What does it take to be the best hospital?

Below is a reply I wrote to a question raised on Hospital Impact, “What does it take to be the best hospital on the planet?”


I’d like to hear what you think it would take.

Great question and one that needs to be asked with much regularity.  I target my comments at the healthcare business as opposed to the business of healthcare—the clinical part.

May I begin with a statement that may have many readers reaching for their delete keys?  As one who has consulted to many industries, to me the healthcare business appears to be stuck in a 0.2 business model and is being forced to rapidly reinvent itself in a 2.0 model—my use of the term 2.0 does not imply the Internet.

My comments are based on observations, conversation, and inference.  My executives have told me privately that world-class physicians do not necessarily become world-class business executives.  Many lack the depth of experience that is needed to know what aspects of the healthcare business is broken, duplicative, wasteful, or in need of repair.  While discussing EHR, I was told recently by a former CEO of a large hospital that his peers were making multi-multi-million dollar decisions without any sense of the data needed to support those decisions, basing them on what a friend had decided, what they read in an in-flight magazine, or a conversation they had at a convention.

There seems to be significant faith placed in the notion of, “That’s the way we’ve always done it.”  That expression surfaces often when one raises the issue of why a hospital has multiple IT departments, multiple HR groups, payroll, registration, and so forth.  Why do something once if you can do it less well five times.

There seems to be enough waste that for some hospitals looking at moving forward with EHR, my first piece of advice is instead of aiming for best practices, let’s aim for a single practice.  Evaluate how to implement a shared service or managed services approach to business functions that are not part of your core business model.

I close with the notion of what other businesses call customer relationship management (CRM).  For a hospital, patient relationship management (PRM) is one of the unspoken wins waiting for someone to lead the charge.  Add a social media effort to it, and all of a sudden it’s like the hospital gave itself a facelift, at least from the perspective of the patients.


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