Gryphon Advisory

Gryphon Advisory Gryphon Advisory helps hospitals deal with the complexity of and prosper under the march from volume We will help you plan, but plans alone are not enough.

The unique circumstances that every hospital faces mean that one-size-fits-all approaches will never help you reach your potential. Gryphon delivers custom solutions, tailored to your individual and changing situations. We help you achieve success through flawless ex*****on based on clear goals, performance measurement and the right rewards. Gryphon CEO Bob Langston’s 30+ years of consulting exper

ience mean that he can help your organization by providing specialized expertise, jump-starting projects and driving to successful, profitable results. Our services are provided a la carte so that you get precisely what you need.

08/26/2021

On Friendship

The world appears to be enduring a seemingly endless stream of crises and chaos has materialized as the rule of the day. I am generally resilient enough to let most of the noise fade away accompanied by the crescendo of morning ragas and the transcendent perfume of Indian temple incense. For some reason my usual restful sleep was disturbed with fitful dreams and apocalyptic feelings of dread. Greatly was I discomfited when I first arose in the early morning gloom.

After a few minutes’ reflection I had a sensational revelation. Like Emerson “I awoke this morning with a devout thanksgiving for my friends, old and new.” My friends are the bedrock of my existence, an immovable, invariable, constant, and ceaseless source of comfort and joy. This exists no matter what maladies swirl about us.

In 1997, a friend of mine gave me as a birthday present a small book titled, “On Friendship”. I’ve kept on my bookshelf ever since and providentially it caught my attention this morning.

The author provided a brief prologue that I thoroughly enjoyed and think did an admirable job of capturing the importance of friendship to us all. It struck me so that I include it here.

“What is more welcome than the sound of a friend’s voice, the sight of their smiling face, the warmth of an embrace? It is one of life’s finest blessings t have a friend with whom you can safely discuss your fears and enthusiastically share our dreams – someone who accepts us totally as we are despite our shortcomings.

A true friend encourages us, comforts us, supports us like a big easy chair, offering us a safe refuge from the world. A true friend stands at our side during the best of times and the worst of times. A true friend listens when we need to talk through a problem. A true friend answers the phone at midnight and does not resent the call. A true friend will defend us to the world.

We speak of “friends and acquaintances” because we know the difference. Acquaintances we meet, enjoy, and can easily leave behind. But friendship grows deep roots. Even when we are separated by time and distance, friendship continues to grow and mature. We’ve all had the experience of meeting an old friend after many years and discovering that we are able to renew our relationship as if the separation had only been a few minutes.

A Nigerian proverb advises, “Hold a true friend with both hands.” True and faithful friends are indeed a treasure, touching our hearts and strengthening our spirit with their words, and sometimes just by their silent presence.”

I hope that no matter what is going on around you or how the current state of the world’s affairs is affecting you that you have friends that can double your joy and halve you sorrow.

“Think where a man’s glory most begins and ends
And say my glory is I had such friends.” (W. B. Yeats)

When Br’er Deer and Br’er Terrapin Runned a Race “I still t’ink Ise de fas’est runner in de worl’” the bewildered Deer c...
01/10/2021

When Br’er Deer and Br’er Terrapin Runned a Race

“I still t’ink Ise de fas’est runner in de worl’” the bewildered Deer complains after a race in which Terrapin has done something that would get him banished from every competition in the world. “Maybe you air, Terrapin responds, “but I kin head ou off wid sense.” (Uncle Remus and Algonquin tales)

There is always more to the story than appears on the surface. Consider this excerpt from Chapter Six of Malcolm Gladwell’s ‘David and Goliath’ about Bill Hudson’s [AP civil rights photojournalist] iconic 1963 photograph of police brutality in Birmingham, Alabama.

“The boy in Bill Hudson’s famous photograph is Walter Gadsden. He was a sophomore at Parker High in Birmingham, six foot tall and fifteen years old. He wasn’t a marcher. He was a spectator. He came from a conservative black family that owned two newspapers in Birmingham and Atlanta that had been sharply critical of [Dr. Martin Luther] King. Gadsden had taken off school that afternoon to watch the spectacle unfolding around Kelly Ingram Park.

