Pat Lynch’s Calendar

January 20, 2013 by Pat Lynch

Ask me anything at  plynch@gmi3.com

2011-09-01 08.22.35

2014 Calendar

April 8 – HTMA-Nevada, Las Vegas

April 9-11 – MD Expo in Las Vegas

April 29 – Gateway Biomedical Society, St. Louis

April 30 – Meeting of Biomedical Service providers to Haiti

May 9 – HTMA-SC Conference (Columbia, SC)

May 20 – CMIA Orange County

May 30 – Manny’s Meeting at AAMI – Philadelphia

May 31 -June 2 – AAMI in Philadelphia

July 15, 16 – MD Imaging Expo – Indianapolis

Sept 3,4,5 – NCBA (NC) in Concord, NC

Sept 10, 11, 12 – NCBA (MN)

Sept 17, 18, 19 – VBA – Richmond, VA

Sept 24, 25, 26 – BAW – Wisconsin (presentation via teleconference)

October 1,2,3 – MD Expo/FBS – Orlando

October 24 – Oregon Biomedical – Portland, OR

 

Best practices don’t matter. Here’s what does.

August 29, 2014 by Pat Lynch
Written by Lindsey Dunn | August 27, 2014
High-reliability organizations don’t implement best practices. They continually make new best practices.

Healthcare is an industry obsessed with best practices. And for good reason. Our costs our growing almost uncontrollably, and quality is highly variable from hospital to hospital, department to department and physician to physician. It makes sense, then, that organizations seeking to improve a measure would look to those who are top performers and emulate their processes.

However, instituting best practices isn’t the approach taken by the highest-performing organizations.

What is?

To read the entire article, click here.

Hand-Held Medical Sensor – Tricorder?

August 28, 2014 by Pat Lynch

Finally, that nerdy dream has come true in the form of the Scanadu Scout, a small scanner that lets you conduct sophisticated medical examinations without any of the uncomfortable conventional medical instruments.

real-life tricorder health data measuring device

Scanadu was created in NASA’s Ames Research Center after a two-year mission to create a portable medical scanner. The Scout, which can fit in the palm of your hand, measures temperature, heart rate, and pulse oximetry (or oxygen in the blood). All of the measurements are performed simply by holding the Scout up to your forehead.

hand-held health analyzing device

The Scout transmits this vital health information via Bluetooth to a smartphone app. Users can then keep their own medical information stored safely and track trends as they emerge. The information can be shared with doctors as needed, or users can spot trends related to how stress, medications and certain situations are affecting their health. It’s a device that can change the way consumers manage their own health, minimizing needless trips to the doctor and alerting patients to possibly serious conditions.

Who are you hiring for your C-suite? 10 statistics

August 27, 2014 by Pat Lynch

Written by Dani Gordon  August 25, 2014

Forty-four percent of internal hospital or health system CEO promotions were former COOs, according to a recent Billian’s HealthDATA report.

The healthcare market sees a plethora of C-suite moves each year. Billian’s HealthDATA released a report pooling data from 384 executive moves from January to July of 2014. Here are 10 statistics on hospital hiring, according to the data.

1.    Forty percent of placements were internal promotions, whereas 60 percent of hospital placements involve an outside-hire.
2.    More than half (58 percent) of CEO outside-hires were former CEOs of other hospitals.
3.    CEO moves to other CEO positions at sister campuses made up 12 percent of internal movements.
4.    The promotion  . . .        read more here .   FROM Becker’s Hospital Review. . .

60 things to know about healthcare reform

August 25, 2014 by Pat Lynch
Written by Dani Gordon (Twitter | Google+)  | August 19, 2014

Health reform is and has been a hot-button issue for both politicians and healthcare leaders for the last few years, though talk of significant, government-led reform has been discussed for decades. In the wake of the Patient Protection and Affordable Care Act, healthcare reform is a highly contested and very politically polarizing issue. It is therefore very important to know what is going on and where. The following are 60 things to know about healthcare reform in the United States.

