The Power of Delegating

Philip Betbeze, for HealthLeaders Media , April 11, 2014
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This article appears in the April 2014 issue of HealthLeaders magazine.

As healthcare reform takes hold at hospitals and health systems, leaders are recognizing with great clarity that their processes are inefficient, their operations are wasteful, and their labor needs are dramatically different than they were just a few years ago, and as a result of all of this, patient care suffers. Increasingly, so will the bottom line. What's forcing these changes increasingly has the power of money behind it, so margins and balance sheets will be as unhealthy as their patients for organizations that can't change the way they provide care to make it safer, cheaper, and better.

It can be easy to throw money at the problem or even to ignore that it exists, given the deliberate—some might even say plodding—progress healthcare payers are making in the transition of reimbursement incentives. It's difficult to change one without the other. Yet to make steady progress in re-creating healthcare organizations that are more patient-focused, more connected with other modalities of care, and generally more value-oriented, changes need to be implemented now.

"Senior leaders are grappling with moving toward pushing care out of the hospital walls, but there's a real variety in what hospitals are doing," says Carol Geffner, PhD, president of Newpoint Healthcare Advisors, a consultancy with offices across the United States. "The best-in-class hospitals are making great progress in extending the continuum of care."

Much of the challenge comes in determining how quickly to implement these changes. That's largely an operational issue. But empowering change is a wholly different concept. Are top leaders empowering senior leaders and even the rank and file to do what's necessary? The executive leader who can inspire and empower people to want to make the changes that will be necessary to compete may have an easier time engineering the most important transformation most will face in their career.

Averting a crisis

On his first day as the chief financial officer for the three-hospital Citrus Valley Health Partners in Covina, Calif., Roger Sharma walked into a crisis in the making.

"Things were pretty serious," he says of that day in October 2011.

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