Healthcare Collaboration » Learning

Collaborative Anticipation

Kenneth Cohn — Sun, 29 Apr 2012 16:10:44 +0000

Next month, I expect to be home only three full days. I quip that this is a marital protection strategy, now in its 28th year and give kudos to my family for supporting my passion to reach out to disgruntled doctors and hospital leaders, listen to their issues, and help them solve their problems through improved communication, engagement, and collaboration.

I call this process collaborative anticipation as I brainstorm ways that I can:

connect with people’s pain and aspirations
help them depersonalize their differences
make their time count
help them leave a lasting legacy

For example, I travel this week to Chicago to facilitate a 2-day discussion of quality and safety issues, which will give me the opportunity to learn from experts and share with them the insights in a chapter that I coauthored with Gary Yates and Carol Sale in Getting It Done on the pioneering work at Sentara to improve their safety culture. To deal with inadequate communication, inattention to detail, noncompliance with policy, and failure to recognize high-risk situations and use error-reduction techniques, they implemented four strategies to promote the practice of safe behaviors:

Expectation setting: developing behavior-based expectations (BBEs)linked to techniques for error prevention for all hospital staff, hospital leaders, and physicians
Operational focus: establishing “red rules” to focus employees’ attention on high-risk procedures that can result in patient harm if not followed exactly (e.g., positive identification prior to any action with a patient, site verification before surgery)
Effective tools: developing an enhanced root-cause and common-cause analysis process that was more timely and geared toward producing long-term, systems-oriented changes
Streamlined rules: adopting an approach for simplifying policies and procedures (e.g., identifying and standardizing key steps in a checklist)

Proof of their success lies in their results:

Staff increased their use of expected communications behaviors (such as using repeat-backs and clarifying questions) by 42 percent. Ventilator-associated pneumonias were reduced by 92 percent (6.15 to 0.42 per 1000 ventilator days) from January 2002 through December 2009, and the device-associated bloodstream infection rate fell 93 percent (3.68 to 0.42 per 1000 central line days) from January 2002 through December 2009.

Additionally, symptomatic catheter-associated urinary tract infections within the critical care units fell 66 percent (1.86 to 0.60 per 1000 foley catheter days) from January 2007 through December 2009. Total compliance to proper hand hygiene increased to 96% by December 2009.

What seems unique about the Sentara experience is that Dr. Yates was not satisfied with healthcare-specific benchmarks, so he looked to industries like nuclear power and aviation to improve quality and safety. What do you think?

What is unique to your situation that benchmarks do not address adequately
What can you learn by making “apples-oranges” comparisons with leaders in other industries
Where can you benefit from collaborative anticipation, disrupting your thinking and your routines in order to improve care for your community

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

Kenneth H. Cohn

Disclosure: I have not received any compensation for writing this content.

Collaborative Anticipation is an original post from Kenneth Cohn, Healthcare Collaboration. If you enjoyed this post, be sure to follow Ken on Twitter, Facebook or Google+.

Collaborative Ecosystems

Kenneth Cohn — Wed, 11 Apr 2012 20:00:00 +0000

I apologize for going nearly six weeks without writing a blog post here and have no idea where the time went. Like a proud papa, I announce the birth of a new website, The Association for Healthcare Collaboration, which I have dedicated to putting experts from a wide variety of fields under one URL, covering leadership, financial and legal matters, and social media.

http://www.youtube.com/watch?v=CkddB9syOrY

I have also reviewed approximately 30 books related to healthcare and leadership, the newest being The Wide Lens by Tuck Business School Professor Ron Adner. Prof. Adner cites the health information technology industry as an example of ecosystems in dynamic change.

By 2009, only 9% of hospitals had implemented electronic health information systems because the incentives were misaligned: insurers benefit from the increased ease in sharing information, hospitals benefit from improved billing, patients benefit from the decrease in complications, and radiologists benefit from being able to look at films from home, but for most doctors, nurses, and physician assistants, the burden of increased training time and decreased initial efficiency seeing patients, to say nothing of the costs of entering information into the record, made the costs outweigh the benefits.

The process did not take off until federal legislation introduced a carrot-and-stick approach, paying physicians who received reimbursement from Medicare up to $44,000 ($63,750 for doctors who treated Medicaid patients) until 2015 when penalties begin for lack of compliance with meaningful electronic information use standards.

