Top 10 challenges for healthcare executives in 2018

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/top-10-challenges-healthcare-executives-2018?cfcache=true&ampGUID=A13E56ED-9529-4BD1-98E9-318F5373C18F&rememberme=1&ts=10012018

 

 

 

These 6 healthcare leaders say quality improvement is an organizationwide effort and a cultural imperative

https://www.fiercehealthcare.com/healthcare/6-inspiring-quotes-improving-quality-from-6-healthcare-leaders?mkt_tok=eyJpIjoiWVRNeE1HSTFPREkwTmpsbSIsInQiOiJtcHFUTmw4bU5UWE0rbE44Q0ExcUc5cEI5SSt0UVdcL0ZYVDllbUhMN3VNXC9ab2JTTlwvKzVYOXMyTmVmRlwvZjJ2VzNZWmp5Z2VJeERzVytyWUZOdkVyRmdnVWNWSEV6SVhkSWVHSFljSkhRV05rMUt5WFwvemVvM2dsMEpUeW1rYUx2In0%3D&mrkid=959610

Executive looking out window

Despite recent uncertainty about the government’s commitment to value-based care, healthcare organizations remain focused on efforts to improve quality, patient care and employee engagement.

In 2017 the Centers for Medicare & Medicaid Services cancelled mandatory bundled payment models for hip fractures and cardiac care and also asked providers for feedback on other value-based payment models.

But healthcare organizations seem committed to the initiatives they have already put in place to improve quality. Indeed, last year healthcare leaders shared their successes, challenges and lessons learned as they worked to improve quality and patient outcomes. We’ve rounded up the most memorable quotes from these healthcare thought leaders about quality, the importance of physician engagement and how to achieve a culture of patient safety.

Here are six of our favorite quotes from our interviews and industry news and event coverage over the past 12 months:

1. “We had to challenge our old paradigms. Physicians are instrumental in setting the tone, and unless the physicians believe we’re on the right path we don’t have the kind of alignment that will help us move forward.”

Gary Kaplan, M.D., chairman and CEO of Virginia Mason Health System, explained in a webinar this fall how the Seattle system improved patient safety using a patient-centered approach. Virginia Mason’s safety culture transformation began in 2001, Kaplan said, when system leaders realized that a physician-centered approach alone would not improve patient care.

2. “You need to start with the early adopters. You can’t start with folks who will fight you tooth and nail. You want to start with early successes and then evolve from there.”

Felipe Osorno, an executive administrator at Keck Medicine of the University of Southern California, spoke at the Institute for Healthcare Improvement’s annual quality forum about strategies to engage physicians in improvement initiatives. The secret was designing a program in which physicians were respected for their competency and skills, their opinions were valued, they had good relationships with their medical colleagues, they had a broader sense of meaning in their work and they had a voice in clinical operations and processes, he said.

3. “We really want to attract folks who believe at their core, not just intellectually but in their heart, that kindness can heal. … If we do it right the first time and we assess candidates based on the fit of the organization, ideally we will have more engaged employees who deliver care in a way that is patient-centered.”

Wanda Cole-Frieman, vice president of talent acquisition at Dignity Health, talked to FierceHealthcare this summer after the California system was named by an online job platform as the best place to interview in 2017. Among its techniques: It assesses candidates’ behavioral competencies for human kindness, compassion and the human experience.

4. “To create a true culture of safety and reliability we need to engage everyone, and it can only be driven when we have strong alignment. Everyone can play a role in safety.”

Gary Yates, M.D., a partner in strategic consulting at Press Ganey, explained in an interview that building and promoting a culture of safety at healthcare organizations is important to retain current staff members, but is also an especially effective recruiting tool for millennials, who will make up half of the workforce by the year 2020.

“People talk, and people ask about the culture inside different organizations,” Yates said. Putting the spotlight on safety and quality could “tip the scales” for young people.

5. “Our focus is safety, to fundamentally be a safe hospital. If we start there or if any hospital starts there, patient experience will take care of itself, quality metrics will take care of itself as will employee morale.”

FierceHealthcare caught up with Nicholas “Nico” R. Tejeda, CEO of The Hospitals of Providence Transmountain Campus in El Paso, Texas, at an American College of Healthcare Executives event. He talked about opening a new teaching hospital and establishing the culture of the organization from the beginning and with every hire.

There are no acceptable levels of errors, he said. And while it may be nearly impossible to achieve zero incidents, he still wants the organization he leads to strive for perfection.

6. “We don’t see quality as just a clinical goal. It’s an enterprisewide priority that encompasses customer service, compliance and wellness.”

