John R. Sigsbury
President and CEO
Emanuel Medical Center
We are going through some of this right now. The sentiment is that you have to really pull out of the management staff before or during any other cuts you make in the rank and file. A lot of the mistakes that organizations make and the misread they have with culture in their organizations is you have to put everybody on the same plane.
For the cuts, 5% is a great target. The pain you go through in the organization isn't worth anything less than that. In terms of quality care, you have to rely on the people at the bedside. If you haven't engaged them in a conversation and you haven't explained the realities, you are in big trouble. You have to look at the patient types, the complexity of care, and you have to understand what the needs of the caregivers are in providing that bedside support.
You have to make sure that every day on every shift those issues are being covered. Then management that remains has to be very visible with patients. They have to engage patients. And you have to make adjustments as you get feedback from patients.
The magnitude of the cost cutting that we need to do requires us to look at all the relationships in the organization, and our medical staff is a key player in maintaining the standard of care. No cost cutting would be effective without the support of the medical staff.
This article appears in the January/February 2013 issue of HealthLeaders magazine.