Many hospital executives around the country are cautiously communicating with their boards, medical staff, patients and community; attempting to explain why they are facing reimbursement penalties from processes or outcomes which failed to meet established benchmarks. Beyond these somewhat awkward conversations, what are these leaders expected to do next?
Of course, a natural response might be to find someone to blame, whether it be subordinates, physicians, payers or even government. Beyond perhaps feeling better having done so, it is not likely this will reduce the likelihood of facing similar penalties next year. Since credit is afforded to those institutions that make great improvement, many executives view a “low” starting point as an opportunity to recognize significant gains.
So where do you begin? Data. Not just any data. Validated, risk-adjusted and trusted data is the cornerstone upon which to build a strong yet flexible structure, anchored by transparency, accountability and empowerment. This information can be used to construct a pipeline of opportunities, at the procedural or diagnosis level, representing the greatest gap from best practice and impacting the largest number of patients. With a clear appreciation of organizational bandwidth, it is then possible to strategically launch, implement, and sustain initiatives that recognize inherent strengths while addressing barriers to best practice.
Given the uncertainty within the healthcare community, it is easy to become reflexive or even despondent. Yet, it is in these times of flux that innovation, courage and true leadership emerges. The data are there. The talent is there. The commitment to excellence is there. So now is the time to take charge on behalf of board members, medical staff, patients, and most importantly community!
Michael R. Udwin, MD, FACOG
National Medical Director