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trustsmallAuthor Stephen Covey wrote that “trust is the glue of life.  It’s the most essential ingredient in effective communication.  It’s the foundational principle that holds all relationships.”  Such an observation goes a long way toward explaining the massive disconnection and disaffection between citizens and their elected representatives.

In the latest findings from its annual poll, the Gallup organization showed only 8 percent of Americans rated the honesty and ethical standards of Congress as “high” or “very high.” State officeholders did somewhat better at 14 percent.  In between the two groups are car salespeople at 9 percent. Meanwhile, a Wall Street Journal/NBC poll released earlier this year showed President Obama’s job-approval rating at an all-time low, while only 34 percent of those polled said their member of Congress deserved another term.

At the other end spectrum are those who provide health care.  Nurses once again topped the Gallup poll, with 82 percent rating them high/very high for honesty and ethics. Nurses were followed by pharmacists, who tied with grade school teachers at 70 percent, and medical doctors, who tied military officers at 69 percent.

Hospitals no doubt benefit from these positive perceptions; a 2013 Harris Interactive poll measuring Americans’ trust in various industries showed hospitals second (supermarkets were first).  Still, only 28 percent of Americans agreed that hospitals are “generally honest and trustworthy,” though that easily bested banks (18 percent), carmakers (11 percent) and health insurance companies (7 percent).

In terms of public trust, business has historically fared better than government. The 2014 Edelman Trust Barometer shows the largest ever gap between the two since the study began in 2001, indicating that government is losing trust while business is gaining.  In analyzing these results, CEO Richard Edelman wrote that government now lacks the agility to effectively partner with business to bring about innovation as well as the credibility to lead innovation.

“Now it is business’ turn to ascend the ‘bully pulpit,’ Edelman wrote. “Business has recovered trust from the crisis period because it is seen as having made demonstrable strides in transparency, supply chain and product quality.”

Edelman’s first recommendation: CEOs must become “Chief Engagement Officers” who publicly “make the macro case for forward progress, not just the micro case for a given product…There should be the usual strong economic rationale, but there must be thoughtful consideration given to arguments that address emotion and risk, as well as societal benefit.”

From there, Edelman urges business leaders to empower employees and seek input from a broad range of stakeholders with a clearly articulated business strategy, beginning foremost with how a proposed change will improve lives.  As change moves forward, it should evolve based on collective inputs.  Leaders should report frequently on progress against specific quantitative and qualitative targets and be prepared to acknowledge and deal with shortfalls.

In health care, there are clear connections between Edelman’s findings and advice regarding trust and the issues and strategies hospitals are dealing with.  Coordinated care, patient-centeredness, value-based purchasing, transparency, community benefit, use of social media – these all hold the promise of building public trust in health care providers by strengthening individual relationships with both external and internal audiences.

The primary take-away is that patients, particularly in younger generations, don’t want to be “sold” care; they want to partner with providers to manage and improve health.  They want a relationship. As Covey points out, without trust, relationships dissolve.  As Edelman shows, people expect to be engaged – to have a relationship – with the businesses they choose to trust.


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Christmas is long gone and by this time most people have figured out what gifts really strike a chord and others not so much.  One of the biggest gifts this holiday season was personal health trackers such as the Nike Fuel Band and the line of FitBit wristbands.  While something that is intended to promote better health might fall into the category of Grandma’s crocheted socks or soap-on-a-rope, the bigger picture reveals an altogether different notion.

Phillips Intellivue is just one concept of how wearable technology can impact modern medicine.

Phillips Intellivue is just one concept of how wearable technology can impact modern medicine.

Products such as the FitBit wristbands are part of a growing tech trend known as “wearables” – or technology users wear that tracks or provides some enhancement to their daily activity.  An example that most might recognize is Google Glass, a headset that provides visual cues and interacts in conjunction with the user’s phone and firsthand point of view.  Many have been quick to dismiss Glass as a swing-and-a-miss device, but some maintain that this isn’t completely true and is actually already making waves in health care.

