by Craig Ahrens
I have not blogged in a long time and I apologize. As most of you know, I attempted to launch www.thebusinessofhealthcare.tv months ago and unfortunately had to pull back on the website official launch again until next month. Long story short, it is difficult to start any business – legally the loops you have to jump through are extreme especially when it comes to this type of business model. It has been an all consuming effort and fortunately I have partnered with individuals who are going to ensure a smooth startup. So, look for it again and I appreciate your support and welcome your ideas!
At the same time, I left the consulting world to work for one of my clients. They offered me the opportunity to work in one of the most competitive markets and service lines in the country – Indianapolis as a Neuroscience Service Line Executive Director. Normally, I would not have been interested in this position, but the chance to work in a non-CON, advanced specialty hospital, competitive market with an excellent health system was too enticing. I thought that it would be interesting to post my experiences working in a new role.
Service line executives are difficult roles to manage. They are difficult primarily because of three reasons:
1. Many of the relationships with operational staff are matrixed through Chief Nursing Executives.
2. Physicians and CEOs are used to negotiating business development opportunities minus a “middleman”.
3. Operationalizing plans and business development initiatives is difficult given the myriad of relationships to navigate.
How does one overcome these issues? In my opinion, the most important thing is for the CEO/executive team to visibly communicate to administrators and physicians that you are the go to person for the service line. Without this support, you are dead in the water with the matrixed relationships. Further, the physicians will continue to pursue the pattern of going straight to the CEO to discuss any opportunity. To some this may seem odd, but you need to market yourself internally and to be seen as the person who shepherds initiatives and gets them done through navigating the internal political hospital dynamic. I will continue with part II next week. Any comments?
Craig Ahrens, MHA, MBA, FACHE is the Executive Director of Neurosciences for St Vincent Health in Indianapolis, Indiana (part of Ascension Health System). He is also President of www.thebusinessofhealthcare.tv (due to launch in late 2007), which is the web’s first internet tv program dedicated to healthcare business news and interviews. He can be reached at info@thebusinessofhealthcare.tv
Comments:
I feel your pain. I am a Cancer Services HSL Leader and experience many of the issues you described. Matrix reporting many times results in inaction due to the parties involved not being sure who makes the final decision.
Physicians still want to speak directly to our CEO/CAO when it comes to discussing issues or planning.
All of these things lead to frustration and inefficeincy to producing a growing service line. I think part of our problem is we still are thinking and operating in the departmental mode rather than service line
We need a refresher on the purpose of the Service Line and what it should be doing. The Service Line should be strategic and market-focused with an emphasis on growth rather than operations. While it is important to monitor P&L performance, Service Line managers should be spending most of their time on finding ways to grow volume and shift market share. This requires an obsessive focus on market intelligence and calibrating performance with changes in the market.
Admittedly, a matrix structure is tough to deal with in the confines of the traditional hospital structure. For this reason, I submit that Service Lines should be organized under the Business Development umbrella rather than operations. You will never be able to effectively lead dotted-line managers who hold allegiance to the COO/CNO--however,you can hold them accountable through tracking key market-oriented metrics, the main one being market share. Finding ways to help them grow should be your main preoccupation.
As hospitals increasingly organize around Service Lines, the organizational and structural issues will assume greater importance. This should be an ongoing topic for discussion and dissection as we create the hospital of the 21st century.
Having spoken to the C-Suite leaders, the problem is the education needed to persuade the hospitlas that having the student graduates employed is in their best interest, and all the while, having someone with the wherewithall to oversee the operations of expanding and marketing service lines.
so, I guess my question to you is how does one from the outside persuade the hospitals and institutions that are conducting business as usual to think outside the box, outside the silos and effect changes that include the capital labor force and the need to provide quality services with competent personnel?
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