Winter 2012

International ACHE Profile:   

Su-Lin Chong, MD Director Healthpdm Kuala Lumpur, Malaysia

"Tap into ACHE’s educational offerings even if you have very different healthcare systems, because fundamentally, we all face the same issues: patient safety, physician alignment, working with third-party funders and balancing the for-profit needs with national and social philosophies."

Q: Tell us briefly about your background in healthcare management.
A: I fell into the field by chance. After working as a practitioner in the United Kingdom, I earned an MBA and then spent a couple of years working in health economics for a boutique consultancy providing pharmacoeconomics studies to help drug companies with their marketing strategies. I returned to Malaysia after an absence of almost two decades and didn’t know what I should do. I ended up as an administrative resident with a private hospital in Kuala Lumpur. At that time, the hospital was managed by a team from the U.S.-based National Medical Enterprises (later Tenet Healthcare). The organization managed a group of hospitals in Singapore and Malaysia.

Q: How did you arrive at your current position?
A: I'm currently interim CEO at a private hospital in the middle of Kuala Lumpur, having been hired to help hold down the fort when the owners terminated their management agreement with the existing operator. I'd left full-time employment as a CEO of Sunway Medical Centre in fall 2011.

Q: What are your primary job responsibilities?
A: I am responsible for keeping the operations going and restoring trust among key stakeholders, including our physician group and funders. I also have to assess the viability of the hospital and understand the clinical service drivers.

Q: What is the biggest challenge you face in your current position?
A: The hospital has gone through an extraordinary amount of change and turmoil in the short time since it was founded. Consistent systems, processes and workflows are not in place, so it’s an intense period of putting things in place. I do miss my previous management team. Redeveloping a core team is a task in itself; when this isn't there, and there is such urgency to turn the business around, it makes for long days.

Q: What is the biggest reward?
A: The biggest reward has been regaining the trust of the physicians, owners, patients and staff.

Q: Briefly describe the overall healthcare atmosphere in the country in which you work.
A: The private hospital industry is based loosely on the U.S. model. Medical insurance is voluntary, and the insurance funders (AIA, Prudential and ING) came into the market in the late 1990s, fueling a boom in the entire sector. Healthcare is growing quickly—not just the hospital sector, but also the larger ecosystem of medical insurance, pharmaceuticals and medical devices. Having said that, there is also emotional and political angst about the rising costs of healthcare delivery because a majority of our technologies, drugs and supplies are imported from the United States and Europe. Labor costs are rising as well.

Q: How do you see the field of healthcare management changing in the next 5 years?
A: Healthcare is one of the 12 national key economic areas within the Economic Transformation Programme (ETP) of Malaysia for creating sustainable economic growth. The ETP brings the private sector players together with the government agencies to grow the entire industry. These are very exciting times.

Q: What advice can you offer for other international affiliates?
A: Tap into ACHE’s educational offerings even if you have very different healthcare systems, because fundamentally, we all face the same issues: patient safety, physician alignment, working with third-party funders and balancing the for-profit needs with national and social philosophies.

Feature Article:   

The Why and How of Consistent Patient Safety

Getting All Divisions and Locations on the Same Page

By Megan Downey

Craig Clapper, a founding partner and chief knowledge officer, and Carole A. Stockmeier, managing partner and COO, Healthcare Performance Improvement LLC, share their thoughts on why uniform processes across all divisions is crucial for achieving and maintaining consistent patient safety.

Why is uniformity important?

According to Stockmeier, leaders from any organization need to be firm and consistent in the principles and processes they expect their staff to achieve. Inevitably, the loudest message wins. "Healthcare leaders expect their staff to be good at everything, but they also have to provide prioritization," she says"What people hear most is what they're going to focus on. A muddled message can create inconsistencies."

Creating standardized practices to be employed throughout the organization is an inherent advantage. Standardization fosters an environment for adopting practices that can be reviewed and measured, and then employing best practices that are safe and reliable. If all divisions perform consistently over time, the organization will see true results.

Ultimately, reliability is the chassis. "When we talk 'patient safety,' reliability is the means to preventing failures that result in harm," Stockmeier says. "A reliability culture drives results in safety as well as other areas of performance excellence."

How can uniformity be achieved?

The path to uniformity starts at the top. Senior leaders need to explicitly position safety as a critical component within the organization's mission and vision. It should also be seen as the foundation of exceptional patient experience.

