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Learning From the Night Crew
I greatly enjoyed your article in the October 2008 issue of HealthLeaders, "The 24-Hour Executive." In my 21-year military career as an Air Force Medical Service Corps officer and in the 18 years since, I have been a strong advocate for 24-hour leadership. Usually within my first two weeks at the helm of a hospital I come in through the emergency room at 2 a.m. to meet my night crew and observe the hospital "in action" in the middle of the night.

Frequently I have been greeted with suspicion and the question, "Are you here trying to catch someone asleep on duty?" To that inquiry I typically respond, "No, I am here to meet you as a member of our patient service team and to hear what you have to say."

I have learned that I can frequently learn more about the hospital from a 20-minute chat with the night crew than I can from any board member or from most members of the executive team. After that first encounter I try to follow up at least once a month by coming in before shift change and making myself available to hear from my night shift. With this level of interest I have earned the trust and confidence of my staff (day and night shifts) and, more important, their respect. As a 24-hour executive, I am committed to the concept and success of "management by walking around."

Alan J. Burgess
Chief Executive Officer
Tehachapi (CA) Hospital

Editor's note: The following letter is in response to the online column, "Dealing with the Credit Conundrum" (HealthLeaders Media Finance, Oct. 27, 2008.)

Another Insurance Option
In your Oct. 27 article, you stated, "First, there's no more bond insurance to speak of, and if you can get it, no one really trusts that it will pay off anyway if you default." The statement is correct, but there is mortgage insurance (which backs bonds) from the U.S. Department of Housing and Urban Development and the Federal Housing Administration (FHA).

We are a customer-oriented branch of FHA that is really making a difference for many hospitals. Much of our staff is composed of industry professionals. Our business is now up significantly and we are focused on helping as many hospitals as possible through a streamlined process. Our Web site, www.fha.gov/hospitals, gives an uncomplicated view of who we are and what we do. Click on: "How to get started."

Thanks for your important work.

Robert V. Deen
Senior Account Executive
U.S. Department of Housing and Urban Development
Office of Insured Health Care Facilities
Washington, DC

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