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Engaging the C-Suite:Leading from the BasementJune 8, 2015 | 10:00 a.m.-11:00 a.m.
Valdez Bravo
Health Systems Specialist
VA Portland Health Care System
© 2015 Association for the Advancement of Medical Instrumentation www.aami.org 1
ENGAGING THE C-SUITELEADING FROM THE BASEMENT
Valdez BravoJune 8th, 2015
Welcome
Disclaimer: The views expressed in this presentation are those of the author and do not reflect the official policy or position of the U.S. Government, the Department of Veterans Affairs, or
the Association for the Advancement of Medical Instrumentation.
About me
• US Army Medical Equipment Repairer (95-03)• Oregon Health & Science University (03-04)• VA Portland Health Care System (04-Present)• Portland Community College (04-06)• Portland State University (06-09)• Army-Baylor Graduate Program in Health and
Business Administration (13-15)
About VAPORHCS
• Built in 1987, 277-bed facility, 12 sites of care across 2 states, 26 counties, 33k square mile area
• Fastest Growing 1A Facility in VHA, serving over 91,000 unique Veterans
• #11 in VHA Research programs ($34M)• Kidney/Liver Transplant programs• Mental health programs with emphasis on PTSD, TBI• Battling homelessness in Oregon and Washington
C-Suite:“A widely-used slang term used to collectively refer to a corporation's most important senior executives. C-Suite gets its name because top senior executives' titles tend to start with the letter C, for chief, as in chief executive officer, chief operating officer and chief information officer.” - InvestopediaSource: http://www.investopedia.com/terms/c/c-suite.asp
Shocking, but true …
QuestionWhy is there a disconnect between clinical engineering and the C-Suite?
• Understanding the Problem1
• Propose a System of Engagement2
• Discuss Possible Outcomes3
Today’s Overview
Engaging the C-Suite
• Healthcare organizations tend to undervalue clinical engineering departments
• This disconnect is the result of a lack of understanding and communication
• It is the duty of clinical engineering to engage the healthcare system at all levels
• There are four levels of engagement• Healthcare systems that fail to engage clinical
engineering have missed opportunities
Driving the Cost of Healthcare“Technological innovations have been the single most important factor in medical cost inflation over the second half of the 20th Century. They have accounted for about one-half of the total rise in real…healthcare spending during the past several decades.”
Delivering Health Care in AmericaShi & Singh, 2012
Healthcare Technology Management is perhaps one of the only in-house departments that can
mitigate some of the forces driving medical inflation rates.
Contextual Factors Driving Cost
• “The Technological Imperative”
• Market Differentiation
• Physician Preference Items
• Lack of Planning
But Why Is There a Disconnect?
Causes for Disconnect
• The Technological Divide
• Administrator Education
• The Publishing Problem
• Humility vs. Self-Promotion
The Technological DivideMany Folks Just Don’t Know Exactly What All We Do
• Relatively new career• Rise to prominence in the 1970s• A fairly small field• Success means not being called
Administrator EducationWhat are healthcare administrators learning in school?
• Healthcare Delivery• Finance• Economics• Project Management• Healthcare IT
• Not Medical Equipment Management• Not the Role of Clinical Engineering• Not Capital Equipment Replacement Strategies• Not the Benefits of an Engaged Clinical Engineering Department
The Publishing ProblemWhat Clinical Engineers Read (and Publish In):Journal for Clinical EngineeringBiomedical Instrumentation & TechnologyIEEE24x7 Magazine
What Healthcare Administrators Read:Journal for Healthcare ManagementJournal of Healthcare FinanceHealth AffairsHealthcare Executive
Clinical Engineers
Clinical Engineering
Journals
Read By
Healthcare Administrators ✖
Health administrators know a lot about lithotripters!
Humility vs. Self-Promotion
• Biomedical professionals tend to be humble
• Mechanisms to market ourselves not readily available in many systems
• Minimizing downtime is goal; crisis = failure
• When we are elevated in the conversation, it may be to explain a crisis
• Behind the scenes standard of success; “No news is good news.”
• Perpetuates the lack of understanding• National Biomedical Appreciation Week
is an opportunity that we all have
I Saved Our Hospital $168,000 Last Year!
Engaging the C-Suite
Time Spent Demonstrating Results
Leve
l of C
omm
unic
ation
Reporting
Working Toward Engagement
Advocating
Partnering
Leading
QUESTIONHow Well Do You and Your C-Suite know each other?
The C-Suite• Do you know the names of
everyone in your C-Suite?
• What are the goals and objectives
of your C-Suite?
• What are your CFO’s concerns?
• What are your hospital’s capital
priorities this fiscal year?
• When did you last meet with the
Chief Information Officer or IT staff?
Adapted from a slide by John-Paul Guimond, 2013
What is the C-Suite’s Perception of Clinical Engineering?• Is your department viewed as a break/fix service? If
so, you are a commodity that can be outsourced.
• “Located somewhere in the basement …”
• “Biomeds fix general equipment but not the really
high-tech stuff”
• “Clinical engineering guys aren’t financially savvy…”
• “They work hard but they don’t communicate.”
• “I have no idea what those people do.”
