Clearly a hospital Chief Executive Officer (CEO) must, sooner rather than later, culturally align the medical staff with the mission, vision, and values of the healthcare enterprise. If the CEO fails to manage this alignment she will find herself is a position analogous to a head college football coach. I call it the “… what have you done for me lately?” situation. If you’re not winning, you will be another casualty of the nationwide 18% CEO turnover rate.
Improving Patient Care
First of all, it is imperative that you engage the medical staff leadership and take a collaborative approach to involve them in every aspect of efforts to improve patient care. It is remarkable to me how many hospitals still dissociate the medical staff from working side by side to provide the best patient care possible. Some administrations are wary of involving the medical staff for the very reason that they should be doing so: They are concerned that medical staff members are not loyal to the hospital and they will be happy to move to one of the other hospitals in the service area.
A hospital CEO must, sooner rather than later,
culturally align the medical staff with the mission, vision,
and values of the healthcare enterprise.
In my 26 years of being a CEO I have employed a technique I call the “Top 10 List.” I conduct an annual Medical Executive Committee dinner at which I use a form of the nominal group technique. The medical staff leadership is asked to come up with their biggest concerns about the hospital. Leadership is urged to convey these ideas in order to improve overall hospital functions and not to simply advance their own self interests.
Remarkably, virtually all of the staff concerns align with the concerns of the hospital leadership. I have observed very little bickering over these points Typically the “Top 10 List” turns out to be 5 or 6 issues long, and that’s okay. Theoretically it’s not good to tackle too many issues at once. As well, the issues identified usually involve improving quality, technology, efficiencies, and patient experience.
It is not uncommon for the top issue to be the stability of administration and improving communication with senior management. After all, the medical staff do not themselves want turnover among the administration. It is my recommendation that before the evening is up the CEO should establish subcommittees to address each issue designating both an administrative champion and a physician champion for each issue.
I also recommend that at least quarterly the CEO should update the status of the issues at the Med Exec monthly meeting. Just like it seems there’s always work to be done repairing and expanding the interstate highway system in the U.S.; the work is never done. When the highway teams get to one end of the country, it’s time to start again on the other end. No matter how much fixing you do, you’ll always be dealing with issues. Annually you should retire a completed, or significantly completed issue and replace it with one or more relevant issues.
Cultural Alignment
I also believe that it is important to formally engage the entire medical staff in your efforts for cultural transformation. Certainly you have to gain the support of the members of the Med Exec Committee first. Invariably this cultural concept came up in your Top 10 dinner as an issue. Medical staff members always want an inviting, more collaborative place to work. In this day and age, most hospitals are involved in cultural improvement efforts with the hospital staff and, after visible successes from these efforts, the medical staff will want to be part of these as positive changes as well. They will be influenced and will want to be a part of an improved culture.
If you’ve initiated behavioral expectations for your employees as a component of their job description to which they have formally attested, why not do the same with your medical staff?
I am pleased to share these 2 strategies because over my career they have been very effective for me in aligning an important constituency to optimize my hospital operations. To involve the medical staff, even to the extent of the governance of the hospital, will be key to your overall success.
Dennis Knox is currently CEO of Aethena Healthcare Holding Company in Los Angeles. Aethena “is a healthcare consolidation platform with the mission to consolidate the fragmented Urgent Care industry. We plan on having scalable growth, achieving exponential revenue growth with incremental increased costs through streamlining operations. We are seeking vertical and horizontal integration of all facets of assets within this sector. Through standardization of care along with major improvements in the business infrastructure, we will be the Starbucks of Urgent Care, projecting to go public by 2020.”
Mr. Knox has also been CEO of Antelope Valley Hospital in Lancaster, CA; CEO of Western Medical Center, in Anaheim, CA; CEO and Managing Director of UHS/Southwest Healthcare System; CEO of Ardent Health Services/Lovelace Medical Centers/Downtown & Gibson, in Albuquerque, NM; CEO of Vanguard Health Systems/Phoenix Baptist Medical Hospital and Medical Center - Phoenix, AZ; CEO and System Vice President of Memorial Hermann Health System/Memorial Hermann Pasadena Hospital & Memorial Hermann Continuing Care Corporation in Pasadena, CA; and CEO and Executive Director of R.T. Jones Regional Hospital/Hospital Authority of Cherokee County in Canton, GA, among other prominent roles in healthcare.