The officer in the picture is Dick Middleton. He was a modest and reserved man. ‘The K-9 Corps,’ McWhorter writes ‘was known for attracting straight arrows who wanted none of the scams and payoffs that often came with a regular beat. Nor were the dog handlers known for being race idealogues.’ The dog’s name is Leo.

Now look at the faces of the black bystanders in the background. Shouldn’t they be surprised or horrified? They’re not. Next, look at the leash in Middleton’s hand. It’s taut, as if he’s trying to restrain Leo. And look at Gadsden’s left hand. He’s gripping Middleton on the forearm. Look at Gadsden’s left leg. He’s kicking Leo, isn’t he. Gadsden would say later that he had been raised around dogs and had been taught how to protect himself. ‘I automatically threw my knee up in front of the dog’s head,’ he said. Gadsden wasn’t the martyr, passively leaning forward as if to say, ‘Take me, here I am.’ He’s steadying himself, with a hand on Middleton, so he can deliver a sharper blow. The word around the movement, afterward, was that he’d broken Leo’s jaw. Hudson’s photograph is not at all what the world thought it was. It was a little bit of Br'er Rabbit trickery.

You go to use what you got.

‘Sure, people got bit by the dogs,’ [Wyatt] Walker [Executive Director of the Southern Christian Leadership Conference] said, looking back twenty years later. ‘I’d say at two or three. But a picture is worth a thousand words, dahlin’.’”

The AP widely circulated Hudson’s photograph, shocking and appalling many, and doubtless influencing members of Congress to pass the Civil Rights Act a year later.

Consider the similarly shocking photograph of protestors scaling the Capitol wall. What do we know about these individuals? What assumptions are being made? Have these photographs been examined critically? What don’t we know that would add context to their actions?

01/17/2017

Just wondering: will the Deep State prevent meaningful change following the repeal of the Affordable Care Act?

04/01/2016

1% inspiration; 99% perspiration. Thomas Edison said that he never made a discovery, but rather all of his work was deductive. He would evolve a theory, stretch it until it was untenable and then evolve another theory to be tested.

So it must be with our pursuit of success under accountable care and bundled payment. Effectively lowering the cost of a clinical bundle or episode takes a great deal of work (the 99% perspiration kind). One of the challenges is the shortage of expertise created by the overwhelming demand by hospitals. This challenge will be exacerbated by the looming physician shortage. This vexing scarcity can be reduced by internal skill building and supplementation with business savvy consultants, particularly when supported by senior leadership through rewards for experimentation and a broad tolerance for failure.

Your team’s efforts have little prospect of success if they are not supported by effective information. Understanding the subtleties of the business and how to measure success comes only where teams have access to aggregated relevant clinical, financial and operational information. While there are a great number of extant EHRs, data warehouses and other data solutions, it is unlikely that any single one of them will be sufficient for your needs.

Lastly, consumer driven healthcare is here and here to stay. Any successful model must take patient engagement and patient satisfaction into consideration. This has to occur at the earliest possible moment in the care pathway and be an integral component throughout the pathway until the patient no longer needs care for the episode or bundle.

Strong executive and physician leadership with a clear strategic understanding of episodic care and a willingness to let their teams stray from hide bound approaches will lead the organization to remarkable success.

03/31/2016

8 Things Hospitals Should Be Asking to Ensure Readiness for Tomorrow’s Launch of CJR (spoiler alert: 60% or more aren’t ready):

1. Have you built surgeon and hospital alignment to foster CJR success? If so, how do you know its working?

2. What opportunities exist to reduce costs and improve clinical outcomes? How deeply have you drilled?

3. How can you reduce post discharge costs? How will you reduce admissions to SNFs and rehabilitation facilities?

4. Have you considered adding a gain-sharing component? Can your initiatives be successful without one? How would that occur?

5. What clinical pathways are required from the point of initial contact with the patient through the end of the episode period?

6. What changes must be made to governance and operational structures to support and optimize results?

7. How will you ensure real-time sharing of patient information between the surgeon, clinical teams and administrative teams?

8. How will you measure and drive performance? What information/scorecards will be required? Do you have the right technology to support the effort?

BONUS QUESTION: Do you have the internal experience and expertise to pull it off?

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