Here are five questions and solutions about common challenges facing hospital executives.
1. How can I ensure efficient patient flow at my hospital?
Hospitals with the most efficient patient flow processes usually got there by implementing both technical and human process changes, says Anthony Sanzo, president and CEO of Teletracking Technologies. These hospitals know immediately when a patient bed is available and ready to be cleaned, benchmark the time it takes to turnover rooms, have-real time data on available beds so new patients can be assigned and in a bed within 1-2 hours and benefit from less congested emergency departments and the additional revenue that comes with quicker turnover.
Nearly all hospitals regularly track performance against a category of goals, such and quality, financials and patient safety, and often, these same goals trickle down to executive and individual employee performance measures. Mr. Sanzo says hospitals should include patient flow as an additional category of measurement since it has such a significant impact on a hospital's performance.
"First and foremost, attention must be paid to knowing what the triggers are for success and failure and building them into executive and employee expectations and goals," he says. For example, a hospital would establish an expectation that admitting a patient into an assigned and clean bed will take place within one hour. Then, management could track how each employee performed against that benchmark. For instance, certain employees would be evaluated on how long it took to assign the bed, and others would be evaluated on how long it took to clean the bed or ready and transport the patient to the assigned bed.
2. In today's changing healthcare environment, how can I stay on top of strategic growth planning?
When devising strategic plans, hospitals should now focus more on effectiveness strategies than growth strategies, says Luke Peterson, a National Director of Kurt Salmon's Healthcare Strategy Group. "What we are seeing in the market is that effectiveness is critically important, along with growth," he says. "We anticipate some push-back to this change of focus, but we believe this is where the market is heading."
While growth plans are predominantly about external markets and volumes, effectiveness plans require the organization to look at its internal processes and value equations says Mr. Peterson. "It is no longer simply about growing the top line," he says. "Finding ways to fundamentally change the care processes to improve quality, service and reduce costs require different approaches and information."
There are certain competitive strategies that the hospital can't influence — including geography, demographics and payor competition — but they can influence the relationship between the hospital, payors and area physicians. Many times, this includes a physician-hospital alignment strategy. The hospital can also explore alignment with other tertiary providers in the community to provide a seamless continuum of care. All of this requires access to information across the continuum.
Additionally, hospital executives can influence how they develop the different departments. Many departments are modernized when the hospital partners with surgeons to perform new procedures, purchases new technology and updates data collection capabilities. "Timely access to the right information is key, but don't forget to have the right human resources assets in place and the right people in leadership positions to focus on advancing care and improving the department's culture," says Mr. Peterson.
3. How can we attract and keep high-level professionals at our facilities?
Provide a living wage for employees, says Gary George, Senior Vice President of Human Resources, Mercy Northern Region. "At Mercy, we pay employees more than minimum wage for positions that could be compensated at that level — for example, housekeeping and dietary positions," he says. "The impact of turnover among these positions can sometimes be overlooked in favor of nurse or other clinician turnover, but continuity among these workers can be just as important. We have established a living wage specific to the four counties where our hospitals are located, and we make sure no employees are compensated below that level."
Additionally, many hospitals regularly perform surveys to gauge employee satisfaction, but employee engagement is more directly related to overall hospital performance. Satisfied employees focus on themselves, while engaged employees focus on themselves and the organization. They are physiologically committed to the organization's success — the bigger picture. "At Mercy, we've partnered with The Gallup Organization to measure employee engagement," says Mr. George. "Each department within our hospitals then works to develop an impact plan focused on improving certain areas of engagement. The plans are reviewed each month, and new objectives are set as needed."
