The Persona: Hospital Executive – CMO

cmoPosition: CMO – Community Hospital, Not-For-Profit

Location: United States of America

My Background and Role

I am a mid-career psychiatrist who has recently joined a medium-sized community hospital that has affiliations with a large academic- health system.

My Focus, What Is of Value to Me, and How I Am Evaluated

My work is highly mission driven. All of the things that the hospital does, and the reasons that it operates, is to achieve the mission of treating patients. Doing good is a “threshold test” – if any new initiative or intervention is to be even considered, it must meet the “doing good” requirement … or meet the mission. I strive to create working relationships between physicians and hospital administrators that are beneficial to both.

The Decision Maker: Hospital Chief Medical Officer (CMO)

The Chief Medical Officer has a major responsibility for driving a culture of safety and quality of medical services provided by (Insert Hospital name) Medical Staffs. This includes taking a leadership role, in partnership with other executives from the executive leadership, in the development and implementation of strategies which will result in continuous improvement in clinical safety, quality, and value provided by the medical staffs. The CMO takes the lead in developing relationships and partnerships with members of the medical staffs which allow (Insert Hospital name) to implement strategies consistent with a changing healthcare environment. The position is a key link among Board, management and medical staff.

While the Hospital must meet the mission, it must also be financially stable. Whether for profit or non-profit, without money there is no mission. The CMO has the need to make sure costs for procedures are controlled. This can be achieved by reducing costs to ensure that waste in processes and organization are minimal. Secondly identifying the best strategies to achieve the same or preferably better outcomes with more efficient use of resources.

Staff are the most costly and important resource in the organization. Staff are the most costly and important resource in the organization. It is ideal if the CMO can reduce the amount of staff turnover and ensure that new staff have the proper institution culture and are able to work with existing staff. Staff turnover is one of the most expensive costs to an institution.

It is ideal if the CEO can reduce the amount of time taken away from the workplace and improve the quality of care at the same time. Training close to the patient has many advantages, including providing a stronger context for learning, teams using the equipment they have available, working with other members of their unit and interfacing units, and (most importantly) reduced time away from work.

The hospital wants to maximize the referrals from local physicians. Improving communications with the referring physicians coordinating a well-planned and properly executed treatment plan for their patients

Typical value domains of those who function in the role of CMO are:

  • Financial
  • Compliance
  • Risk Management
  • Quality of Care

The CEO has been very specific that I am measured by the following (and this is what I therefore value highly):

  • Financial – It goes without saying that we are in the business of healthcare – that is our mission. But, the CEO has set clear goals:
    • Cost management – which can be a big issue for the organization, when it has such small margins; and
    • Efficiency – we are always looking for ways to improve the efficiency of the operation – for example, with better workflows or technology. We have KPIs that are related to efficiency.
  • Compliance – ensuring that we can continue to meet our obligations to the regulatory authorities.
    • Institutional Compliance – We need to make sure that we meet all of the Joint Commission requirements for the facilities; and
    • Individual Compliance – We need to ensure that the employees are qualified to do their job.
  • Risk Management – this is related to rates of litigation, and the claims that get paid every year. It is a simple economic measure – reduced risks = reducing claims and costs. We need to ensure we:
    • Monitor errors – to understand the problems;
    • Identify root causes – to identify the fixes that should be made;
    • Implement interventions – to reduce errors and reduce cost.

We start with those errors that have the highest cost rate.

  • Quality of Care – this is quality as it is seen by the patient. Every patient that stays overnight at the institution needs to complete a quality of care survey. This affects our marketability, and we need to ensure that quality is high so that we stay marketable.

Strategic Approach/Messaging

  • Use your knowledge of the Hospital Simulation Center Director and the institution to customize your message and select the metrics that indicate how the resources needed for the project will be offset by its benefits/outcomes.
  • Review the case-based scenarios on the website [insert link] to identify one or more that is similar to yours. Customize and use it as a successful example.
  • Use the tool [insert link] to select the value domains that you believe are a match for those of the Hospital Simulation Center Director and rank order them. The tool will generate a list of messages that match each domain with suggested measurement metrics and related articles that support the message and metrics.
  • Begin with how your proposal aligns with the institution mission and strategic goals to ensure that you couch all your plans within their language with metrics that link back to the strategic plan.
  • Focus on improved outcomes related to: teamwork, communication, and collaboration that lead to quick wins for your stakeholders.
  • Also focus on shared educational goals across professions and how simulation allows for improved teamwork and communication while also reducing duplication of effort across departments and divisions.
  • If the CMO is not familiar with the benefits of simulation, integrate relevant advantages of simulation into your proposal. Consider selecting some seminal articles from the resource list [insert link] and providing copies as supplemental material.
  • If you intend to apply for grant funds to support all or part of your proposal, include information about the grant, and include the time and resources you will need to prepare it.
  • Collaborate with the Hospital Nurse Education Director to design the comprehensive simulation-based, Interprofessional Education Training Program.

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