Six Keys To High Performing Hospitals: Key #3

I have previously commented on strong value based CEO leadership and a clearly articulated mission, vision, and values. Today I want to move on to the critical importance of clinical excellence and the leadership it takes to achieve it.

3) Strong clinical leadership and capabilities

Eight of the 10 high performing systems interviewed mentioned this as essential to their success. This actually touches on several subjects. The first is my favorite mantra "quality first, finances follow". The second is the critical importance of having a competent and supportive medical staff. To achieve both of these you must have strong physician leadership. No hospital can achieve enduring success without it.

I have seen hospitals that have dissension within the medical staff and conflict between the medical staff and the board. This makes for a dysfunctional environment and will certainly hold the hospital back from becoming a high performer. The analogy that a hospital is a three legged stool comes into play here. It is supported by the Board, the Medical Staff and the CEO. If one of the 3 is missing, the stool falls over. This often requires some give and take on both sides. Some of the high performers mentioned the value of joint ventures with their physician groups. While some Boards may not be willing to share revenue with their physicians, the high performers have learned that sacrificing something in the short run will pay larger dividends down the road when strong relationships have been developed.

Strong clinical performance also extends beyond the medical staff to include nursing which is the backbone of the care provided as well as the other clinicians who provide care and support. Effective leadership in these areas is also key to high performance.

One final thought. With the advent of healthcare reform, there will be a stronger push for fully integrated care systems that include prevention, primary care, outpatient services and hospitalization under a single billing structure. Maybe we will finally see that capitated payment system that we all got ready for in the late 90's. Either way, systems that have all of these elements integrated will excel.

More on high performing hospitals tomorrow.

Mark Brodeur