Why Hospitals Should Use Financial Management Checklists

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Financial Management Strategies for Hospital and Healthcare Organizations [Tools, Techniques, Checklists and Case Studies]

By Neil H. Baum MD

Dr. BaumIt is fitting that ME-P Editor Dr. David Edward Marcinko MBA CMP™ and his fellow experts, have laid out a plan of action in Financial Management Strategies for Hospital and Healthcare Organizations: Tools, Techniques, Checklists and Case Studies that physicians, nurse-executives, administrators and institutional Chief Executive Officers, Chief Financial Officers, MBAs, lawyers and healthcare accountants can follow to help move healthcare financial fitness forward during these unchartered waters.

In medicine – It all began with Dr. Atul Gawande, a surgeon at Massachusetts General Hospital, who reviewed the airline industry and their use of checklists prior to take off of an airplane.

The history of aviation checklists began in 1934 when Boeing was in the final process of testing a U.S. Army fighter plane with a potential contract of nearly 200 planes riding on the final test of the plane. The test aircraft made a normal taxi and takeoff. It began a smooth climb, but then suddenly stalled. The aircraft turned on one wing and fell, bursting into flames upon impact killing two of the test pilots. The investigation found pilot error as the cause. One of the pilots who was unfamiliar with the aircraft had neglected to release the elevator lock prior to take off. The contract with Boeing was in jeopardy.

Thus, the pilots sat down and put their heads together. What was needed was some way of making sure that everything to prevent crashes was being done; that nothing was overlooked. What resulted was a pilot’s checklist developed before takeoff, during flight, before landing, and after landing. These checklists for the pilot and co-pilot made sure that nothing was forgotten and safety of the planes was insured.

Medical Care and Hospitals

So, what does airline safety have to with medical care and hospitals?

There are so many activities that take place in medicine such as the operating room, that are far too complicated to be left to memory of doctors, nurses, anesthesiologists, and others involved in the surgical care of patients.  Dr. Gawande identified the key components of a surgical procedure which include the name of the patient, the procedure to be performed, the estimated length of the procedure, whether the right or left side is the surgical target, how much blood loss is anticipated, whether antibiotics have been given prior to making the incision, and the anesthetic risk of the patient.  This use of a checklist which takes approximately 30 seconds has not only prevented wrong side surgery but also instills a discipline of higher performance.

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Financial Management Strategies for Hospitals and Healthcare Organizations

Financial Management Strategies for Hospitals and Healthcare Organizations: Tools, Techniques, Checklists and Case Studies

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From the Clinic to the Boardroom

And so, should [can] we port the clinical checklist example of Atul Gawande for use with non-clinical topics like hospital financial management and administration?

Assessment

Yes – We have a challenge and the Financial Management Strategies for Hospital and Healthcare Organizations: Tools, Techniques, Checklists and Case Studies is a step in the direction to make all of the stakeholders in the healthcare arena become sensitive to reducing and controlling costs and at the same time preserve quality of care.

This can be done.  I suggest you start by reading, using and referring to this excellent book.

And so, what is my final advice? Read the Book!

Some of you who will read this book are CXOs COOs, Chief Medical Officers and maybe even COS. (Chiefs of Staff). But, all of you should become CLOs (Chief Life Officers)!  Read this book and the initials CLO will appear after your name!

Note:

Neil H. Baum MD is a Clinical Associate Professor of Urology at the Tulane Medical School, New Orleans, LA. He is also a thought-leader for this ME-P. 

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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8 Responses

  1. Hospitals Lost Jobs Last Month

    In this essay, Dan Diamond says that some old data just got new life, when the Brookings Institution issued a report that compared health care jobs growth versus all other industries.

    http://thehealthcareblog.com/blog/2013/07/06/hospitals-lost-jobs-last-month-should-we-be-surprised/

    Should We Be Surprised?

    Ann Miller RN MHA

    Like

  2. A Financial Management Curriculum for Surgery Residents

    A timely article by Jason Mizell MD & Katherine Berry EdD.

    http://wingofzock.org/2013/07/10/a-financial-management-curriculum-for-surgery-residents/

    Dr. David Edward Marcinko MBA CMP™
    http://www.CertifiedMedicalPlanner.org

    Like

  3. Too all:

    I eagerly anticipate the release of this new textbook; and have just ordered same.

    Sharon

    Like

  4. Picturing a World with No Hospitals

    Dr. Marcinko – Your book is excellent but, imagine a world where hospitals only exist for intensive care, surgery and other procedures? There would be fewer visits to doctors’ offices as well. All monitoring would be done at home.

    http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=8200007622

    Scripps Health’s Eric Topol, M.D., says this future is closer than we think.

    Dr. Chernow

    Like

  5. 9 Survey Findings on Hospital Salaries and Incentives

    1. Roughly 84 percent of hospitals and health systems are increasing salary budgets or are keeping salary increase budgets the same for 2013
    2. Hospitals and health systems have budgeted the highest salary increases for staff-level employees
    3. On average, hospital staff members are expected to see a 2.9 percent salary raise. Middle management and executives are projected to receive 2.8 percent and 2.6 percent, respectively
    4. The main factors affecting salary decisions in 2012 were expected financial performance this year, actual financial performance in 2012 and local salary trends
    5. About 75 percent of hospitals have an incentive plan for their executives
    6. Almost 90 percent of responding organizations with executive incentive plans will pay out awards based on performance in 2012
    7. Roughly 10 percent of executives have incentives tied to physician alignment
    8. The 4 most common criteria for physician alignment awards in executive incentive plans were meeting CMS quality standards, physician adherence to clinical pathways, physician use of EMR & readmissions
    9. About 37 percent of hospitals said they pay float pool registered nurses the same as regular staff RNs

    Notes: Derived from Integrated Healthcare Strategies’ 2013 spring compensation survey, which gathered responses from 177 hospital and health system executives
    Source: Becker’s Hospital Review
    Source URL: http://beckershospitalreview.com/compensation-issues/8-surve

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  6. Is the end near for small community hospitals?

    An essay from colleague Mike Sevilla, MD.

    http://www.kevinmd.com/blog/2013/09/small-community-hospitals.html

    What do you all think? I do not think so; despite the above.

    Dr. Chernow

    Like

  7. Why Aren’t Checklists A Financial Planning Standard?

    As financial planning for clients grows more and more complex, it becomes increasingly difficult for planners to recognize every planning issue, opportunity, and concern from memory alone.

    As a result, there is an rising risk that planners commit malpractice and make a mistake – albeit by accident – in the struggle of trying to apply everything they have learned to an incredibly wide range of client situations.

    http://www.kitces.com/blog/why-arent-checklists-a-financial-planning-standard/

    More by Michael Kitces MSFS, MTAX, CFP®, CLU, ChFC, RHU, REBC, CASL

    Ann Miller RN MHA

    Like

  8. 2013 Hospital Operating Margins

    Systems With Negative Operating Margins Average Operating Margin

    * 2011 12.6% 3.4%
    * 2012 9.5% 3.6%
    * 2013 14.5% 3.1%

    Source: Modern Healthcare

    Like

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