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This article by Kathleen McGinn Spring was prepared for the June 26, 2002 edition of U.S. 1 Newspaper. All rights reserved.
Healthcare Under the Microscope
What could be more challenging than running a top-notch
healthcare system in a managed care environment, circa 2002? Hospitals
that have risen to the occasion, winning awards from Quality New Jersey
for their results, are set to share their secrets for success.
On Thursday, June 27, at 8 a.m. the American Society for Quality holds
a full-day "Leading Healthcare into the Next Decade" seminar
at the New Jersey Hospital Association Conference Center on Alexander
Road. Cost: $199. Call 609-777-0940. Among the award winners addressing
the gathering are AtlantiCare and Robert Wood Johnson University Hospital
A resident of Hamilton Township, she has been with the hospital since
it opened its doors. A nurse, she holds a bachelor’s from Felician
College and an master’s degree from Widener University. Warm and energetic,
she says her background in nursing has been a great help in understanding
— and solving — the challenges her institution faces.
Perhaps ironically, the biggest challenge right now is finding and
keeping nurses. As medical technology becomes ever more sophisticated,
skilled technicians are tough to find too, as are pharmacists. But,
says Cardello, it’s the nurses that are the most prized quarry.
The same is true at nearly every healthcare facility. Cardello says
RWJ Hamilton uses the quality criteria of Quality New Jersey, basically
the elements of the Malcolm Baldrige quality program, to attract and
keep good nurses.
"You can offer signing bonuses. You can raise salaries," says
Cardello, "but that won’t get nurses to stay." What will,
she says, is a supportive working environment with good leadership,
all the equipment the nurses need to do their jobs well, and —
perhaps most important of all — recognition for their performance.
Every manager, says Cardello, is encouraged to send letters of recognition
to the homes of nurses who are doing an exceptionally good job.
The quality appraisal process RWJ Hamilton went through includes seven
elements — leadership, strategic planning, customer service, management
of information, human resources, process management, and results.
It did well enough in its appraisal and implementation to win a gold
Of all the categories, Cardello is most proud of her hospital’s customer
service results. "Our patient satisfaction level is in the top
six percent of the country," she says. Every patient receives
a phone call the day after being discharged. Negative comments are
not discouraged, she says, because the hospital is eager to know exactly
where any problems exist. Factors that make for a positive patient
experience, she says, include efficiency, caring, and concern. "It’s
a lot of people behavior," says Cardello.
While tending to patient-pleasing behaviors inside of the hospital,
Cardello also is overseeing expansion. Demand for RWJ Hamilton’s services
are growing by leaps and bounds. A new cancer center, offering, among
other things, radiation oncology, is coming on-line in the fall. A
three-story building just opened. It houses a number of growing departments,
including critical care, intensive care, telemetry, and a new E.R.
While RWJ Hamilton at 20 years old is a relative youngster on the
New Jersey healthcare scene. AtlantiCare in Atlantic County has roots
that go back over 100 years, to the time it was Atlantic City Hospital.
That institution is still one of its facilities, but it has added
another acute care hospital, a hospice, a child care center, 13 outpatient
behavioral care centers, and more.
AtlantiCare also participated in the Quality New Jersey program, and
has won recognition in the form of the 2001 Governor’s Award for Performance
June 27 healthcare seminar. "We used the criteria to see how well
integrated we are all across our business units," she says. Determining
that every patient seen in every setting is getting the full value
of AtlantiCare’s many services was the challenge.
Part of that challenge, and a big issue for AtlantiCare, is operating
under the constraints of the insurance companies, which pay the bills.
Balancing patients’ needs, best medical practice, and insurance companies’
policies is not an easy job. For example, says Brennan, "even
though you believe the patient can get a service in an outpatient
setting, the payer might prefer another setting."
It becomes a challenge for AtlantiCare, and for every other healthcare
provider, to walk the line — giving patients’ the best care, often
in multiple settings, while satisfying the demands of insurance companies.
On June 27, Cardello and Brennan, and a number of other leaders in
providing quality healthcare services, share how applying quality
appraisal standards help them balance the complicated, often conflicting,
demands of running a top-notch hospital system.
