Cath Lab Digest

Staff support is the overriding principle. Loss of security has occurred. Their anxieties are real. As a leader, find outlets for them to find positive, adaptive coping mechanisms, or, without direction, there will be negative outcomes. Be thick-skinned. People are going to be extremely emotional and say things in a passive aggressive manner. They may emotionally project and act out in ways that are very spiteful. Have frequent staff meetings to allow for venting, questions and squelching of rumors. Invite the administration from the new business to a meet-and-greet, so employees can ask questions and break the ice.

As the director, work with the corporation as their advocate to maintain staff wages and keep benefits intact; try to grandfather their tenure for paid time off and 401k vesting. Sit in on their employee interviews, if they so desire. Keep your medical director heavily involved as well. He or she can be an invaluable asset.

Some facilities have employee assistance groups that can offer personal counseling. As a manager, be available. Be a listener. Attrition may occur. Be prepared and have a list of prospective employees for hire.

Turn Your Hardship into Success

At this point, we do believe it is important to emphasize, that at both Colorado Heart Institute (CHI) at Platte Valley Medical Center, in 2008, and at CHI in Aurora, January, 2011, ALL the staff moved with Scott and Adele to their respective facilities. No one left due to the transition. Though this was tremendously emotionally difficult for every team member, they realized that the hospital setting was not “the enemy.” The process they underwent was what was so destructive. All of these people work in healthcare by choice. Many had worked in hospitals before. They love caring for patients. These same patients originate in the hospital. The transition was hard because leaving their employer was not a choice made by a group of adults living in a free culture. To eliminate the decision to be employed by one’s job due to a law, or contract, is hard medicine to swallow, whether one is in the medical or corporate world. Platte Valley Medical Center and The Medical Center of Aurora provided good examples of trying to work with the employees to help them through a complex process. On another level, it became as hard for them as it was for the employees. They had to manage these broken people, attempting to help them heal while integrating them into their systems.

This may be one of the most difficult tasks that can be taken on by a cath lab, the manager and team. The team may look different after the hospital corporation takes over, but it still remains the team. Usually, the physicians are still working with the employees, just not employing them. The director’s attitude will influence that of the cath lab, so there is no luxury to let your guard down and become dismayed. Press forward and help the team stay strong in their new environment. Do not let the Stark Laws cause the demise of your cath lab. Remember what mathematician James Yorke said, “The most successful people are those who are good at plan B.” Choose to succeed!

References

1. Coping Mechanisms. Available at http://www.changingminds.org/explanations/behaviors/coping/coping.htm. Accessed January 20, 2011.
2. Kübler-Ross model. Available at http://en.wikipedia.org/wiki/Kϋbler-Ross_model. Accessed January 20, 2011.
3. Gordon JH. Government Resources: Summary of Key Aspects of the Final Stark II Rule. HHS issues final rule prohibiting physician self-referrals. AIS Compliance: A Channel on AISHealth.com. Available online at http://www.aishealth.com/Compliance/HCFA/StarkII.html. Accessed January 20, 2011.
4. American Health Care Association. Physician Self-Referral (Stark Law). Available online at http://www.ahcancal .org/facility_operations/ComplianceProgram/Pages/PhysicianSelf-ReferralStarkLaw .aspx. Accessed January 20, 2011.
5. Stark Law. Information on penalties, legal practices, latest news and advice. Available online at http://www.starklaw.org. Accessed January 20, 2011.
6. Gosfield AG. The Stark Truth About the Stark Law: Part I. Fam Pract Manag 2003 Nov-Dec;10(10):27-33. Available online at http://www.aafp.org/fpm/2003/1100/p27.html. Accessed February 17, 2011
7. The online office of Congressman Pete Stark. Representing California’s 13th District. Available online at http://www.stark.house.gov. Accessed January 20, 2011.