As for FitBit, this wearable is designed to track daily activity and help drive its users to improve and maintain better health behaviors.  The devices are able to track steps, calories burned, distance traveled, floors ascended and sleep pattern activity.  All of it is wirelessly synced to the user’s smart phone and online profile.  What makes these personal biometric devices so popular is a combination of forward-thinking technology, wireless syncing and social competition all packaged in a cool-looking accessory.

As a society, we’re becoming more attuned to good and bad behaviors (looking back, mom probably shouldn’t have cooked everything in butter) and becoming more dialed into being accountable for ourselves.  Iowa’s Blue Zones Project and the Iowa Health and Wellness Plan are part of the paradigm.  Technology such as FitBit makes it easier to participate because the devices are largely automated so there’s very little user input required.  And, of course, adding a social component makes us naturally inclined to compete or simply keep up.

Wearables are catching on in the public realm as well.  In January, the Wall Street Journal published a feature where FitBits were given to three athletes headed for the Winter Olympics to track their activity as they train for the games.  It’s not the first time these metrics have been analyzed, but it’s likely the first time such analysis was ever done without the use of a myriad of lab equipment and hours of number crunching.  And if athletes find this sort of thing cool, then odds are this is no passing fad.

But what’s the long view for concepts such as this?  And how do hospitals factor in?

Despite the lack of popularity for Google Glass by consumers, surgeons are already realizing its benefits in the operating room with concepts such as the Phillips Intelivue.  With a patient under the knife, they have the ability to view live stats from monitoring equipment around the room from just a glance above their line of sight and don’t have to take their eyes off of the patient or their work.  At the same time, these procedures can be recorded via Glass for live streaming or on-demand recording for educational purposes.

As for FitBit’s role in the health care community, there are a number of possibilities that could be derived from patients tracking their own health data.  If at some point that data were to be paired with an individual’s medical record then it could mean a true game change in modern health care.

There are numerous insights to be gleaned from the analysis of such raw, granular data that could go a long way toward improving overall community health.  This all plays right into established pursuits of lowering readmissions and providing more value-based health care.  However, in the short term, look for companies to begin providing these devices to their employees as part of ongoing wellness efforts as a first big step.

Some of the brightest minds in technology have their sights on health care as the next great frontier for innovation.  Beyond the benefits provided by specialized equipment like the da Vinci Surgical System, this next wave is originating from the consumer perspective.  It aims to make health and wellness easy, fun and cool.

If we managed to land on the moon using technology that was less advanced than today’s average cell phone, then perhaps the task of counting our daily steps is the next giant leap for mankind.

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Report shows $225 million annual impact of Sioux City hospitals
The two hospitals in Sioux City combine to produce 2,481 jobs that have a $225 million impact on the regional economy, according to a new study by the Iowa Hospital Association.  “The impact Mercy Medical Center has on the vitality of the Siouxland area is significant,” Interim President and CEO Jim Fitzpatrick said in a statement. “Mercy is proud to be able to continue providing this level of care to those who depend on us.”  “It’s an honor to serve the Siouxland community,” UnityPoint Health — St. Luke’s President and CEO Peter Thoreen said in in a statement. “We remain committed to making sure that our investments in health care also have a positive impact on the well-being of the community’s growth and development.”  (Sioux City Journal)

Public health will start in Muscatine
UnityPoint Health-Trinity Muscatine Public Health will host a free open house in recognition of National Public Health Week.  The event will be held from 10 a.m.-2 p.m. Monday, April 7, at the Nancy Kent Building, 1609 Cedar St. This year’s theme is Public Health: Start Here.  Every year in the United States, seven out of 10 deaths are due to preventable chronic diseases such as diabetes and heart disease. In fact, chronic diseases account for a whopping 75 percent of national health care spending, yet only 3 percent of our health care dollars go toward prevention. (Muscatine Journal)

Greene County Medical Center breaks ground for expansive addition
Despite the cold and dreary weather Thursday a large crowd gathered in front of the Greene County Medical Center in Jefferson to celebrate the groundbreaking of a large expansion and renovation project. GCMC CEO, Carl Behne says the new 51,000 square foot addition is designed around three principals: improving privacy, efficiency, and accessibility. (1380KCIM)

