On a lighter side and in the spirit of family with all its diversity of talent and good intentions we have included with this message a video that depicts a family enjoying time together at Thanksgiving
Ralph E. Jordan
Trident Health Resources, Inc.
Optimizing Open Heart
Operating Rooms
One Hospital at a Time
What's Lean Six Sigma? It's a long-term business approach to planning and controls to improve productivity and reduce waste - and it combines a great many techniques.
What's old is new again. The management strategies that transformed the manufacturing industry in the 1980s and the total quality management principles that flooded MBA degree programs at business schools through the 90s... all come back now with new fangled spins relevant to 2011 and beyond. So.. so if you're not familiar with the term "lean six sigma"... I guarantee before long you'll be hearing it everywhere now that you're reading about it.
Just this week the AP issued a news release that in a recent Fox News interview, Republican Party candidate Newt Gingrich said Lean Six Sigma can save government over $500 million. Gingrich is just one of the latest politicians to sign up to campaign group Strong America Now's pledge to get politicians to use Lean Six Sigma to improve government operations.
And Lean Six Sigma is getting acclaim in healthcare, too. By employing proven processes, hospitals are able to boost productivity and reduce waste. I read a report by The American Society for Quality that showed 53% of hospitals are employing strategies considered "some level" of Lean deployment.
I like the term "blackbelt" -- a catchy name attributed to those who have certification in six sigma strategies, are able to train others and who spend full time hours engaged in activities that lead to quality improvements. We may not be a blackbelt, but we're also more than the "wax on-wax off" style that Mr. Miyagi taught the Karate Kid before he got his belt. We're no stranger to Lean Six Sigma at Trident Health Resources, Inc. and we believe when it comes to managing open heart programs, a whole lot more goes into the services we provide than putting a perfusionist behind the pump. Our perfusionists are part of a tightly woven team that helps hospitals save costs and operate efficiently.
Isn't Always the Right Answer
I was catching up on some reading and just finished reviewing a 2011 study sponsored by the American Society for Healthcare Human Resources Administration (ASHHRA) in association with a private HR firm. In a survey of 234 Healthcare HR professionals, a few key findings were reported. This prompted my thinking about perfusion staffing in the O.R.
The report concluded the following points regarding HR departments' desires to cut costs with regard to hospital staffing:
Indeed, staffing is a matter of major concern because of the effects it can have on patient safety and quality of care, so minimum standards are the norm and presumed. It's also understood that it is a challenge to balance costs while keeping in mind that patients come first. In consideration of the O.R. and the job of the perfusionists, an obvious sound strategy for those hospitals which are managing their own heart surgery programs may include establishing lean perfusionist staffing levels. Also, in an effort to maximize budgets, one doesn't want to pay for underutilized resources. And for the most part, though it is more art than science, this type of management results in a tightly run department with good patient care and outcomes and financial sensibility. You determine staff levels for your department based upon need; and past experience is the best predictor of the future, right? As such, forecasting needs are based upon trends.
Oh, Really? Murphy's Law tells us that what can go wrong does go wrong. To quote the Great Dwight Eisenhower: "the plan is everything, the plan is nothing." Of course planning is critically important in healthcare, but reality rarely plays out as expected, especially when the forces are human, especially in matters of cardiovascular surgery, especially when it comes to hospital emergencies. You don't want to be caught short, nor do you want to presume your core staff (which may already be overworked) can pull extra hours in overtime in a pinch. (In fact, a fairly recent research report shows that there is a high percentage of sleep-deprived perfusionists based upon heavy caseloads and overscheduling). But pulling from existing resources is just exactly what many hospitals try to do... limping through, stretching thin. Is this the best possible way?
The survey findings say that HR departments want to "reduce reliance on agencies and temporary workers" to save costs. But there's a Paradigm Shift Hospital HR Departments need to take in their thinking.
Here's the Paradigm Shift: In most cases, employing locum tenens perfusionists through Trident Health Resources, Inc. to meet patient demand in hospitals would cost less than paying overtime. Contracting perfusion services can save on associated costs of benefits and compensation issues of hospitals hiring permanent additional staff. And the use of locum services always assuages the burden of overworked staff. Did you know that Trident just may be a staffing alternative that ends up less of a hit to the budget than hiring more permanent staff or paying overtime, less of a strain on your team, less trouble all around?
Rather than overburdening hospital staff and finances, the obvious solution is to make greater use of flexible locum Trident perfusionists to support the workforce during periods of high demand. Not only does it cost less, hour for hour, but it also prevents overworked staff, which could compromise patient care. Trident offers solutions. We respond within hours and in virtually all emergent cases, we can have a certified perfusionist flown to your location, working by the next day.
