Persistence and Communications: Keys to Successful Financial Turnarounds

Updated on April 22, 2016

Jim-Surman-228x300By Jim Surman

Calvin Coolidge once said:

“Persistence: Nothing in this world can take the place of persistence.

Talent will not; nothing is more common than unsuccessful people with talent.

Genius will not; unrewarded genius is almost a proverb.

Education will not; the world is full of educated derelicts.

Persistence and determination alone are omnipotent.”

So you want to turn around your hospital’s bottom line?

It’s almost a cliché: Make the commitment and persist by making it happen. But how do we really do that? By building an approach that helps your organization achieve alignment and process improvement for profitability, growth, and competitiveness.

Measurement: The First Step

Measurement is the starting point to changing culture for success.  Today more than ever before, managing a hospital is not just about caring for your patients; it is also about running a successful business so that you can provide quality care for your patients. Without the persistence to change and succeed, quality of service will ultimately suffer, and then what follows is financial failure. To thrive is to make informed decisions, but this is the greatest challenge. After all, as the saying goes, “You don’t know what you don’t know.” Without measuring relevant operational indicators, you might find yourself relying on educated guesswork.

Thankfully, there is an alternative to guessing: Benchmarking – a strategic management tool that helps evaluate effectiveness and fosters goal-setting. For benchmarking to be effective, however, it can’t just be about measuring – it also must involve an active commitment to goal-setting. Being able to set realistic goals, the proper tools are needed to evaluate: How efficient your hospital is currently, how much you have improved over time (compared to your own past data) and how much you have improved, compared to peer data.

It is one thing to know what you should be doing and quite another to implement it. Many times we hear form clients, “we haven’t enough time to benchmark with this level of detail.” There is one straightforward solution to this problem: automate your practice. The right practice management software will not only make benchmarking much easier (running reports takes seconds rather than hours), but it will also enable you to streamline your workflow and maximize your revenue so that the goals that you’ve set become much more attainable. Generally, the cost of automating your practice is quickly recouped.

The second step and probably the most important…

Communications: A Key to Making Change Happen

“Hmmmmm. I know you think you understand what you thought I said, but Im not sure that what you heard is what I actually meant.”

The words are the same, but in reality, they mean different things to different people. * When the finance department reports patient days, the nursing department sees a different number. Finance counts midnight census while nursing counts census each shift and divides by three, and nursing also counts overnight stays. * Or when home health count visits, do they count the first visit as two visits (most clients do count them as two)?  * Or when Dietary counts equivalent meals using the accepted HFMA method, do they follow the formula by adjusting the factor each time prices are changed, typically we find the do not make that change. * Or many times managers don’t know what is being counted in the charge master or general ledger for measuring performance in their departments, since every department in the hospital has a Key Volume Indicator (KVI) for performance measurement, which if not defined and communicated properly can result in decisions that negatively impact performance, quality and the bottom line.

Definition of terms and documenting these KVIs and communicating them to all management levels is absolutely necessary for planning and setting performance targets. Communication, written and verbal, is paramount to a well-run hospital, because when the CEO or COO has their weekly management meeting, everyone is “on-the-same-page.”

The words are the same, but the meanings many times are different.

The CEO that makes the commitment to change and persists in the implementation, have made the difference: DuBois Regional Medical Center, Indiana Regional Medical Center, Titusville Hospital, and Ellwood City Hospital, are some of our clients that follow that formula for success.

In my 38 years of management consulting with Blue Cross of W. PA., Coopers & Lybrand (PWC), and in my own business Resource Productivity Institute, Inc., in every case when hospitals make a dynamic financial turnaround, the hospital CEO has made the commitment to persist in maintaining and implementing culture change. They do not delegate the responsibility of changing the management culture of the organization to someone else in the management team.  Total commitment and persistence by the CEO make the difference.

Jim Surman, a certified management consultant for 40 years, is chief executive officer of RPI, Inc. At RPI, all staff is certified management consultants and/or hold master’s degrees, and have a minimum of five years of successful healthcare management experience. For more information, e-mail [email protected] or visit

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