Every hospital is focused on reducing re-admissions? Why? Avoidable re-admissions shortly after discharge cost Medicare nearly $15 Billion a year. They are “avoidable” because better care during the inpatient stay, and better discharge planning and better coordinated care post-discharge would keep the patient’s chronic condition from deteriorating to the point of needing to be admitted. The current pressure on hospitals comes from Medicare’s new payment program which penalizes hospitals for excessive re-admissions.
I can assure you there are meetings and committees this very week in your hospital talking about this problem. I can also assure you that most of them aren’t engaging human resources, and staffing and talent acquisition professionals in the discussions – but they should be!
Every organization faces a challenge the same way – after analysis, they look at processes and technologies that can solve the problem. Eventually they realize there is a “people” piece to the puzzle.
How does this apply to hospital outcomes? Well – consider the fact that in 2004, Joint Commission issued protocols to eliminate wrong-site surgeries, including having the surgeon mark the surgical site. Any process engineer would tell you this is an elegantly simple solution, but we still have more than 3,000 wrong site surgeries a year! Clearly there is a behavioral component to solving this problem – accountability, attention to detail, conscientiousness – all play a role.
Similarly, some hospitals have proven that relatively simple steps can virtually eliminate hospital acquired central line infections. But – we still have over 40,000 a year! Hospitals that are successful don’t have access to some “secret” procedures – they just have a culture of accountability and communication and people who make the effort to ensure that every step of the process is followed every time. It’s about culture. It’s about behaviors.
And now this from a recent Robert Wood Johnson Foundation study: Nursing work culture has a bigger positive impact on reducing re-admissions than nursing education levels. Can there be a better example of the impact of behaviors and culture on outcomes? Sure, technical skills and training will also be important, but healthcare is learning what other industries already know. Results depend on important behavioral competencies. Think about your own organization:
- Have you defined the very specific behaviors that create the culture you want, and patient experience and clinical outcomes results you need?
- What are you doing to make sure that every hiring and promotion decision you make supports what you are trying to accomplish?
- Has anyone talked to HR about how their talent acquisition approach will support your operational goals?