Don't wait until emergency strikes... we welcome hospitals to contact us and establish a working relationship early on... before the need arises. Visit Trident's website to learn more about our locums services as well as our long-term comprehensive program for your heart program including:
Trident Health Resources, Inc. employees are top notch certified clinical perfusionists, skilled and experienced in a wide variety of clinical modalities.
Trident Health Resources, Inc. is a perfusion services management company that supports hospital open heart programs through consultative leadership and staffing support. We do more than "put a person behind a pump" or simply place certified staff with you as an employment agency might do. Our consultative role expands into the management of all the related functions of perfusion services - from program financing, supplies, staff training, and administration on a 24/7, 365 days per year basis. Since 1988, we've provided specialty perfusion services and successfully assisted hospitals to save costs and meet or exceed goals for quality perfusion services.
We can Address Your Specific Needs:
Let Trident help when resources in the O.R. are stretched thin.
CALL TODAY! (800) 888-8408
LINK TO THE OCTOBER ISSUE OF THE HEARTBEAT!

Whatever happened to the company formerly known as Fresenius Perfusion? It's been a while since I've blogged about them, but seems like quite a flurry of activity is happening these days. I'm reminded of the classic game of Monopoly - high finances, buying and selling, bankruptcy, taking a "chance" card. So if you don't know by now, the latest acquisition by Specialty Care / HCSG (formerly Fresenius/ Edwards Lifesciences/ Baxter/ Psicor) is Advanced Perfusion Care (APC), a really good company based out of Pinehurst, NC. It certainly caught a lot of people by surprise, especially the employees. We wish them the very best... they now are part of a new monopoly game based out of Wall Street, who join those clinicians who feel like they've passed GO and didn't collect their $200.

But You're Only As Good
as Your Last Pump Case...
& Other Anecdotes about Reputation
By Ralph E. Jordan, CEO & President
Trident Health Resources, Inc.
A few weeks ago, an article in the Houston Business Journal ran about the favorable medical reputation of Houston. This is attributed to the trailblazing research and inventions pioneered by Dr. Michael DeBakey, who among many his achievements devised a roller pump that years later became an essential component of the heart-lung machine DeBakey helped secure Houston's medical reputation and is remembered as one of the 20th century's great pioneers of cardiovascular surgery. He was the chancellor emeritus of Baylor College of Medicine in the hub of Texas, director of The Methodist DeBakey Heart & Vascular Center, and senior attending surgeon of The Methodist Hospital, also in Houston.
What can we glean about reputation from DeBakey? First -- that it is far-reaching. It is far-reaching beyond one person's contributions and extends to entire programs, hospitals, and even cities. So precious is professional reputation is that, in the words of Benjamin Franklin, "It takes many good deeds to build a good reputation, and only one bad one to lose it." Perhaps we all know of a person who was fallen from grace by a singular incident. So in knowing this, we recognize the daunting reality of the work performed by a perfusionist.
The pressure to perform with perfection lies within the nature of the perfusionist's work, monitoring the heart and lungs during surgery. Experience matters greatly - even more than clinical expertise and quality education. Repeating success gains reputation - doing what you do best over and over builds confidence and strength in performance
There is little room at the top for aspiring medical professionals who make errors. And yet, I think there must be a dosage of reality... that is, to be humble as a professional. For no matter how great the skills of a perfusionist, he or she truly is only as good as the last pump case. Someone once told me, the bigger the career climb, the harder the fall if one does fall. Mistakes do happen... does that mar a professional's reputation? What do you think?
Another anecdotal line is that "Perfection is the enemy of good." For perfectionists, the slightest err can be paralyzing. But it is important to recover quickly from errors, assume responsibility for the repair and keep going. I have found working with Trident's perfusionists that they are often hardest on themselves. In managing people and being alongside them in their long-term careers over the years, I have found that it is certainly possible to arise above mistakes and retain a favorable reputation.
As a company, Trident isn't perfect. We have been fortunate to have had very few issues in our history. Being forthright and attentive, we address problems immediately and completely. Our corporate culture is people-focused and real. We work with people and through them and, in contrast to what others may do, we do not subscribe to an unyielding top-down approach to management or patient care. We know that the heroes in perfusion have lived through difficult cases. Valuable lessons have been gained through trials and experience. Without myopic eyes but instead through a big picture lens, the leaders of this industry, no doubt, have their share of stories of difficult cases, mistakes they have overcome, and ways they were able to overcome.
The Trident blog welcomes comments and stories to highlight the topics of discussion. Feel free to post here (you may comment anonymously).
Click HERE for MORE articles and news from the February Issue of THE HEARTBEAT, a monthly newsletter by Trident Health Resources, Inc.
This month's HEARTBEAT features a summary of results from a national survey of perfusionists and hospital administrators on Locums Perfusionist Staffing.