Planners have approved plans for a medical office building to be part of Wesley Chapel, FL's first hospital. The 90,000-square-foot building will be part of a three-building medical complex that will include a hospital. Hospital officials expect to start construction on the site next year, if all goes as planned. The proposed hospital is a joint venture between Adventist Health System and University Community Hospital. The two companies won state permission to build the hospital despite a challenge from Pinellas-based Baycare.
The Maryland Department of Health and Mental Hygiene has developed a Web-based project to ask thousands of residents whether they've been laid low by flu symptoms. The Maryland Resident Influenza Tracking Survey is designed to augment reports from the doctors, hospitals, and medical laboratories traditionally used to gather data on the geography and intensity of the flu season. The health department sends a weekly e-mail to people who sign up, asking them such questions as whether they've had a fever or a sore throat. With a more complete picture of a spreading flu epidemic, health officials say, they might be more effective with efforts to vaccinate people and teach them how to avoid catching and spreading the flu.
Nebraska lawmakers met in an emergency session this week to change their safe-haven law by restricting the age under which a child can be dropped off at a hospital without the parents being prosecuted. The current version of the law did not have an age limit, but was intended to allow parents to hand over an infant anonymously to a hospital without being prosecuted. The problem? Since the law was enacted in September, 35 children have been dropped off at hospitals but only six have been less than 10 years of age.
Millions of patients each year are harmed or even killed as a result of medical errors in U.S. hospitals. Most of them are avoidable, yet ultimately result in added and unnecessary costs. This inspired a campaign through the Institute for Healthcare Improvement of Cambridge, MA, that since 2006 has urged hospitals to adopt 12 specific goals to avoid causing unnecessary harm.
If you were in business school during the 1970s, you were likely a disciple of one of the hottest management trends of that era—product line marketing. Proctor & Gamble and General Electric led the way, sharing the wisdom of thinking from the customer's perspective and organizing the business accordingly. Graduates of leading MBA programs soon began to covet assistant brand manager jobs, hoping they would lead to executive positions where they would orchestrate the work of sales, manufacturing, and other functional areas to meet the needs of their clients. Brand leadership soon reigned supreme within our most respected corporations.
If you studied healthcare management a bit later, say the early to mid-1980s, you were likely captivated by the notion of service line management, healthcare's counterpart to product line thinking. It hardly seemed like a big leap. By then, product line thinking was no longer unique; it was ubiquitous. It worked. The logic behind healthcare service lines was similar and compelling.
That was 25 years ago, and healthcare still struggles with service lines. A few hospitals and health systems have made the conversion with aplomb and it is evident to many of their consumers that these hospitals think differently. Yet, some healthcare leaders still wonder if it is a good idea. Most are somewhere in the middle—tried it and failed or are still trying it.
Are we that different from other sectors? Is service line thinking such a complicated idea? In some ways yes, but probably not to the degree we often like to think. And as with most practices that don't work out over a long period of time but remain compelling, what separates the winners from the losers is less a matter of sophistication and smarts, and more often a matter of commitment to key principles.
In the case of service lines, those key principles are skillful leadership, clear goals and accountability, and results measurement. These are the areas where we get stuck.
Skillful leadership
It isn't difficult to imagine that when a company undergoes a transformation from being functionally led (i.e., manufacturing or sales) to being product line led, strong leadership would be required to overcome years, if not decades, of a hidebound leadership model that is threatened by the new direction.
So, let's imagine that this has happened in a hypothetical consumer products company, where the leading soap powder is called Brand X. We would be surprised if Brand X's new product line leadership was, in effect, a committee with representatives from manufacturing, sales, and other disciplines leading the charge and working in a way that seemed more like a task force than an executive team.
Alternatively, we would also be surprised if a single executive—right out of graduate school—asked to take on this demanding product line role, facing down veterans in manufacturing and "sharp as a tack" sales representatives.
But somehow, in healthcare, that has all too often been our approach—triumvirates of physicians, nurses, and administrators, or freshly minted MBA/MHA types. And in a few cases, largely due to CEO backing and/or a supportive culture, these have worked (at least the triumvirate model).
But most of the time the challenges of this role require a skillful, experienced executive with influence, communication skills, and inspirational qualities to lead an organization forward. These are positions for top flight executives whom others are naturally inclined to follow. These positions require executives who have led mega-change processes. And, most important, these are not part-time jobs, as they are sometimes structured in our field. Service line leadership requires the commitment of an impressive and skillful executive to be successful.
