by Anthony Cirillo

Did you know Febreze, the stuff that knocks out odors, was a flop when it was introduced? Why? The company first marketed to the people it thought needed Febreze the most, pet owners, particularly cat owners. But guess what? The owners had adapted to the smell of their pets and what might smell bad to a visitor smelled just fine to them.

That got me to thinking that healthcare CEOs must be cat people--because they can't smell the problems in their own organizations but are quick to notice it in others. My argument to that: the HealthLeaders Media 2012 Industry Survey in which 56 percent of CEOs assessed the state of the healthcare industry as on the wrong track, while 74 percent said their organization was on the right track. Something fishy there. Oh, different odor.

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CEOs were more dubious about the industry as a whole and more optimistic of their own organizations than their colleagues' organizations. The report also noted 46 percent of hospital staff and physicians said healthcare was on the wrong track and 66 percent said it was on the right track in their organization. Which really lends to the ivory tower analogy: How can 74 percent of CEOs think everything is peachy within their organizations while their own staff thinks it is less so?

Let's go back to the topic du jour. Febreze turned its marketing around by positioning the product as something that is a reward for all of your housework. Febreze is the finishing touch, the make you feel good piece. With that new angle it made billions. Ah, rewards, carrots and sticks.

Guess what was the top organizational priority by respondents in the HealthLeaders survey? Patient experience and satisfaction. Could that have something to do with value-based purchasing, with money on the line? Hmmm. It's not what is measured that matters but more what is rewarded--or punished.

Now let's jump to the American Hospital Association's FutureScan 2012, in which industry pundits outlined the challenges facing healthcare, encouraging leaders to "adopt a point of view," rethink service offerings and care processes, and "adopt a team-centric approach," only to go on and say these efforts "will require determined leadership and a certain type of military management and precision" to be successful.

Anthony, Anthony, Anthony, where are you going with all this?

Leadership.

Let me try to summarize.

With CEOs jumping ship at rates approaching 20 percent annually, we are left with some who think things are great. They seem to be disconnected from their own staff and further disconnected from their healthcare colleagues, whom they may have to work with in an accountable care organization. And they are being told they still need a certain amount of attitude that says it's their way or the highway (that command and control stuff). And when there is focus, it is on what's being rewarded (or punished).

It is not hospitals we should be talking about. It is healthcare. And it is delivered across a continuum, much of which is outside of hospital walls and inside people's homes. Everyone is talking the game but who is really steering their organizations to recognize this fundamental shift? I don't see many.

We need perspectives and leaders from outside the hospital industry. I see some hospitals bringing former high-end hotel executives into healthcare. But that is to mainly address the hot topic of 2012--patient experience. I think it goes beyond that.

We need people who can look at a continuum of services and unite it. That doesn't mean you don't have operations people who are steeped in healthcare. You must. But the top dogs, the CEO and the board chair, maybe they need to be from other industries. Do we need yet another physician CEO?

Don't worry, though, because the hospital industry is no different than the nursing home or assisted living industry. Everyone is battling for survival, yet claiming it's all about the patient first. Healthcare needs to get its story straight and be united across the continuum. As I said last month, it's about person-centered living not patient-centered care.

Of course telling that story is not a main concern, as strategic marketing was 8th on a list of 10 top priorities for hospital leaders in the HealthLeaders survey.

Anthony Cirillo, FACHE, ABC, is president of Fast Forward Consulting, which specializes in experience management and strategic marketing for healthcare facilities. He also is the expert guide in Assisted Living for About.com and Healthcare Channel Partner for CEO².