I Choose the Size of the Needle
The healthcare system is fraught with challenges — ranging from disruptive technologies and reimbursement complexity to price and cost obstacles, as well as pressure from government, insurers and businesses. It often appears from our vantage point, healthcare executives embrace a “sky is falling” mentality to reducing costs initiatives, though reality doesn’t always follow this perspective. Pressures continue to mount and the industry is increasing in complexity while hospital administration is hell bent on extending those pressures to cut costs and increase efficiency.
We see clinicians and administration tackling these issues as best they can together to uncover new ways to reduce expenses while better serving patients. Effective collaboration mandates breaking down existing biases and building a culture of trust — centered on enhancing patient care. Sounds great in theory without any element of stress, right?
Sure, and it’s contingent, however, upon leaving your preconceived notions and ego at the door to re-establish and build an open collaborative environment verus the traditional controlling confrontational landscape we’ve seen for far too long. Hey! We’re not enemies.
Let’s dive into the meat-on-the-bone of it: To create a more collaborative culture, hospital administration and clinicians must break down three biases that are blocking sustainable change to move forward as an organization together in one direction.
Conflict and Tension are Detrimental to Success
The polarity between hospital administration and clinicians can foster a healthy dialogue inspiring innovative problem solving to enhance patient care, reduce costs and improve efficiency. Conflict is not always a bad thing! It’s an opportunity to listen and uncover objections, to gather new or more information to a recurring problem that may have been stagnant or the redundant, ‘this is how we always do it.’ Isn’t it time to try another tact to an age old problem. How about sharing a new mindset of, ‘this is how we’re expected to do it.’ Let’s communicate more often, solve our problems together and see how we can systematically ensure we’re not repeating the old ways of inefficiency again and again.
Despite the differences, clinicians and hospital administration must eliminate the US versus THEM perspective each other too frequently shares. How do we create a more cohesive team atmosphere that welcomes new ideas and respects each other’s needs and priorities? Together, we must step into the grey, be willing to be uncomfortable and find uncommon ground. Here’s what’s NOT working:
Questioning every decision and challenging everyone
Blaming people and pointing out their flaws
Pushing WAAC – win at all costs – let’s show them how good we are!
What DOES work?
We currently have a client who must reduce operating room supply costs. They created a diverse team of surgeons, administrators and support staff from across the system to find opportunities to consolidate and reduce complexity and unnecessary redundancy. Physician pushback was anticipated, given strong personal preference and reluctance to change what isn’t broken from a patient outcome perspective. However, the team discovered the costs were unknown to most, if not all, surgeons. When presented with the cost differences for many items and how much this would eliminate the need for nurses to train on multiple, yet similar, items for individual surgeons, they too could not justify the need in many instances.
Not only will a collaborative culture inspire a group to find new ways to enhance patient care, but it also led clinicians and hospital administration to better identify avenues to cut costs and improve efficiency. Hospital administration is now empowered to make more strategic investments that benefit doctors and patients. What’s the financial win here? It dramatically frees up capital to invest in other more strategic endeavors, i.e., new operating rooms, surgical technologies, etc. Isn’t cutting costs also in the patients’ best interest, as they want medical bills to be as low as possible, while not diminishing the quality of care?
All too often, we think we see efficiency in control and coordinated efforts. While efforts must be disciplined in the healthcare enviornment, an ineffective structure can cut off common sense and create more friction and less dynamic movement to do two things – reduce costs and enhance patient care.
All Change is Bad Change
The next shift to uncommon movement forward is to address the uncertainty of change. Change can be challenging — especially for organizations at the top of their field. One executive feeling overly confident in himself bellowed, ‘We are the premier provider of outpatient surgical care in the US.’ I absolutely agreed with him…followed by, ‘…well why am I here then?’ As his ego came down into check, he said, ‘we’re consistently inefficient and thousand dollar bills are flying out the window.’ Great, now we have a direction to go!
His hesitancy to change for fear of losing his premier provider status masked what was really going on. Far too often, this is the case – the problem isn’t the problem – it’s just a sympton. We don’t dole out prescriptions or set a case up for surgery because ‘it’s a revenue opportunity’. We dig deeper into finding what is causing this ‘inflamation’ and angst. Anytime there is a horizon of a new way of working or thinking, the feelings of unease and vulnerability, both from clinicians and hospital administration, begin to surface. Once we uncover how it manifests itself, then we have a direct path to potential resolution. Remember, the problem may not be the problem. Regardless, vulnerability can be beneficial. It keeps you hungry, learning and, most importantly, keeps you asking, ‘How can we better serve patients?’
Just as they welcome new cures or medical innovations, clinicians must apply the same appetite they have for embracing change in medicine to the systems side of the equation.