American Association for Physician Leadership

Quality and Risk

Quality Patient Care: The Best Business Plan

Sunil Kadakia, MD, FACC, FSCAI, CPE

January 8, 2020


Abstract:

“The customer is king” is as relevant in the healthcare industry as it is in the retail sector. Every action, decision, and policy in a healthcare organization must be made in the best interest of the patients. When an organization is patient-oriented, success is inevitable — a happy customer can promote the organization a hundred times better than any marketing advertisement; increasing clients increases the organization’s productivity. Anything contrary to 100 percent customer satisfaction exposes the organization to potential demise.




“The customer is king” is as relevant in the healthcare industry as it is in the retail sector. Every action, decision, and policy in a healthcare organization must be made in the best interest of the patients.

When an organization is patient-oriented, success is inevitable — a happy customer can promote the organization a hundred times better than any marketing advertisement; increasing clients increases the organization’s productivity.

Anything contrary to 100 percent customer satisfaction exposes the organization to potential demise. Consider the case of the Skytop Medical Health Center (a fictional clinic). The clinic was established in the early 1990s and had since grown to gain an impressive advantage over competing clinics. Its demise was a result of the management’s myopic approach to revenue generation that ignored customer satisfaction and focused on the pursuit of political and financial benefit.

The clinic’s leadership had decided that a new, more cost-efficient process should be established for patients admitted with acute neurological complaints. Initially, patients would be examined by nurse practitioners who followed normally accepted protocols. The clinic would generate revenue from test analysis and doctor consultation; bed space and meals would bring more income. A neurologist would be consulted only when conditions were critical.

The president of the clinic presented this million-dollar idea to the board of directors, who saw it as a profit-making one. Shortly thereafter, the new policy was put into effect.

One day, a 75-year-old man who was in town to spend the Christmas holiday with his daughter and her family, collapsed while jogging. His daughter advised ambulance personnel that over the past three to four hours he had complained of intermittent slurred speech and mild right-side weakness.

Rather than being examined by a neurologist, the patient was admitted to the observation unit where he was subjected to a series of expensive tests, none of which were neurology-related.

Several days after his admission, when the patient showed difficulty in speaking, a neurologist was called to consult — a futile effort because the patient was already paralyzed, according to the neurologist’s reports. After careful examination, the neurologist said, “His inability to talk is a result of the damage to a part of his brain. It is obvious that he had collapsed from a high blood pressure-induced stroke. All the facts point to it.”

The patient, who upon discharge was able to neither walk nor talk, eventually took his own life. His daughter, in an effort to draw attention to what she perceived as irresponsible clinic policy being responsible for her father’s death, took to social media platforms and before long had irreparably tarnished the clinic’s reputation. Traffic decreased drastically because no one had confidence in the clinic’s ability or desire to put patient satisfaction above all else. Such was the sad story behind the demise of Skytop Medical Health Center.

Elements of a Quality Plan

Healthcare organizations can learn a lesson from the rise and fall of Skytop Medical Health Center. The best business plan is the one that keeps patients front and center. Consider the following key elements of an effective business plan.

Management Expertise

In comparing the elements of a successful business and one that is not as successful, it would seem that both organizations have similar practices, yet one thrives and the other doesn’t. What makes one different from the other?

Some differences are obvious. Consider the airline industry, for example. Passenger comfort and safety and the overall customer experience are essential to success. One airline invests in modern aircraft, well-trained crews, popular routes, and superior maintenance; another rejects the amenities as eating into profit. The deficiency lies in understanding how to make a profit, not what determines the bottom line. The answer is management expertise.

Communication

In turbulent times, open and transparent communication can be a key to success. It reassures the staff, circumvents misunderstandings, and squelches rumors.

Consider a healthcare facility that alters the way in which it provides service in order to save money and implement greater cost efficiencies. If the changes are not communicated well, alarm bells ring and staff members assume jobs will be lost, creating panic and insecurity. When the changes are communicated effectively throughout the process, however, the message is clear and although a few jobs may be lost, chaos does not reign and business continues.

Ensuring staff members are trained in effective communication as well as the skills necessary to perform their duties makes organizations successful — a principle that deficient organizations don’t realize.

In healthcare organizations where people feel disconnected, complacency sets in and the quality of care drops. Organizations with even the slightest lack of respect for people will crumble fast. Teaching staff members how to communicate effectively is one of the most prudent investments organizations can make. Effective communication develops a strong sense of teamwork; everyone understands their roles and responsibilities.

Companies that are constantly looking to boost profits, however, often don’t see the expense of staff development as an investment. Instead, they try to keep costs low to make themselves look good. Looking good at the expense of long-term goals that bring long-term benefits could well be the death of an organization.

Leadership

Internal politics and poor leadership are issues in many struggling companies. Working toward a common goal is a challenge for organizations where egos are more important than policy.

Overcoming egos and political wrangling requires leaders who encourage others and create employee engagement throughout the organization. Leaders who get down to grass roots and roll up their sleeves to truly understand the organization around them are respected and better able to bring about the positive changes needed to grow the business.

The most successful businesses are those in which the leaders are part of the team and understand that the team — not one single person — is responsible for the success. On the other hand, when team members hear “I did this” and “I did that” over and over, they begin to feel disrespected. Many employees need their jobs, so they keep quiet; however, they lose interest in their jobs and performance drops. Egos often are the reason good employees leave an organization, and unfortunately leaders in these organizations are too self-absorbed to recognize it.

When people see leaders whom they perceive as genuine and whose processes are team-oriented, they become more engaged and more effective.

Conclusion

The greatest strength of an organization is in its people and their ability to problem solve, lead, and communicate. In the current competitive business environment, organizations must consider the financial, management, employee-related, legal, social, technological, and ethical issues that affect the success of the organization. They must continuously adapt to a changing world. Leaders must step back and take a critical look at the organization and be honest about its deficiencies so those shortcomings can be resolved.

This article is adapted from the author’s book, 101 Deficiencies Which Lead to the Demise of a Healthcare Organization, published by Paige Publishing, 2019.

Sunil Kadakia, MD, FACC, FSCAI, CPE

Sunil Kadakia, MD, FACC, FSCAI, CPE is medical director, cardiovascular services, Advocate Heart Institute, Good Shepherd Hospital, Lake Barrington, Illinois. E-mail: sunilkadakia@comcast.net.

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