1. The Senate passed the PPACA on Dec. 24, 2009 with a 60 to 39 vote after months of heated partisan debate. It then passed in the House on March 21, 2010 with a vote of 219 to 212 to approve the measure, and on March 23, 2010, President Obama signed the original PPACA into law.

Read the rest at Becker’s Hospital Review

http://www.beckershospitalreview.com/lists/60-things-to-know-about-healthcare-reform.html

 

TEE Transducers – What care do they need between patients?

August 25, 2014 by Pat Lynch

There are a few special items in medicine which are not currently being care for properly.  We all know that instruments used in surgery must be sterilized between patients.  We also know that IV tubing and syringes must be kept sterile after opening the package in which they are contained.  But what about TEE transducers (also called TEE probes)?

TEEs are special (and expensive) ultrasound probes which are placed into a patient’s mouth and down their throat.  The purpose of a TEE is to see a clear picture of the heart.  You see, the sternum (or breastbone) forma a protective armored plate over the heart.  Ultrasound cannot penetrate the bone of the sternum.  So the only way to see the heart clearly is to go BEHIND the sternum.  Conveniently, there is an available passageway which doctors can use.  It is the esophogus.

Since TEEs are used on multiple patients, there is a prescribed cleaning method between each patient.  This is intended to assure that any germs, etc. from one patient are not transferred to another.  Each TEE manufacturer had their own cleaning process, but they are all very similar.

A problem exists when the TEE develops a pinhole tear in the plastic covering.  This canhappen through normal wear and tear, but can also be caused by a single incident.

Unfortunately, humans don’t like having things stuck down their throats.  They do all sorts of things like gag and bite and choke.  It is this reason that relaxation drugs are used to reduce these effects and provide comfort for the patient.  But these drugs don’t completely eliminate the involuntary events, like biting.  So the common (and required) practice is to use a BITE GUARD when performing these procedures.  Bite Guards are plastic devices which fit between the teeth and keep the patient from biting (and damaging) the very expensive TEE.  Often bite guards are not used or they become dislodged.  When a patient bites the TEE, there is a real possibility of cross-contamination between patients.

How do we discover if a TEE has a pinhole inthe outer insulation?  Visual inspection is ineffective, because the holes are often too small to be seen.  There is only one way to provide complete assurance that a TEE is safe for use on the next patient:  perform an electrical leakage test to determine the electrical and biological integrity of the TEE.

It is a property of electricity that when measuring electrical resistance between the inside and the outside of a TEE, the reading will be infinite (and no electricity will flow) if the plastic outer covering (sheath) is completely intact.  If the covering has even the smallest pinhole perforation, there will be some measurable electicity flowing through the pinhole. This is only detectable by using a sensitive voltmeter designed to measure this LEAKAGE CURRENT.

A leakage current of ZERO provides proof that the sheath is in tact and there is no chance of hidden cross contamination.

An added financial benefit of this testing is that early detection of a pinhole minimizes the chance of fluid invasion and the corrosive damage that it can cause if undetected for any period of time.  Very early detection can lead to immediate repairs – often at a much lower cost than undetected leaks which can completely ruin an expensive TEE.

Free Ebook about furthering your career

August 12, 2014 by Pat Lynch

This ebook is free and has 50 tips for furthering your career.  Originally written for IT people, it applies equally well to Biomeds and the HTM profession.  Seriously, it has some very excellent tips for all of us. Unless you are withing 3 years of retirement, you need to do the things it recommends.     Pat

Download Ebook

10 Ways for Hospitals to Reduce Costs (see number 9)

August 11, 2014 by Pat Lynch

10 Ways for Hospitals and Health Systems to Increase Profitability in 2012
Written by Bob Herman | November 29, 2011
Social Sharing

To say hospital and health system operating margins are different today than they were a decade ago may be an understatement. Medicare reimbursement reductions, cuts to state Medicaid programs and rising tides of uncompensated care have created an atmosphere where some hospitals, particularly smaller, community hospitals, are simply happy with a break-even balance sheet.

