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by Lynn McVey
In healthcare, many managers have "risen through the ranks." They were probably great clinicians, assumed to be great leaders, and then promoted. We thoroughly know being an amazing clinician is unrelated and a very different skill set from being an amazing leader. Potentially, every great clinician can become an amazing leader with the right development and mentoring. Unfortunately, we don't have time for mentoring right now. What we need now is not to be mentored, but to be measured.
I've read about and heard the terms "leadership program" or "mentoring" but have never actually experienced either. In my first management job, there wasn't even a job description. Without any instructions, guidelines or list of tasks, I didn't know how to effectively manage, so I began counting everything. Whatever could be counted was measured and tracked each month. Today we call that evidence-based management, but in 1982, I called it "This is what happens when there is no mentoring or leadership program."
by David Balto and James Kovacs
In its recent decision in an Idaho healthcare provider acquisition matter--Saint Alphonsus Medical Center-Nampa Inc. v. St. Luke's Health System Ltd.--the Ninth Circuit proclaimed that it is not the court's "job to determine the optimal future shape of the country's healthcare system." But in affirming a district court decision that enjoins an acquisition with clear procompetitive benefits, the Ninth Circuit did exactly that: It created a potentially insurmountable barrier to the type of healthcare realignment that is essential to improve quality and reduce costs.
Without question, the American healthcare system is undergoing a fundamental change. As part of this transformational change, the Affordable Care Act (ACA) and other public and private initiatives encourage providers to move healthcare away from fragmented services toward more integrated, value-based and patient-outcome-oriented healthcare. The ACA pushes providers to adopt such changes via numerous provisions within the law, including the reduction in certain reimbursements and penalties for lower quality. Additionally, the ACA has created a structure for more integrated entities known as accountable care organizations, through which Medicare rewards doctors, hospitals and other providers for working together to deliver high-quality, organized care, according to the Centers for Medicare & Medicaid Services.
It's not often you come across an executive of a $2.6 billion integrated health system with 14,000 employees who takes the time each morning to exchange pleasantries via email with a unit secretary who works at one of his hospitals.
But then there aren't many CEOs like Chris Van Gorder. I recently interviewed him to learn more about his frontline approach to leadership, which helped bring Scripps Health back from the brink of financial disaster and cut staff turnover in half.
As he talked about the importance of his Friday leadership rounds, when he visits and interacts with employees at one of the system's five hospitals or 28 outpatient clinics, he mentioned how one unit secretary from the 11th floor of Scripps Mercy Hospital in San Diego emails him every day.
And he responds every time.
She begins each email the same way, "Hi Boss." On the day we had our scheduled interview, Van Gorder says Arby Bautista had asked over email about his weekend and what was on his schedule for the day. Knowing that she worked over the weekend, he replied, saying he hoped she could take a couple of days off during the week.
"It only takes a couple of seconds" to respond, Van Gorder says.
As the national movement away from fee-for-service healthcare--the seismic transformation from volume to value--gains steam, hospitals are beginning to understand on a deeper level that keeping entire communities healthy is an effort that (almost literally) takes a village.
While many hospitals are forming organic relationships with community partners like primary care physicians, skilled nursing facilities, health departments, social service agencies and others, here in Maryland, hospitals have found a another dedicated partner in the state government.
A little more than a year ago, Maryland's health secretary designated five Health Enterprise Zones (HEZs)--areas throughout the state with traditionally poor health outcomes that needed a boost.
I am writing this on a plane with my seatbelt strapped tightly around my waist. We have just experienced what the pilot casually referred to as "slight turbulence." It dawned on me that slight turbulence to him was not the same to me. My gut was in a knot and by the expression on the faces of my fellow passengers, they didn't think it was "slight," either.
I was reading an article on value-based care as I bounced about in my seat, and thought about all the healthcare policy changes that have occurred over the past 18 months. Those of us in healthcare know and understand that commotion in this industry is expected and eventually passes with time, but the turbulence we have undergone and continue to face does not have an end in sight.
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