In a recent Governance Institute E-briefing, Peter J. Betts, LFACHE, president of Peter J. Betts & Associates, provides four key steps hospital boards should take to mitigate hospital weaknesses and improve overall hospital performance:
1. "Get a grip" on all aspects of the organization. Hospital boards should have an external assessment done of all hospital key operational elements. An assessment of the entire operation by a qualified external individual or firm reporting to the board will, hopefully, verify all divisions are functioning well. If not, specific areas requiring intervention will be highlighted by the external assessment so they can be addressed. Problems cannot be fixed if they are not recognized. The assessment should focus on areas such as finance, quality, patient satisfaction, information systems and compliance.
2. Develop a critical success factors list. Hospital boards should develop a list that at the very least covers key areas in which to assess performance. Goals with target dates for completion need to be established for each area included in the external assessment. There also needs to be a timely reporting system put into place that is tailored to the needs of the hospital board and its specific goals.
3. Begin turnaround. Depending upon the nature and scope of needed corrective action, the hospital board may decide that a turnaround is required. A turnaround needs to be led by an experienced external individual or firm because an external advisor is objective and less influenced by political pressure. Additionally, an external advisor will achieve results for the hospital more quickly and provide the intense focus needed to get the job done.
4. Create culture of accountability. Once the hospital is stabilized and back on track, it is imperative to create a culture of accountability by installing a system to ensure the solutions achieved are built upon and not lost over time. This means the hospital board cannot lose its focus on achieving agreed-upon goals. Management and the medical staff need to drive accountability throughout the organization by delegating goals and tasks down and holding staff accountable for achievement, just as the board holds them and itself accountable.
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