University Health Systems of Eastern Carolina Board of Directors
Displaying a keen sense of vision of vision as well as an occasional sense of humor, Chairman David Brody prepared these remarks for the inaugural meeting of the University Health Systems of Eastern Carolina board of directors Feb. 16. This and other articles may be found in the University Archives.
Citation for this article is: "Brody Outlines 'Focus Four' to Lead Health System in '99," UHS People, Vol. 8 No. 2, March 1999, page 10.
Since this is the first meeting of the University Health Systems board of directors, I hope you will indulge me for a few "tone setting" remarks.
The normal tendency in life is to resist change rather than lead it. Leading change can be uncomfortable, difficult and risky, particularly in a chaotic environment like health care. But if institutions resist change, then pressures build. When they finally break, your instituion is in danger of being swept away. This idea is known as the "dam effect."
Clearly in the last year we have taken steps to lead change. These steps have now created what I call dynamic tension -- the stress and challenge of charting a new path.But that tension is far more preferable than clinging to the imagined safety of the status quo and having the dam break and destroy everything you've worked for.
The challenge for us now is to come to the UHS board prepared to manage all that we have undertaken. Above all, we must be able to focus strategically -- not just on the road at our feet but far down the road as well.
With this in mind, . . . I would like to offer a few thoughts on what I call guilding themes -- broader concepts that serve as the context for the goals and strategies. Although shorter than my normal top ten, you might remember them as my "focus four":
It's the patient, stupid!
Like the 1992 Clinton campaign strategy that kept the voters focused on the economy, we should never lose focus on quality patient care.So long as patients and doctors have confidence in the quality of our care -- and this board's commitment to quality care -- then our hospitals will remain full and able to attract the best physicians.
In the world today, whether you are runing a fast food resaurant, retail store, bank, or a hospital, the enterprise that delivers the best quality will win. I remember back in the 1980's when Ford developed its slogan, "Quality is Job 1." Ford backed up that claim on the assembly line and immediately took eight points of market share from General Motors.
To make sure that we are meeting our customers' expectations of quality, we need to pay careful attention to our patient satisfaction surveys and perhaps have some form of physician satisfaction surveys, not just from our local community and medical school physicians but from the region as well.
Rising to a new level of core competency
We have proved we can run a large medical center with the best of them. But we have not proved we can run a system, and we are now a system.
Most health systems recently formed in the country have not fulfilled their vision of cost savings. We must not only save money, we must also seize the opportunity to realize our vision of higher quality and more efficient health care throughout the system. By more efficeint we do not mean fewer resources; we mean better use of resources. Having what is needed, where it is needed, when it is needed.
Setting Priorities
There seems to be no end to opportunities or projects. Sometimes it seems like every chief of service, physician or adminstrator has an endless list of projects, some of them very expensive. In reality there are far many more worthy projects than we can ever begin to fund. It is incumbent on us to become more focused, more disciplined and yet flexible in setting priorities.
The public and others tend to look at our reserves and profits and say we can afford to do anything and everything. They are wrong.An enterprise of this size and scale needs large cash flows to fund its growth, its opportunities and its maintenance, as well as large reserves to cushion potential bad times. For when the economic tide turns against an organization of our size, money can flow out just as quickly as it came in.
In the dictionary the word economics is defined as the efficient allocation of scarce resources. When you see Jack Holsten's projections on capital spending, I hope you remember these words.
As Dave (McRae) has said on many occasions, "No margin, no mission." We shall now refer to that as the "M&M Principle."
My last theme is, "Trust is earned, not given."
The last year was very destructive to our public image. The naysayers eroded an enormous amount of trust in the Institution. Damage was done in the region, with our employees and in the community.
The damage is not irreparable.And fortunately, we have an enormous reservoir of good will built by our history of service to sustain us. However, this reservoir must be replenished.We must go forth and rededicate ourselves to quality, fairness and service so that no one can ever dare to question our values again.If we reach out to our doctors and our employees, if we are truly focused on the needs of our patients and the health of our community and region, we can work wonders.