"Generally, what patients want is a culture of 'Don't hurt me, heal me and be nice to me,' and in that order," Stockmeier says. "If you fumble at making safety a core value, it destroys everything else. If the organization fails in safety and a patient is harmed, the rest of the patient experience doesn’t matter for that patient."

When mistakes are made, they need to be communicated so that other areas of the hospital can address the questions, “How could that happen here?” and, “How can we prevent that from happening?” But openness to telling these types of stories hasn’t always been encouraged.

"The authority gradient can differ from national culture to national culture; for example, in the Philippines, you do not speak against a male," Clapper says. And in some cases, professional cultures are even stronger than national and regional cultures. "While you know this is work that needs to be done, these barriers can be difficult to overcome. It really boils down to making it okay for people to speak up."

Healthcare executives can employ several practices to create a culture in which talking about mistakes is encouraged rather than avoided. For example, don't use patient or employee names when discussing errors that were made; make sure you've collected all the details to present a complete story; and create a "harm report" that provides a standardized way of talking about these incidents.

Another key strategy to achieve uniformity is to consistently communicate that patient safety is the job of everyone in the organization. This can be achieved by leading by example and developing service standards together. In addition, have a document that all members of the organization can point to that sets behavior expectations and outlines desired processes.

Accountability is also a necessary consideration. Accountability makes performance gaps visible and allows organizations to work to close those gaps and measure the results. It's what you do with those measurements that matters, Stockmeier says. "It takes practice and rigor that we’re not used to in healthcare."

International Hospital Federation   

ACHE President Thomas C. Dolan Named President of International Hospital Federation

ACHE President and CEO Thomas C. Dolan, PhD, FACHE, CAE, was named president of the International Hospital Federation (IHF) in late 2011 and is currently serving a two-year term. He previously served two years as president designate and will subsequently serve two years as immediate past president.

The IHF, a nongovernmental organization, is the global association of healthcare organizations, which includes in particular, but not exclusively, hospital associations and representative bodies and their members and other healthcare-related organizations. As the worldwide body for hospitals and healthcare organizations it develops and maintains a spirit of cooperation and communication among them, with the primary goal of improving the health of society.

The IHF is currently in a period of revitalization, working to have as many countries represented as possible, Dolan says. The organization is seeking both full and associate members. Full membership is open to any association or organizational body deemed representative of the healthcare organizations in a country or region of the world; associate membership is open to healthcare organizations and other institutions having a distinct relationship with the provision of healthcare.

For more information about IHF, visit ihf-fih.org.

ACHE Resources:   

Below are new ACHE resources, such as books, study courses and websites, to help you excel in your career.

International Sessions at ACHE’s 2012 Congress

There’s still time to register for ACHE’s 2012 Congress on Healthcare Leadership, March 19–22 in Chicago. In addition to the ability to network with top healthcare management professionals from around the world, the schedule also includes five sessions geared toward international healthcare:

• Key Elements of International Hospital Partnerships
• Developing Sustainable International Hospital Partnerships
• World-Class Healthcare: Global Innovations in Quality, Safety and Efficiency
• Globalization, Competency Development and Health Management Education
• Starting an International and Commercial Services Division

ACHE is also sponsoring an International Affiliate Reception the evening of Tuesday, March 20, to give international affiliates an opportunity to exchange ideas about what is happening internationally in healthcare.

Visit ache.org/Congress today to learn more, register and make your travel plans.

Additional ACHE Resources

Books:

Healthcare Strategic Planning, Third Edition Alan M. Zuckerman, FACHE, FAAHC Lean Done Right: Achieve and Maintain Reform in Your Healthcare Organization Thomas G. Zidel

List Your Hospital in ACHE’s Directory of U.S. Hospital Partnerships With Foreign Hospitals

The purpose of this directory is to provide a key resource for U.S. hospitals seeking to initiate partnerships with foreign hospitals as well as offer hospitals with an existing partnership the opportunity to be part of the directory.

Learn more and view the directory.

Professional Pointers:   

Common Mistakes Leaders Make and How to Avoid Them

By Joan Lloyd, president, Joan Lloyd & Associates

Here are four common mistakes made by leaders at professional organizations.

1. They are too involved in the technical work instead of leading.
2. They don't collaborate well with other departments.
3. They can't deliver a professional presentation that informs and persuades.
4. They lack "executive presence."

Read the full article here.

This article was originally published Feb. 3, 2011, by Joan Lloyd & Associates, an executive consulting firm.

Networking:   

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