Marie Sinioris Explains the Goals of the National Center for Healthcare Leadership

Marie E. Sinioris is president and CEO of the National Center for Healthcare Leadership.

Q: What is the National Center for Healthcare Leadership?

Marie Sinioris:
The center conducts research on global best practices and tests new models of leadership excellence. We bring together thought leaders who can help shape our forward-thinking agenda. Our goal is to ensure that high-quality, relevant and accountable leadership will be available to meet the challenges of delivering healthcare in the future.

Q: What is hospital leadership looking for?

MS: Hospital leadership is trying to achieve a more efficient use of resources. They want to get to better outcomes at lower costs. That is, they don't simply want to be more efficient; they want to be more effective. We're going to see some creative ways of doing this. One thing we're going to see is reductions in payments for readmissions. We can borrow tools from other industries to improve efficiency, such as Toyota lean and Six Sigma. We can look at the literature for other industries.

Q: What's an example of a difficult challenge that hospitals face?

MS: Embracing change. When an organization attempts to change it fails 75 percent of the time. It fails to deliver on the expected return on investment. One key reason it fails is that leadership hasn't prepared its culture for change. You must have a clear vision that is transmitted to everyone in the organization. If the culture hasn't embraced the change, it is not going to happen.

Q: How do you prepare a culture to embrace change?

MS: You have to invest in your resources. Your most important resource is your employees, so this means providing training programs. The most effective kind of training is practice-based learning or "action learning." This involved learning on the job. You learn best when you are doing your work. This is more effective than lectures, which engage your cognitive functions but d not help you retain what you learned. The first step is to bring outside experts into the institution and have them "train the trainers." These trainers are in-house people who will pass the knowledge on to others within the institution.

Q: What sort of skills would be taught?

MS: A good example is health information technology. This is a very important piece of training, because HIT can reduce errors. But training is not limited to technical skills. It could also involve interpersonal skills.

Q: What sorts of changes do you see coming in healthcare?

MS: Everyone wants better outcomes, better compliance with pharmaceuticals to reduce hospitalizations and better accountability. This requires collaboration between doctors and hospitals, two groups that are used to functioning separately from each other. They would come together in accountable care organizations in which a hospital or health system works closely with a network of primary care physicians, specialists and others to provide care to a defined patient population.

Q: What will be the forces that bring hospitals and physicians into integrative relationships?

MS: CMS is experimenting with bundled payments, which are given to the hospital and the doctors for the entire episode of illness. CMS pilot projects on bundled payments are already under way. In Massachusetts, a state commission is recommending switching to a system of global payments, under which all caregivers get a set sum of money.

Learn more about National Center for Healthcare Leadership.

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