While we talk a lot about applying manufacturing techniques to healthcare, the reality is there is one very large difference between healthcare and manufacturing. Most industries build the entire production or service model around the end product. The idea of building care delivery models around the patient – around distinct patient populations, is relatively new. The concept of managing hospital “service lines” is still really in its infancy.
I spent several years helping hospitals with service line strategies and tactics. Our experience showed that success depended on several variables including the availability of adequate clinical and technical resources and tools to manage financial and quality performance. Over and over again, however, we found that two variables were most predictive of success: (1) Physician Leadership; and (2) A service line administrator with the right mix of skills. Without these, failure was almost certain.
A recent Healthleaders, report, Service Lines Grow Amid Strategic Challenges points out the problem, talking about service line management and the related, popular concept, clinical “co-management”:
[Co-management] is really more difficult than it sounds; effective physician leaders are relatively rare, and successful departmental managers do not necessarily have the same skill set to be successful service line administrators. Both of these positions are critical to the success of the service line.
--Lane Savitch, President, Kadlec Regional Medical Center, Richland, WA; and report advisor.
Unfortunately, their presence is more often than not, left to chance. Why invest hundreds of thousands of dollars to re-organize the care delivery model, management approach, and implement a co-management model but invest no time or money to make sure you have the right leadership in place? Makes no sense, does it?
The Service Line Administrator is a senior level position responsible for a large book of business. It requires an ability to manage clinical issues, financial issues, to develop work with physicians, and to manage complex projects. As Savitch points out in the HealthLeaders report, you cannot assume that a manager has these senior level skills. Similarly, a good physician is not necessarily a good leader. How do you ensure that candidates for these roles have the business acumen, leadership and critical thinking skills to ensure the return on your investment? Apply the same science of selection that other industries do for healthcare hiring.