by Anna Ferraro
It’s a tenuous time for healthcare providers in America. With the advent of the Affordable Health Care Act (ACA) under the Obama administration, and the uncertainty of how the ACA will weather the changes being implemented by the current Trump administration, medical caregivers of all backgrounds and levels feel tentative about what their future careers hold.
Despite the complexities, when Harry Schmidt entered the role of president and CEO of Passavant Area Hospital in January 2017, he had positive things to say about the hospital, commenting, “I inherited an organization that is already running well. My goal is to continue the success that Passavant has earned and achieved.”
However, notwithstanding their growth, success, and favor in the community, Schmidt acknowledged the complexity of the current state of local and national healthcare, saying, “Healthcare affects everything. It affects me and my staff on a personal level, and a professional level as well.” He shared that a basic goal he has in 2017 is to smoothly guide the hospital through complying with the various mandates being dished out by legislators. In that process, he promises to prioritize “being fair to staff, and being fiscally responsible as an organization.”
That promise does not set Schmidt up for an easy job, but as a former U.S. Navy officer, and an accomplished pilot, he is used to navigational challenges. Whether they’re occurring 30,000 feet in the air, or on his office desk, he confronts the challenge with a level head.
In Schmidt’s position at Passavant, he is on a mission to continue the outstanding quality of service they offers to local patients, and improve it in any way he can – including expanding their services to keep patients close to home, but providing them with the tools to heal. He plans to accomplish growth while maintaining high standards, saying, “On a quality standpoint there are three things every patient wants when they enter a hospital. 1) Don’t hurt me, 2) Make me better, and 3) Provide me with compassionate care.”
On the first issue, Passavant has to work to reduce the amount of any hospital-acquired conditions. On the second, Passavant has to navigate through a steep field of competing healthcare providers that they are constantly being compared with. Finally, as a hospital works to provide service with care and compassion, leaders like Schmidt have a big role in that – energizing their staff to give themselves wholly to their patients, and not let anything going on in their personal lives affect their performance at work.
The weight that Schmidt carries in leading his team is augmented under the ACA. Surprisingly, one of the biggest challenges created by the ACA is not paperwork or a policy issue. Rather, it is the daily wrestling match hospitals now entertain with a concept known as Hospital Value Based Purchasing (VBP) – where hospitals are paid not just for the excellence of their care, but whether or not the patient perceives the care they were given as being excellent. In essence, Schmidt feels that Hospital VBP is one of the biggest challenges that hospitals created by the ACA.
He summarized it this way: In healthcare today, “All power comes from Medicare.” In the past, healthcare providers used processes, then, they looked at the outcomes. If the outcomes were satisfactory, then the process was deemed successful. At the end of the day, hospitals were paid for the services that they rendered.
In today’s healthcare arena, with Hospital VBP, there is a new component – the patient-experience component. Beginning in 2012, a portion of Medicare’s payments to hospitals became based on the quality of services they offered – not just the quantity. Like everything, it has its pros and cons.
Schmidt felt that the top benefit of that component is how it has encouraged better outcomes for patients, stating, “It’s a great thing for healthcare when you’re incentivizing quality.”
When asked to identify the greatest drawback to the component of emphasizing patient-experience, his answer was decisive and succinct – “subjectivity.” Again, it’s no longer just about the care you give, “it’s about the perception of that care.”
In a positive tone, Schmidt emphasized, “The power of Passavant is that our staff is very well-intentioned. They’re fantastic, they’re engaged, and they want to do the best. That is a tremendous aspect that they have to leverage. But each day, their greatest challenge is, they don’t know who will walk through the door next.”
Through surveying patients, and tallying the results of those surveys, the dollar signs of hospitals are now spinning on a point system dictated by the patients. As Schmidt said, it’s highly subjective. For example, how do you define a “clean” room? A standard of cleanliness that may be immaculate to one individual could be repulsive to the next. And does the age of the facility play into a patient’s perception of “clean?” What about personality issues between caregivers and patients? An exchange that is negatively perceived by a patient could translate into low ratings on that patient’s survey. Finally, what about communication? If a nurse gave detailed directions to a patient during their discharge, and the patient had a very limited knowledge of medical care, is that the nurses’ fault, or the patients?
As the patient surveys flow in constantly, and hospital funding fluctuates based on survey results, Schmidt encourages his staff to “parse the data, and rationalize it,” but always strive for better.
In regards to those interactions with the patients where subjectivity is at its highest, Schmidt had a clear picture of the need – “It’s back to that service mentality, and figuring out what’s important to each patient.” From his position as president and CEO at Passavant, down to every janitor on every floor, Schmidt emphasized the importance of the collective staff addressing that question in every workday – what is most important to the patient? When the staff finds the niches of successful treatments and ultimately, patient satisfaction, “repeatability” was a keyword that Schmidt used, saying, “Our pride in healthcare is in the repeatability of our process.”
Thus, in the same way that he guided countless naval planes through safe takeoffs and landings over the course of two decades of military service, Schmidt desires to safely navigate his staff through the healthcare complexities of today.
And at the end of the day, Schmidt said, “I want to be remembered for that I cared for people – the patients of the community, and the staff. [The staff is] not just a tool – they’re the heart and soul of the organization…. A lot of people give me credit – I reflect that to the staff…. I’m just thankful to be a part of the team.”