Revamping Your Hospital's Mission Statement

Who am I? Why am I here?

Oh the questions of human existence. They should also be the questions of your hospital's existence. Mission statements can be for the organization as a whole, but also for each part of the organization that feeds into the larger mission. Whether your mission is for the organization or for the med/surg first floor, your mission should have the same characteristics:

1. Missions should be broad in scope but specific in action - You don't want your mission statement to put your organization in a box. "We will treat elderly women who have breast cancer." That may be a great mission for a department, but it doesn't allow innovation and creativity in the services your organization offers.

2. Mission statements aren't meant to change with the newest fad - Mission statements are meant to last the test of time. Your mission statement in the 90's may have been to develop an organization to meet the needs of managed care. However, we have seen managed care decline dramatically, and that would not be an appropriate mission for today.

3. Your mission statement should specifically identify the market that you serve - This is the who, what, when, and where of your statement. Some hospitals may serve a town, some may serve at state, and some may serve a special group (think the VA).

4. Your mission statement should convey the special qualities of your organization - This is about how your differentiate yourself in the marketplace. It helps you to distinguish your hospital from the one in the town 10 miles away. As we talked about in earlier posts, service quality can be a great way to differentiate yourself from your competitor.

Life Without Medicare - Hospitals

Take any business whether it be for profit or tax-exempt and tell them that they are going to lose half of their revenues and they are done. That's what would happen at many acute care hospitals if Medicare were to disappear.

The first thing that would happen is that hundereds of hospitals would likely close. This would take much of the excess capacity out of the system. Hospitals would then be faced with a population that would have to turn to the private sector for insurance.

Unfortunately, insurance companies are not going to be keen to pay for a population that is very likely to have a return on their investment. Therefore, the population is likely to pay for their own care.

In this circumstance hospitals are going to have to have the service of a hospital and the precision of an airline. Hospitals would have to being to provide real value to their patients. That means the feeling of wellness whether real or perceived must be provided to patients to the level of what hospitals are asking to be paid.

Come back for more on the effect of the dissolution of Medicare on hospitals.

Mission Impossible

Everyone has to have a mission statement. At least that is the conventional wisdom that hospital have taken from the for-profit world. I've been looking at many mission statements from various types of institutions and find many of them lacking. In particular, I looked at mission statement for these institutions.

Johns Hopkins Hospital -
To be the world's preeminent health care institution
To provide the highest quality care and service for all people in the prevention, diagnosis and treatment of human illness
To operate cooperatively and interdependently with the faculty of The Johns Hopkins University to support education in the health professions and research and development into causes and treatment of human illness
To be the leading health care institution in the application of discovery
To attract and support physicians and other health care professionals of the highest character and greatest skill
To provide facilities and amenities which promote the highest quality care, afford solace and enhance the surrounding community.

Google - Google's mission is to organize the world's information and make it universally accessible and useful.

Aetna - Aetna is dedicated to helping people achieve health and financial security by providing easy access to safe, cost-effective, high quality health care and protecting their finances agaisnst health related risks.


When I look at these three statements, I think about how useful they are. If I had to rank them they would be Google as the best and Hopkins as the worst. The reason being is that I believe a good mission statement is short, concise, but not vague. As an employee at Google, I would know what to think about to bring value to the organization. At Hopkins, I'm not so sure.

Interestingly enough, I looked up the mission statement of a hospital in Maryland that I knew was having financial and operational difficulties. The mission was no where to be found. This teaches us that short is better than long, direct is better than vauge, but something is obviously better than nothing.

Hospital Beuracracy at it's Worst

One of the many blogs that I read on a daily basis is the Freaknomics Blog by Steven Levitt and Stephen Dubner. I always find their articles to be thought provoking which is the same goal I have with this blog.

Anyways...earlier today they posted an article on military advancement. The article explains that in the military, promotion is awarded based on length of service, not on merit. The result of this being those who are strong performers find other careers out of frustration and the middle or low performers are promoted to the top.

I believe that hospitals in the United States operate in a very similar fashion. As an early careerist, I see that there are many individuals that are put into positions because of their seniority in the organization. Ambitious individuals are forced to move around from hospital to hospital to progress through to the executive level. This has to be a large drain on an organization's performance.

GE is famous for its move up or move out culture, creating a highly competitive workforce of high performers. This is not exactly what I am advocating, but I believe that hospitals need to start to move in this direction. Are hospitals in the United States or even the World thinking about and implementing systems that reward positions based on merit?

The Cuban Clinic Model

I was reading an article in the Miami Herald today on the implementation of Cuban-style clinics for senior citizens. This model is the model all of health care should be implementing and has great growth potential for hospitals.

These clinics involve free exercise classes, free lunches, and access to primary care physicians. Hospitals can integrate this model into their business plan as a means of keeping the community healthy and driving business through primary care physicians.

Place these wellness centers in locations that are convenient to the public such as shopping centers and business parks. Bring people in with these free services and staff a primary care physician or nurse practitioner on site. Finally, negotiate into your managed care contracts a payment for each of these patients that use the facility. The going rate goes about $1,000 per patient according to the Miami Herald.

If you would like to read the full article:
http://www.miamiherald.com/154/story/38715.html

Walter Reed Is Just the Beginning

One seismic shift in the layers of the Earth is the impetus of a tidal wave. That seismic shift has occured at Walter Reed Army Medical Center.

"This is going to be comprehensive; it's going to be vigorous," said Donna Shalala, who is in charge of investigating the care at Walter Reed. The American public is outraged at the conditions soldiers arriving back from Iraq and Afghanistan face in their hospital care. The public holds hospitals to a high standard in quality of their work. However, Walter Reed is having issues with taking care of the families of the poor patients, upkeep of the facility, cutting through bureaucracy to treat patients in a timely and sufficient manner.

They say that hundreds of miles out into the ocean one can't even see a tidal wave forming. The outrage on display now is nothing compared to the outrage to follow. If the Washington Post were to go to any hospital in the United States, what would they find? Would they find the perfectly managed facility that they expect? Hospitals need to prepare themselves to address issues in their facility that they would not want on the front page of their local newspaper.

The tidal wave is just on the horizon, better batten down the hatches.