Managing a Hospital : How to Succeed As a Clinical Leader in the Post-Pandemic Age

This book demonstrates how hospitals can be transformed into dynamic, patient-centered, and cost-effective organizations. It describes systems for providing safe, high-quality medical services and outlines the importance of data for health outcomes. In this regard, the book underscores the importance of decision-making and delegation, as well as the effective use of administrative staff, new technologies, and evidence-based medicine to benefit patients and boost efficiency. At the same time, it emphasizes the importance of applying metrics to improve cost-effectiveness. Although primarily intended as a hands-on book for clinical leaders, it also considers hospitals from a broader societal perspective, making it of interest to leaders at all organizational levels in hospitals and to policymakers alike. Preface 6 Acknowledgments 7 Key Messages 8 Contents 9 About the Author 14 List of Figures 16 Introduction 20 1: Safety First 22 1.1 Patient Safety rounds 26 1.2 Safety at Point of Care: Safety Cross 27 Reference 29 2: Prove Quality 30 2.1 Outcome Data Is the Most Important 32 2.2 Volume Data Reflect Quality 34 2.3 Present Complication Data, But Do It Right 35 2.4 Document Adherence to Guidelines 36 2.5 What About Quality Data in Psychiatry? 37 2.6 Help Patients Who Want a Second Opinion 37 2.7 The Importance of Respecting Patient Preferences 38 2.8 Physicians Doing Research Is a Quality Marker 39 2.9 Support Employees Who Want External Training 39 Reference 39 3: Show Empathy 40 3.1 Empathy Is a Core Value for Hospitals 40 3.2 Be Aware of Your Behavior 41 3.3 The Hospital Is Not a Repair Shop: It Is All About Empathy 42 Reference 42 4: Reduce the Administrative Burden 43 4.1 Organization: Chain of Command 44 4.2 Organization: Hospital Support Staff 48 4.3 Make the Administrative Staff Efficient 49 4.4 Power Up Your Routines 52 4.4.1 Make the Meeting Agenda Efficient 52 4.4.2 The “Must Have” Meetings 54 4.4.3 Additional Meetings 57 4.5 Energize the Organization 58 Reference 59 5: Take Control of Finances 60 5.1 Macro Perspective: Big Challenges 61 5.2 Core Curriculum of Hospital Finance 69 5.3 Capitation and Fee for Service 70 5.4 Hospital Payment Based on Diagnosis 72 5.5 Hospital Payment Based on Value 73 5.6 You Need to Read This Brief Theory 75 5.7 Know Your Metrics 76 5.8 The Good, the Bad, and the Ugly 77 5.9 Be Up to Date on Clinical Activity 80 5.10 Be Up to Date on Procedure Cost 81 5.11 Be Up to Date on Employee Numbers 82 5.12 Flat Budget Cuts Are Demoralizing 85 5.13 Keep Your Finger on the Pulse 85 5.14 The Role of the Finance Manager 85 5.15 Avoid Fragmentation of Responsibility 86 5.16 Hunt Down the Big Five 88 5.17 Doctors vs. Managers 97 5.18 Be Professional with Evidence-Based Medicine 98 5.19 New Expensive Technology: A Case for Bundled Payment? 101 5.20 A Leader Has Total Responsibility 101 5.21 Best Practice Budget Process 102 5.22 Manager Profiles and Budget 105 5.23 Have Responsibility Centers: Avoid Cost Centers 109 5.24 Running Hospital Means Running Business 111 5.25 How to Measure Hospital Productivity? 111 5.26 Optimize the Number of Nurses 112 5.27 Management and Financial Crisis 116 5.28 Avoid Outsourcing to Monopolies 117 5.29 Use Consultant Companies Only if You Know Where to Go 118 References 118 6: How to Make Decisions 120 6.1 The Art of Making Decisions 121 6.1.1 The Big Decisions 124 6.2 The Power of Compassionate Leadership 126 6.3 World Café to Empower Decisions 127 6.4 Make Sure You Involve the Employees 129 6.5 Dialogue with the Labor Unions 130 6.6 Formal and Informal Leadership 131 References 131 7: See Your Employees and Define Your Personal Added Value 132 7.1 Be Fair and Show Respect 133 7.2 Celebrate Achievements 133 7.3 See Your Employees When They Work 133 7.4 Listen More and Do It Right 134 7.5 Define Your Hospital’s Core Values 135 7.6 Define Your Personal Added Value 135 7.7 Do Employee Pulse Surveys 137 8: Useful Tips for Becoming a Better Leader 138 8.1 Do You Really Need an MBA? 138 8.2 Does the Leader Need Medical Insight? 139 8.3 Improve Your Weak Points 139 8.4 Never Punish Collectively 139 8.5 When Employees Do Serious Errors 140 8.6 Don’t Waste Time Checking Every Travel Bill 140 8.7 How to Dress 141 8.8 Be Friendly, But Not a Friend 141 8.9 Make Your Boss Shine 141 8.10 Minimize Bureaucracy 142 8.11 Open-Plan Office: A Health Hazard? 142 8.12 Negativity Is Like a Contagious Disease: Stop It 143 8.13 Loyalty Is as Fundamental as Honesty 143 8.14 The Right Attitude 144 8.15 Managing Prima Donnas 144 8.16 In-hospital Romance and Forbidden Love 144 8.17 Avoid Nepotism 146 8.18 #meetoo 148 8.19 Zero-Tolerance for Harassment 148 8.20 Show Respect for the Non-medical Personnel 149 8.21 Hiring and Dismissing People 149 8.22 Don’t Let the HR People Pick Leaders 150 8.23 Support Employees When They Need You 151 8.24 Do Not Allow Administrative Staff Mess Up the Command Line 151 8.25 When You Need a Good Lawyer 152 8.26 When the Leader Takes It All 152 References 153 9: How to Meet the Press 154 9.1 The art of Communication with Media 155 9.2 Be Prepared for Media Scandals 155 9.3 Tips and Pitfalls During TV Interview 157 9.4 The Art of Apologizing 157 10: How to Get Control Over Your Own Time? 159 10.1 Optimize e-Mail Handling 160 10.2 Get Rid of the Monkey 162 10.3 Delegate as Much as You Can, But Do It Right 164 References 165 Glossary 166