For entrepreneurs hoping to get government grants, you
have until Friday, June 28, to get on the inside track for some of
the $600 million that will be given out by the Department of Defense
over the next six months. Until the end of June you can call those
who control those funds to discuss the grant requirements and sell
your company’s capabilities.
"We have just entered what is probably the busiest time of the
year for the Small Business Innovation Research (SBIR) program with
hundreds of millions of dollars of R&D grant opportunities available
from the big three agencies and others," says
director of the Technology Commercialization Center. Proposals are
being solicited by the Department of Defense (DOD), NASA, NIH, and
the departments of education and agriculture.
"The biggest SBIR agency is the Department of Defense," Harmon
says, "and like all the agencies, it is trying to switch the grant-making
process to online." To encourage use of the online version of
the grant list rather than the paper version, the DOD releases the
online version in May and the paper version in July. Until the paper
version is released you can call up the people that sponsor different
topics. "You can get more-or-less inside information about the
sponsors’ interests and market your core technical competencies to
them," says Harmon. "This information can help you write a
stronger proposal and improve your prospects for an award. But in
July they won’t talk to you."
To find the right person to call, go to the National Science Foundation
website (www.sbir.com), where you will find a link to the DOD site.
You can conduct searches of open solicitations, put in key words,
and identify the grants that match your core competency. The search
also works for past solicitations, and, as Harmon points out, the
past is often a predictor of the future.
For free help in identifying topics that may fit your core competencies,
contact the New Jersey Small Business Development Centers of Rutgers
Business School at 800-432-1832. The centers will also help companies
develop their proposals.
These proposals can garner up to $850,000 for proof of concept work
and development of a prototype, but three years after the first grant,
entrepreneurs are expected to commercialize their technology.
"Beyond the immediate value of providing companies with a much
needed cash infusion, the real underlying value of SBIR is that it
can be a pathway to equity financing," says Harmon. "By completion
of Phase II, a company may be able to remove enough risk from their
venture to attract the interest of equity investors."
"With more than $1.3 billion available annually, SBIR is inarguably
the best source of risk capital for developing promising new technologies
and is probably the closest thing to `free’ money," says Harmon.
"Given the current state of the equity markets, and the elimination
of the New Jersey Commission on Science and Technology’s valuable
Springboard program, SBIR grants are more important to New Jersey’s
high tech businesses than ever."
Postal rates rise on Sunday, June 30. In requesting,
and winning, the rate increases the United States Postal Service (USPS)
cited a rise in the price of fuel, transportation, utilities, labor,
and healthcare costs. It said the effects of the anthrax attacks it
suffered play no part in the increases, for which it applied on September
The price of a first class stamp rises from 34 cents to 37 cents.
In answer to questions by those seeking to avoid a pocket full of
pennies, the USPS says the stamps were not priced at an even 40 cents
because "no one should have to pay more than necessary." Also,
the agency says, on its website (www.usps.com), most customers do
not purchase just one stamp, but rather buy stamps in books, paying
$3.70 for 10 or $7.40 for 20.
Priority Mail increases an average of 13.5 percent, while Express
Mail goes up 9.4 percent. The overall average increase for periodicals
rises 10 percent. Standard mail rises an average of 7.1 percent.
More detail — much, much more detail — is available on the
USPS website, which devotes no fewer than 30 pages to spelling out
the minutia of the changes. Those seeking the least expensive way
to send out bulk mailings will want to study this information.
Of more general interest is the fact that among the newest 37 cent
stamps is a gorgeous collection of photographs by America’s top photographers.
Peter Bunnell, professor of the history of photography and modern
art at Princeton University and curator of photography at the Art
Museum, assembled the collection. Demand has been brisk, especially
at Princeton area post offices. See story on page 32.
<d>Johnson & Johnson has given $610,000 to Rutgers
for such projects as mentoring programs for Hispanic and black youth,
a statewide conference on culture diversity, preparation of nontraditional
students for careers as healthcare professionals, pharmacy outreach
for underserved populations, artists’ workshops in South Africa, and
fellowships for graduate and undergraduate students. The grant brings
J&J’s total gifts for this fiscal year to more than $1.4 million.