Adapted from a slide by John-Paul Guimond, 2013
Level 1: ReportingWe all have to report. But how do you do it?• Synthesize data for executive level staff
• Dashboards, Key Performance Indicators (KPIs)
• Avoid using too much jargon; clarify and explain data• Use professional terminology to refer to your department, staff,
and roles
What do you report?• Go beyond the standard metrics• Illustrate cost-savings, utilization, and impact• Align your data with organizational mission, goals, and strategic
objectives• Utilize benchmarks if managing multiple sites• Health device hazards and manufacturer recalls• Customer satisfaction survey results
Level 1: Reporting
Adapted from a slide by John-Paul Guimond, 2013
Level 2: AdvocatingAdvocating is different than whining• Tell your story• Ensure higher-ups are aware of your
situational reality• Illustrate needs and projected
Return on Investment (ROI)• Cost-Benefit Analysis• Highlight savings
• Sell the “WIIFM”• Be persistent yet tactful
Level 3: PartneringEnsure you have a seat at the table• What committees are you on?• Does the C-Suite / organizational leadership
check-in with you before making a move?• Is Clinical Engineering on everyone’s radar?• Do you have equal say in capital equipment
planning, technology assessments, contract decisions, and hospital projects?
Level 4: Leading“What dreams may come.”What if:• Clinical engineering drove change
instead of facilitated it?• Healthcare Technology
Management was effectively used to formulate strategy?
• Clinical Engineering helmed healthcare IT?
• Clinical Engineering was at the C-Suite Level?
Perfect World!
This could be a new reality for Clinical Engineering in the 21st Century. However, it will be up to clinical engineering departments to affect the change.
Possible Outcomes
Does Your Department Actively:• Perform healthcare technology assessments?
• Assist, or lead, capital equipment planning?
• Illustrate the “true” cost of ownership when making
recommendations?
• Lead Systems Integration efforts?
• Partner in project planning? Strategic planning?
• Play a role in your Patient Safety program?
• Manage your own contracts?
• Align with C-Suite goals and objectives?
• Use C-Suite lingo when communicating upwards?
IMPLICATIONS OF MISSED OPPORTUNITIES
ImplicationsMinimized ROI• Poor health technology assessments (HTA)• Premature Asset Replacement• Misguided or Incomplete Buys• Failure to include facility engineering in
purchase decisions, resulting in devices and systems that cannot be installed
• Failure to realize full integration possibilities with existing IT infrastructure
• Failure to achieve optimized performance of medical devices and systems
Minimized Resourcing
• Less likely to get the bodies you need• Less likely to get the schools you need• May not get the equipment you need
AVOIDING MISSED OPPORTUNITIES
Avoiding Missed OpportunitiesStrategies for Individuals• Document, document, document
• For the C-Suite, metrics are everything• Communicate significant savings to your team lead
or manager• Lifelong learning; Continuing education
• Formal (Clinical, technical, IT)• Informal (Magazines, Websites, Blogs)
• Involvement in professional societies • (OBA, WSBA, AAMI)
• Professionalism• Appearance• Communication• Product
Avoiding Missed OpportunitiesStrategies for CE Departments• Market your department!
• Department Photos• Engaging Intranet Site• National Biomed Week• Newsletters• Apparel / Uniforms
• Hire managers with diverse skillsets• Communicate savings and other
accomplishments to the C-Suite• Plug your department into everything; earn a
seat at the table• Visit clinical departments, walk the Gemba• Proactively advise customers on capital
equipment requests at start of FY• Consider hiring a consultant to offer an
objective view of operations
Avoiding Missed Opportunities
What is your reporting structure?• Hospitals are large, hierarchical systems• Communication is always a challenge• Where you are at in the food chain matters• Decision-making can be heavily influenced by which
department you report to• What is the ideal?
HTM departments reporting through logistics?Through facilities?Through IT?Through nursing?Directly to the C-Suite?
Avoiding Missed OpportunitiesStrategies for the Field• AAMI’s I AM HTM Campaign
• Resources geared towards diverse audiences
• AAMI Presentation in 2013 by John-Paul Guimond• C-Suite Driven Clinical Engineering Operations
• Field should publish How-To Guides for clinical engineering managers; evidence-based technology management?
• Publish in journals/magazines that healthcare administrators read
• Foster professional societies
John-Paul GuimondJPG Consulting LLC
Overcoming Resistance• “We don’t have time to do these things. We’re
supposed to be fixing equipment.”• “I don’t want to be stuck at meetings all day. I’m a
biomed.”• “Would be nice but nobody listens.”• “I like being out of sight, out of mind.”
Departments that perform well, share their successes, educate their system about the breadth of their knowledge and services, and who get involved with decision-making, will have a greater impact on their organization and their own well-being.
Case Study
• Manager A– Reports PM data/repair stats monthly– Avoids hospital boards, meetings; – Rarely leaves office– Minimal presence outside of biomed
realm
Manager A
Case Study
• Manager B– Reports PM, repair data monthly– Maintains budget dashboard – Plugged into hospital boards/committees– Publishes a department newsletter– Is well known throughout hospital and
takes the time to talk to staff members, both inside and outside of the department
– Maintains clear lines of communication with C-Suite and other stakeholders
Manager B
Discussion
• Who will be more effective in managing their healthcare system’s technology?
Manager A or B?• Who will be better staffed/resourced?• Who adds more value to their system?• Who will be more likely to react to the
changing needs of today’s healthcare environment?
Summary
• The Disconnect Persists Today– No immediate solutions to the technological divide,
publication problem, and lack of education• We must advocate and educate from our own
individual foxhole– Each department has a responsibility to itself and to their
stakeholders to add value to their system• The Future is What We Make It
– Nobody will lead this change for us– The people in this room need to do it here in Washington
State
Resources
• AAMI’s I AM HTM Campaignhttp://www.aami.org/IamHTM/index.html
• Bravo, V. Engaging the C-Suite. 24x7 Magazine. December 19, 2014.
• Guimond, J.P., (2013, June). C-Suite Driven Clinical Engineering Operations. Symposium conducted at the annual AAMI conference in Long Beach, California.
• Shi, L., & Singh, D. A. (2012). Delivering health care in America. Jones & Bartlett Publishers.