The environment is unlikely to change in the short term. The supercommittee was unable to reach a bipartisan agreement to cut $1.2 trillion over 10 years, and it will cause sequestration cuts of 2 percent to Medicare starting in 2013.

While 2012 may appear to be a grim time for hospitals to keep their finances positive, there are several things hospitals can do to go beyond just maintaining solvency. Hospitals and health systems essentially have two options: They can either cut costs or create new revenue streams. Here, several healthcare leaders share their thoughts on how this can be done and offer one recurring theme: Hospital and healthcare leadership needs to evaluate a multitude of planes rather than relying only on across-the-board savings cuts.

1. Focus on the continuum of care. One of the biggest changes occurring in healthcare is the full-scale shift away from fee-for-service and volume-based measures toward accountable care organizations and quality-based measures. Ann Pumpian, CFO of Sharp Healthcare in San Diego, says hospitals will need to look at the entire continuum of care, regardless if they join an ACO, if they plan to stay profitable in 2012 and beyond. She says the continuum of care hospitals need to focus on includes the initial admission, how services are provided within that admission to create the most efficient process for a quick yet appropriate discharge, a discharge to the appropriate post-acute setting and follow-ups with that discharge.

Pearson Talbert, president of Aegis Health Group, says hospitals can take it one step further by fostering stronger, mutually beneficial relationships with physicians — especially primary care physicians. In addition to quality- and value-based principles, healthcare reform is also centered on preventive care, managing chronic illnesses and keeping people healthy before a hospital trip is required. To do that while staying profitable, Mr. Talbert says hospitals must focus on physician alignment and actively engage with the primary care physicians in their communities. “The primary care physician is the air traffic controller for the patient,” he says.

Ms. Pumpian also emphasizes the hospital-physician relationship. Although some states prohibit hospitals from employing physicians, she says hospital efficiency and solvency hinges on a hospital’s affiliation and collaboration with physicians. Physicians facilitate patients through the continuum of care, and next year, it will be paramount for hospitals to keep and recruit high-quality physicians who increase a hospital’s referral base, have high ratings of patient satisfaction and have the highest commitment to quality patient care. “What is key is to make certain that these physicians and institutions are going in the same direction,” Ms. Pumpian says. “Both need to be incented to do the same thing, which is what’s best for patient care.”

2. Design models to reduce readmissions. Hospitals that realign their goals toward the entire continuum of care can then focus on one of the more pertinent aspects: reducing readmissions. Readmissions negatively impact a hospital’s bottom line in several ways, such as the high costs associated with them and scrutiny from private health insurers and patients. Now part of President Barack Obama’s healthcare reform, hospitals with high levels of preventable readmissions face the potential of losing a portion of their Medicare, Medicaid or other governmental reimbursements. “If [other hospitals] are not gearing up for that now, they are really behind the eight-ball,” Ms. Pumpian says. “They should’ve been doing this years ago.”

She says there are several ways hospitals and their physicians can effectively reduce their readmissions, such as ensuring patients attend post-acute office visits routinely after discharge and overall providing resources to people to ensure they are taking the proper post-discharge steps. “This has proven to be a key indicator to keep readmissions from occurring,” Ms. Pumpian adds.

Scott Downing, executive vice president and chief sales and marketing officer at VHA, says a hospital’s preparation for the readmission risk is “absolutely critical,” and much of the responsibility will fall on a hospital’s case management and preventive care staff, who will need to be properly trained and managed to ensure overall readmission rates go down. “A hospital’s case management [staff] has to engage in conversations with the patients to help them be compliant with that care path,” Mr. Downing said. “There’s a wealth of effort and resources that hospitals apply, but they’re going to have to become even better at that.”

3. Have a good relationship with payors, and renegotiate managed care contracts. While hospitals cannot control the underpayments from Medicare, Medicaid and other governmental payors, they have a semblance of control over one major outlet: commercial and employer-based payors. Mr. Talbert says private insurance carriers comprise, on average, 35 percent of a hospital’s revenue.

