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Hospital leaders must overcome resistance and disrupt their own organizations

February 19th, 2015

by Lynn McVey

The traditional theory of disruption calls for outsiders to shake up an industry. A recent survey of 150 healthcare executives revealed "more than 50 percent felt healthcare is ready for disruption," according to Harvard Business Review.

However, nearly two-thirds of respondents said resistance was the biggest hurdle to innovation, according to the report. Inefficient or outdated analytics and processes were also cited. "The overwhelming sentiment was that the impediments to change are mostly internal," Paul Merrild wrote in HBR. "Overcoming such challenges requires intrepid leadership."

Respondents to the survey said they scan widely for models of executives who have successfully disrupted their own organizations. "When we asked which companies' healthcare executives most admire, the top choice wasn't Mayo, Cleveland Clinic or any other blue chip healthcare institution," wrote Merrild. "Top choice was Apple: the tech giant who cannibalizes its own products and promotes disruption before being overtaken by it."

We say "hindsight is 20/20." If we had the chance to do it over again, wouldn't we have chosen an electronic medical record for all facilities? We could have been years ahead of where we are now in terms of Meaningful Use, standardizing and sharing information. Yes, this country is proud of its free market but I question whether healthcare should remain a part of that market, especially given what we now know about the fraud, abuse, unnecessary testing and corruption in the industry.

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I had the absolute pleasure of speaking to Chuck Lauer on the phone recently. Lauer published Modern Healthcare magazine for many years and now is a frequent consultant. He reminds me of my father, a former Marine with integrity, honesty and a passion for hard work. If you have read any of Lauer's published works on the current fiasco in healthcare leadership, you can immediately sense his commitment to commit. About 2014's soaring 20 percent resignation rate among hospital CEOs, he said, "I and a number of other observers think the data reflect a lack of will and commitment. Faced with a once-in-a-lifetime opportunity to overcome the silos, inefficiencies and quality problems plaguing American hospitals, more and more CEOs are making a beeline for the exit, hefty retirement packages in arm."

My dad, Chuck Lauer and others from "The Greatest Generation" are not afraid of the hard work needed to fix this healthcare mess. To survive, it is not business as usual. A manager just asked me to pre-approve eight hours of overtime for a project tonight. A traditional executive might trust this manager and blindly approve it. An evidence-based executive asked for the details. The project added up to only three hours, so I only pre-approved three hours. An hour later, he walked back into my office to proudly say he could break up the project into several nights, so he wouldn't need any overtime after all.

Years ago, I replaced a manager who told me on his way out, "This department runs itself." What I heard was, "This department is padded so that I have less work to do." I used six national key performance indicators (KPIs) to quickly locate and eliminate several inefficiencies which added up to $50,000 per month. Because traditional management does not use comparative KPIs to gauge managers' performance the administration never knew it wasted $12 million over the 20 years the manager oversaw the department.

We may be called "micro-managers" when we drill down for evidence, but I call that my job.

Lynn McVey serves as chief operating officer of Meadowlands Hospital Medical Center, an acute care, 230-bed hospital in New Jersey.

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