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Collaborative Congress: Post 85

I believe that this Congress of the American College of  Healthcare Executives was the best educational forum that I have ever attended.  Imagine Congress passing major healthcare legislation the same week that over 4,000 healthcare executives met in Chicago to discuss implications of healthcare reform.  I felt that I was part of the present, especially as Mike Fecher and I addressed over 100 people re: Field-Tested Physician Recruiting, Contracting, and Retention Strategies.  I found it provocative that nearly everyone conducted exit interviews of departing physicians to ask why they were leaving, but nobody in the room asked physicians who had been with them at least five years why they stayed and what they could do to make their time more productive.

Some of the many highlights of this outstanding meeting included:

• Maureen Bisognano’s Building Strong Connections Between Cost and Quality, in which she encouraged leaders to “think outside the building,” to improve safety, engage patients in improved self-management, reduce arbitrary individual variation, root out waste, and create a culture that supports the delivery of cost-effective care
• Chuck Mowll’s Best Practices of High-Reliability Hospitals, in which he cited Sentara’s practices of putting red tape around medication dispensing machines to warn people not to interrupt the person using them, using simplification experts to review processes, and encouraging staff to comment on any safety issues that concern them
• Nate Kaufman’s Proven Strategies to Enhance Performance Under Healthcare Reform, in which he encouraged participants to view upcoming challenges as thrills rather than threats as they approached physicians to break even on Medicare by strategic cost reduction, rebalancing payer contracts, recruiting clinical stars, improving coding, revenue cycle, and patient flow, developing an embedded medical group, selectively adding fixed costs, and auditing all financial relationships with physicians
• Ruth Brinkley’s Positioning Yourself for Success, in which she summarized the six ingredients for career success: competence, confidence, courage, resilience, humor, and people
• Gerry Ibay and James Higgins’ How to Succeed as an Early Careerist, in which they described the capacity for deep listening, challenging one’s own point of view to hear others’ perspectives

Although I usually do not stay through Thursday, I was glad that I did this time, to attend Kathleen Bartholomew and Joe Bujak’s Of Lions and Lambs: Transforming Physician-Nurse Communication.  They dressed in costume to role-play disrespectful dialogue and its effect on clinical and financial outcomes, especially in causing people to take out frustrations on colleagues who had nothing to do with the harmful interaction. 

They pointed out that depersonalization protects power and autonomy and that we need to come to know each other as people by celebrating successes rather than focusing solely on mistakes.  When respected physician and nurse leaders come to consensus on behavioral expectations to which everyone is accountable, the majority of those who transgress will apologize and those who don’t will leave.  Safety and clinical quality establish the moral high-ground.

What do you think?

• Does the prospect of healthcare reform make you excited, fearful, or ambivalent
• Can we build a strong connection between cost and quality
• What physician-hospital collaboration do we need to do to break even on Medicare reimbursement
• Do nurses and physicians where you work share behavioral expectations to which everyone is held accountable to improve healthcare communication

As always, I welcome your input to improve healthcare collaboration. 

Kenneth H. Cohn

© 2010, all rights reserved

Disclosure:

I have not received any compensation for writing this content. I have no material connection to the brands, topics and/or products that are mentioned herein.

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