According to Kyle Kobe, principal at healthcare consulting firm Equation, hospitals must take the time to understand existing contracts, benchmark managed care contracts against each other, conduct research to know what percentage of the insurer’s business comes from the hospital, routinely update stagnant and evergreen contracts and look for carve-out opportunities. Hospitals and their managed care departments must be prepared when renegotiating contracts, but at the same time, a level of respectful dialogue must exist — otherwise, fallouts will occur, leading to costly periods of no reimbursement and a public relations nightmare. “Often times, people don’t think about the fact there is a mutual respect that needs to occur with the payor and institution,” Ms. Pumpian says. “That is earned over time in a manner that allows you to help collaborate, design and develop the care delivery models and product designs that those payors will ultimately use.”

4. Manage new service lines to increase market share. When it comes to “creating new streams of revenue” for hospitals, this most commonly refers to adding new service lines. Larry Moore, CFO of Cumberland Medical Center in Crossville, Tenn., agrees increasing market share through new services is the most effective way to deal with any reduction in net payments.

Hospitals should not merely add any service line — for example, orthopedics — because it is historically profitable. Mr. Moore says hospitals need to conduct research and look at the demographics of their locale to determine which service lines are needed, what competitors in the area offer and what services stand to gain the most referrals. For example, roughly 10,000 baby boomers are becoming eligible for Medicare every day, and Mr. Moore says Cumberland, which has a high Medicare population, has been focusing on cardiovascular services. Additionally, he says the surrounding population tends to have a higher concentration of obese patients, and therefore Cumberland is also focusing on enhancing its orthopedic service line.

Conversely, if hospitals want to become or remain profitable next year, they will have to monitor their service lines to see if any are hemorrhaging money. Jack Lahidjani, president of Mission Community Hospital in Panorama City, Calif., says this is especially important for community hospitals, as community hospitals can’t be the healthcare provider for all. “Most community hospitals don’t create a differentiation between themselves and a tertiary facility or a teaching facility,” Mr. Lahidjani says. “We can’t have the same number of programs as a Cedars-Sinai. They can afford to lose money on 10 to 15 programs because they are making money on the other 80. We need to evaluate every program on a quarterly basis and make adjustments accordingly. Hospitals need to be aware of community needs and cater to those needs.”

5. Control labor costs with meticulous data collecting. At most hospitals, more than 50 percent of expenses are related to labor costs or labor-related costs, and Mr. Lahidjani says “if you can’t control your labor costs, working on anything else almost becomes immaterial.”

Mr. Lahidjani, who also used to be CEO of the physician-owned and Los Angeles-based Miracle Mile Medical Center and CFO of Los Angeles-based Alta Healthcare System, says his hospitals hold daily “labor control meetings” for 10 minutes. Every department shows up, goes over their respective staffing metrics and manages their labor on a dollar-per-patient-day level. “If we are overstaffed by one nurse in surgery and understaffed by one nurse in the emergency room, can we move the surgical nurse to the ER?” Mr. Lahidjani says. “This type of communication where every manager and operator in the hospital gets on the same page also creates awareness of what’s going on in the other parts of the hospital.”

If hospitals do not manage their labor costs or have staff meetings on their labor rolls every day, then he says hospitals should, at the very least, be data-driven on this front on a bi-weekly, monthly, quarterly and annual basis.

6. Reduce supply costs by working with vendors and physicians. After labor costs, supply costs are the second-largest money eater of a hospital’s operating budget. Clark Lagemann, vice president of Health Options Worldwide, says hospital leaders can reduce supply costs through two main ways: working with vendors to improve contracts and encouraging physicians to make fiscally responsible supply decisions. “A hospital should not shy away from approaching vendors for discounts,” Mr. Lagemann says. “This may help alleviate costs on the purchase product, and in my experience, most vendors are willing to negotiate if the volume of product allows for it.” Additionally, approaching physicians and working together to create a more cost-conscious supply plan for every department can help foster a better working relationship with physicians in addition to supply savings.

7. Improve deficiencies in the emergency room and operating room. Many hospitals consider their ERs and ORs to be two of the most important areas of a hospital because they represent a traditional “money loser” and a traditional “money winner.”

