Kenneth A. Samet is the new president and CEO of MedStar Health, a seven-hospital system in the Baltimore-Washington, DC, region where he has career-long ties. Samet and others believe he is taking over MedStar at a time when health systems will be growing again, in size and in importance. Several systems such as MedStar lost money during recent years when hospital rates were squeezed. "I'm proud of building the MedStar of today, but any time you have new leadership you get an opportunity to bring new focus," Samet told the Baltimore Sun.
Litigation and high medical malpractice insurance rates are threatening access to healthcare in central and Southern Illinois, according U.S. Senate candidate and physician Steve Sauerberg. Sauerberg said many health professionals have retired or this region of Illinois because of litigation and high insurance costs, and added the area stands to lose even more in the future. He has introduced a health plan that includes establishing an administrative hearing process for malpractice claims.
R. Barker Bausell says he arrived at the University of Maryland's alternative medicine center with an open mind toward exploring the potential of acupuncture, herbal remedies and other unconventional treatments. But after five years as research director, he quit the Center for Integrative Medicine in 2004, convinced of one thing: None of the alternative treatments he has seen works any better than a placebo.
Maryland health officials told state lawmakers yesterday that they were taking steps to minimize possible abuse of the addiction treatment buprenorphine as they spend millions to expand its availability. While insisting that misuse is currently not a serious problem, they outlined precautions in an appearance before a House of Delegates committee. These include screening for buprenorphine in overdose deaths, coordinating with police to monitor street sales and supporting a bill that would call for monitoring prescription drugs, including buprenorphine.
The Bush administration is proposing the first changes in more than a decade to regulations that give workers unpaid leave to deal with family or medical emergencies, a move that concerns some of the law's supporters who want to see it expanded. The Labor Department announced that it had sent the first proposed changes to regulations governing the Family and Medical Leave Act to the White House's Office of Management and Budget for approval.
Iron-fist leadership is on its way out, according to this Q&A with Harvard Business School Professor Linda Hill. Future leaders must employ a more inclusive and collaborative leadership style, Hill says, meaning that organizations must look past the traditional image of leader in order to uncover "demographic and stylistic invisibles."
One of the principles of good journalism is name and title verification. Never guess that a source's name is Christine (not Kristine, Cristine, or Krystine); never assume that a company head is CEO (not founder, president, his highness, or something else). It seems like a simple enough rule but as organizations add clever and unusual titles to their org charts, getting the title right has never been so difficult.
I've met the Vice President of Clinical Effectiveness and Efficiency, the Director of Innovation and Bright Ideas, and the Manager of First Impressions since I started writing about healthcare. New and creative titles aren't just reserved for mid-level staff. Even the C-suite has expanded to include other chiefs: the Chief Nursing Officer, the Chief Medical Staff Officer, and, more recently, the Chief Quality Officer.
Baptist Health in South Florida is one system that recently added a CQO to its senior leadership. Although Baptist's always focused on quality, CEO Brian Keeley says his CQO (a former CMO) drives quality at a system-wide level. Keeley calls the decision to add a CQO to the executive suite one of the best decisions he's made. "We should have done this many years ago," Keeley says.
Other titles growing in popularity include proceduralist, transition coach, and Chief Governance Officer. New titles like these reflect the changing landscape of healthcare and some of its biggest focus areas: quality and transparency, the aging population, ED overcrowding, and the increase in board involvement.
Sometimes a new title reflects an organization's individual needs or goals, like the Chief Learning Officer at North Shore Long Island Jewish Health System. With more than 35,000 employees system-wide, NSLIJ's got some serious staff training needs. The CLO heads the Center for Learning and Innovation and oversees its $2-million training budget.
Of course, not all new titles are good ones. In fact, I'd argue that most new titles aren't worth the trouble. When you make someone the manager of first impressions, there's a good chance other employees will want to be "manager" of something, too. Unless a new manager/chief/director actually has resources and staff under them, don't bother with the fancy title.
When you add a new title just to suit an employee's particular skills, you'll need to recreate job descriptions and tailor performance evaluations for no other reason than to fit the new title. And while giving someone a clever new title may increase their job satisfaction today, that alone won't keep them around tomorrow.
So, beware, although new titles do occasionally bring about better business, the addition of one little title could cause big headaches for you, your staff, and yes, journalists like me.
What titles has your organization recently added? Have you created a new position to address a long-term need? Or do you have an existing employee whose skills just demanded a change in name? Drop me an email; I'd love to hear about it.
Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.
Rapidly increasing levels of uninsured patients. Unsustainable costs. Demand for services outstripping capacity. Welcome to 2008--a "Perfect Storm" in healthcare is about to hit. At no other time in the history of the U.S. healthcare system have we reached this point--one where all of the fundamentals of our system will be stressed to the breaking point. In the very short term, hospital administrators will be asked to start examining their processes in light of these pressures and will be looking for innovative approaches to providing service. Here are a few of the most significant issues for the coming year:
Emergency Department. The front line of the battle will be played out in the Emergency Department. As the point of entry into most institutions, this is where the combination of capacity constraints and uninsured patients meet. With wait times exceeding six hours for many patients, EDs will need to create capacity via process improvement.
