Wednesday, December 20, 2006

Healthcare Tomorrow Has a New Home

I am happy to announce that Healthcare Tomorrow has a new home.

Come visit my new website at

All new posts will be there.

Friday, December 15, 2006

The Best of the Best

Top Gun was one of the first "cool" movies I remember watching. Maverick and Goose are rebellious Navy pilots that are chosen to attend an elite aerial combat school where they duke it out to see who would be the best of the best. I am pretty sure every boy fantasizes about that kind of glory, but I have always wondered how they knew who should attend the Top Gun flight school. How did they know who the best were?

Now that I am getting more intimately acquainted with HR I have begun to wonder the same thing about nurses and managers and executives. When we are out looking for new talent for the organization, how do we know who the best are and where do we find them? It would seem that most of the time we are just sifting through the available pool of local talent to fill positions with “the best available”. But how far will that get us? For an organization, like my own, that strives to be the best medical center in the nation, I don’t think it gets us far enough.

The problem is that healthcare workers don’t have box scores printed in the Sunday paper. The best of the best are likely humming along within their organizations and potentially invisible to the outside world. There are people that receive public awards, but those are few and far between (and those are often popularity contests anyways).

I can hear the recruitment specialists of the world saying that you find talented people by offering the right incentives and then the best will come to you. Perhaps there is something to that, but what do the best want that would distinguish them from the rest? More responsibility…more pay…more prestige…more freedom…more resources at their disposal?

But maybe it is another truism about business – it is who you know – that is the secret to finding the best. We already give referral bonuses to employees for finding new talent, but maybe we haven’t gone far enough down that road. Do your best employees know other high performers? Perhaps LinkedIn is a better search tool than Monster.

These are some interesting questions and, obviously, I don’t have the answers. I would be interested to hear from people on this subject. And don’t worry, we won’t steal you best people…yet.

Tuesday, November 28, 2006

Next I do Surgery

So I have been studying for my Certified Healthcare Executive accreditation for the past few months (hence the low number of posts) and it has gotten me thinking about what it means to be a competent healthcare administrator again. This has come up as I have seen a number of reports on recommended quality practices. For instance, an article in the NEJM sponsored by the National Heart, Lung, and Blood Institute, recommended a series of practices to reduce door to balloon time for myocardial infarction patients. What struck me about the list was a number of the recommendations weren't just for clinical folks. Plain old healthcare administrators, in the right role, could implement some of these practices and presumably impact a healthcare outcome.

This isn't really earth shattering on its surface. As healthcare administrators, we talk about improving quality all the time, but most of that talk is around structural or process issues that speak to the cost, availability, or effectiveness of services. We certainly care about patient outcomes, but those measures have been "owned" traditionally by the medical and nursing staff. They were the ones with the training and tools (I would argue that their perspective plays a key role as well) to evaluate the outcomes of clinical care. That certainly hasn't changed and healthcare administrators will always depend on our clinical counter-parts for this.

I think what has changed is the expansion of what is being considered to impact patient outcomes. More and more we are looking at process measures, not just for efficiency sake, but for their impact on the patient. An example is wait times in the ED. We are also looking at aspects of the hospital environment that impact not only patient satisfaction, but health outcomes as well. An example is natural lighting in the patient room.

I have always said that every decision impacts the patient in a hospital, but it is becoming more clear, to me at least, that healthcare administrators impact patient outcomes. What does that mean for us as professionals? Can bad management kill patients? Perhaps. All the more reason I need to pass my test.