leadership Archives - Page 3 of 4

4 Features of an Outstanding Clinic

Helping in new clinical settings over the past year, I find these core features in great clinics and hospital departments.

Outstanding clinics:

1. Remember Their Core Motivation

Most of us run from task to task without asking why. At some point, we chose to do what we are doing right now. Even with years of training, people don’t have to keep providing patient care; they could look elsewhere.

People need help to remember why they do what they do, and why they work in a particular place.

Most people who work in healthcare applied from a desire to help people. They looked for specific jobs that allowed them to help and serve patients.

Outstanding clinical groups never forget that serving patients comes before anything else.

2. Support Their Core Business

Especially in large groups, staff might think the clinic or hospital pays them. In a sense, that’s true, but also very wrong. Every business gets paid for doing something.

Although revenue flows through the clinic before it gets to the staff, employees must know that the clinic stays open if physicians see patients. Anything that slows, or stops physicians seeing patients results in poor patient service and less revenue.

Great clinics keep physicians working at what physicians do best: seeing patients.

3. Think About Governance

Governance refers to how organizations are governed and controlled, how decisions get made, and how decision-making units fit together. A solo physician deals with everything, or delegates to an office manager.

Problems arise as clinics grow. At some point, groups need to think about a formal, simple governance structure. Communication, authority, and accountability must flow in a line through the structure. If structure gets ignored and leaders start talking like customers expecting to be heard like owners, chaos ensues. (Check out: The Imperfect Board Member)

High performing clinics have an explicit governance structure that everyone follows.

4. Manage Performance

Once everyone remembers why they are there, knows how the clinic earns income, and understands how decisions are made, staff needs support to perform well. With clear expectations, most staff members excel; some do not. Even in a small group, staff needs performance reviews, incentives to improve, rewards for excellence, and follow-up on underperformance.

Outstanding clinics measure performance using explicit criteria supported by everyone. When members do not perform well after attempts to help them change, great clinics help low performers find work elsewhere.

Final Thought

Oppressive workplaces leave you emotionally exhausted at the end of a day, fill you with dread at going to work, and require you to tiptoe around icy colleagues. Dennis Bakke wrote bestseller Joy at Work suggesting that we embrace human values as ends in themselves, not just means to business ends.

Outstanding clinics foster uplifting, healing work environments.

How to be Great Without Being Gifted: Knowledge Integration

Some say you achieve greatness, or excellence, by finding your unique talent and pouring life into it. Malcolm Gladwell’s writes about people who master their talent with 10,000 hours of practice in Outliers.

One talent, sport, pastime, or ability. Gifted people with tones of time.

For the rest of us, excellence is less obvious.

We can all have it, but unique greatness shows up invisibly to us. It grows out of a life of enthusiastic passion poured into a unique combination of interests particular to our individuality.

Consider your interests in quilting and guacamole, or petunias and meteorology: we combine interests unlike anyone else. If you think of more, say porcelain, hydrology, glass blowing and poetry, you should expect very few people in the whole world to be passionate about all of them at once.

If you take a unique mix of ideas and add decades of enthusiastic exploration, you end up a world expert. YOU become a world expert at the unique integration of knowledge that’s been your life’s passion.

You: a World Expert.

We all have the time. We all have interests. The only decision remains whether we will spend our time passionately pursuing all that captures our interest around us.

What’s your expertise? How can you share it?

How to Fix Healthcare: Let Leaders Lead

Everyone knows Canadian healthcare cannot continue without significant change. No one debates the need for it.

People Look at Two Things:

Inputs: funding, expenses, cost cutting, efficiency, policy change, contract negotiations, etc.

Outputs: quality, performance, results patients get from the system.

Inputs get most attention, but more sophisticated observers have started focussing on outputs. A few inside the system talk about ways to remove waste (LEAN, Gap analysis, etc.).

No one talks about control inside the system.

Funding Should Follow Governance

People make the imminent demise of our bloated healthcare system an issue of funding or spending, but it’s neither. Whether money comes from taxes collected by the government or ‘taxes’ collected by insurance companies, the issue is not about money.

The debate must shift from how money comes in to who’s in control of how money gets spent.

Everyone demands accountability from the system, but no one gives those in the system the freedom or authority to truly change outcomes. There are too many self-interested outside stakeholders trying to control the system all at the same time. They all think they know what’s best for patient care, but very few actually provide care.

Authorities make major decisions outside the system and then expect those within the system to operate after all the rules have been set; all the room to lead has been removed.

For example: the government negotiates contracts with nurses and then tells hospitals to be accountable to quality and efficiency within a contract that has zero productivity incentive.

We can still rescue publicly funded healthcare if we look at pockets of innovation where providers are given the chance to structure creative incentives that encourage clinicians to work differently.

We need to give the professionals inside the system a chance to show what can be done to improve patient access, quality, and service. You can’t demand accountability without giving people freedom to control and deliver what’s being asked of them.