EDs today suffer from significant serial processing, whereby patients wait in beds while tests are performed. This serial processing, coupled with major variation in patient care processes, results in significant waste in care time, bed capacity, and clinician time. With uninsured patients hitting the EDs, most institutions lack non-urgent, "Fast Track" capabilities to quickly process these patients to unclog the patient funnel. It is a public imperative that hospital EDs implement best practices in order to utilize specialized treatment centers for non-urgent patients, while improving the flow of urgent and emergent patients through parallel processing.
Performance Improvement Methodology. In order to drive enhancements, 2008 will see hospitals aggressively utilize performance improvement methods developed in the manufacturing industry--Lean Operations and Six Sigma. The war on waste and variation will move rapidly into the executive suite discussions at hospitals around the country as they seek new ways to improve patient access, while improving quality and reducing the cost of service.
As operational experts have learned in manufacturing firms, the proper application of these techniques can have profound impacts on the efficiency and effectiveness of all clinical and ancillary services. Hospitals in 2008 will begin to seriously leverage these principles to transform their cultures while adopting high-performing processes.
Aging Population. Hospitals will, for the first time, feel the effect of Baby Boomers in 2008. As the cusp of this mass of 78 million Americans enters retirement, demand for healthcare services is starting to rapidly rise. In specialty areas of cardiology and oncology, hospitals will need to create greater delivery capability to support these patients. At the same time, this will be a major catalyst for healthcare costs reaching almost 18% of GDP by the end of 2008.
Hospitals will be expected to be more transparent and accountable for their expenses. Issues including Performance Improvement and No Pay for Poor Performance will begin to become part of the lexicon in hospitals. Hospitals that seize the initiative to improve quality and performance levels will be the early adopters in 2008, as these forces hit the mainstream of the industry by year's end.
Obstetrics. Obstetrics is the best example of the impacts of defensive medicine and changing practice patterns. With the cesarean birth rate expected to rise to near 35% by the end of 2008 and inductions becoming the rule while spontaneous labor is the exception, virtually every OB practice will face severe capacity constraints during the year. In order to gain control of this situation, it is necessary for two changes to be vigorously pursued.
First, alternatives to the current tort system will become part of the dialogue for industry change in 2008. Reducing the impacts of defensive medicine and establishing mechanisms like Health Courts will allow practitioners to actively pursue best practices and standard protocols for birth methods. This second initiative will begin to be more prevalent, whereby institutions and physicians will be held accountable for performing within a clinically accepted benchmark for all services, using their training and experience coupled with best practices instead of performing unnecessary procedures.
Political Impact. The political debate during the election cycle will continue to make healthcare reform a major issue. Coverage for the uninsured, price transparency, competition, and healthcare technology are just some of the reforms being discussed. This year will mark the first time the combination of political will and patient unrest join together to catalyze the industry to seek a new path into the future. The challenges facing the healthcare industry would be insurmountable by virtually any other American enterprise.
Hope or Despair?
So, why should anyone be optimistic with all these pressures? The answer is contained in the nature of the major stakeholders: dedication. Physicians, nurses, technicians, administrators, and executives share the same passion for healing, patient care, and excellence. It is this dedication that will enable the industry to change from the inside out. Anything short of this could threaten the system, resulting in legislative moves to adopt socialistic medicine. The major players have the will and desire to make serious changes. Now the hard work of implementing these capabilities will prove successful in 2008.
As the president of Tefen USA, Barry Calogero brings more than 20 years of management experience to the company. He directs all activities within North America as well as Asia in all manufacturing and service industries, including life sciences, general manufacturing, semiconductor, hospitals/healthcare, and federal government. Barry has an extensive background in all aspects of product and service optimization with significant operations management consulting solution delivery in both manufacturing and product development environments.
Tefen USA, a subsidiary of international management consulting firm Tefen, works with hospitals and health organizations to make sustainable improvements in the areas of business strategy, operations excellence, project management and organizational development by applying LEAN, Six-Sigma, and related operations strategies to improve the cost, quality, and access performance of healthcare organizations.
A former emergency department director and practice manager, Lynn Massingale is no stranger to the problem of ED overcrowding. In this interview, Dr. Massingale discusses throughput and how hospitals can make theirs more efficient.
Carolinas Medical Center-Union has again asked the state to approve a proposed "HealthPlex"--a 21,00 square-foot, $20.4-million emergency care and diagnostic center in Waxhaw, NC. The proposal stalled last year after the N.C. Division of Health Service Regulation declined to issue a certificate of need, saying CMC did not adequately identify the population the HealthPlex would serve and demonstrate need for the facility. CMC's new proposal addresses these issues.