In Getting It Done, Joel Berman and Michael Green, who have been working in health information technology since 1997, offer suggestions to improve physician adoption of health information technology (HIT):

Most physicians care more about the institution’s mission than its margin; therefore, financial arguments carry less weight than care-related calls to action.
In a physician’s hierarchy of needs, workflow (in the long run) trumps all other considerations. HIT initially slows physicians’ workflow.
Most systems are in their adolescence. They are not plug-and-play but must be custom designed for an institution by physician-led multidisciplinary teams.
The use of computerized information systems poses cognitive challenges to physicians who are not comfortable using computers.
Standardization of provider workflows and order sets across an organization presents significant cultural challenges to physicians of all generations.
Health information technologic challenges are 80 percent sociological and 20 percent technological . Unwavering physician leadership is essential to solving sociologic challenges. The Concord Hospital group used John Kotter’s model (defrosting activities) to set the stage for sustained success.
Change and its associated transitions often prompt physicians and members of their care teams to put up emotional walls. Concord Hospital’s Office of Organizational Development periodically offers change and transition workshops to help physicians recognize and address negative emotions at an early stage, before they become problematic.
Begin with the end in mind. What do you want this application to do for you in one year? In three years? Work backward to design it to deliver what you want.
Optimize provider workflow so that quality improvements are not achieved at the expense of provider efficiency.
Because electronic applications convey more information than paper systems do, physicians can drown in data. To effectively manage this data deluge, encourage physicians to transform their individual care delivery to team-based approaches.
Before deploying HIT, communicate the message that most errors are due to bad systems, not bad physicians, and that paper-based order entry is a poor system, leading good physicians to make mistakes. Make this message stick by using local stories rather than national data.
Deployment of HIT will be one of the most challenging initiatives your organization undertakes. Allocate resources accordingly.

I hope that you will register at no charge to join The Association for Healthcare Collaboration and tell friends and colleagues about this exciting new resource.

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

Kenneth H. Cohn

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.

Collaborative Ecosystems is an original post from Kenneth Cohn, Healthcare Collaboration. If you enjoyed this post, be sure to follow Ken on Twitter, Facebook or Google+.

Collaborative Governance

Kenneth Cohn — Sat, 11 Feb 2012 18:16:52 +0000

At a combined retreat that I facilitated last month, a Board chair commented on the challenge of collaborative governance and lamented her steep learning curve: “It took me two years just to learn the vocabulary.” For people who do not have healthcare backgrounds, imagine the challenges of being responsible for hospital strategy in these rapidly changing times, with the viability of a valuable community resource resting on their decisions.

For this reason, I recommend that new Board members receive a copy of Houle & Fleece’s latest book, The New Health Age: The Future of Healthcare in America. This 311 page book comes with a glossary of healthcare abbreviations and 17 chapters divided into three parts: History and Context, The Dynamics of The New Health Age, and The Landscape of The New Health Age.

The flow dynamics of The New Health Age are:

How we think about health care, moving from sickness to wellness
How we deliver health care, moving from a reactive, episodic non-system to a more proactive system focused on providing coordinated,holistic care
The economics of health care, in which we shift from volume-based, procedural reimbursement to more value-oriented metrics, based on quality, safety, and patient satisfaction scores.

By gaining an awareness of these dynamic flow changes, the benefits of change become clearer. For example,who would attack being more proactive to improve poor health care outcomes and reduce costs?

For those people who feel trapped in the headlights of life, not knowing where to start, I offered five “evergreen” suggestions for collaborative governance that will remain viable regardless of the outcome of the Supreme Court decision later this year:

1. Improve communication around hand-offs: one of the biggest reasons for hospital readmissions is failure to communicate a plan for patient needs across the care continuum.

2. Call patients after discharge: Waterbury (CT) Hospital has instituted a program where every patient receives a call from a healthcare professional within 48 hours of discharge. This process benefits the hospital in several ways. First, the patient is less likely to be readmitted to the hospital because of inadequate follow-up care, saving healthcare costs. Second, the patient feels a personal connection to the hospital and is more likely to recommend its services to family and friends. Third, the hospital catches medical issues more rapidly and is able to treat them with less-extreme options than if adverse drug reactions or signs of infection fester.

