They have heard, and hopefully understand, how important it now is. They are going to have to change their organizations in major, cataclysmic ways especially if they haven't started to do so already.
Tom Dolan, president and chief executive officer of ACHE, says leadership in general is now "much more knowledgeable" about the steps they have to take. "They know they need to reduce costs. They understand they have to adopt Toyota and Lean manufacturing strategies. They know they have to reduce errors, medication mistakes, reduce readmissions and improve quality measures for specific diseases. "They know they have to dramatically re-engineer the way we provide care and can't tinker the way they have in the past."
Here is what I am not sure of, and I mean this with affection and respect. I am not sure that the current generation of leadership in academic medical centers knows how to do what is summarized above. I actually think that leaders of some community hospitals might be better trained in such matters. Why?
Well, the career path of people chosen to be leaders of academic medical centers tends to be based on success in the things valued in the academic medical environment. As is often the case in universities, people work their way up through the ranks of the faculty based on prowess in research and specialized clinical areas. Sure, as they become division and department chairs, they take some courses in business and management, but their promotions tend to be based more on academic achievement than on managerial and leadership skills. And the continuing education courses often do not include strong training in the kind of process improvement techniques and philosophies mentioned by Mr. Dolan.
There are, of course exceptions. I can think of a handful of people who have made the transition and have demonstrated great leadership in instituting these kinds of approaches in an academic medical center. Gary Kaplan at Virginia Mason in Seattle is the prime example.
But maybe I am wrong. Let's give my readers an invitation to offer the names of others they know in this category. This is your chance to brag! Which people in academic medicine are in the vanguard of the kind of change mentioned by Mr. Dolan?