This year’s community grants from
$1,000 to First Book to purchase books for underprivileged children,
$500 to the Historical Society of Princeton to support volunteer programs,
and $500 to Big Brothers Big Sisters of Mercer County to support "Hugs
and Smiles for Orphans."
laboratory in the college’s new science building, set to open this
fall. RVCC students earning their associate degrees in ophthalmic
science are prepared to work in retail optical stores, ophthalmologist
and optometrist offices, hospital clinics, and private practice. They
can fabricate and grind lenses and fit, adjust, and dispense eyewear
and contact lenses.
Reading problems tend to run in families, says
Fogler, and they tend to generate a virulent form of ingrown guilt.
Her mission as an educational psychologist and reading specialist
is to lift that guilt from both adults and children, and to give both
age groups ways to cope.
Neurological problems can’t be prevented, but reading experiences
can be improved. "If dyslexia is inherited, there is no cure,"
she says. "But there are ways of coping and strategies. Reading
to a child constantly can help a slow readers."
Fogler has moved her practice, Read Right Educational Services, from
Manhattan to Lawrenceville. An educational psychologist and reading/writing
specialist, she offers tutoring, educational evaluations, workshops
for parents and educators, and professional consultations. She teaches
with a multisensory system based on the Orton-Gillingham method.
Parents trying to groom a future Ivy League student may berate a son
or daughter who forgets the lesson that was drilled into them the
previous day. "Parents with children who have reading problems
often haven’t been told what the difficulty is, how it begins, what
it entails," says Fogler. "I help them understand that it
is not the child’s fault — that the child is not being lazy, ornery,
or difficult, but that it is neurologically based. There is no one
"I give strategies of what to do at home, what to expect from
the school, and how to have a collaborative relationship with the
school," she says. In her workshops she tells how to read to children
and how to look for signs of later reading difficulties.
Read to babies as young as six months old, she admonishes. "They
pick up sounds, how the language is put together, and the rhythm of
the language. It doesn’t matter that they are not understanding. Being
read to is the single biggest predictor of reading ability."
Fogler has always been an avid reader, but she is one of those who
do not do well on standardized tests. The youngest of three children,
she grew up in the Bronx, where both her parents were lawyers. She
went to Sarah Lawrence, then to Hunter College School of Social Work,
and worked as a psychotherapist. When she decided not to continue
as a therapist, she wanted to keep on working "one to one"
and to focus on children with educational problems. "In private
practice I had gotten to love having a close relationship with one
person to help them and guide them. I have always had a special relationship
with young children and reading," she says.
After earning a 60-credit master’s in educational psychology from
Teachers College of Columbia University, she opened a practice to
work with private schools in Manhattan. But after September 11 she
gave up the well-established practice for the quieter climes of Lawrenceville.
Many who emigrate from Manhattan have a hard time adjusting to the
slower pace of suburbia where bagel stores don’t dot every block,
but not Fogler. "I don’t miss a single thing about New York. Here
life is much more manageable. I am a runner, hiker, biker, and birder,
and all those are so much more accessible here. I can breathe fresh
air, see the sky, and be safe on the towpath. What more could I ask
Lawrenceville, Box 3403, Princeton 08543. Adrienne Fogler MSW, CSW
EdM, president. 609-799-2882.
<d>Judith Teller, chief information officer for the
state of New Jersey, announced the completion of the aerial photography
for the New Jersey Orthophoto Mapping Program 2002-’03. This is the
first step in an ambitious undertaking that will significantly improve
the way New Jersey’s Geographic Information Systems (GIS) community
does business in the future.
During the early spring before the trees leafed out, a flyover was
done of the entire state — the first since 1995 — using a
scale that will provide much greater accuracy and detail.
"The digital orthophotos that will be developed from the aerial
photos will serve as the state’s high-resolution basemap on the New
Jersey Geographic Information Network (NJGIN)," says Teller. "Orthoimages,
the foundation for many other geographic datasets, are critical to
the development of various municipal and commercial GIS applications
in such areas as property assessment, transportation design, permit
review, land use planning, and emergency management."
To capture aerial photographs of New Jersey’s land surface, three
aircraft, each equipped with sophisticated RC30 cameras and a Global
Positioning System (GPS) unit, were used. The planes flew at an altitude
of 9,600 feet along 48 specific north-south flight lines designed
to cover the entire state. Approximately 4,000 photo frames have been
acquired using Kodak Aerochrome III 1443 Color Infrared film, which
is less sensitive to undesirable atmospheric effects such as haze.