3. Look at long-term value as well as day-to-day needs: Often, we focus so intently on day-to-day and month-to-month department budgets that we forget to step back and look at the overall cost structure. For example, using mid-level providers to facilitate physicians’ discharging their patients earlier in the day and on weekends can drop overall length of hospital stay dramatically.

4. Eliminate as much non-value-added care as possible: Approximately 40 percent of the medical care provided in the United States may not add value, based on reports from The Dartmouth Institute for Health Policy and Clinical Practice. A good way to streamline healthcare practice is to use post-it notes and write down every step in the patient care process. Then put all the post-it notes on a wall, step back and determine which steps are unnecessary, consolidating the steps to make sure that each is adding value.

Medical centers in Indianapolis collaborated on quality and safety measures that would improve care and found 23 non-value-added steps they could remove and thereby decrease cost and improve outcomes. The likelihood of error increases with every step added to the care process.

5. Encourage patients to make better decisions about their health: A 2002 Health Affairs study that found that the contribution of medical care to longevity is only about 10 percent, compared to 40 percent for patient decisionmaking. The biggest contribution to patient longevity involved the decisions patients make about exercise, food intake, tobacco, seatbelt use, and whether those with multiple partners use protection.

Patients need to be reminded at every encounter that they have the biggest impact on their own health.

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

Kenneth H. Cohn

Disclosure:

I have a material connection because I received a review copy that I can keep for consideration in preparing to write this content.

Collaborative Governance is an original post from Kenneth Cohn, Healthcare Collaboration. If you enjoyed this post, be sure to follow Ken on Twitter, Facebook or Google+.

Unconscious Competence: Viviendo la vida locums

Kenneth Cohn — Sat, 07 Jan 2012 00:05:12 +0000

I apologize for the delay in posting. Although I looked forward to taking a holiday vacation, I have come to the aid of a surgical colleague at a critical access hospital in New England who had no backup. I enjoy being of service and being thought of as a solution rather than the problem.

Last weekend, I was asked to consult on a patient who fell and had a 10% pneumothorax (a small air leak in the lung into the chest cavity). Usually, the air appears on the lateral (outside) surface of the lung, but this time it was medial, a finding that I had never seen before. I shared my lack of certainty with the patient and encouraged her to be transferred to the tertiary hospital where they had interventional radiologists on call who could guide her treatment.

I learned later that the medial air collection was due to the lateral lung being stuck to the chest from a previous injury or inflammatory process and that a chest tube placed via the (traditional) lateral approach would likely injure the adherent lung and not evacuate the pneumothorax.

My grandmother called these episodes her “once-in-a-whilers.” May we all be so fortunate to have as many “once-in-a-whilers” as she did during her 95 years. A talented, intuitive general surgeon commented when I did something right, “Ken, the Good Lord, she was surely watching over you.” A cardiac surgeon quipped, “It just goes to show that even the blindest sow finds and acorn now and again.”

During residency, I learned about the journey through the four stages of competence:

Unconscious incompetence: people make mistakes because they are unaware that they are missing information (e.g. the July 1 house officer transition)
Conscious incompetence: usually following unconscious incompetence, they feel upset and embarrassed and question their knowledge
Conscious competence: over time, they feel more comfortable about their skills, knowledge, and judgment
Unconscious competence: they trust their instincts and allow those instincts to influence their decision-making, especially when something “just doesn’t feel right.”

Donald Schoen described unconscious competence as reflection in action, a series of course corrections that experienced practitioners make, often without realizing that they are making them until they are asked to think aloud by a student or resident who is shadowing them. Whatever the explanation, I feel fortunate to work in a profession where I am allowed, and occasionally encouraged, to trust my gut.

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

Kenneth H. Cohn

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.

Unconscious Competence: Viviendo la vida locums is an original post from Kenneth Cohn, Healthcare Collaboration. If you enjoyed this post, be sure to follow Ken on Twitter, Facebook or Google+.