4. If my hospital needs to make lay-offs, how can I minimize the stress on our current employees and community?
One of the first ways to prepare for employment reductions is to delineate the goals of layoffs, says Sherilynn Quist, workforce efficiency practice leader at management and consulting company Quorum Health Resources. Understanding both short- and long-term goals can help hospitals determine which departments can be targeted for reductions to leave the best possible imprint on the organization and ensure patient care is not compromised during the process. Adequate preparation can also help hospitals avoid having to make multiple sets of layoffs over a short period of time, which can raise tension among staff due to uncertainty over when the layoffs will end. Ms. Quist says deciding where and to whom the cuts should occur is an analytical, methodical process, and should be governed by a tight preparation timeline.
Hospital leaders should examine the organization's labor management process when considering layoffs. She suggests executives "take a look at their labor productivity by department and [determine if] they have the right people in the right place doing the right things." The "right" things can be measured by benchmarking departments against similar organizations and determining if processes can be changed to become more efficient.
To assess employee performance on an individual basis, hospital leaders should work with the Human Resource department to develop a skills inventory list that includes objective criteria. The inventory should include important information about the employee such as length of employment, full- or part-time status and any patient complaints. Ratings from the skills inventory can provide guidance for which departments, positions and employees to consider for layoffs when they are necessary.
5. How can our hospital stay abreast of patient collections?
It's important to stay abreast of the ever-changing technology in the healthcare environment. When implementing new revenue cycle and collections technology at your hospital, you want to make sure your manual processes are effective and Business Process Outsourcers can help with smoothing out a an inefficiencies, according to a report from National Patient Account Services. Hospitals should also assess the ability of patients to pay their part. One of the most effective and inexpensive way to work with all accounts is through new dialer systems. You can credit-scored accounts to gain insight on the patients' credit when they enter the facility. You can determine the patient's ability to pay with their credit score.
You may also want to record phone calls with patients about payments. Having the recording of phone calls available allows you to review work done by your BPO, and you can examine any customer service complaints easily with this technology. You can validate a complaint by checking these records and make the necessary changes.
Related Articles on Hospitals:
Value-Based Purchasing Requires Behavior-Based Hiring
Creating an Outcomes-Based Culture: How to Engage Front-Line Staff in Process Improvement
9 Recommendations for Hospital Health IT Staffing and Training
1. How can I ensure efficient patient flow at my hospital?
Hospitals with the most efficient patient flow processes usually got there by implementing both technical and human process changes, says Anthony Sanzo, president and CEO of Teletracking Technologies. These hospitals know immediately when a patient bed is available and ready to be cleaned, benchmark the time it takes to turnover rooms, have-real time data on available beds so new patients can be assigned and in a bed within 1-2 hours and benefit from less congested emergency departments and the additional revenue that comes with quicker turnover.
Nearly all hospitals regularly track performance against a category of goals, such and quality, financials and patient safety, and often, these same goals trickle down to executive and individual employee performance measures. Mr. Sanzo says hospitals should include patient flow as an additional category of measurement since it has such a significant impact on a hospital's performance.
"First and foremost, attention must be paid to knowing what the triggers are for success and failure and building them into executive and employee expectations and goals," he says. For example, a hospital would establish an expectation that admitting a patient into an assigned and clean bed will take place within one hour. Then, management could track how each employee performed against that benchmark. For instance, certain employees would be evaluated on how long it took to assign the bed, and others would be evaluated on how long it took to clean the bed or ready and transport the patient to the assigned bed.
2. In today's changing healthcare environment, how can I stay on top of strategic growth planning?
When devising strategic plans, hospitals should now focus more on effectiveness strategies than growth strategies, says Luke Peterson, a National Director of Kurt Salmon's Healthcare Strategy Group. "What we are seeing in the market is that effectiveness is critically important, along with growth," he says. "We anticipate some push-back to this change of focus, but we believe this is where the market is heading."
While growth plans are predominantly about external markets and volumes, effectiveness plans require the organization to look at its internal processes and value equations says Mr. Peterson. "It is no longer simply about growing the top line," he says. "Finding ways to fundamentally change the care processes to improve quality, service and reduce costs require different approaches and information."
