Days of Cash and Orders of Magnitude

It has been awhile since I updated the blog, and in some ways, I was wondering what new insights might be interesting and enlightening to those of you still following my thoughts. Then, once again, a confluence of disparate experiences provided me a new perspective.


I’ve just returned from my 3 week session in Boston with my colleagues at the Masters in Health Care Management program. We spent a great deal of time on the financial structures of hospitals, endowment portfolios, and concluded with a project analyzing and rating bond proposals. As my team worked through financial statements to determine liquidity, we calculated days of cash on hand. In all the statements, the numbers were expressed in thousands of dollars. A million looked like a thousand and a billion was expressed as a million. Daily operating expenses allocated to thousands of dollars per hospital bed. It is a necessary shift in thinking as you move toward hospital administration –when your previous individual P&L was allocated to the dollar, small changes could make big differences. Now it is time for me to think on a different scale and with an eye toward the system and not the individual.

So when I opened my email the other day, I was pleased to see an update from CRUDEM and Hospital Sacre Coeur. Although the acute earthquake related patient population is drawing down, it became clear that the Hospital needed to expand to serve the population and increase the range of services. As I was leaving in April, a new NICU had been opened and the Haitian medical staff were being trained by CRUDEM volunteers. Lou Snyder, a cardiologist and classmate in Boston, had visited Haiti last month, including HSC. He was extremely impressed with the infrastructure being developed, and hoped to make cardiology services more widely available. The water plant is up and running, and oxygen system coming on line. I was excited to hear of the progress and commitment to continue to grow beyond the current 83 beds.



All this takes money. I have previously noted that on a per dollar basis, HSC provides high value medical care. So do you want to sponsor the Hospital for a full day (and increase balance sheet liquidity?) You can do so through CRUDEM – for only $2342 (that's just a "2" on our big balance sheets.) The Angel of the Day program gives everyone the ability to help the Haitian people and know where your aid is going. There are other fun events locally, including a Taste of Haiti to be held later in September in Boston. You can look on the CRUDEM site – www.crudem.org for more info.

I will be returning to Milot the second week of September. Through some degree of kharma, it will be six months from my initial visit and I look forward to sharing updates on our patients and the recovery of the Haitian people. I am truly grateful for your thoughts and encouragement. Plus, I need some new pictures to share and experiences to add to the blog. For friends and family that haven't yet been able to travel to Haiti, I hope that my words and images reflect the multiple orders of magnitude returned on your investment in time, money, and support.

I'll be blogging more as the time approaches, and certainly during the trip.