Surgeon’s fingers find outlet in crocheting
Dr. Mark Stelzer’s grandmother taught him to crochet.  The Le Mars man was in high school at the time.  “I wasn’t very good at it,” Stelzer said with a grin.  He has perfected his art for most of the last 40 years, Stelzer said.  During that time, he has made afghans for family members including baby blankets for his grandchildren. “It’s something their grandpa made,” Stelzer said. “I think that’s pretty special.”  He’s also made larger afghans for his wife, his daughter and his daughters-in-law.  “It’s a warm blanket and they use them,” Stelzer said.  He’s never sold his afghans, but he recently donated one to the Floyd Valley Hospital Auxiliary. (LeMars Daily Sentinel)

Enhancing children’s healthcare in Siouxland with a radiothon
Friday morning it was all about ‘caring for kids’ for UnityPoint Health – St. Luke’s Children’s Miracle Network.  All of the Sioux City Clear Channel radio stations broadcast a morning minithon sharing heartwarming stories of children that have benefited from the Children’s Miracle Network at Unity Point Health-St. Luke’s. (

National News

ICD-10 Delay Creates Headaches
Killing ICD-10 would have made a lot of doctors happy — despite all the money wasted preparing for the transition to the new diagnosis and medical billing codes. Delaying it for a year may be a relief to them, as well, but it’s nothing but grief for ICD-10 project leaders.  The delay of at least a year from the previously firm Oct. 1 deadline was a mere footnote in a bill Congress passed and President Obama signed Tuesday. The bill also pushed back previously mandated cuts in Medicare reimbursement to physicians. (InformationWeek Health)

Next steps for states, health insurance under the ACA
Like other states that opted to run their own exchange, Colorado spent several years and hundreds of millions in federal dollars to create an insurance marketplace specifically tailored for Coloradans.  Complex legislation, multiple studies, numerous vendor contracts, dozens of public hearings and behind-the-scenes preparations led up to the launch of Colorado’s site in October.  As of April 1, Colorado signed up 119,000 people for commercial insurance – a little shy of its goal of 136,000. State officials are already working on improvements for next year’s enrollment period, which starts Nov.15 and runs until Feb. 15, 2015.  “It makes me sick to think about it,” said Lindy Hinman, chief operating officer of Colorado’s exchange, Connect for Health. “But we’re already working on next year’s enrollment.” (USA Today)

Final O-Care enrollment deadline to hit April 15
The final deadline for enrolling in the ObamaCare exchanges is April 15, according to the Obama administration.  People who have started but were unable to complete applications for private health coverage under ObamaCare will have nearly two weeks to complete their work and avoid a tax penalty.  Federal health officials announced last month that people with applications in progress on the original deadline, March 31, would be provided more time. (The Hill)

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bilde-1.jpegIowa’s culture of efficient, high-value medical practice manifests itself every day in countless ways.  But has there ever been a more potent and poignant individual example than the life and contributions of the late Ignacio Ponseti?

Dr. Ponseti was a researcher, mentor, inventor and healer who spent decades at the University of Iowa perfecting, practicing and teaching a method for correcting congenital talipes equinovarus, the birth defect better known as clubfoot.  Today, the Ponseti Method of gentle foot manipulation followed by plaster casting is considered the worldwide “gold standard” for treating clubfoot, with a success rate exceeding 90 percent.

While children with clubfoot began receiving treatment in Iowa City as early as the 1940s, it took about 50 years for the Ponseti Method to gain the wide acceptance it enjoys today.  Dr. Ponseti’s approach initially competed against other nonsurgical methods that were popular but not nearly as successful.  He was also up against proponents of surgery, which seemed to gain a resurgence until the 1990s, when research again confirmed Dr. Ponseti’s casting technique was the most effective and efficient treatment.

