The Journey to Success - Part 2

Author

Stephen C. Hanson, FACHE, Partner, CEO Advisory Network
Steve is a senior executive with a consistent track record serving five health systems and four independent hospitals providing services to seven states over a multi decade career.

RSS Feed

Getting a Grasp on the State of Things

​The interim CEO or COO have generally parallel paths and areas on which to focus.  The main difference is in the reporting relationship above and below.  First the areas of commonality:
 
Regardless of the level of prior success of the organization the interim executive should take nothing for granted.  He/she needs to focus on the facts:  data and analytics, complemented by qualitative observations of course.

Interim CEOs and COOs are trained to start by asking tough, but important questions:
​
PATIENTS/FAMILIES

• What are the measures of quality and safety and patient experience?
• Which parts of the organization are doing well? Which need some work?
• Are processes to achieve top quartile (or potentially top decile) performance hardwired? 
• Do these indicators get talked about in every setting from governing body to medical staff to various levels of administrative meetings?

 
PHYSICIANS/NURSES

• What are the levels of physician engagement and are they consistent with the entire medical staff or do they vary by department/section? 
• Is there variation among “employed” physicians, contracted physicians and completely independent physicians?
• What are the employee engagement scores for the nurses? 
• What are the action plans to improve where necessary and are the actions hardwired? 
• Where are the variations? 
• Are the action plans to improve hardwired? 
• How effective is the nursing governance process? 
• How high is nurse turnover and overtime, extra pay practices and what steps are in place to improve?

Note:  Other employees and volunteers are also critical to the process and attention to these individuals should follow the doctors and nurses.

FINANCES

• What are the key balance sheet ratios and income statement indicators?
• Are the numbers being presented correctly (one must be sure)?
• What are the opportunities to improve net revenue, starting with gross revenue, the various types of contractual allowances and bad debt?
• Are the latest technologies being used in the revenue cycle process?
• What can be done about labor? What
• Is there excessive agency staffing?
• Is there excessive employee turnover and “extra pay”, as mentioned above with nurses?
• Is there outsourced labor that could better be in-sourced or vice versa?
• What can be done about non-labor expense?
• Is the supply chain management function as robust as possible?
• What is being done about pharmaceutical expense?
• What are the other non-labor expenses and what can be done to manage them more effectively?
• Of course, all the analytics should be complemented with sound qualitative practices such as purposeful rounding, executive presence in medical staff and surgical lounges and physician practices, employee meetings, governing body and committee meetings and the like.  However, the analytics need to drive and inform the overall leadership practice.

 
But it isn’t just enough to know the right questions to ask, at CEO Advisory Network we understand that once you have the answers you need interim leadership who knows how to take action to address concerns.  That’s where an interim CEO or COO can bring the greatest value.  Highly experienced interim leaders have dealt with simple and complex problems throughout their careers.  Many of them run small, mid-sized and large hospitals and health systems.  Frankly put, they’ve seen it all:  the good, the bad, and the ugly — most importantly they know how to equip a team with the tools, talent and treasures needed to move your mission forward.  

So, an effective interim CEO/COO now has a good handle on the three major components that drive any health organization: patients/families, physicians/nurses and finances.  They are hardwiring practices and processes to rectify any negative variation in a proper, timely manner.  

Once the interim leader has a grasp on the current state, it’s important the right reporting relationships are established and there’s a healthy understanding of what interim leadership must do to help the organization along its journey to success.  Tomorrow we’ll review reporting relationships and some of the pitfalls governing bodies and system leaders fail to address before interim leaders step in.  www.ceoadvisorynetwork.com