HHS Secretary Tommy Thompson's pitch last week for increased numbers of organ donors was punctuated by another urgent plea, this time to Congress: Staff my department!
Speaking to a National Press Club luncheon last week, Thompson chided both the legislative and executive branches for creating an appointment and confirmation process under which it takes months before top-level officials formally can begin work. Among the people who have yet to fully occupy their offices in HHS is Thomas Scully, now president of the Federation of American Hospitals and President Bush's designee for HCFA administrator.
He didn't blame his boss, Bush, nor the congressional leadership, and he certainly isn't the first person to complain about the length of the confirmation process. But Thompson said he wished he had at least one assistant secretary or deputy secretary working for him full time.
"What a loss to have a department like HHS that wants to do so much and can't get anything done," Thompson said to the assembled scribes and their guests at the press club. "I know General Motors would not stand for that. That's the federal government, but that's not right."
Meeting demise. Spring in the Southwest is usually a time of climbing temperatures, colorful desert blooms and state hospital association annual meetings. One of those events won't be experienced this year in Arizona.
The Phoenix-based Arizona Hospital and Healthcare Association canceled this year's annual meeting, which is typically held at a resort in late May or early June. There are no plans to revive the event. Association President John Rivers cited declining attendance and the rise of "distance learning" for the meeting's demise.
"People can take their (continuing medical education classes) via CD-ROMs or the Internet, so they're less inclined to travel to an event," Rivers says. Since Rivers joined the association in the mid-1980s, attendance at the annual meeting has declined from 800 to about 200 last year.
The cancellation of the annual meeting doesn't affect other regularly scheduled regional events or dinners, Rivers adds.
Life imitating art. It's not uncommon for a Hollywood production designer to study emergency rooms for tips on how to build a convincing hospital film set. It's far less common for hospital architects to turn to Hollywood for pointers on how to build real-world emergency departments. But that's precisely what Kirk Hamilton and Ray Pentecost have done.
The two healthcare architects recently visited the set of NBC's hit drama "ER" to gain clues on what to do-or more precisely, what not to do-to create a calming environment for patients, families and medical staff.
"We wanted to find out what things are most symbolic of a hospital, what visual cues immediately tell TV viewers that they're in an institutional setting," says Hamilton, president of Houston-based American College of Healthcare Architects. "Typically, those are the things to avoid if you want to make a real hospital less institutional, less scary and less cold."
For example, "ER" intentionally clutters its nurses' stations with stacks of charts and lines its main corridor with crash carts and gurneys-all to give the impression of urgency, confusion and overcrowding. The set, which stands on the Warner Bros. lot in Burbank, Calif., also uses a stark, dingy waiting room with rows of stiff, plastic chairs, drab green paint and sharp angles to convey the sadness and discomfort of patients who have been waiting for hours.
"Everything is deliberate. The architecture is contrived to communicate a story line and heighten the show's drama," says Pentecost, CEO of the Health Enterprise Group, Norfolk, Va.
But in a real hospital, these elements create tension and anxiety. "You want to eliminate them and go for (a look) that's more organized, accessible and friendly," Hamilton says.
To do so, Hamilton and Pentecost say hospitals should create storage rooms to stash equipment out of patients' view and design workstations with ample drawers and shelves to maintain a level of order and efficiency. For the waiting room, they suggest comfy chairs clustered in groups rather than rows, lots of plants and artwork.
Also, "Be aware of the emotional impact of the colors you pick, and lean toward more `happy' shades and textures," Hamilton says.
The architects also warn against the openness of the hospital interior shown on "ER." The set uses several windows and few walls so that the characters and TV viewers can witness multiple plots occurring simultaneously. In some scenes, the camera pans from the waiting room, across the nurses' station, through the observation bay and into the trauma room all in a single shot.
"Obviously, you don't want that kind of transparency in a real hospital. You don't want to be looking at a surgeon cutting on your husband or wife," Pentecost says. "(The layout) should be designed to screen you from the action."