Democratic lawmakers have introduced legislation that would stop a 10.6% pay cut from going into effect for doctors who treat Medicare beneficiaries. The bill also would give doctors a 1.1% rate increase in 2009. In the last five years, Congress has routinely intervened to avoid similar payment cuts for physicians, and the legislation unveiled by Sen. Max Baucus is the latest such attempt.
Baylor All Saints Medical Center at Fort Worth (TX) intends to open a $13 million breast-cancer center in 2009. Although most of the new center's services already are available at the hospital, staff will focus on better integration to speed up treatment and to help coordinate patients' care. Baylor administrators want to raise money to pay for the entire project through an endowment, and construction will begin once $2.4 million has been collected.
After months of turning away some emergency patients with brain and spine injuries because of a shortage of neurosurgeons, Harris Methodist Fort Worth (TX) hospital has returned to a full schedule of trauma care. Hospital administrators and doctors reached an agreement that ensures that a neurosurgeon is available around-the-clock every day. The surgeons will provide full coverage until September, but it remains to be seen whether the solution will become permanent.
Nurses at Centerpoint Medical Center in Independence, MO, have presented a petition to hospital administrators saying that the hospital needs to beef up staffing to ensure patient safety. Nurses United for Improved Patient Care, a union that represents Centerpoint nurses, noted that Centerpoint scored worst among area hospitals in key patient ratings reported recently by the federal government. Representatives for HCA Midwest Health System, which runs Centerpoint, acknowledged that Centerpoint needs more nurses than the 300-plus who are currently on staff but added the hospital is successfully recruiting new nurses.
Former hospital administrator Matt Person and his business partner, James Stevens, MD, are the driving forces behind the American Institute of Healthcare & Fitness, a Wal-Mart-size healthcare mall in North Raleigh, NC, that puts doctors, nutritionists, physical therapists, counselors, and a fitness center in one place. The mall’s concept is called integrative medicine, and it encourages teamwork among physicians and others who provide healthcare. The Institute has been open for more than a year, and now the two men are planning two smaller expansions.
A new Web page launched by the NC Institute of Medicine will help Medicaid recipients and people who don't have health insurance find doctors, clinics, dentists and other health resources in their communities. The site was established for the 1.5 million state residents who have no private insurance coverage. According to a recent study, only about half of uninsured North Carolina residents were aware of community services that could help them.
So, you're finally taking this succession planning stuff seriously. You've implemented an ongoing process to prepare a replacement should you one day retire, resign, or die; you're no longer taking a reactionary approach to finding future leaders; and you've got a strong team of executives, any of which could step in at a moment's notice and lead your organization to success. Yay, you! But you're not there yet.
It's not enough just to prepare your COO to fill your shoes one day or to train your controller to take the reins of CFO.
According to a 2006 survey by the American Organization of Nurse Executives, 62% of CNOs said they expected to make a job change in less than five years, and one quarter of those said they were planning to retire. In a few years, hospitals won't just face a shortage of staff nurses; they'll need experienced nursing leaders—front-line managers who've gained the leadership experience they need to take the reins of CNO. Chances are, in the future, you'll be easier to replace, but your middle managers will be irreplaceable.
Middle managers are an integral part of every organization. As one HR leader recently told me, "Middle managers run the hospital"—yet they're often the group most ignored. Healthcare leaders spend a lot of time training newly minted nurses and worrying about retiring baby boomers, but the middle guys—the 30- or 40-somethings that seem settled and content—are often neglected.
One of the biggest contributors to turnover in hospitals is a lack of leadership development. A nurse manager leaves unexpectedly and an ill-prepared floor nurse takes his place. Everyone who reports to her is miserable because she's a terrible boss, and she's unhappy because she's overwhelmed and inexperienced.
Front-line managers, especially nurses, need to be trained in management, but that training shouldn't come through promotions.
At Chilton Memorial Hospital in New Jersey, for example, succession planning includes middle managers. High performers are identified early and given opportunities to learn leadership skills through lateral moves that provide new experiences and management experience without the risks that come with a promotion. Chilton president and CEO Deborah Zastocki says this prepares front-line managers for future leadership positions without putting them in positions for which they're not yet ready.
Leadership development is not about promotions (and it's not about piling on the responsibilities of a higher position without awarding the title). To truly develop future leaders, you must expose them to new experiences and opportunities on a small scale, then provide feedback on how they're doing. You also want to connect them to mentors—people within your organization who are proven to be good managers ("good" is the key word here).
Succession planning is about more than just replacing you. It's about identifying, mentoring, and developing leaders outside of your executive team. Because, in the future, these are the leaders you might most need.
Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.
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Sister Mary Jean Ryan, president and CEO of SSM Healthcare in St. Louis, talks about the system's decision to stop offering bottled water at its 20 facilities.
Healthcare leaders talk a lot about Toyota, but what really makes an organization like Toyota? Harvard researchers studied Toyota for six years and uncovered a "culture of contradictions" that drives Toyota's business. As the article says, "emulating Toyota isn't about copying any one practice; it's about creating a culture." This article is required reading for those leaders who really want to be Toyota-like.
