Just Got Word

Introduction Hospitals large and small are among the most complex “organizations” to understand with respect to human interactions and the processes/systems meant to manage those.   They are equally fascinating and frustrating to interpret and advise/counsel, respectively.   The following article draws on the authors’ experience as management/operations consultants in hospital settings.   It discusses the communications characteristics unique to hospitals and some suggested remedies, particularly within the context of using communication as a change agent. The Problem Experience has shown that hospitals have difficulty meeting quality standards and financial targets when there is a lack of effective communication across the organization.   (This is certainly not exclusive to hospitals.   Every organization relies on effective communication to meet quality/financial objectives.)   More importantly, continued cost pressures coupled with new governmental rei...

First it was piano legs Hillary Clinton and Ira Magaziner doing the national health care thing.  Boy did they get far, real far, about as far away from the issue as they possibly get could once they realized how futile their "little" nationalized plan was going to go.  When it comes to health care in the US, the scale of greed and intractability speaks volumes for the practicality of the status quo. Fast forward to March, 2010, when President Obama signs into law the National Health Care Act, a monumental piece of legislation designed to do all sorts of things, from eliminating pre-existing conditions, to opening health care insurance to all, to cutting back on Medicare reimbursements.  Everyone, other than President Obama and his crafty advisors, are up in arms over this prescribed government/social change. Why are people so upset?  Hard to say; aside from the epic Lilliputian battles that rested on which side of an egg one should break when making eggs, I can't...

Tonight, on a cold, snowy, January night, David Fitzsimons of tPF will be attending a heated Obamacare debate at the NYU campus in New York City.  This is one in a series of "Intelligence Squared" US debates sponsored by the Rosenkranz Foundation. As a backdrop, back in March, President Obama signed into law the Affordable Care Act, the biggest overhaul of our health care system in decades.  According to a recent Kaiser Family Foundation poll, 40% of the public would like Congress to expand or leave untouched the new health reform law, while 49% are in favor of repealing all or parts of it.  Can the new law reduce the deficit and expand coverage to millions of uninsured Americans, or, as its critics warn, will it actually increase the deficit and fail to control costs that are spiraling out of control? tPF will be reporting on this healthcare slugfest in this blog quite soon.  Stay tuned for information on the debate and how we voted.

Stay tuned for information about our first study of 2011, which will ask Hospital executives to look at the US Healthcare Reform Act and predict which provisions of the Act will be enacted and repealed.  The Study will also examine the measures being taken by these executives to deal with Medicare reimbursement shortfalls and other implications of the Act.  Later this week, the Study will be put to the 'straw man' test as we have asked several US hospital executives to look at the text of the study and give us feedback and pointers before we distribute it to several thousand hospital executives online.  The information gleaned from this Study will be shared with Study participants and the press in order to elevate public consciousness around a contentious and critical issue.

Like any business, health care represents a significant challenge as far as having the correct staffing levels.  Having too many employees means wasted money; not having enough means compromising the quality of patient care.  Hospitals, for example, prefer to staff around anticipated procedures -- using standard, prescribed times as their work capacity targets.  There is typically one time standard per department.   For example, a post-open heart surgical unit may have a target of 18 hours per patient day.  A medical nursing unit might have a target of 8 hours per patient day.  An Operating Room may be at 0.15 hours per OR minute.   The difference in time standards between departments can be huge. Closing the variance represents a significant financial opportunity for hospitals and other health care organizations. If there are 100 departments in a hospital and they all have a 10-hour unfavorable variance per pay period, that translates to 1,000 hours ...