International Healthcare Collaboration: Stockholm Memories

Kenneth Cohn — Sun, 18 Dec 2011 00:52:02 +0000

Dr. Martin Backdahl, Prefekt of Molecular Medicine and Surgery, Karolinska Institute

Drs. Lars Stange and Mia Granberg with their sons Per and Anders

Greetings from Stockholm, where I returned to visit people with whom I collaborated during residency and to promote international healthcare collaboration. As I wrote in a previous post, despite working in a country that has a socialized medical system, practitioners in Sweden enjoy local autonomy in clinical decision-making. The government assigns a budget for healthcare and expects practitioners to live within it, but does not tell physicians and nurses how to practice medicine on a day-to-day basis.

I was pleased to learn that they too deal with issues of physician-physician and hospital-physician collaboration. They use physician champions, like the ones featured in the photos above, to influence fellow practitioners. Although I do not believe that the Swedish healthcare system can be transplanted to the US, I am proud to include them in my group of cherished co-mentors, who influenced my outlook, as I have influenced theirs. We face similar pressures to provide more coordinated, cost-effective care and support international healthcare collaboration.

Stockholm sunrise, 9:30 am

Stockholm sunset, 2 PM

In this land of the midnight sun during the summer, I would like to believe that my visit brought some cheer during a time of national darkness.

God Helg is Swedish for Happy Holidays

Happy holidays to all my readers, and thanks for your readership and your insights the past year. Please stay tuned for more information on how you can be part of the Association for Healthcare Collaboration in 2012.

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

Kenneth H. Cohn

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.

International Healthcare Collaboration: Stockholm Memories is an original post from Kenneth Cohn, Healthcare Collaboration. If you enjoyed this post, be sure to follow Ken on Twitter, Facebook or Google+.

What I learned at the Community Hospital 100 Conference

Kenneth Cohn — Fri, 11 Nov 2011 20:33:39 +0000

I had a wonderful time delivering the closing keynote, “Moving from Me to We: A Practicing Surgeon’s Journey to Collaboration,” at the Community Hospital 100 Conference, October 23-25, 2011. For those who would like to learn more about the highlights of this conference by watching a four-minute video, please click here.

Leading the Health of Our Communities

The first session discussed the transition from fee-for-service to more value-based metrics. Lori Knitt, Chief Quality Officer at Aurora Sheboygan Medical Center, described her journey of giving physicians specific provider data, so that they could see how they were doing compared to peers in the same specialty.
Clinical champions encouraged laggards by constructing a mock jail cell in the physicians’ lounge and putting their photos behind bars with the caption “Most Wanted.” She feels that physician-driven innovations like these help her hospital become more nimble in dealing with disruptive innovation.

Joshua Potter of Steward Healthcare System relies on health information technology to monitor outmigration of consultations. The primary care physicians generally stay within network. Steward has facilitated conversations among specialists to foster increased accountability.

Mina Ubbing, CEO of Fairfield Medical Center, described baby steps a community hospital can take to move toward providing more collaborative (accountable) care, After her orthopedic surgeons asked for a heightened management role, she developed a co-management agreement that allowed them to improve processes and quality outcomes and to share risk with payers. She facilitated the process by serving beer on tap in her basement. The success of this process led to primary care physicians, nephrologists, cardiologists, cardiac and vascular surgeons, and interventional radiologists forming an institute to provide more collaborative care.

The Future of Independent Hospitals

John Dawes, CEO of Bothwell Regional Health Center, partners with the Federal Qualified Health Center in his area to hold health summits, improve communication, break down myths, and assist with recruiting physicians to the area.

Jill Fuller, CEO of Prarie Lakes Healthcare System, looks for disgruntled doctors who do not want to be part of large healthcare systems any longer because of loss of autonomy. She entices her physicians to participate in Monday evening conferences over dinner by offering timely discussions on focused topics of mutual interest like, “How are we going to get paid in the future?”

Dealing with Disruptive Innovation

Clayton Christensen, Professor at Harvard Business School, said that community hospitals represented three different business models within one structure:

Solution shop: where patients present with diagnostic problems that require treatment (eg. Emergency Department)
Start and finish business: eg. where patients come in for elective surgery
Facilitated networks: where people share information (eg. chronic disease registries like inflammatory bowel disease or breast cancer survivors’ groups)

Solution shops function on a fee-for-service basis, start and finish businesses can thrive on a pre-arranged fee structure (eg Diagnostic Related Groups), and facilitated networks are financed via a membership fee or monthly or yearly dues. For every doubling of pathways that hospitals provide to be a full-service enterprise, they can expect overhead to increase by 30% due to the attendant increase in complexity.

