By: Ted Schmidt, R.Ph., CERM
With all of the changes in healthcare reimbursements, how do you ensure that your hospital is properly funded to meet your financial/operational needs while achieving your hospital’s vision? These changes are especially concerning for Hill-Burton hospitals, Safety Net hospitals, and faith-based hospitals that serve a disproportionate share of indigent patients.
Fortunately, some of you may already have the architecture in place to help keep your focus, namely, your DNV-GL accreditation. By bundling NIAHO℠ with ISO 9001, DNV-GL creates the best platform for hospitals to address their clinical needs and achieve their Vision in a disciplined, proven system of management. Here’s how it works:
ISO 9001:2015 is part of your accreditation. So, your accreditation requires hospitals to align their strategic and business processes with the quality management system. Your accreditation also requires you to integrate your process management with your risk management. Other requirements include creating and managing objectives (operational as well as financial); measuring your performance to your objectives; analyzing and evaluating your performance; and responding to your performance for improvements as needed.
Your hospital’s vision, mission and values are fundamental to success. You need to know where you are going and whom you are going to serve…your vision. You need a plan to get where you are going. Strategic, tactical and operational plans are paramount to define your mission to achieve your vision. And your hospital and personal values are those attributes that are key to your success.
If you have a vision: “to be the healthcare provider of choice in the community” or “to deliver care to the poor and underserved in the community”, your vision needs to be realized. Your accreditation allows you to create high level objectives that will help you fulfill your vision. The objectives created for the mission should always cascade from the vision objectives. These mission objectives can be strategic (deploy homeless initiative in our community), tactical (develop and deploy teams of clinicians and social workers), or operational (teams focus on primary needs for women and children, specifically maternal and new baby services). Your values will give you those attributes needed to be successful, personally and collectively. Many hospitals measure the degree of implementation of their values in their employee performance evaluations and surveys.
You use risk-based thinking (RBT) to focus on what’s most important so you can maximize your resources. RBT is nothing more than employing some activity to determine what could prevent you from achieving your objectives. Once you know where to create objectives and what objectives to create, fulfilling the objectives is achieved by creating more objectives at the lower layers. These objectives cascade down to the lowest layer so that everyone’s work helps achieve your overall objective.
To illustrate, the owner of any NFL team has to have full faith and confidence in his/her general manager. If the general manager is in lock-step with the head coach, the synergy is evident. Together they manage the talent (current and future), the salary cap, the PR, etc. When the same head coach is in lock-step with the team captain, then the players all work to help achieve the objectives. In today’s NFL, a half-step taken incorrectly can ruin a play. One play can win or lose a game. It’s that predictable. More over, the likelihood of the team achieving its vision is greatly enhanced when all of these layers align and the player taking the half-step is aware of the importance of that half-step. It’s the same in hospitals.
The old phrase in healthcare, “no margin, no mission” still applies today. Communicating your vision at all layers is as important as the objectives you need to achieve to reach your vision. Cascading your objectives can help ensure your hospitals remain financially and operationally sound. If you get it right at the high layer (the NFL team owner or the governing body in hospitals), you will have success at the operational layer. The means for managing these objectives at all layers lies in your accreditation. How about that? You’re already paying for your accreditation!
Ted is a Pharmacist, a Certified Enterprise Risk Manager (CERM©), and a Senior Advisor with BlueSynergy Associates. BlueSynergy Associates maximize innovation, experience and customer perspective to reduce risk and make hospitals a safer environment. He advises and instructs hospitals in quality, risk and environmental management systems. Ted led the largest ISO 9001 implementation in healthcare at the Veterans Administration. He is a Senior Member of ASQ and a certified Lead Auditor in quality management systems by Exemplar Global. He can be reached by email at firstname.lastname@example.org or by calling toll free at 844-424-7825.