Micromanagement is actually counter productive if you take the time to analyze how much time you have put into a process and what you have achieved by doing that. The only way forward is to try to see the big picture and not to get involved to detailed personally. I realize: easier said than done. But, a way to start a new leading role (or leaders role) is to pick just 1 or 2 problems and to create a small team of people you trust and like to work with. They should, of course, remotely be part of the proces you want to change. A sense of urgency needs to be created (creating responsibility to solve it for the members of this small group at the same time) among this team first and a few (common) goals must be set. Make sure someone takes notes, so no doubt is created on who should do what. Have regular meetings to discuss progress and make a “to do list” that can be analyzed at each meeting. Start small, make it bigger if the first small “wins” are achieved.
Thanks for sharing this: a very common and frustrating process for all involved. Yes, we do have bed managers who are quite well informed about the status of free beds all over the hospital. We have grown to a more flexible system where departments have the right on a certain amount of beds, but this is calculated on a monthly or 3-monthly basis. So, at the end of the period, you should have the amount of beds agreed on, but not on a day-to day basis. Keeping beds empty for elective cases the next day is kind of acceptable but should be transparant as many will keep their beds reserved as it’s just easier for the staff at night. Furthermore, the reason why patients get discharged at such a late hour should be examined as clearly, this is a logistical problem.Departments should get incentives to discharge patients as quickly as safely possible and for discharging patients before, say, 9 am. Should be do-able, I’d say.
Can primary care hospitals get an incentive to accept appropriate patients better?
This is a more often seen problem that comes with a system that works with mostly individual medical specialists in a financially competitive environment where there’s no accepted leadership. From the outside, this is a clearly unacceptable system where quality clearly is not on the top of everybody’s list, unfortunately. Having said this, I realize this is a very common system that’s basically unbeatable unless a clear hierarchy comes in place. To be honest, I guess this problem is unsolvable for you in it’s current form as “your CEO” has left, and proceeding will get you a lot of extra enemies without a reasonable chance of succeeding. If possible, it’s probably better to get back into practice and set other goals for yourself, or find a similar job within a more hierarchic system. Sorry to be so negative, really don’t think you’ll find satisfaction in this way.
Incredible organization! I guess sharing “wins” is key to this transforming process. Make sure truly great achievements are being noted by the staff as well as the customers. This can be done through advertising, local TV commercials, small newspaper like reports etc. People have to notice that real change can be made by individuals. I’m sure it already happens, I guess just nobody notices it as it’s not communicated.
Yes, this is a very well known and problematic issue. The fixed salary model is a killer for initiative and creates very lazy people, unfortunately. I agree that a basic, fair salary per day would be a good start that can be higher if well defined goals are met, incl patient satisfaction, innovative treatments and work done for the whole group instead of only for yourself (like advertising, giving talks to generate more patients etc) I guess it would be fair to have a minimum as well as a maximum salary in order to try to prevent too much difference between the physicians.