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Big gender gap persists in hospital C-suites

Modern Healthcare reports that women represent  only 26 percent of hospital CEO positions, although they have about 75 percent of healthcare jobs (largely because most nurses are women). At Fortune 500 companies involved in healthcare, women have only  21 percent of executive jobs and 21 percent of board members.

The publication notes: This inequality at the C-suite level has gotten the attention of those healthcare organizations that are striving to improve the diversity of their leadership teams. Their efforts are helping women advance further along in their careers. But societal stereotypes and cultural norms continue to remain stubborn barriers standing in the way of faster progress, experts say. ”

To read the piece, please hit this link.

How to attract greatness in 21st Century healthcare



John W. Kenagy, M.D.,  director of Kenagy & Associates in Longview, Wash., and a clinical professor of surgery at the University of Washington, writes in Hospitals & Health Networks about what he sees as attracting “greatness in 21st Century healthcare”.  Among his observations:

“The great healthcare organizations of the 21st century will make new choices that attract innovation. So what attracts innovation? Decades of well-accepted research across the globe and in many realms has shown that innovation requires a different set of capabilities: sense/respond/adapt.

Every successful startup has to sense, respond and adapt to succeed. My work has focused on the small number of successful make/standardize/sell companies that were also able to sense, respond and adapt: Toyota, Intel and Apple, for example.

Sense/respond/adapt requires different capabilities than make/standardize/sell does. Here are the characteristics of sense/respond/adapt success, whether in a new startup or an innovative venture inside a large, established organization:

  • A market or customer-centric value proposition focused on an unmet need. In healthcare, it’s easy: more access to better, safer care at continually lower cost. Leaders then translate the value proposition into a meaningful purpose to align the people attracting innovation.
  • A replicable, scalable, low-risk, high-reward system with these tenets: People with autonomy build mastery, simple rules match accountability to control, and self-managing teams rapidly prototype new value opportunities close to real-time work.
  • Sustainable, inspiring results that are low-risk, high-reward and fast.

”….Consider Mayo Clinic Health System. Mayo tested a sense/respond/adapt approach to diabetic population health at five different clinic sites. Within one year, the physicians in those clinics had improved their diabetic scorecard results by 122 percent compared with the cumulative results of the rest of the Mayo system.

“That was a significant pay-for-performance benefit for the system, while the physicians gained the value of all the flexible, responsive teams that sense/respond/adapt thinking developed to support them….”

“Make/standardize/sell fails at innovation because it views the workplace as a machine with identifiable problems and implementable solutions. Innovation is seen as a technical “fix.” But innovation isn’t a mechanistic improvement because, by definition, it doesn’t exist. It’s new and yet to be discovered. Make/standardize/sell organizations are great at improving what they know how to do, but the data show that they find it almost impossible to do what they don’t know how to do. It is clear that value-driven healthcare is not a system fix, consulting engagement, new technology or implementation; it is something you attract value to and create….”

“You have to attract its components and bring them together. Purpose; the ingenuity of people; simple rules focused on low-risk, high-reward discovery; and a safe place to work are the attractors. Once you start, it’s so attractive it’s difficult to get people to stop innovating to create new value.

“Attraction creates the innovation, and the innovation closes the loop. Now, the parent organization has something new to make, standardize and sell. That’s the great advantage that the attractive 6 percent acquire. In the future of high-value health care, the choice is not either make/standardize/sell or sense/respond/adapt, it’s and.”



Northwell CEO urges regulatory streamlining


In this interview with Becker’s Hospital Review, Michael J. Dowling, president and CEO of Great Neck, N.Y.-based Northwell Health, formerly North Shore-LIJ Health System, talks about his much admired tenure  at the big New York City area system and changes in healthcare.

Becker’s asked him:

“If you could eliminate one of the healthcare industry’s problems overnight, which would it be?”

He answered:

“I would say to reduce the conflicting and over-burdensome array of regulatory demands on healthcare organizations. We are inundated with a plethora of micro-regulations, and that, I think, just makes the business much more complicated than it needs to be. It consumes excess resources and doesn’t do enough to improve outcomes for patients. This is not to suggest that I’m against compliance, but the constant development of dozens of regulations on an ongoing basis makes the machinery of progress move much more slowly than it could.”


“What do you consider your greatest achievement at North Shore-LIJ/Northwell Health so far?”

He answered:

“I think our greatest achievement is the product of multiple players. When you’re part of a team, success isn’t the result of the actions of one person. I would have to say I’ve been very happy with being part of the creation of a culture of innovation, creativity and teamwork. We are an organization that looks forward on how to improve and advance — not constantly looking in the rearview mirror.

“I also believe that, irrespective of how successful one is, you should never be completely comfortable or happy, but always raising the bar. This culture and mindset is what builds long-term sustainability in the organization and allows you to make a difference.”

Videos: New ways to pay for and deliver care


Videos: Here are the first three animated videos of the Commonwealth Fund’s new series illustrating new approaches to paying for and delivering healthcare.

They look at how these reforms could make life better for patients, clinicians hospitals and other healthcare organizations.

A plea for hospital ‘management by process’


John S. Toussaint, M.D.,  CEO of the Thedacare Center for Healthcare Value discusses how hospitals can’t approve outcomes without better managements.  He is the former CEO of Thedacare, an integrated health system in Wisconsin, where he introduced the Toyota Production System principles in 2003.

He makes a pitch in this Harvard Business Review piece for “management by process” instead of the traditional  “management by objective.”

He says among many other things: “{O]ld-fashioned management-by-objective systems often work to actually undermine all of the good works by those frontline improvement teams.”

Management by objective “encourages certain behaviors, such as top-down bureaucracies and seeking whom to blame for problems or unmet goals instead of how to fix or achieve them. Information sharing is often seen as more threatening than helpful.”


“The healthcare organizations that have switched to management by process train every leader — from shift supervisors to senior executives — to lead their teams in problem solving with the scientific method. In this case, however, managers and executives are not expected to fix problems; they are trained to facilitate problem solving by those that best know that work.”








The importance of knowing when/how to stop



Tamara Rosin, writing in Becker’s Hospital Review, reports on how various healthcare organizations stopped things to improve patient care and other operations.

Her examples include:

Cleveland Clinic removing  McDonald’s from its cafeteria; three prominent academic medical centers  moving to ban low-volume surgeries; New York City hospitals agreeing to ban reality TV filming without patient approval; Mayo Clinic stopping requiring an outmoded dress code for women, and CVS stopping its sale of  tobacco products.

She notes: “Stopping one thing doesn’t just have to be an effect of starting something else. Rather, the deliberate departure from existing approaches, systems and norms should be given equal consideration as healthcare organizations look for ways to innovate and improve the care they provide. Stopping something might be the best innovation for a hospital, even if it is uncomfortable to break from the norm.”

“Change requires that you break from habit,” Manuel Hernandez, M.D., MBA, practicing emergency physician and leader of CannonDesign’s Health Advisory Services, told Ms. Rosin. “Many of the steps and processes people are engaged in — in any industry — can become almost automatic and oppressive.”






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