Hospitals are where medical miracles are performed each day. But given the tenor of the healthcare debate, it seems that many also think of hospitals as a big part of the problem of increasing healthcare costs, as havens of just plain old waste, and as a good place to go if you want to get sicker through debilitating infections or medical mistakes. As CEO, you're in charge of that perception, right or wrong.
In the big picture, that perception is largely deserved, I'm sorry to say. Several studies have suggested waste in healthcare of near 30%, the Institute of Medicine shook the establishment years ago when it published its "100,000 Lives" study, and stories about surgical instruments left in patients or the infections they get while in the hospital are regularly among the most-read, according to our statistics.
And whether this perception is reality for the majority of hospitals or not, just like it took a lot of mistakes, miscalculations, and misplaced priorities for hospitals to get to this place of dubious distinction in the American psyche, it's going to take a lot of hard work to recover from it, even if you are one of the good guys.
Speaking of good guys (and gals) this new breed of CEO doesn't backslap at the chamber of commerce. He doesn't recruit important specialist physicians over rounds of golf or rounds of martinis. She doesn't spend her time playing the political games that many seem to feel are so necessary for modern hospitals' survival. OK, maybe sometimes he or she does those things, and still needs to, but more often, the people who will be leading hospitals 10 years from now roll up their sleeves, talk to their lieutenants, and motivate caregivers to help reduce waste and achieve better outcomes. That is, after all, the stated reason for the hospital's existence in the first place.
Doing the hard work of improving outcomes and taking better care of patients is a process that's been going on for nine of the 13 years that Jim Anderson has been at the helm of Cincinnati Children's Hospital.
"I was unburdened by knowledge of how healthcare really worked and it was clear there was a dramatic difference in attitude and approach to quality," he says (as opposed to his previous work as president of an industrial company where improvement and quality were near theology). "That was perplexing and intriguing to me, but I didn't know what to do with it until IOM's 100,000 lives program."
In early 2000, Anderson says, he and the hospital's top leaders were exposed to the idea of family-centered care as the featured characteristic of better healthcare outcomes.
"Healthcare is dysfunctional and the opportunity to focus on processes to provide better value was a critical underdeveloped area, filled with enormous opportunity," says Anderson, who will retire at the end of the year.
OK, yes, it's a children's hospital. And adult hospitals face vastly different—some claim more difficult—challenges than their children's hospital counterparts. But that doesn't mean you can't learn plenty of lessons from their examples. Stay tuned. Next week I'll tell you more about the specifics of how Cincinnati Children's solved the problem of improving outcomes while still growing revenues at a 15%-a-year clip.
"We didn't intend to be ahead of our time," he says, "but the evidence just made such compelling argument."