Insights from the 2001 Annual Chairman & CEO Report, A
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Insights from the THE 2001 Annual GOVERNANCE ©2002, The Governance Institute INSTITUTE Not for Distribution Chairman & CEO Report To Order Copies Please Contact Our Office Toll Free (877) 712-8778 www.governanceinstitute.com N OVEMBER 1-3, 2001 • THE B REAKERS R ESORT • PALM B EACH • FLORIDA Table of Contents able of Contents T Preface 1 Faculty 2 Chapter I The Role of Leadership in Pursuing Excellence in Quality 3 The Best Leaders Strive to Be the Best . .3 Spiritual Leadership as a Way to Motivate Employees . .4 Financial Leadership as a Catalyst for Quality . .7 Chapter II The Strategies and Tools for Excellence in Quality 13 First Task: Understanding the Quality and Safety Problem . .13 Evidence-Based Medicine as a Tool for Excellence in Quality . .16 “Six-Sigma” Quality as a Tool for Improvement . .22 Achieving Quality through Productivity . .27 Chapter III Other Key Issues for Boards and CEOs to Monitor 33 Issue 1: A New Standard of Public Accountability for Boards? . .33 Issue 2: Health Policy in the New Administration . .39 Moving Toward Excellence in Quality Reported and produced by: The Severyn Group, Inc. Ashburn, VA Contact: Larry Stepnick Phone: 703-723-0951 Fax: 703-858-9077 Email: [email protected] ©2001 The Governance Institute Preface Preface In today’s fast-changing and unforgiving healthcare environment, hospitals increasingly face demands for improved quality of care. Be it pressure from payers who see better quality as an opportunity to curb double-digit increases in healthcare premiums or demands from Internet- savvy consumers who are increasingly taking responsibility for making healthcare decisions (and paying a larger part of the bill), hospital chief executive officers (CEOs) and board members face a clear mandate to improve the quality of services they offer to their customers. Studies from independent organizations, such as the Institute of Medicine (IOM), make it clear that there is plenty of room for potential improvement, particularly when it comes to reducing preventable errors and deaths. This 2001 conference of board chairmen, chairwomen, and CEOs of the members of The Governance Institute was organized to help respond to the challenge of meaningfully improving quality. The annual Chairman & CEO Conference provides an opportunity for The Governance Institute to help its members exchange practical ideas with experienced faculty. This year marks the 11th anniversary of the event. Its theme, “Moving Toward Excellence in Quality,” addresses perhaps the most important priority facing boards of leading U.S. hospitals and health systems. An excellent faculty joined in Palm Beach, Florida, with over 170 health sector leaders from 33 states. This paper summarizes the observations and conclusions reached during the session. Please direct any questions or comments on this document to: Contact: Karma H. Bass, M.P.H. Director of Research & Publications Toll-Free: 877-712-8778 Fax: 858-551-0147 Web: www.governanceinstitute.com Email: [email protected] 1 Moving Toward Excellence in Quality aculty The Governance Institute thanks the speakers at the 2001 Annual F Chairman & CEO Conference for being so generous with their time and expertise: Bill Clement Tor Dahl Former Professional Hockey Player President & CEO ESPN Broadcaster Tor Dahl & Associates Michael L. Millenson Marisa Hinnenkamp Principal Senior Associate Health Care and Group Benefits Tor Dahl & Associates William M. Mercer, Inc. James L. Scott Michael B. Guthrie, M.D. Senior Vice President Senior Vice President Advocacy Unit Premier, Inc. Premier, Inc. Linda B. Miller C. William Pollard President Chairman of the Board Volunteer Trustees The ServiceMaster Company Lowell C. Kruse Kenneth Kaufman President and CEO Managing Partner Heartland Health Kaufman, Hall & Associates 2 The Role of Leadership in Pursuing Excellence in Quality Chapter I he Role of Leadership in Pursuing TExcellence in Quality Without question, the most important determinant of an organization’s ability to provide high-quality care is the quality of its leadership. Great leaders are able to motivate their employees to pursue excellence and provide the financial resources and other tools necessary for them to succeed. To shed light on this issue, the Chairman & CEO Conference included three speakers who touched on the critical aspects of being a “If you live successful leader, including spiritual and financial leadership. in the past, The Best Leaders Strive to Be the Best you’re a loser.” Bill Clement, a former star in the National Hockey League, entrepreneur, Bill Clement actor, and television broadcaster, opened the conference with a simple yet powerful message for the leadership of hospitals and health systems—strive to be the best in whatever you do. Mr. Clement knows a lot about being the best; not only did he win two Stanley Cup championships during his playing days, he also became a top actor and broadcaster after retiring. To