With continual changes in reimbursement, regulation, and an increasingly competitive landscape for healthcare dollars, the emphasis on securing the right talent necessary to effectively lead a hospital’s clinical service lines has become heightened. This is particularly true as it relates to the few remaining strategic service lines in healthcare organizations that still offer a positive impact on a hospital’s bottom line. Three such service lines included on this short list are cardiac, vascular, and neurosciences. In fact, in Corazon’s experience, cardiac and vascular services alone can represent as much as 40% of a hospital’s bottom line. Unfortunately, a number of hospitals across the country continue to operate these and other service lines without the talent necessary to lead the way. As has been the case for some time, hospitals and health systems across the country have been struggling with staffing shortages. This fact, although troubling, is true at a time when a number of institutions are struggling to understand the impending effects of healthcare reform. If that’s not enough, there continues to be a shortage in the retention and a gap in the recruitment of hospital leadership; the same leaders that we look to for guidance and support when navigating these changing waters. As alarming as this may be, demographic trends point to a growth in this leadership shortage over the coming years. Organizations that are operating with ineffective service line leadership and those without a leader in place are certain to feel the effects of the gap in talent. Unfortunately for those organizations, the lack of the right leadership has a ripple effect across the organization. As it relates to key service lines, a gap in effective program leadership will cause a loss of direction, leading to a loss of momentum, possible decreases in morale, and an underwhelming financial impact upon the organization as a whole. We have found that when there is no service line leadership in place, whether due to an unexpected departure or cost-cutting initiative, another member of management assumes an additional role to their current one. Although this approach can offer a quick fix, it is likely to be ineffective even in the short run. It can be argued that this approach is no better than simply leaving the void in leadership. In either case, organizations run the risk of:
- Incurring losses in revenue and market share potential
- Increasing costs of care
- Confusing internal stakeholders (e.g., physicians, staff, etc.), and resulting dissatisfaction
- Declining quality of care offered
- Lacking focus on a strategic service line
Corazon Case StudyRecently, we had the opportunity to provide an interim cath lab director for an organization in the midwest. This organization provides diagnostic catheterizations, as well as primary and elective angioplasty without cardiac surgery on-site. This particular organization had experienced programmatic volume declines, physician partnering challenges, and overall staff moral issues. In a short time, the interim director of the cath lab accomplished the following:
- Conducted an unbiased cath lab assessment, including policy and procedure review, staffing patterns and competency, clinical outcomes review, and equipment and inventory control.
- Identified and addressed multiple opportunities for process and quality improvement in the cath lab, working in conjunction with the medical director, cath lab team, and hospital administration.
- Worked with the cath lab staff to revise the call schedule and helped to address several employee dissatisfaction issues that were present.
- In collaboration with the cardiologists, worked to improve relationships that resulted in an increase in procedural volumes.
- Addressed financial concerns related to inventory control and cost per case. Tight management of the financials led to the organization being able to decrease their loss per case, and placing them on a track to increase revenue by 13%.
- Began the process of succession planning by working with an existing employee, mentoring them to transition into the leadership position once the interim role was completed.