Author: Dorron Blumberg - Florida Hospital News and Healthcare Report

Gervasio A. Lamas, M.D., director of cardiovascular research and academic affairs at Mount Sinai Medical Center, has been named Latino of the Year by the Latin Business Club of America for his outstanding contributions to medicine and the community. The award recognizes individuals whose efforts expose Latino influences above and beyond Latin markets.

Born in Havana, Cuba, Dr. Lamas received his BA in biochemical sciences (cum laude) from Harvard College and his M.D. with honors from New York University. He completed his internship and residency at the Brigham and Womens Hospital of Harvard Medical School, where he later served as assistant professor of medicine. Dr. Lamas relocated to South Florida in 1993, when he started work as chief of cardiology at Mount Sinai Medical Center. During the last decade, he has had authority and responsibility for the enrolling thousands of patients in more than a dozen U.S. and international trials, in order to improve cardiac care and prevent death and disability from heart disease. He served as chairman of the Mode Selection Trial in Sinus Node Dysfunction (MOST), a trial that revolutionized cardiac pacemakers. He presently serves as co-chairman for the Occluded Artery Trial (OAT), and study chair for the Trial to Assess Chelation Therapy (TACT), a $30 million trial sponsored by the National Institutes of Health. Dr. Lamas has served as President of the Miami Chapter of the American Heart Association, and District Counsellor for the American College of Cardiology. Dr. Lamas also served on the American College of Cardiology/American Heart Association joint committee that re-wrote the national guidelines for the treatment of heart attacks. Dr. Lamas is author of 130 publications, including 78 original reports, 14 book chapters and 38 reviews. He also directs the training program in cardiology at Mount Sinai Medical

Center and works as a clinical cardiologist with the South Florida Medical Institute.

As I write this, New Orleans, Mississippi, and Alabama are still reeling from Hurricane Katrina and Texas is bracing itself for an unwelcome visit by Hurricane Rita. We Floridians are no strangers to the potential devastation of a hurricane. So these are not fun times for any of us who share the Gulf Coast.

When faced with a storm of such magnitude, you cannot help but be forced to put things in perspective. In pure size, both Katrina and Rita were massive storms, bigger than any of the states they threatened and, in fact, dwarfing even Texas. The power of their winds and rushing water overwhelmed anything mere mortals could devise to stop them. All anyone could do was get out of the way (if possible), wait it out, then go back to see what, if anything, was left to rebuild. It made us, masters of the known universe, seem small indeed.

These storms had a message for everyone, even those of us fortunate enoughat least this timenot to be directly in their paths.

To begin with, they made many of us think about what we would do if we were caught up in the devastation. One day you have a house, a car, a job, a routine the next, everything you have come to know and to rely on has been swept down the street, literally. How many of us could face such a prospect and have the courage and the fortitude to recover?

But it also gave us another perspective. In the Felix household before Katrina and Rita, many of lifes annoyances would dramatically affect Carol and me: everything from a blown fuse to someone taking the last Diet Coke from the refrigerator. How unfortunate or ill timed such nuisances would seem.

But now, in the aftermath of these hurricanesand realizing that more will come and, like a frustrating game of Russian Roulette, some might turn their frightening power on Floridaweve adopted a new attitude. Our code phrase to invoke is “No Biggie.”

The cable guy didnt show up for the third time in a row. No Biggie. Lets turn off the TV and play Canasta.

One of our old pipes sprung a leak and we need to call a plumber? No Biggie. At least we have fresh water. And its not covering everything we own.

Flat tire? No Biggie. Lets call the Auto Club and relax. Wherever we had to go, itll be there tomorrow.

I appreciate that we humans have short attention spans, so I know it wont be long before once again I m upset because the pizza is delivered late, or it rains after Ive washed the car, or I spill something on my laptop

But for now, all of those are No Biggies. No matter what minor irritant befalls me, Im feeling pretty fortunate right now.

Charles Felix, Publisher

While working for HospiceCare of Southeast Florida, Caren Bock realized the need for a children’s book that could prepare, inform, and guide children through the experience of a loss. Inspired by her husband John, family, and dear friend Susan G. Telli, Caren created Wings: A Story of Transformation, a delightful children’s book about the transformation of life and death. This unique story is about a young boy named Christopher and his friend, a caterpillar named “Fuzzy”, who through transformation becomes a beautiful butterfly leaving Christopher to cope with his change. As a critical care pediatric RN, Caren feels this book will help many families through difficult times. Wings offers care and support to children, parents, grandparents, guardians and families, counselors as well as healthcare providers as they face end-of-life, and deal with the issues that come after the death of a loved one.