ERs and trauma areas are vital to any community health system, but hospitals have been facing growing numbers of uninsured patients walking into their ERs. This is leading to high amounts of uncompensated care. However, there are ways hospitals can reduce the large costs and pressures associated with the ER and its high volume of uncompensated care. Phil Lebherz, executive director of the non-profit Foundation for Health Coverage Education, says hospitals must actively use the ER to their advantage, as roughly 80 percent of the uninsured patients who come into the ER are eligible for some type of publically funded program. He says hospitals should make it a priority to help ER patients complete applications for publicly funded health coverage like Medicaid. This could make patients more willing to seek preventive care instead of resorting to last-minute, much-needed and highly expensive ER treatment, and it will also directly reduce a hospital’s uncompensated care and bad debt.

A hospital’s OR is typically one of the most profitable areas of a hospital due to the type of surgeries performed, and Mr. Lagemann says improvements in the OR can help a hospital maintain its levels of profitability. For example, he says future profits lie in new equipment, such as smart ORs and hybrid ORs. Mr. Lagemann adds that new technology, although an investment at first, can eventually lead to higher market share and patient volume, and it can also lower reoperation rates, which could improve reimbursements.

8. Create population health management programs to gather health data analytics on chronic illnesses. The ACO model, or at least its population-health emphasis, is shifting hospitals’ thinking of how to be profitable. Mr. Talbert says hospitals are asking themselves if they are in the “healthcare” business or the “sick-care” business, and more often than not, he says they find they are in the “sick-care” business as they wait for patients to become sick before addressing health issues.

To counter this, Mr. Talbert says hospitals will need to create formal population health management programs through which the hospital can reach out and gather health data analytics on its local patients as a way to address potential health problems before they become costly, chronic issues. “If we are going to control costs of healthcare and start bending the curve downward, we have to start looking at things from the perspective of population health management,” he adds. If hospitals are able to see data and cost figures associated with chronic diseases — such as diabetes, cardiovascular disease, asthma, hypertension and others — they can reach out to their communities to start chronic care programs to mitigate costly, long-term health problems.

9. Consider outsourcing some services. Outsourcing services at hospitals is nothing new, but Mr. Lahidjani says eliminating the administrative overheard and farming out functions that are better handled on an independent contractor basis will directly result in bottom line savings. Laundry services, housekeeping, food services, facility maintenance and some biomedical and clinical departments are commonly outsourced services. Mr. Lahidjani says his hospital has also experimented with outsourcing its nurse education. Mission Community Hospital did not want to end its nurse education program, but it also did not know if it could continue to incur the program’s operating costs. Currently, the outsourced company has individuals that show up two or three times a month to hold its nursing educational seminars. Mr. Lahidjani says their nurses are still getting quality “know-how,” but their expenses have since been lowered.

A hospital must be prudent when it decides to outsource a service, though, and it must have a contingency plan if the proposal does not work out. “Whenever you outsource a service, you need to be prepared to bring it back in case the relationship disintegrates or if the third party is not able to provide the level of service we expected or anticipated,” Ms. Pumpian says.

10. Revamp the energy cost strategy. “Going green” could be more than just a strategy that positively impacts the environment and reduces reliance on fossil fuels — it could also save on a hospital’s bottom line.

Dennis Olson, vice president of facilities at Mayo Clinic Health System in Eau Claire, Wis., says the hospital system has been actively revamping its sustainability and energy cost strategies, and it’s led to significant results. One of the larger projects involves the use of geothermal energy at a one of the health system’s dialysis centers under construction. Various pieces of equipment run through the ground and can extract heat or cooling from the natural ground water, which is typically around 45 to 50 degrees Fahrenheit. This extracted heating or cooling can be diverted to warm up the building in the winter and cool the building in the summer. He says a geothermal energy project is fairly expensive up front, but the benefits are in the long-term. Hospitals can expect a payback on its investment within seven to eight years, all while the hospital provides its own, truly natural energy. “You’re not burning any fuel to get heating and cooling sources such as natural gas or oil, and instead, you’re letting the Earth’s resources handle that,” Mr. Olson said.