The fact that the method can be readily taught, is relatively inexpensive and relies on easily obtainable materials is also important, given that most of the 200,000 children born each year with clubfoot live in developing nations.  The key now is to train health care providers on a global scale, which is the topmost goal of the Ponseti International Association, located in the international office of University of Iowa Healthcare, not far from the Ponseti Clubfoot Treatment Center.

Dr. Ponseti died about a year after receiving the IHA Iowa Hospital Heroes Award.  His name came up recently in a National Public Radio story that focused on how the Ponseti Method has become more widely known and used thanks in part to a growing global online network of parents, providers and supporters.

Dr. Ponseti’s story reminds one of another Iowan whose work continues to have global impact.  Norman Borlaug, the plant scientist who taught the world to feed itself and whose work saved hundreds of millions of lives, began his life on a farm near Cresco.

The life trajectories of both Dr. Ponseti and Dr. Borlaug were oddly similar.  Both did their most important research in the 1940s.  In fact, their paths nearly crossed in Mexico as Dr. Ponseti, then a refugee from his war-torn Spanish homeland, was practicing in a tiny village near Mexico City, while Dr. Borlaug was testing wheat strains in the Sonoran Desert and Central Highlands.  Coincidentally, they were both born in 1914 and they both died, only weeks apart, in the fall of 2009.

While Dr. Borlaug’s international path took him away from Iowa and Dr. Ponseti’s brought him here, their legacies are both firmly planted in the Hawkeye State.  For Dr. Borlaug, it’s the World Food Prize in Des Moines; for Dr. Ponseti, it’s his clinic and association in Iowa City.

There was talk, shortly after his death, of nominating Dr. Ponseti for the Presidential Medal of Freedom, the nation’s highest civilian honor.  Dr. Borlaug received the medal in 1977.  Perhaps the Ponseti Method does not rise to the level of the Green Revolution, but Dr. Ponseti’s accomplishments are certainly worthy of consideration, given that his impact on the world continues to grow and has been favorably compared to the polio vaccine (Jonas Salk also received the Medal of Freedom in 1977).

What better celebration of America than to award the Medal of Freedom to a Spanish immigrant who settled in the Heartland and dedicated his life’s work to perfecting an affordable and accessible treatment that would allow children all over the world to walk, play and live their lives normally?

In this way, Dr. Ponseti not only invented a cure, he created freedom.

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100greatlogoThe “100 Great Iowa Nurses” program annually recognizes the state’s outstanding nurses whose courage, competence and commitment to patients and the nursing profession stand out above all others.  The 100 Great Iowa Nurses for 2014 will be honored during a May 4 celebration at Veterans Memorial Convention Center in Des Moines.

Nurses selected for this honor represent many sectors of health care, including hospitals, long-term care facilities, hospice, schools, public health and medical offices.  This year, more than 80 of the 100 honorees are nurses at Iowa hospitals or health systems and nine of those are members of the Iowa Organization of Nurse Leaders, IHA’s Personal Membership Group for nurse leaders:

  • Laura Juel, UnityPoint Health-Des Moines
  • Linda Klimesh, Winneshiek Medical Center, Decorah
  • Connie Koehler, Waverly Health Center, Waverly
  • Virginia Koontz, Genesis Medical Center-Davenport
  • Neal Loes, Mary Greeley Medical Center, Ames
  • Bernice Morrison, Mercy Iowa City
  • Lori Murphy-Stokes, Allen Hospital, Waterloo
  • Lucinda Shipley, UnityPoint Health-Des Moines
  • Linda Whaley, UnityPoint Health-Fort Dodge

Several Iowa hospitals and health systems have joined IHA as 2014 sponsors of 100 Great Iowa Nurses, including: UnityPoint Health, Mercy Medical Center-Cedar Rapids, Genesis Medical Center-Davenport, Mary Greeley Medical Center in Ames, Mahaska Health Partnership in Oskaloosa, Mercy Iowa City, Shenandoah Medical Center, Wheaton Franciscan Healthcare, St. Anthony Hospital & Nursing Home in Carroll and Waverly Health Center.  Anyone wishing to become a sponsor can find more information here.

To see the full 2014 list of nurses, click here.

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