Quo Vadis Opinions

Standard medical training does not develop an understanding of  management skills.  Dr Cornelius Cronin shows this when he wrote to the newspapers on Saturday.

Dr Cronin complains Mallow general hospital budget has been cut by  over half a million euro under the casemix system.

The casemix system has been around since 1993 in various forms.  It is an attempt by the HSE to reward efficient hospitals and penalise inefficient hospitals.  It’s based on

• the number of  patients treated
• the complexity of treatments
• how much it cost to treat them

It bands hospitals, so a small county hospital like Mallow is not compared to say the Mater but to other county hospitals. The system is not perfect but at least it’s on the right track of ensuring more money is directed to hospitals who treat more patients more efficiently.

Dr Cronin claims because the hospital does not have  a budget for  the clerical resource to prepare  HSE casemix paperwork, it’s unfair to cut the budget.

But the hospital does have a general manager, whose role is to manage, which includes helping to manage budgets presumably. Managing generally includes planning, organising and getting results. So why is there no focus on results, that is making sure the hospital gets its budget? 

So why, knowing they were likely to lose money was not enough action taken?

Mallow hospital claim to be very efficient and they have good ratings on rate my hospital so they might even have obtained extra money, if they had submitted their paperwork on time

I’m no fan of the HSE  (see here) but this appears to be an example of

“poor us , we’re victims of the big bad HSE and we’re helpless to do anything.”

Obviously the ban on HSE recruitment means they can’t employ additional staff but there’s other options which effective managers would have taken.

I’m not familiar with the paperwork required but  here’s some tips for Mallow hospital on how they can get that pesky but all  important paperwork in on time- without employing extra people.

1. Talk to the heads of the different departments to explain the problem and get agreement on the easiest and most efficient way to compile this paperwork. For example theatre operating lists could be stamped with one of those sequential  numbering stamps that are available from just €30 each. (Mallow have just 75 beds, so volume of operations are not huge)

2. Have a meeting with unions and staff representatives from all departments, explain the problem, show the paper work required and look for helpful ideas. With the right approach, there’ll be plenty of ideas as there are many talented and experienced staff in the HSE.

3. See whether computerising the paperwork would save time & effort- a local firm might help free gratis with this in return for some publicity

4. Energetic transition year students are always  looking for work experience and maybe they can help. (Make sure they sign a confidentiality agreement and get proper training)

5. Mallow have a relationship with University  College Cork, so ask for some help there.

6. Ask the existing clerical staff whether all the work they do is essential or could be done in a different way so possibly freeing up their time to do the returns.

7. See if anybody from the local community is interested, be it from a formal back to work scheme or informal volunteers or somebody from  “The Friends of Mallow Hospital Committee”

8. Track casemix for certain representative  days only  and then estimate the remaining days. (It’s called sampling, a well known technique)

9. As a last resort pay an outside agency to do the paperwork.

10. As a very last resort, get a management consultant in to examine what’s going on and recommend a low cost solution.

In  every situation there’s always alternatives if you look for them. Whether it’s doing what appears to be an impossible task as in Mallow, or if you’re being bullied, unfairly denied promotion or feel you’ll never get another job that pays as well or simply can’t manage your job.  Always look for alternative options. That’s what successful management and career development is about.    

Edward De Bono’s 6 thinking hats approach can be useful here in helping to generate ideas.

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Tags: De Bono, HSE, mallow hospital, management skills, options

This entry was posted on Tuesday, January 22nd, 2008 at 6:59 pm and is filed under Skills. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.