Contributed by Joanne McCool
If you cherish your sanity, this is no time to be a hospital administrator. The number of hospitals operating in the red demonstrates the mounting financial obstacles that exist to delivering effective care. Add to this the impact over medical errors and the pressure to correct them, and it’s no wonder that administrators are scrambling to balance clinical and financial demands.
Administrators need to create a balance by managing a complicated array of people and projects – and there’s virtually no room for error. When they’re not putting out fires, executives are overseeing the advent of electronic healthcare, preparing for visits from the Joint Commission on Accreditation of Healthcare Organizations, trying to reconcile underpayments from Medicare, communicating the status of strategic initiatives to the board of trustees, or negotiating contracts with everyone from nurses’ unions to a wide range of health plans and insurers.
Despite this complexity and diversity of projects, many hospital administrators still are using ad hoc approaches to manage them. These personal approaches of choice include sticky notes, whiteboards, spreadsheets and tables created with word processing programs. Few administrators have the detailed, up-to-date information at their fingertips needed to make the best decisions – both long- and short-term.
Without current information and a strategic view of its projects, healthcare organizations lose time, energy and money, and with margins in healthcare now razor thin, these planning-related losses are especially painful.
The projects and decisions with the most significant implications for cost and care involve the daily strain of managing a vast and diverse workforce, ranging from clerks and janitorial staff to nurses and physicians. This management is made more complex by the fact that some are regular staff, while others are contractors. It’s difficult to keep labor costs under control, especially as case mix fluctuates, hospital census constantly varies and contractually and legally mandated staffing requirements come into play. Staff with special skills for various narrowly focused tasks are often especially hard to find.
Directing workforce and organization projects requires flexible management skills and access to crucial information if administrators are to make cost-effective decisions. Because spreadsheets, whiteboards or tables developed with word processing programs are static and must be edited manually, they’re haphazardly updated when new information is available. In light of the number of decisions associated with projects and their impact on the institution’s financial viability, these ad hoc solutions are inefficient and ineffective.
Healthcare executives striving to better view and manage their projects strategically and holistically need to begin by adopting best practices for managing project portfolios in the following areas:
Workforce management. Possess a clear and up-to-date picture of the organization’s people and their skill sets, matched against contractual arrangements, regulatory requirements and project or unit requirements. This level of oversight enables administrators to put the right people on the right job at the right time, in the most cost-effective way.
Demand management. Know the full list of projects being managed, including those that are only in the planning stages, and then prioritize them according to overarching financial and clinical goals.
Governance. Ensure that all relevant managers have complete, up-to-date information about compliance deadlines and regulations. This information will lead to wiser decisions about which projects to pursue and when they should be completed.
Project status. Track project progress on an ongoing basis, including financials and workforce assignments, and model the resource gaps and cost impact of decisions. This enables executives and administrators to exert more control over scope and budget, and it helps them avoid surprises.
Communication and collaboration. Create a communication process that enables better management of expectations and gives people time to adjust to change.
Some executives are turning to computerized approaches, such as the use of a dedicated project portfolio management application. An automated approach can provide access to all information needed about a hospital’s portfolio of projects, and progress toward completing these projects is constantly updated. Moreover, applications enable information to be aggregated in one place and displayed in easy-to-use dashboards that enable executives to see the big picture and then drill down into the details as necessary.
Automated approaches hold the promise of enabling hospital executives to constantly link long-term strategy with the planning and delivery of projects, better achieving savings in time, energy and money because administrators will be empowered to oversee and attain key project goals, rather than constantly putting out fires. And finally, they may regain some measure of their sanity while still managing to keep the doors of their healthcare organizations open.
Joanne McCool is general manager of Primavera Evolve, a Bala Cynwyd, Pa.-based company that provides collaborative project, resource and portfolio management applications.