Clear Goals & Accountability
We would be surprised if we learned that our consumer products firm told its newly selected Brand X leadership to "grow the business, increase market share, strengthen financial performance, improve customer relationships" without real precision as to what those targets would be. We would expect that those goals would be crisp.
We would assume that the CEO had developed a culture that highlighted the importance of the product line and connected the results of Brand X and other product line efforts to those of the organization as a whole. It would seem intuitive to us that even though the organization is highly dependent on matrix structures, that goals throughout the organization would be aligned with product line targets to help ensure a cohesive and consistent direction.
We would assume that the product line manager for Brand X within the company would be accountable to a very senior executive—depending on the size of the organization this might even be the CEO.
There are lessons here for many of us in healthcare, who sometimes struggle to make service lines work "on the cheap." Leaders in successful service line delivery models are in high-profile positions operating with clear and well understood goals that pull in matrixed partners and align work products.
Successful service lines have clear goals and are accountable to the highest level of the organization.
Results Measurement
Back to our fictitious soap manufacturer. Now picture that after setting up the new Brand X manager, he is told that it won't be possible to measure results accurately. It seems our company's systems were set up to count results a bit differently. We won't be able to recognize certain kinds of revenue, but we will try to estimate the amounts. There will be double counting of certain expenses, but that shouldn't make too much of a difference. The reports will not be particularly timely, but we can maintain some manual reports that will help keep us on target.
Brand X would likely be the correct name for this product. And yet, too many healthcare service line providers operate in ways that mimic all or part of this story. Guesstimates are common place. Real results are not known. Financials are in dispute. So success or failure is not clear.
Successful service line programs invest in systems that track results to enable management decisions and provide timely and accurate reports on those results. Service lines are tough to lead. But as with most management practices, success often distills down to doing a few things really well. And in the case of service lines, it is skillful leadership, setting clear goals with accountability, and carefully measuring results.
Keith T. Pryor is the director of leadership advisory services for Health Strategies & Solutions, Inc. He can be reached atkpryor@hss-inc.com.
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Meetings are a waste of time. OK, maybe not all of them—plenty of meetings address important topics and are conducted in a productive manner. But many of the executives that I talk to each week say they spend too much time in rambling meetings that are not so productive. The result? Executives who spend their meeting time checking e-mail on their handhelds or skimming unrelated reports.
There are a couple of problems with this trend. For starters, when senior leaders divide their attention, they are inevitably going to miss certain parts of the conversation. They may, in fact, miss the one item that would have made attending the meeting worth their time in the first place.
But perhaps even more troubling is the fact that senior leaders may be sending the wrong message to employees—namely that this project or initiative isn't important enough to warrant senior leadership's full attention. Or that meetings in general don't require undivided attention, so it's acceptable to work on other things. Pretty soon, the whole workplace—not just the executive suite—is only half listening in meetings, which then become even more disorganized and ineffective.
Don't get me wrong; I understand the need for healthcare executives to multitask and not waste one precious minute of the day. After all, healthcare is a 24/7 business, and there are emergencies or situations that may require immediate attention or a quick e-mail. And some meetings really don't require their full attention. But perhaps there are better solutions than giving one ear to a meeting for an hour.
Maybe senior executives should just come for the last 15 minutes of a meeting—sans BlackBerry. That way they can devote their full attention, hear the wrap up, action steps, and raise a concern or offer feedback. And who knows—that same concern may have already been resolved in the meeting, and now they can just hear the solution.
Or why not try a walking meeting. Senior leaders can get some exercise and have a meeting at the same time. I know—for some people, the very thought of this sounds dreadful. But I think the idea may have some merit. And considering that a CEO panel convened by The Wall Street Journal claimed that obesity should be the top healthcare priority, here's an opportunity for executives to lead by example. Some potential benefits:
You are likely to be more engaged in the conversation, because it's awfully hard to check e-mail or read other materials when you are navigating a walking trail or city streets.
Interruptions are less likely.
You may be able to build relationships with employees more easily in this setting than around a conference table or from behind a desk.
You're improving your health—unless the end destination involves some sort of decadent treat.
A little fresh air can help you refocus and be more productive for the rest of the day—that goes for your employees, as well.
Such alternate meeting structures are not a panacea. But they may make some of your lower-priority meetings more tolerable. For them to be effective, however, the same rules apply as with traditional meetings. First and foremost: planning. Have a specific agenda prepared. Be clear about the deliverables that you expect to take away from the meeting. And if the meeting will be mobile—wear comfortable shoes.
With Thanksgiving just around the corner, the idea of a walk doesn't sound half bad.
Carrie Vaughan is leadership editor with HealthLeaders magazine. She can be reached at cvaughan@healthleadersmedia.com.
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