There are certain competitive strategies that the hospital can't influence — including geography, demographics and payor competition — but they can influence the relationship between the hospital, payors and area physicians. Many times, this includes a physician-hospital alignment strategy. The hospital can also explore alignment with other tertiary providers in the community to provide a seamless continuum of care. All of this requires access to information across the continuum.
Additionally, hospital executives can influence how they develop the different departments. Many departments are modernized when the hospital partners with surgeons to perform new procedures, purchases new technology and updates data collection capabilities. "Timely access to the right information is key, but don't forget to have the right human resources assets in place and the right people in leadership positions to focus on advancing care and improving the department's culture," says Mr. Peterson.
3. How can we attract and keep high-level professionals at our facilities?
Provide a living wage for employees, says Gary George, Senior Vice President of Human Resources, Mercy Northern Region. "At Mercy, we pay employees more than minimum wage for positions that could be compensated at that level — for example, housekeeping and dietary positions," he says. "The impact of turnover among these positions can sometimes be overlooked in favor of nurse or other clinician turnover, but continuity among these workers can be just as important. We have established a living wage specific to the four counties where our hospitals are located, and we make sure no employees are compensated below that level."
Additionally, many hospitals regularly perform surveys to gauge employee satisfaction, but employee engagement is more directly related to overall hospital performance. Satisfied employees focus on themselves, while engaged employees focus on themselves and the organization. They are physiologically committed to the organization's success — the bigger picture. "At Mercy, we've partnered with The Gallup Organization to measure employee engagement," says Mr. George. "Each department within our hospitals then works to develop an impact plan focused on improving certain areas of engagement. The plans are reviewed each month, and new objectives are set as needed."
4. If my hospital needs to make lay-offs, how can I minimize the stress on our current employees and community?
One of the first ways to prepare for employment reductions is to delineate the goals of layoffs, says Sherilynn Quist, workforce efficiency practice leader at management and consulting company Quorum Health Resources. Understanding both short- and long-term goals can help hospitals determine which departments can be targeted for reductions to leave the best possible imprint on the organization and ensure patient care is not compromised during the process. Adequate preparation can also help hospitals avoid having to make multiple sets of layoffs over a short period of time, which can raise tension among staff due to uncertainty over when the layoffs will end. Ms. Quist says deciding where and to whom the cuts should occur is an analytical, methodical process, and should be governed by a tight preparation timeline.
Hospital leaders should examine the organization's labor management process when considering layoffs. She suggests executives "take a look at their labor productivity by department and [determine if] they have the right people in the right place doing the right things." The "right" things can be measured by benchmarking departments against similar organizations and determining if processes can be changed to become more efficient.
To assess employee performance on an individual basis, hospital leaders should work with the Human Resource department to develop a skills inventory list that includes objective criteria. The inventory should include important information about the employee such as length of employment, full- or part-time status and any patient complaints. Ratings from the skills inventory can provide guidance for which departments, positions and employees to consider for layoffs when they are necessary.
5. How can our hospital stay abreast of patient collections?
It's important to stay abreast of the ever-changing technology in the healthcare environment. When implementing new revenue cycle and collections technology at your hospital, you want to make sure your manual processes are effective and Business Process Outsourcers can help with smoothing out a an inefficiencies, according to a report from National Patient Account Services. Hospitals should also assess the ability of patients to pay their part. One of the most effective and inexpensive way to work with all accounts is through new dialer systems. You can credit-scored accounts to gain insight on the patients' credit when they enter the facility. You can determine the patient's ability to pay with their credit score.
You may also want to record phone calls with patients about payments. Having the recording of phone calls available allows you to review work done by your BPO, and you can examine any customer service complaints easily with this technology. You can validate a complaint by checking these records and make the necessary changes.
Related Articles on Hospitals:
Value-Based Purchasing Requires Behavior-Based Hiring
Creating an Outcomes-Based Culture: How to Engage Front-Line Staff in Process Improvement
9 Recommendations for Hospital Health IT Staffing and Training