All proceeds of this book will be donated to HospiceCare of Southeast Florida, Inc.

HospiceCare of Southeast Florida, Inc. will be celebrating their 25th Anniversary with the Book Launching of Wings, on November 17th from 5:30-8:30 p.m. For more information, call (954) 467-7423 or visit www.hospicecareflorida.org.

A recent survey by Deloitte & Touche USA disclosed that 29 percent of hospital CEOs believed that their hospitals could fail in the next five years. Although down from 32 percent two years ago, the outlook and the challenge to survive and thrive is still daunting.

What are hospitals doing to meet their mission statements and deliver exceptional quality in a cost-effective way? Are community hospitals at greater risk, or do large, teaching facilities tackle tougher times ahead?

Jackson Health System in Miami, is a mega-complex with nearly 1,498 beds and more than 10,000 FTEs. It is also a tertiary teaching hospital offering transplants, a burn center and a trauma center. It is also the parent to Jackson South Community Hospital, a “community hospital” with approximately 200 beds.

But over 30 percent of the health systems admissions are unfunded, according to Steven Klein, Executive Vice President and Chief Operating Officer.

Eighteen months ago, the system called in Deloitte Consulting to set a plan into motion to keep the organization viable.

“We were running out of cash,” says Klein.

The result was “Project Recreate Jackson” a strategy that dealt head-on with cost reduction, revenue enhancement, and cost avoidance a formula that has worked!

Cost reduction was key, but difficult, says Klein. “We had to address better pricing on supplies, pharmacy, reduce equipment expenses, and seriously look at reducing FTEs. This is essential, but never easy.”

About Steven Klein

Education: Masters Degree in Public Health, University of Pittsburgh
Family: Wife and two children, residing in Coconut Grove
Community Involvement: American Cancer Society; Blood Bank of South Florida; Dade County Economic Development Council
What he likes most about working in health care: “The variety and the challenge”
What “inspires” him: “The success of others. If they can do it; I can do it.

He adds that the greatest challenge is to accomplish this and honor our commitment to exceptional care while maintaining “one standard of care for everyone.”

Being in Miami, many of the hospitals patients are indigent and transient uninsured or underinsured. “Miami is a gateway,” Klein explains. We get patients from all over the world some for transplants or other tertiary or higher levels of care. Other patients represent a more “floating” population for trauma and more traditional treatment and care. Miami-Dade County is also “atypical,” with one-third of the county being uninsured or underinsured.

Cost avoidance has been integral in managing this challenge and providing a better bottom line.

“We have implemented a better mechanism for screening patients up front to determine non-residents and transitory patients and define what provider is most appropriate for them.”

In addition, Jackson has been aggressive with “denial management” implementing processes for determining Medicaid qualification and working proactively with all insurance providers to reduce the percentage of uninsured days.

These two steps have resulted in “revenue enhancement” and have helped keep the system extremely viable in an intensely competitive market.

How competitive is the Miami-Dade County healthcare market?

“On a scale of one-to-10, were about a 10.5,” says Klein. “There are about six major healthcare systems in the area. This is one of the most competitive areas in the country.”

Unlike some hospitals, physician recruitment is not a problem at Jackson Health System it is owned by Miami-Dade County and is an academic teaching hospital affiliated with the University of Miami Miller School of Medicine representing some 600 doctors.

Klein says “The work we do here the trauma, transplants, tertiary care, and beyond attracts physicians because of the stimulating, challenging environment.

Jackson Health System, like other hospitals and systems in the country, continues to be challenged by increased insurance premiums by the public, reduced coverage to employees, rising costs of equipment and labor and staffing.

“Insurance and reimbursement issues have become increasingly intricate and complex,” Klein adds, resulting in more sophisticated insurance contracts to ensure adequate coverage especially with the acute levels of care the Jackson delivers.

“We will continue to meet our challenges and obstacles, while seeking out new opportunities to provide the same standard of care for which we are known and deliver that care to everyone.

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