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Ask The Expert - Michael R. D’Agnes
Michael R. D’Agnes
Raritan Bay Medical Center
Michael R. D’Agnes, President and CEO, has more than 30 years experience as a health care executive, and has led Raritan Bay MedicalCenter for 9 years.He is past chairman of the NJ Hospital Association and a Fellow of theAmerican College of Healthcare Executives (FACHE). Under his leadership Raritan Bay has been designated a national Magnet hospital for nursing excellence, has ranked in the top 10% of hospitals nationally for stroke care, and is a three-time recipient of the Horizon Blue Cross Blue Shield Hospital QualityAward.
What do you see as the biggest challenge in healthcare right now?
Federal and state pressure to reform our current health care system is creating enormous challenges for hospitals. A significantly large aging baby boomer population requires more comprehensive hospital and long-term care services, placing a heavier demand on our federal Medicare program. Hospitals must continually upgrade their physical plant and acquire cutting-edge medical technology to be effective, but shrinking reimbursement on both the state and federal levels has made it difficult for hospitals to merely cover day-to-day expenses. All of these factors affect a hospital’s ability to fulfill its mission of caring for its patients.
Through a cooperative relationship with state and federal governments, the business community, hospitals, and physicians, however, we will be able to remove many of these obstacles.
As part of the health care reform debate, there has been a lot of focus on quality and public reporting. As a patient should I be concerned about that?
Like many regulated industries, hospitals have always collaborated to develop and implement the best practices in patient care. As a patient you should expect your local hospital to deliver the best quality care in accordance with the industry’s highest standards. Most publicly reported data, however, provides only a snapshot of a facility at one point in time. That data is usually at least one year old. Patients should always discuss with their physician the care they expect to receive and the best hospital where that care can be delivered.
In some cases a patient may want to take into consideration any national or state quality designations the hospital has received. One such designation is the Magnet designation for nursing excellence. This national designation, awarded by the American Nurses Credentialing Committee (ANCC), is not simply an award, but a 4-year accreditation process that must be earned. A Magnetdesignated hospital undergoes a 3-day site visit; in addition, they must submit volumes of documentation that show evidence of the best nursing practices, excellence in nursing leadership and professionalism, and shared governance, among other items.
There are also a number of national health care rating agencies that compile statistics on a facility’s morbidity and mortality rates and then benchmark that data against national standards. Health-Grades, one such agency, rates hospitals and doctors nationally, using a five-star rating method. Again, these are resources that a patient may use to get information about the services their local hospital may excel in; but ultimately the decision of where to seek medical care should be made in conjunction with one’s physician.
Where do you see the future of healthcare?
Through the advent of technology we will continue to see a shift in the delivery of health care from more of an inpatient setting to an outpatient one. Hospitals will also be held more accountable for how patients are treated from a customer service/satisfaction perspective in addition to the clinical care they provide, both of which will be attached to the reimbursement process. These factors will give rise to greater communication between patients, physicians, and hospitals, and will require patients and their family members to become more engaged in decisions that involve their health care.
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