Tight On Cash, But Need Advice?

A few factors work against executives in small rural hospitals when they need advice. First, there may be no one around to ask within their organization—this is especially true for independent facilities that don't have a larger system of support backing them up. Money is also a top concern. Rural hospitals often don't have the $25,000 that's required to hire a consultant to come to their hospital. In addition, some rural leaders simply don't know where to look for advice and information, while others don't want to ask for advice, because they don't want to be told how to run their business by an outsider.

I can't help too much with the last one. But if you need advice, here are some places to start:

1. State resources. State hospital associations or state rural health centers often have a variety of expertise that rural hospitals can access for free or at a nominal cost. For instance, the Arkansas Hospital Association gathers all of the state's critical-access hospitals together to discuss different issues that are unique to them, says Chris Kuhlmann, the chief financial officer for Howard Memorial Hospital in Nashville, AR. But some rural hospitals don't get too involved, he says. "They don't see the need or aren't real aware of what you can find out by collaborating with other facilities—especially larger facilities across a diverse geographic area."

2. Healthcare associations and networks. Hospitals are often members of various organizations like the American Hospital Association, VHA Inc, or a rural hospital network. These organizations offer support on a variety of topics like quality, safety, materials management, pharmacy, nursing, recruitment, reimbursement, and legislation. So use them. Some networks even have listservs where individual questions can be posted and colleagues can respond. According to industry experts, most healthcare leaders are generous in taking the time to respond to these inquiries.

3. Web-based tools. While not free, a number of consulting companies and healthcare organizations are providing information through Webinars, Webcasts, and audioconferences. These tools are often a cost-effective way for small rural hospitals to receive information without breaking the bank. These tools cut out the travel expenses and registration fees required for attending conferences, and they are often much more affordable than having an onsite consultant. For example, Howard Memorial takes advantage of the expertise provided by its management company's Web-based seminars and mentoring program. "We have the ability to call and get an answer to just about anything we want on a whole myriad of issues, whether it is HR, or finance and reimbursement, or related to a new government regulation," says Kuhlmann.

And for those leaders who need information but don't want a lot of oversight, good news: You don't have to be managed by these organizations to access many of their Web-based seminars. "It provides a lot of guidance, but what it doesn't provide is heavy-handed oversight. That is what I love. I have access to the same resources as if I was working for a 60-hospital chain, but I still have the autonomy to make my own decisions that are applicable to my market," says Kuhlmann.

4. Peers. Perhaps one of the easiest ways to get advice is to ask your colleagues. Even if you're not part of a larger system, you can still search out best-practice hospitals and ask them for advice. Or consider asking five colleagues what they would do in a certain scenario or where they might look for answers. Leaders should establish a professional network that they can turn to for advice, experts contend. Don't feel limited to a phone or e-mail conversation, either. Sometimes you can arrange a site visit at a best practice hospital, as well, says Steven Simonin, the CEO of Wright Medical Center in Clarion, IA. "If you see something you like or something that intrigues you in another setting—doesn't have to even be healthcare—call them and ask," he says.

When all else fails, you can always try Google. Just remember: When searching the Internet, it may take a while to sort through the useless information until you find something useful.