(This column is not outsourced to Mexico.)
How many chiefs can you name? C-Levels, not Indians. I found these–COO, CIO, CTO, CMO, CMIO, CEO, CAO, CFO, Chief Purchasing Officer, Chief Network Officer, Chief Engineering Officer, Chief Benefits Officer, Chief Development Officer, Chief Brand Officer, Chief Staff Officer, Chief Health Officer, Chief Legal Officer, Chief Quality Officer.
Besides who gets the corner office, these titles demonstrate a firm’s commitment to those areas of their business, and these positions provide that business sector visibility all the way to the top of the firm. There’s a certain cachet that comes from having your sector of the business headed by a C-Level. Those are the ‘in’ jobs, the jobs to which or to whit one is supposed to aspire. You never see anyone clambering for a B-Level position. B-Level is the repository for all non C-Level jobs.
Remember Thanksgiving dinner when you were a child—apologies to those of who aren’t from the colonies. Anyway, if yours was anything like mine, there were two tables, the nice dining room table for the adults, and the smaller card table for the children, the B-Level guests.
So what does this have to do with patient care? You tell me. Let’s go from the premise that the C-Level positions are an accurate reflection of you firm’s focus. Why are we in business? If you go from the premise it must be because of finance, marketing, IT, Purchasing, or any of a dozen other things. The only thing missing in this view of the firm is the patient. The only entity without a seat at the grownup’s table is the person in the firm responsible for the patient. It seems to me a firm’s very existence, it’s raison d’être, is the patient. If that’s true, when do they get to eat with the grownups?
Pale Rhino Consulting 
How about Chief Learning Officer (CLO)?
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Good point.
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I like the CPO angle. It should have been done long ago.
As an administrator in a 600 bed hospital, I was tasked with making “Patient Welcome Rounds”. All managers and directors did this monthly. I understood the intent perfectly, but the technique of deploying a manager without a clinical background to a patient room seemed to be of dubious value, and the program died after a couple of years. The problem was in the feedback loop. If I found a problem/patient concern and reported it, there was no loop back to me. The patient left either happy or not, and I went back to my day job of geeking around with computer-based medical systems. Any control system must come full circle. Imagine turning on your blinker in the car with no aural or visual indication – you just hope for the best. I saw some really stupid things like a nurse openly berate a patient after she asked one too many times about her test results. I had no authority to intervene and all I could do was inform her manager – and hope for the best.
My immediate suggestion was to have a dedicated team that does nothing all day but actively seek out issues and solve them right at the patient room level. Staff get to know them (and maybe fear them a bit). Give them authority to make changes. A CPO would head this up and a small group of three would be enough to cover a medium-sized hospital.
The Press-Ganey scores would shoot up like crazy.
SN
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