It is just about time for March Madness, the NCAA college basketball playoffs. This national tournament reminds us that competition is everywhere, even in health care - although we sometimes forget to notice it.
There are ten hospitals in town that provide services in particular medical specialty. One hospital has made an investment in teamwork training and standardized work for its nurses and staff in that specialty. Consequently, the community-based physicians in town that practice in this specialty always have efficient, standardized, high performing teams to work with when they provide care in that hospital. Physicians can get in, and get out - providing great care efficiently. Which of the 10 hospitals has won the competition for attention from the community’s physicians?
There are six ASCs and day surgery centers in town that patients can choose for surgery. One invests in its safety with a real culture-changing safety initiative, has a focus on the patient experience, recruits its patients and their families to be a part of the safety team, and makes its safety and quality statistics available on its web site. Others are muddling through, arguing about the business case for safety, factoring in mistakes and adverse events as part of the cost of doing business in health care, hiding their results under the cloak of secrecy, and doing business as usual. Which one will ultimately command a higher premium for its services while also doing the right thing for its patients?
You have fifty openings for nurses or other staff. You are competing with 8 other hospitals in town for qualified personnel. The working hours and pay rates are about the same all over town. Your nursing turnover rates are the lowest in town. Your employee satisfaction surveys are the highest in town. Your safety climate surveys are the best in town. Your culture of interactive communication between physicians and staff is the most collegial in town. Your core measures are the best in town. Your HCAHPS survey results are the highest in town. Which hospital has the most number of nurses wanting to interview with it?
There are ten new jobs in town for the superstar mid-level administrator who is looking for a new challenge. One hospital offers a culture of accountability where the staff speak up and hold one another to the standards of performance they have all agreed to. It has a commitment to standardized work and is not constantly re-inventing the wheel. All of the managers are committed to giving and receiving objective, specific, detailed, non-defensive performance feedback from one another. It has a history of giving its physicians a seat at the table when new procedures and systems are implemented; it never struggles finding physician champions for its projects. It gives its managers the tools and the freedom to work on interesting projects that improve the safety and quality of care. Where does she choose to apply?
We don’t have to like competition but we must understand that it exists. While certainly not the only initiative available to win the competition, effective patient safety programs give physicians, nurses, staff, administrators, and patients a very compelling reason to pick you and your organization.