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Thomas Dolan is president and CEO of the American College of Healthcare Executives.
Thomas Dolan

Leaders need to prepare for demands of reform

Uncertain future: Leaders will need to prepare for the oncoming demands of reform


By Thomas Dolan
Posted: July 25, 2011 - 12:01 am ET
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While no one has a crystal ball with respect to healthcare's future, I have several assumptions.

First, the U.S. will have universal healthcare coverage within the next decade, making it like every other developed country in the world. Second, whether we fully implement the Patient Protection and Affordable Care Act or not, there will be greater government involvement in the delivery of healthcare services.

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Third, the rate of growth of healthcare costs is unsustainable. The most likely ways to control costs in the future are to increase productivity and reduce the increase in real wages and the cost of supplies. What we do not control using the former strategy surely will require using the latter. Finally, integrated healthcare delivery systems will be the optimal way to improve quality and control costs.

Given these assumptions, healthcare executives will need to strengthen or develop a number of skills to meet these future challenges. I'd like to share six:



  • Mastery of change management and change leadership: The change required to successfully implement health reform during the next decade will require healthcare executives to master change management—the technical component of change strategy—and change leadership, the human/cultural component. Healthcare leaders will have to demonstrate to their organizations the need for change, painting a picture of what will happen if the organization does not change (this is change leadership). They will also need to be ready to oversee the implementation of strategies to address change (change management).




  • Continued quality and patient-safety efforts: Numerous research studies have revealed that quality and patient safety are highest in those organizations where the board and management are solidly behind quality and safety efforts. Healthcare executives will need to be familiar with quality tools, and—using their leadership skills—they must be able to persuade others in their organizations to use them.



  • Productivity: Equally important to improving quality and patient safety under health reform are increasing productivity and controlling costs. Healthcare executives will need to be familiar with productivity tools such as Lean, Six Sigma and others, and, again, they must be able to persuade their organizations to use such tools. Within the scope of productivity is a focus on performance excellence. I can think of no better way for healthcare organizations to begin the journey toward performance excellence than by participating in the Baldrige Performance Excellence Program (for a number of great resources on the topic, visit nist.gov/baldrige). Healthcare organizations' participation in the program has had an immeasurable impact on the effectiveness and efficiency of healthcare in this country. Last year, 65% of all Baldrige program applications came from healthcare providers. In 2010, the ACHE embarked on its own Baldrige journey by conducting analysis and study in preparation to apply for the Lincoln Award, the state-level (within Illinois) equivalent of the Malcolm Baldrige National Quality Award for performance excellence. I encourage healthcare organizations around the nation to consider the Baldrige program as a means to furthering their performance excellence efforts.




  • Public policy: Government has always been a major player when it comes to healthcare in the U.S., and clearly its role under health reform will grow. Healthcare executives will need to be public policy advocates for their organizations and communities. Not only will they need to be familiar with the key issues, but they must also be able to effectively represent their organizations and communities with regard to these issues. In addition, they need to be able to effectively organize their boards, medical staffs, employees and community leaders to make the case to federal and state legislators for adequate resources for healthcare.




  • Interpersonal skills: These skills have always been required of healthcare leaders, and they will become even more important under health reform. In addition, interpersonal skills strengthen all the other skills on this list.


  • Communication skills: These crucial skills will grow in importance in the future. This includes oral and written communication in face-to-face and virtual settings. A new skill in the communication arena that healthcare executives will have to develop is a mastery of social media tools. These new media platforms continue to serve as important ways for our organizations to communicate with our numerous stakeholders. Healthcare leaders' ability to communicate and persuade will be vital in these rapidly evolving times.


None of these skills are unique to healthcare reform alone—nor are they the only skills that will be required of healthcare leaders. But they are a good place to start as leaders prepare to address the many challenges ahead.

Thomas Dolan is president and CEO of the American College of Healthcare Executives.



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