become the best (and make the most of it), it is helpful to understand what it is like to be at the bottom and in the middle as well. Mr. Clement has had this experience as well, as a failed restaurant venture left him bankrupt after his retirement from hockey. Dream big and Without question, there are challenges when an individual or organization dare to fail . we attempts to be the best. Hospital CEOs and board members, for example, face financial and economic issues that could threaten their organization’s are best as very survival. With the nation’s economy struggling, hospitals face the climbers striving prospect of caring for more patients without insurance. Complying with to reach the HIPAA (Health Insurance Portability and Accountability Act) mandates will summit, not as add to costs, while finding and retaining an adequate number of qualified nurses and other allied health professionals remains difficult. individuals already perched on the Overcoming these challenges requires leadership. But what is strong leadership? In Mr. Clement’s view, leadership is about motivating people. summit.” Anyone can be a leader. The trick is to figure out how to influence others. Bill Clement Two Pillars of Leadership Mr. Clement highlighted two “pillars” of leadership. Pillar #1: Be a Source of Energy The best leaders are a source of energy for those around them. Being a source of energy requires a positive attitude, even when the ability to remain positive may be tested by physicians and others. As the “flagbearers” of their institutions, hospital CEOs and board members have a 3 Moving Toward Excellence in Quality special obligation to portray a positive attitude. Such an attitude can be a powerful force for influencing others’ behavior, as it can be a clearinghouse for positive energy. For example, the leaders of Fedex Corporation have been incredibly successful in instilling a positive attitude in employees; one employee in a small town in Wisconsin displayed such enthusiasm for (and knowledge about) the company’s quality improvement program that a judge for the Malcolm Baldrige Award* lobbied heavily for FedEx to win the award (which it did). Attitudes are also important because they are one of the few things over which one has complete control. And while a positive attitude can rub off on others, so can a negative attitude. Leaders who constantly have a negative Some See the Glass attitude become “energy vampires” who “suck the life” out of an organization. Half Empty, Others Pillar #2: Act as “Glue” for the Organization by Pulling Others, Not Pushing Half Full Leaders must pull people rather than push. When a leader pulls others, people To demonstrate how different will follow that leader wherever he or she goes. Leaders who push are acting as individuals can have different dictators who will ultimately lose their position of leadership, as pushed attitudes with respect to the individuals rebel or leave. Pulling people, in turn, requires making them feel same situation, Mr. Clement vitally important to an organization and its culture. To demonstrate how powerful this approach can be, Mr. Clement shared a story of his playing days in shared the story of two shoe the National Hockey League. A severe knee injury suffered during the Stanley salesman who went to the Cup finals made it difficult for him to walk, let alone skate. A respected Australian outback in search of a teammate (now a general manager in the league) urged him to try to play by new market. Noticing that the emphasizing how vital his contributions were to the team. That motivation natives did not wear shoes, one inspired Mr. Clement to try, and he went on to play effectively in the next three reported that there was no games, helping his team win the Stanley Cup. Leaders should not assume, opportunity to crack the market moreover, that workers know that their contributions are vital. On the contrary, (assuming that natives would one must take the small amount of time that is necessary to make them feel not change their ways), while important and appreciated. Lip service will not get the job done. the other saw a tremendous Conclusion untapped opportunity. Mr. Clement wrapped up his remarks by exhorting leaders to continue their efforts to influence and motivate others, even when they feel tired of giving. The best leaders are relentless in their efforts. They continue to strive to be better even when they may have reached the top of their profession. Spiritual Leadership as a Way to Motivate Employees As Mr. Clement noted in his remarks, a key aspect of leadership is motivating employees. William Pollard, chairman of the board of The ServiceMaster Company, built on Mr. Clement’s remarks by offering his views on the role of spiritual leadership in motivating and getting the most out of employees. He began by noting the importance of a strong relationship among key leaders; in particular, the relationship between a board chair and CEO can set the tone for an entire organization and help with the challenges that an organization faces.