The next phase of the NJ Orthophoto Mapping Program involves scanning
and processing of the aerial film. The film is scanned with a precision
image scanner to create digital raster image files. The scans are
then processed, using flight altitude, GPS, and ground control survey
information, to tie them to their correct geographic locations and
to alter them geometrically, so the viewer appears to be looking straight
down at the ground at every point. This process converts the aerial
photographs into digital orthophotos. Colors and brightness are adjusted,
and the digital orthophotos are pieced together to form a seamless
basemap with no overlaps or gaps.
Finally, the digital orthophotos are cut into individual pieces called
tiles. There will be 9,201 tiles, which are about 75 megabytes each
uncompressed. Each will show 5,000 feet by 5,000 feet of ground area.
In addition, several other tile sets will be stored in digitally compressed
formats. The total storage space required for all the tile sets and
necessary accompanying files will be about 1,000 gigabytes.
The production of digital orthophotos from the film will last through
mid-summer 2003. The New Jersey Office of Geographic Information Systems
(OGIS) www.nj.gov/ogis will then host the data at the New Jersey Office
of Information Technology through the NJ Spatial Data Clearinghouse,
according to Hank Garie, director of OGIS and the state’s GIS coordinator.
Garie, who has presented extensively at national conferences on GIS,
indicated that the data will also be archived at the EROS (Earth Resources
Observation Systems) data center in Sioux Falls, South Dakota.
Orthoimagery is one of the primary framework data layers recommended
by the Federal Geographic Data Committee (FGDC) to help agencies improve
operations. In fact, orthoimagery provides a foundation for developing
New Jersey’s other essential data layers including Geodetic Control,
Parcels (Cadastral), Government Boundaries, Hydrography (water features),
Elevation, Transportation, Critical Infrastructure, and Land Use/Land
Children’s Futures has awarded nearly $2 million to
six local agencies.
Three of the organizations awarded grants — Catholic Charities,
Mercer Street Friends and St. Francis Medical Center — will create
parent-child development centers that will serve as a hub for activities
focused on improving birth outcomes and strengthening parenting in
Each neighborhood center will recruit women into prenatal care, sponsor
literacy activities and help families access health care. Plans for
a fourth site are underway.
In addition, grants to three other groups will help to engage fathers
in parenting, enhance child care, and address mental health and addiction
Union Industrial Home for Children has been awarded a $225,000 one-year
grant to encourage and sustain positive involvement of fathers in
early childhood. A "Men’s Collaborative" will include community-based
outreach to fathers, a one-on-one mentoring program to engage fathers
either at the birth of their child or before they are born, and help
fathers link to other services to help them become more involved in
the lives of their children.
Child Care Connection has been awarded a $400,000 one year grant to
improve quality in child care centers and family child care homes
in Trenton. The focus will be on enhancing training and education
of child care providers, creating safe and healthy environments, and
enhancing the educational experiences of young children.
The Greater Trenton Community Mental Health Center has been awarded
a $120,000 one-year grant to address mental health and addiction areas
affecting children’s health, including parental depression and substance
abuse. Through this grant, a team of behavioral health experts will
become part of each parent and child center’s multi-disciplinary approach
to prevention, education, and intervention.
grants are focused on Trenton’s youngest children and "create
and support an exciting new system to ensure that every child enters
pre-school healthy and ready to learn."
"Trenton now has the unique opportunity to foster new collaboration
across agencies and organizations to fulfill our mission of improving
health and development outcomes in Trenton from prenatal to age three,"
of Trustees and provost at Mercer County Community College’s Kerney
Richardson notes that Children’s Futures expects to receive additional
grant applications from organizations for its "Innovative Approaches
Fund" that is geared to support new ideas and innovative projects
that complement the initiative’s other activities.
Funding for Children’s Futures primarily comes from a $20 million
Robert Wood Johnson Foundation grant. The City of Trenton is contributing
another $700,000 annually for the next four years from a federal HRSA
Healthy Start Initiative grant to support this program. The Robert
Wood Johnson Foundation, based on College Road East, is the nation’s
largest philanthropy devoted exclusively to health and health care.
Corrections or additions?
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