A few years ago, Anthem decided to make a “rigorous” effort to boost the quality of its plans. And it’s demonstrating results, Anthem’s then-CEO Joseph Swedish said during the 2017 AHIP Institute & Expo. Now, more than half of the insurer’s Medicare Advantage enrollees reside in 4-star plans, compared to just 22% the year before.

 

NEARLY 50% OF UPPER-LEVEL MANAGERS AVOID HOLDING PEOPLE ACCOUNTABLE

Nearly 50% of Upper-Level Managers Avoid Holding People Accountable

 

46% of upper-level managers are rated “too little” on the item, “Holds people accountable … .” (HBR)

You missed the point if accountability is:

  1. Coercing reluctance to do things it isn’t committed to do.
  2. Expecting performance from weakness. Accountability won’t help squirrels lay eggs.
  3. Punishment.

Accountability:

  1. Says we are responsible to each other.
  2. Expresses commitment. Those who aren’t willing to be accountable haven’t committed.
  3. Defines dependability. What’s more insulting than one unprepared person on a team filled with talent?
  4. Demonstrates confidence and self-respect.
  5. Sets the ground rules for respect and trust.

Accountability recognizes strength and honors performance.

Mutual accountability:

I’ve never been asked to lead a workshop on how to hold ourselves accountable. It’s always about others. That is the heart of the problem.

Accountability is something to work on together, not mandate from on high.

One-sided accountability:

  1. Leverages fear.
  2. Depends on carrots and sticks.
  3. Promotes disconnection and arrogance. Relationships disintegrate when leaders stand aloof.
  4. Invites resentment and disengagement.
  5. Dis-empowers those who need to feel powerful.

Mutual accountability:

  1. Requires leaders to go first.
  2. Demands respect-based interactions.
  3. Strengthens connection and relationship. We are responsible to help the people around us succeed.
  4. Honors integrity and courage.
  5. Gives opportunity for humility.

Jim Whitehurst, CEO of Red Hat, said, “Go into every interaction with those who work for you believing that you are as accountable to them for your performance as they are to you for their performance.”, and author of, “The Open Organization.”

Practice accountability:

Blurry responsibility leads to vague accountability. Vague accountability is no accountability.

  1. Who owns the project or initiative?
  2. Who makes decisions? The group. A project leader. Someone who isn’t in the room.
  3. What are the deliverables?
  4. What are the milestones and deadlines?
  5. What happens when deadlines are missed?

Complexity is like fog to accountability.

What might mutual accountability look like in your organization?

How might leaders lift accountability out of the category of punishment?

4 MORE ENEMIES OF VITALITY ALL LEADERS MUST AVOID

4 More Enemies of Vitality All Leaders Must Avoid

Leaders who suck the life out of people promote failure and embrace defeat.

The first four enemies of vitality:

#1. Distrust.

#2. Disrespect.

#3. Proper channels.

#4. Excluding the outside.

Posted here.

4 more enemies of vitality:

#5. Isolation: the message that others don’t matter

3 ways ineffective leaders practice isolation:

  1. Avoid the front-line. Hang with the upper crust.
  2. Mandate don’t communicate.
  3. Make policies when something goes wrong rather than using values as guides.

#6. Favoritism: discouragement for the masses. Energy for the favorites.

Leaders play favorites when they:

  1. Believe they’re above flattery. “… we have a craving for anything that makes us feel good about ourselves. We’ll go to great lengths to get positive feedback, … .” (HBR, July 2010)
  2. Give cushy assignments based on the brown-nose index. (Those who brown-nose the most are at the top of the brown-nose index.)
  3. Promote suck ups. The more someone kisses up, the more likely they are to move up.

Suck-ups get ahead because flattery works.

#7. Lousy meetings: insulting the brains around the table

Talkative leaders suck the life out of meetings.

Rule of thumb: The leader of any meeting speaks no more than 25% of the time. (15 minutes in a 60 minute meeting.)

  1. Assign agenda items to team members.
  2. Create discussion by asking everyone to give one reason why the idea on the table won’t work. Turn the tables and ask everyone to give one reason the idea should be adopted.
  3. Call on quiet team members. If the person is an introvert, give them prep time. “Wilma, would you prepare to address item #2 on tomorrow’s agenda?”

The worst romance is infatuation with the sound of your own voice.

#8. Cowardice: playing it safe is rewarded with advancement

Cowardly leaders:

  1. Can’t make decisions.
  2. Hide behind policy.
  3. Throw people under the bus.

Cowardly leaders suck the life out of people who want to get something done.

Which one of the eight enemies of vitality is most deadly?

What leadership behaviors suck the life out of people?