Healthcare reform and the emphasis on mergers, acquisitions and partnering has captured the attention of many leaders in the field. Rarely does a day go by without some time and attention being paid to these imminent changes.
But hospital leaders must avoid losing sight of what may be the most significant demand on their time and energies-attending to the basics of interpersonal relationships between the hospital and its various stakeholder groups, especially a facility's employees and medical staff.
For many years, effectively managing a healthcare organization has required substantial time and energy. As the healthcare environment begins to change, the time required to set strategies, speculate, network and shape future organizations will require even more of these limited resources.
The rush to compete in tomorrow's market may preoccupy leaders with external activities to such an extent that many internal issues will be neglected. This external focus will rob them of the time required to communicate and coordinate internal operations.
Nowadays, areas that merit special attention include employee morale and feelings of security. More communication will be necessary to help employees understand how they fit into the changing healthcare system picture. Also, the feelings of "connectedness" between senior leadership and middle management are more important than ever before.
As changes rock healthcare, employees likely will develop fears and uncertainty about their future roles, particularly when many of the changes involve mergers and acquisitions. Patient relations also may suffer as employees exhibit anxieties about the changes their organizations are experiencing.
A curtailed focus on day-to-day dialogue between an organization's leader and its employees and physicians can create several problems. Among the more acute are:
Employees may begin to feel disenfranchised, and their strong loyalty and dedication-historically a plus for the healthcare field-may wane.
As employees feel less a part of their organizations and seek careers elsewhere, healthcare managers may find that recruitment and retention may become more difficult. Problems may become particularly severe in light of the impact of the "baby bust" and the resulting decline in the overall labor supply.
It may become an impossible task to coordinate quality and operations improvement activities as interaction between senior leadership and other staff declines.
Less attention to internal systems matters may create negative perceptions among the medical staff, which may impair their allegiance to the organization.
Thus, it's a serious matter to correct the imbalance of focus between the external demands of a changing market and the continuing demands of internal operations. The panaceas of working longer days, or instead, "working smarter, not harder," probably aren't the best approach, because they probably aren't workable.
Effective healthcare leaders will need to make commitments to several actions to avoid losing influence with key internal constituents.
Philosophically, hospital leaders must dedicate themselves to developing and maintaining a missionary zeal in remembering the needs and interests of employees, volunteers and medical staff. The behavior exhibited toward others should reflect a true and sincere respect for humankind. We must not forget that this is what brought many of us into healthcare in the first place.
In terms of action, there should be clear authority given to an internal operations officer, a role that's often traditionally filled by the chief operating officer. Because a CEO probably will be spending more time outside the organization, a single individual must be available within the institution who has distinct and convincing decisionmaking authority.
Communication is becoming more critical than ever, and plans and activities must be communicated to all constituents in as many ways as possible.
More time should be devoted to sharing with lower levels the organization's strategic vision. While most visioning occurs in a top-down method, there's merit in gaining input from staff on organizational direction and strategies.
Those in senior leadership roles must relinquish more of their centralized control and delegate more authority "downward" into the organization.
During the next few years of change in healthcare, it's vital that leaders show thoughtful regard to the needs of internal audiences within healthcare organizations.
The institutions that will flourish and prosper in the coming years will be those with leaders who can focus simultaneously on both internal and external essentials. Effective leaders will need to understand this and dedicate the energy and vigor needed to achieve the proper balance.