For hospitals that are not quite ready to tackle a project as large as self-sustaining geothermal energy, Mr. Olson says there are smaller things hospitals can do in their energy savings strategies that can pay off immediately or within a couple years. Mayo Clinic Health System has installed automatic faucets to reduce water overuse, and it also has had low-flow waterless urinals for a year. Both of those smaller projects have cut their water bills significantly, he says. Motion sensors for lighting, shifting to LED lighting, vegetative roof gardens, mass-scale recycling efforts and several other small-scale initiatives can also give any hospital the ability to cut back on its energy costs as well as its BTUs per square foot.

Equipment Purchase Price Spreadsheet

June 26, 2014 by Pat Lynch

Filling in the purchase price of every individual item of medical equipment is the first step to preparing to calculate the COSR (Cost Of Service Ratio).  It is also next to impossible to research hospital purchase orders to determine the actual price paid.  So we have to estimate.  Below is a tool to help you with that.  I have compiled a list of over 1700 different medical equipment descriptions, along with the average price paid by the hospitals.  It comes from an inventory of 213,000 items, so the number should be pretty good.  Please download it and use it to backfill your inventory price.  You will then be one step closer to calculating COSR.

Cost of Medical Equipment 1A

Pat

 

6 Habits That Keep You From Being Happy

June 9, 2014 by Pat Lynch

from The Daily Mind

Posted: 03 Jun 2014 05:25 AM PDT

Have you been feeling as if you’d never be happy? Have you been yearning for happiness all your life, and it seems that you just can’t reach that state?

Now, have you ever thought that perhaps, you are part of the reason you are unhappy? Perhaps, you have some of these habits that keep you from being happy.

As Abraham Lincoln once said, “Folks are usually about as happy as they make their minds up to be.”

I am the first to admit, however, that it’s easier said than done. You make up your mind to be happy, and yet external circumstances do affect how you feel. Our thoughts may not be under our control, which can ultimately lead to unhappiness.

What I can suggest is to examine yourself, your habits, and thinking patterns. Here are six habits that keep you from being happy, and if you find yourself having at least one of them, then you know what you need to do!

1. Holding on to the past.

There’s this movement about living in the present, appreciating every single thing that is happening to you right at the moment. It is the complete opposite of living in the past, or holding on to memories that do not help you appreciate what you have today.

The past happened, sure. It has its effects on you – both positive and negative, but it does not do you any good to dwell on the negative effects. The past is over. You cannot change it, and you cannot totally forget how it may have scarred you.

If you do want to be happy today, though, then you have to try to overcome the negative effects of your past and not keep thinking about the horrible things that have happened to you. All of us have a past, and yet the happy people do not hold on to that past.

Do you want to be happy? Stop holding on to the past and think about what makes you happy NOW.

2. Waiting for the perfect time.

There is nothing wrong with striving for perfection. There is nothing wrong with waiting. Sometimes, though, if you keep waiting for the perfect time to do something, you’ll end up waiting forever.

What is that one (or two, or three) thing that you have always wanted to do, and yet have not done because you’ve been “waiting for the perfect time”? Make the decision to do it. Set a time limit or a schedule, and just do it.

You might be surprised that you can make any time the perfect time if only make a decision.

3. Always putting the blame on others.

 

Image source

Be totally honest with yourself. What are the things that are making you unhappy? Problems at work? Your relationship? Your finances?

Who/what do you think is responsible for these “unhappiness causes”?

If you’re always finding someone or something else responsible, then maybe it’s time to sit back and really think about things. It’s time to admit that you are actually responsible for the things that happen in your life – or at least how you react to some things – and that blaming others will get you nowhere.

Once you have accepted responsibility, you can actually do something about your situation. You’re not happy? Take charge of your happiness and stop blaming others.

4. Allowing fear to hold you back.

“Fear is the mindkiller.”

That’s probably my favorite quote ever, and it’s from the fantasy classic “Dune” by Frank Herbert. It is very true in my life, which I have to admit is rife with fear; something which I have been working on.

