The CFO Can Not Be A Loner, Quality Demands Inclusion

When one thinks about quality and patient safety, the role and impact of the Chief Financial Officer doesn't immediately come to mind. Well, this mindset is beginning to change. In fact, some organizations have already made the transformation, for the better.

As the business case for operational efficiency and process waste reduction becomes stronger within the hospital, the need for CFO (and COO) engagement is essential. Moreover, increased patient safety has been found to occur within those hospitals that reduce variation and waste. The correlation is meaningful. Consumers and payers have their eyes open.

Organizations can no longer afford to continue emphasizing the monthly financial statistics while relegating quality and clinical performance to the periphery. I submit that those senior management teams who don't adapt to the changing environment will find themselves less competitive and burdened with decreases in patient loyalty, market share, and favorable contracting from commercial payers.

Indeed, there needs to be a marriage between finance and quality improvement within the hospital.

A temperature reading:

• Does your CFO (and or COO) attend your monthly hospital quality committee meetings?
• Is your CFO well-versed and understand the organization's quality and patient safety objectives?
• Does your CFO perform weekly/monthly rounds of the hospital, including clinical areas?
• Is your CFO a member of your hospital Board sub-committee - - Board Quality Committee?
• How would you describe the relationships between your CFO and the Director of Quality and/or Vice President for Performance Improvement?

What is the thermometer reading?

Hospital Quality Overwhelming, But Necessary

Whether one works in a large urban teaching hospital or a small rural community, the professional life and responsibility of the Healthcare Quality Professional is arduous, and often times overwhelming.  The national hospital quality agenda contains essential elements such as: continuous preparedness for Joint Commission accreditation and/or state conditions of participation, data reporting transparency, ongoing physician practice evaluation, patient satisfaction benchmarking, bedside medication verification, computerized physician order entry, electronic medical record implementation, infection control, case management, responding to patient grievances, and effective information management, to name a few.  How does one effectively manage these program elements so that the RIGHT patient, receives the RIGHT care, at the RIGHT time?

Ask any of my peers throughout the country, and they will tell you there are several organizational ingredients that contribute to successful program development and implementation.  Furthermore, I would argue that program sustainability is severely compromised without all five (5) of these ingredients firmly place.  You will find that the Institute for Healthcare Improvement (IHI) provides first-rate research and recommendations in how to incorporate many of these ingredients into your organization.

• Substantive engagement by the Board of Directors, which is reflected by the agenda outline and time spent on Quality and Patient Safety
• Senior Management stewardship and accountability for Quality and Patient Safety operations and strategy, which is demonstrated by the utilization of transparent scorecards or a system dashboard
• Proper buy-in and support of the CFO with the Quality and Patient Safety hospital strategy
• Partnering with the medical and nursing staffs to deliver the clinical elements of the program.  The President of the Medical Staff, the Vice President of Medical Affairs, and the Chief Nursing Officer and Director of Quality, should work closely on matters pertaining to clinical performance improvement.
  
• Proper funding and staffing of Information Technology services

I shall provide further depth to each of these ingredients in future blog posts.

-soft on people, hard on processes