As the healthcare system continues its transition to value-based reimbursement, it has become incumbent on chief medical officers to seek out ways to improve quality and lower costs for their hospitals. Nowhere is this more relevant than the operating room, where each minute of additional time is associated with escalating costs.
Consequently, hospital leaders across the nation face constant pressure to uncover new, more-efficient means of providing high-quality care while keeping costs under control. And they must do so during a time when hospitals are confronting a raft of other challenges: an influx of aging Baby Boomers who require high-risk interventions, an impending national shortage of surgeons, and a frequent lack of the data visibility required to understand and improve clinical performance.
Seen in isolation, any of these challenges would be daunting enough. But taken together, they illustrate the difficult odds hospital leaders are staring down as they seek to position their organizations for success in a value-based world.
Paul Summerside, MD, the former Chairman of Aurora Baycare Medical Center in Green Bay, Wis., and the former Chief Medical Officer (CMO) of Baycare Health System and the Baycare Clinic, knows from experience the many competing priorities that CMOs must juggle on a daily basis.
To better manage the challenges of overseeing an OR, Summerside recommends hospital leaders keep in mind the three following lessons:
1. Hire high-quality staff
There’s no question that leaders across all industries strive to create cohesive, high-functioning teams that work well together and complement each other’s skill sets. Doing so takes on even greater importance in the realm of surgery, which requires strong team chemistry and teamwork in an often tense, pressure-filled environment.
“Success in surgery is predicated on teamwork,” says Summerside. “The entire team must be intensely focused on serving the needs of the patient in the room. It’s no exaggeration to say this is a life-and-death matter.”
For CMOs, the problem is that they have little-to-no data or objective measures to quantify the performance of surgeons who apply to work at their hospitals. Typically, CMOs must make hiring decisions based on a minimal amount of information about a surgeon’s background – resume, degrees, residencies, references – all of which provide little information on actual performance. For surgical staff, such as nurses, performance information is even more sparse.
To overcome this lack of actionable data, hospital leaders should create their own performance metrics, according to Summerside. Implement comprehensive, 360-degree surveys of all new hires at intervals of 30, 90 and 180 days. Admittedly, this is a high-sensitivity and low-specificity process, but in the absence of reliable data, it’s a vital step to promote quality and standardization.
2. Don’t tolerate sub-optimal performance
Even the best hospitals are likely to employ some underperforming clinicians and/or staff members. In most cases, these team members have simply not received adequate training to perform some of their job duties at an acceptable level.
Too often, hospital managers demonstrate a willingness to rationalize poor performance, and hesitate to intervene on known issues because they feel they lack the time and resources to drive behavior change. This is another problem that is further exacerbated by the lack of objective performance data on individual team members in the OR.
Nonetheless – whatever the reason behind the underperformance – once hospital leaders have identified suboptimal performers, it is their responsibility to find a way to ensure that underperforming employees are given the opportunity to improve.
“There’s no way around it,” says Summerside. “If your hospital has underperforming staff, you must invest the needed time and resources in interventions and training that will correct the issues. Find the time and money now, or you’ll end up spending a lot more later.”
3. Address the problem of objective visibility
Leveraging reliable, objective data in the decision-making process doesn’t guarantee that wise decisions will result, but it’s better than the alternative. Hospital leaders who don’t implement systems that produce clear, actionable data run the risk of formulating decisions from information that is essentially guesswork.
“The more ambiguous the data, or the less substantial the data, the easier it is to kid yourself about the results,” Summerside says.
For example, imagine a scenario in which OR staff members unanimously report that a team member is failing to perform up to standards. Without solid data to substantiate these claims, the performance assessment remains anecdotal, and becomes much easier for the underperforming staff member to dismiss – and much more difficult for leadership to affect change.
This scenario clearly illustrates why it is essential that hospital leaders leverage all available data resources to obtain clear, objective feedback on quality and performance. A potential solution to collecting this data is embracing OR integration technologies.
From new reimbursement models to unpredictable government regulations to an aging, more-acute patient population, hospital administrators are confronted with a complex array of challenges that are frequently beyond their control. However, savvy hospital leaders can implement three important lessons – hire high-quality staff, don’t tolerate under performance and address the problem of objective visibility – to seize control of their own futures and place their organizations on a sustainable path forward.