Journal of Healthcare Management - March/April 2014 - (Page 158)

J o u r n al of H ealt H care M anage Ment 59:2 M arcH /a pril 2014 PRAC TITIONER A P P L I C AT I O N Jeffrey T. Gering, FACHE, medical center director/CEO, VA San Diego Healthcare System, San Diego, California I n 1999, the Institute of Medicine released the report To Err Is Human: Building a Safer Health System, which served as a clarion call to hospitals to make patient safety an organizational priority. Despite the significant progress achieved by the healthcare industry in reducing preventable medical errors, much improvement work remains. Over the past 14 years, the pressure to improve quality, patient safety, and performance has been exacerbated by many factors, including hospitals' participation in accountable care organizations; Centers for Medicare & Medicaid Services (CMS) rules mandating greater transparency in public reporting in addition to increased scrutiny by the Leapfrog Group, The Joint Commission, and other stakeholder organizations; and the direct impact that patient safety and quality outcomes have on reimbursement (e.g., CMS's Hospital Value-Based Purchasing program). As director and CEO of a large, complex Veterans Health Administration (VA) medical center, I feel this pressure acutely every day. In the VA health system, the pressure to elevate hospital performance is inherent in the agency's transformational strategy to provide care that is personalized, proactive, and patient driven. I fully expect to encounter resistance to change in implementing this strategy, with some organizational improvement efforts succeeding and others failing to achieve desired results. As is the case with all hospital CEOs, I have an imperative to understand the barriers and factors that are likely to cause change and improvement efforts to fall short of expectations. The authors infer, and I wholeheartedly agree, that it is necessary to tap frontline leaders to know why change initiatives fail. Having an understanding of the barriers to improvement from the front lines allows hospital executive teams, including my own, to preemptively implement foundational and process-related measures that address these common obstacles, and in doing so increase the probability of success. Accelerating improvement requires a transformational shift in an organization's culture-one that taps the talents of those on the front lines. This cultural change is best pursued by engaging staff at all levels to fully participate and improve every aspect of their daily work. Because I hold this belief, I find the authors' work particularly useful and encouraging. Of the top 10 barriers that the frontline-leader respondents believed cause hospital improvement and change efforts to fail, not one is beyond the control and influence of a hospital CEO. To put it another way, the magic 158

Table of Contents for the Digital Edition of Journal of Healthcare Management - March/April 2014

Journal of Healthcare Management - March/April 2014
Contents
Interview With Marna P. Borgstrom, FACHE, President and Chief Executive Officer, Yale New Haven Health System, and Chief Executive Officer, Yale-New Haven Hospital, Connecticut
Specialties: Missing in Our Healthcare Reform Strategies?
Costs and Benefits of Transforming Primary Care Practices: A Qualitative Study of North Carolina’s Improving Performance in Practice
Governing Board, C-suite, and Clinical Management Perceptions of Quality and Safety Structures, Processes, and Priorities in U.S. Hospitals
Use of Electronic Health Record Documentation by Healthcare Workers in an Acute Care Hospital System
Why Hospital Improvement Efforts Fail: A View From the Front Line

Journal of Healthcare Management - March/April 2014