satisfaction among all the prestige chain's properties.

Van Grinsven had world-wide experience in the hospitality industry. He started managing a coffee-shop in a Holiday Inn in Canada. "His expertise in food and beverage ultimately sent him on an incredible global odyssey throughout many of the world’s most acclaimed hotels, including The Mandarin in Jakarta, The Oriental in Bangkok, The Ramada Renaissance in Hong Kong, the Peninsula in Manila and the Hotel Inter-Continental in Berlin."

"Van Grinsven joined The Ritz-Carlton Hotel Co. in 1994 as executive manager in charge of food and Beverage at The Ritz-Carlton, Seoul, where he led the successful opening of the largest food and beverage operation in the company. Prior to taking the helm at Dearborn he was vice president of food and beverage and vice president of pre-opening operations at the parent company in Atlanta."

At this point, Health Care Renewal readers may begin to think I have started April 1 festivities a bit too early. What does any of this have to do with health care?

Actually, the answer, albeit bizarre, is not hard to find. Yesterday, the Detroit News published an article about plans made by the Henry Ford Health System to open the new Henry Ford West Bloomfield Hospital in 2008. Who did the system hire to be CEO of the new hospital? It was none other than Gerard van Grinsven.

The Detroit News article noted that "Van Grinsven has no background in the health industry but brings years of experience managing post Ritz-Carlton hotels. Henry Ford believes that makes him the ideal person to run an upscale hospital designed to woo patients with the promise of privacy and wired rooms that overlook a pond and landscaped courtyard." Hospital "amenities will include Internet access in each room, flat-screen televisions and a wireless communication system that will eliminate irksome overhead paging."

However, "several national experts said they had never heard of someone making the jump from a career in hospitality to hospital president." Furthermore, "some critics say pouring money into pools and private suites is only going to lead to an arms race that drives health care costs higher."

I am sure Mr Van Grinsven is an excellent manager in the hospitality industry, and that anyone would enjoy staying at a hotel he runs. However, it is mind-boggling that a hospital would put a hospitality executive with no health care background, no matter how accomplished, in charge of runing a hospital. This seems to be a unique case of the idea that all managers know best about health care, again an attitude that seems to have been generated by Einthoven's call to break up the medical "guild" and turn control of health care over to managers and bureaucrats.

Hospitals and hotels both provide over-night acccomodations and food. That's pretty much where the similarity ends. Few hospital patients book stays in advance. Hospital patients arive at all hours, often very sick, and with unique needs. Sick patients do deserve health care professionals and support staff who really care about them. In my humble opinion, however, sick patients, even if they are well-to-do baby boomers, really are unlikely to care about flat screen televisions and internet access. Most sick patients care about getting better, and having a future to which they may look forward. I wish Mr Van Grinsven luck, which he will need. I just hope by the time this hospital really opens, Mr Van Grinsven has been able to delegate most of his responbilities to people who actually understand health care.