Fear, excuses, resistance — or leadership

Local hospital experts should work together to find ways to improve quality of care

K

enai Peninsula Borough Mayor Mike Navarre has proposed the possibility of merging the hospitals on the peninsula. Perhaps this is what needs to be done. I’m not sure.  

I believe the mayor has good intentions and wants all the peninsula citizens to have access to excellent, affordable health care. I think he also wants both hospitals to be financially successful. I have spoken with a number of people since the mayor’s presentation to the city council and in Homer I have encountered more negative reactions than positive at this point. 

Most of my contacts have expressed the common concerns of loss of control of the local hospital; potential reduction or loss of services, loss of jobs and a general negative impact on Homer if the hospitals merge.

I am not an expert by any stretch of the imagination, but having worked at both South and Central peninsula hospitals, I think there are lots of opportunities for improving operational efficiencies of both hospitals without the feared negative impacts. (I am leaving the Seward hospital out of the equation at this point because it is not owned by the borough and is operated by Providence.)

The mayor has suggested hiring a consultant to analyze the situation and make recommendations on how to make improvements. In my estimation this is a waste of money.  People in both organizations already have ideas about what needs to be done — the challenge is having the courage to take the first step to implement the needed actions. 

As an alternative to spending a lot of money on a consultant, I would like to offer a suggestion.

An incremental approach to change will be much more palatable to everyone involved and will allow both organizations to learn and improve. Implementing the incremental change will require direct action by the mayor. He should call a meeting of the leadership of both hospital operating boards and service area boards, the chiefs of the medical staff and the chief executive officers of both hospitals.

In this meeting of the health care leaders of both communities the mayor should issue a directive: You have 30 days to identify three areas, activities or services where you can improve the efficiency and effectiveness of operations in a way that will demonstrate an actual improvement in access to care, level of service, operating costs or quality. 

The hospitals should be given six months to implement the changes. After six months, quantifiable results will be reported to the mayor and/or borough assembly, corrections made, if necessary; and three additional opportunities will be identified and implemented.  

The mayor should not direct what the areas of cooperation, collaboration or consolidation should be — the leadership of the two organizations should work together to make these decisions — they are the experts. The mayor should make it very clear that he will not accept excuses, rationalization for why change cannot happen or procrastination in an effort to let the clock run out.

Some possible areas to consider for improved operational efficiencies might include equipment and supply standardization and participation in the same group purchasing organization to take advantage of quantity purchases and cross-leveling of supplies when needed.

Equipment standardization would potentially offer opportunities for sharing expensive maintenance and service contracts on imaging, surgical and other sophisticated equipment.

Other potential areas for cooperation might include standardization and/or sharing of information systems, medical staff services, coding and billing, transcription services and continuing education.

In summary, there are three key elements of my proposal: first, incremental change will allow all participants to get over some of the fear and emotional responses to a proposed merger; second, there will be opportunities to learn, grow and make adjustments to any unintended consequences of the changes that are implemented, and third, the leaders of the hospitals will be responsible for the future success (and survival) of their organizations.

Charlie Franz retired after 25 years service in the Army Medical Service Corps to become the CEO of South Peninsula Hospital in 1996 where he served until retiring again in 2008. In 2009, he was selected to be the administrator of Central Peninsula Hospital’s nursing home, Heritage Place, and held that position until March 2015, when he retired once more.

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