All those times I have allowed fear to control me, I have been unhappier than I have ever been. Fear is very much real, and don’t look down on yourself for feeling it; but if you want to have a chance at happiness, you should put fear in its place – behind you. Take that step forward, and don’t let your fear(s) hold you back from doing something that you believe is true or right.

Try it with little things. For example, if you have this fear of being alone eating at a restaurant, why don’t you try doing it this weekend? Choose a place which you’re comfortable going to, and conquer this fear.

Little by little, you can get over those fears and before you know it, you’ll be doing things you used to be afraid of AND you’ll be happy while doing them.

5. Caring too much about what others might think.

To a certain degree, we all care about what others think. And that’s good. In a way, the opinion of others – especially those whom we love and respect – helps us stay on the right track.

However, if you’re making decisions and doing things because you think that’s what this person or that person will think is right all the time, STOP. You are not in this world to live up to other people’s expectations.

It’s your life. Don’t care too much what other people will say as long as you know in your heart it’s what you want and/or right for you.

6. Going for instant gratification.

This is an easy trap to fall into, what with our culture being a “want now!” one. We have instant noodles, instant rice, movies on demand, and instant everything!

In terms of being happy, we have these little habits that give us instant gratification, fooling us into thinking that we’re happy. The next day (or maybe even only hours later), we fall back into the good, old unhappy rut.

Think: retail therapy, binging on food, and drinking yourself to sleep.

These are all temporary things that give instant gratification, but have no lasting positive effect. If you see this pattern in your life, and you want to be happy now – and for the long-term – then it’s time that you stop indulging yourself all the time.

Do you have any of these habits that are keeping you from being happy? It’s time to let them go, and form new habits!

30 Of The Hardest (But Most Necessary) Things That Must Be Done To Achieve Success

June 2, 2014 by Pat Lynch
Money
posted at EliteDaily.com
 Success is defined differently for everyone; however, facing difficulties on the road to success is a common denominator for anyone pursuing his or her passions.

What separates those who see their dreams through and those who don’t is the ability to do what others will not. Everyone can dream of eventual success, but accomplishing one’s goals requires taking on the difficult tasks and functions for which many people do not have the courage or stamina.

Winston Churchill said, “Success is not final, failure is not fatal: It is the courage to continue that counts.”

Taking on the hard tasks time and time again is what defines a person’s character and generates the most rewarding results. Success is not a tangible product. It is a lifestyle and a mindset. And those who have found their version of success did not avoid the most difficult steps.

Here are the 30 hardest things you need to do to be successful:

1. End friendships if they are not beneficial to your overall goals.

2. Prove the doubters right by making mistakes, before proving them wrong in the long run.

3. Realize if you are unable to maintain a romantic relationship.

4. Avoid the “fake it ’til you make it” belief and focus only on making it.

5. Allow the idea of “the greater the risk, the greater the reward” to lead your actions.

6. Fail with your head held high.

7. Wake up earlier than others.

8. Maintain self-worth even when nobody else sees your value.

9. Talk about ideas, not people.

10. Put in more than you get in return at first.

11. Stick to a strict schedule, even if it makes less time for excessive fun and relaxation.

12. Over-deliver, don’t over-promise.

13. Respect the competition.

14. Support the success of others, rather than hoping they fail.

15. Understand that the first version of your idea may not be the best.

16. Sacrifice your social life and weekends.

17. Admit you need help and ask others for guidance.

18.Turn the complex into simple, so people can best share your vision.

19. Be accountable for all failures without blaming others.

20. Accept insecurity and fear as unavoidable emotions.

21. Don’t actively seek credit for success.

22. Track finances to the penny.

23. Celebrate the small victories even if the end goal is far away.

24. Don’t spread yourself too thin.

25. Embrace change and adapt accordingly.

26. Place money at the end of your priority list.

27. Don’t overthink and learn to trust your gut feeling.

28. Do what others would say is an impossible task, without making excuses or feeling like a victim.

29. Get up after getting knocked down, stronger and more prepared than before.

30. Smile at the people who doubt your abilities.