Conclusion

One of the most important investments that we can make is in our career development. I hope that those of you who work in community hospitals will consider participating in the next Community Hospital 100 Conference, October 14-16, 2012.

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

Kenneth H. Cohn

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.

What I learned at the Community Hospital 100 Conference is an original post from Kenneth Cohn, Healthcare Collaboration. If you enjoyed this post, be sure to follow Ken on Twitter, Facebook or Google+.

Collaborative Blessing

Kenneth Cohn — Sun, 09 Oct 2011 02:09:16 +0000

Fall foliage, Guilford, ME

When nurses tell me to do something, I try to follow their advice.

So, when I was seeing patients in the ED yesterday, and nurses said to me, “You’ve got to check out the covered bridge,” I paid a visit on a beautiful, 75^o sunny day.

Originally built in 1830, it is a national historic landmark. It has been rebuilt four times after being destroyed by flooding in 1832, 1857, and 1987, a tribute to the resilience of local citizens.

National Historic Landmark sign over the Piscataquis River

As I wrote in Collaborative Resilience, resilience embodies the ability to adapt to adversity, problems, and setbacks and the power to reinvent oneself as circumstances change. We strengthen our ability to adapt by accepting the inevitability of change, keeping events in perspective, and seeing ourselves as part of a larger movement.

I felt the beneficiary of a collaborative blessing to be notified by nurses of this bridge’s existence, to have time to see this example of local resilience despite being on call, and to have such a beautiful day to photograph it.

Fall foliage, Guilford, ME

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

Kenneth H. Cohn

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.

Collaborative Blessing is an original post from Kenneth Cohn, Healthcare Collaboration. If you enjoyed this post, be sure to follow Ken on Twitter, Facebook or Google+.

Displaying Collaborative Cultural Sensitivity

Kenneth Cohn — Wed, 17 Aug 2011 13:58:42 +0000

Dr. Cohn speaking to physicians on Dealing with Disruptive Change: The Power of Transformation

Last week, I spent a wonderful two days with over 25 healthcare executives in New York, teaching my ACHE seminar, Practical Strategies for Engaging Physicians. Day one, we discussed differences between physicians and hospital leaders, implications of healthcare reform, and advanced strategies, tactics, and tools to engage physicians. But, the discussion on day two taught me the most.

We discussed the management of a medical staff crisis that resulted from physicians of Asian descent feeling disrespected by the pace of change. The following is a list of steps we came up with to display cultural sensitivity and save face with physicians from other countries who settle in the US:

Call the physician by the formal appellation, “Doctor,” rather than by his or her first name
Make eye contact long enough to notice eye color
Praise publicly
Begin a conversation with the 1% of areas of agreement rather than the 99% areas of disagreement
Discuss concerns privately
Avoid hot-button words, especially in front of colleagues
Come to know other aspects of physician’s life, such as volunteer interests and hobbies
Reach out to physician’s spouse and children, for example, writing letters of praise when the children receive awards
Extend cultural sensitivity to dietary concerns, such as beef with Hindus and pork with Muslims
Be aware of reciprocity of dialect and intonation: a Southern hospital speeded assimilation by teaching foreign-born physicians to say, “Ya all.”
Be sensitive that jokes that make people feel left out have the power to offend
Understand that for those who grew up in poverty fear of losing affluence may shape outlook and behavior

What stories can you share about cultural sensitivity that help foreign-born physicians and their families to feel welcome where they work and live?

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

Kenneth H. Cohn

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.

Displaying Collaborative Cultural Sensitivity is an original post from Kenneth Cohn, Healthcare Collaboration. If you enjoyed this post, be sure to follow Ken on Twitter, Facebook or Google+.

Transforming Clinical Integration

Kenneth Cohn — Mon, 11 Jul 2011 20:33:37 +0000

Last month, I presented at the Governance Institute on Engaging Physicians: Moving from Me to We. For more information on how to help independent and employed physicians at the same time, please see my blog post.

It has taken me longer than usual to summarize the proceedings of this conference because of considerable activity to prepare for the June 30 launch of my newest book, Getting It Done: Experienced Healthcare Leaders Reveal Field-Tested Strategies for Clinical and Financial Success. It has given me great pride to salute healthcare heroes at sixteen organizations throughout the US who have broken down barriers and improved care outcomes for their communities.

Clinical Integration at Advocate Healthcare

Lee Sacks, CEO of Advocate Physician Partners, discussed clinical integration, which he defined as a structured collaboration to improve healthcare quality and efficiency. What made his presentation memorable is that he worked with independent physicians, most of whom in groups no larger than 3 people, to achieve ground-breaking outcomes. Clinical integration creates value for:

Hospitals, by strengthening loyalty and positioning the hospital for healthcare reform efforts that require true partnership, such as decreasing readmissions
Physicians, by helping them to differentiate in a competitive marketplace, giving them disease registry data that helps them improve performance, and assisting them with managed care contracting
Communities, by improving clinical outcomes, focusing on patient-centered efficiencies like online scheduling, and engaging patients in the partnership to improve population health

The metrics that they are using in their value index to monitor and drive down cost include:

Readmissions
Adjusted length of stay
Potentially avoidable admissions
Cost per adjusted discharge
Global cost of care per member per month (they have 230,000 capitated patients)
Advocate attributable cost trend
Non-Advocate attributable cost trend

For further information on this pioneering healthcare system, please view their 2011 value report.

Healthcare Transformation at University of South Florida

Stephen Klasko, CEO, USF Health and Dean of Medicine, University of South Florida, gave an energetic presentation with the subtitle “Can I Click My Heels and Go Back to My (Patient-Centered Medical) Home. He paraphrased Woody Allen’s quote: We are at a crossroads, where one road leads to destruction, the other despair. Let’s hope we choose the right one. He advised participants to forget reform and instead think transformation to:

Redesign care processes
Make effective use of information technology
Manage clinical knowledge and skills
Develop effective teams
Coordinate care across patient conditions, services, and settings
Incorporate performance and outcome measurements to promote continuous improvement
Demonstrate ability to adapt to change

A Wharton study, where he obtained his MBA, demonstrated that 78% of MBAs viewed creativity as an important part of their success in contrast to only 12% of physicians who felt the same way. He quoted Buckminster Fuller: “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.”

He concluded with the following survival guide:

Think into the future
Ask each administrative and physician leader to identify one game-changing idea yearly
Look at the technology that your kids are using as future patient care and marketing opportunities

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

Kenneth H. Cohn

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.

Transforming Clinical Integration is an original post from Kenneth Cohn, Healthcare Collaboration. If you enjoyed this post, be sure to follow Ken on Twitter, Facebook or Google+.

Collaborative DNA

Kenneth Cohn — Mon, 04 Jul 2011 21:54:18 +0000

“I suggest that we fire the Medical Executive Committee President to send a strong message after their vote of ‘no confidence’ in our CEO,” said one of the Board members.

“You have to cut off the head of the snake,” said another Board member

“What if the snake turns out to be a salamander or a tadpole,” I asked

An uncomfortable silence ensued. I continued ”Amphibians, unlike reptiles, are capable of regeneration. Firing the Medical Staff President risks alienating the rest of the medical staff further and could make the situation worse rather than better.”

“What do you recommend?” asked another Board member

“Give them collaborative options,” I said, remembering what one of my surgical mentors had told me, that all gladiators had choices.

Together, we brainstormed ways that we might meet together with a facilitator to discuss whether we could collaborate by building on past successes or finding quick wins that might bring hospital leaders and physicians closer together for the benefit of their community. As I mentioned in a previous post, it is too early to predict the outcome. These processes often play out over years.

For those who wonder where my analogy came from, I quip that I have amphibian DNA because, having worked in 41 states, I have encountered hidden mines and have no alternative other than to regenerate after being surprised that something that was relatively easy in one hospital presents a huge barrier to overcome in another. It is the price we pay to have the privilege to serve healthcare professionals facing hospital-physician and/or physician-physician collaborative challenges.

What hidden minefields have you encountered?
How have you dealt with surprise?
Do you agree with what my grandmother told me, that “the Lord never gives us more than we can handle, in retrospect?”
In return, I asked her, “How will I know when I’m in retrospect?”

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

Kenneth H. Cohn

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.

Collaborative DNA is an original post from Kenneth Cohn, Healthcare Collaboration. If you enjoyed this post, be sure to follow Ken on Twitter, Facebook or Google+.