1. Hader, Richard RN, CNA, CHE, CPHQ, PhD, FAAN, Editor-in-Chief

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Can you easily find a parking space at your organization? If you can park your vehicle without difficulty, chances are your hospital's financial performance isn't what it should be. A goal as healthcare leaders is to constantly make sure that constructing parking garages to accommodate consumer growth remains a key strategic objective when developing a facility's master space plan. Yet, merely maintaining current services without profitable growth is a prescription for organizational economic dissent, which may lead to business paralysis and ultimate failure. We must be active partners with our peers to ensure perpetual growth by developing business strategies that'll yield a positive revenue stream at minimal cost.

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Inpatient acute care services are the fiscal driving force for many healthcare organizations. Reimbursement changes in federal, commercial, and managed care payers have crippled institutions across the country, resulting in the closure of hospitals and thwarted access to needed services. Most disturbingly, these changes have created a downward spiral of consumer confidence in the healthcare system. Technologic advances in medical care that allow patients to receive diagnostic and therapeutic interventions outside of the hospital setting-and physician entrepreneurs who are establishing businesses that directly compete with local hospitals for outpatient services-have forced hospital leaders to reexamine current strategies, enhance their services, and actively seek methods to improve profitability.


Critically evaluating medical management and clinical effectiveness of interventions is the first step to ensuring financial success. Is the care appropriate, cost effective, efficient, and consumer focused? Are your purchasing practices for supplies, equipment, and implants competitive with the market? Are you working with physicians to ensure costs per stay are similar to those of other practitioners with patients who have the same or similar medical acuity? All of these questions need to be systematically answered by conducting a gap analysis. If problems are identified, it'll be necessary to rapidly deploy performance improvement teams to remedy financial and quality issues.


Benchmarking your organization's fiscal performance against like-minded institutions in similar geographic areas provides a vehicle to compare your productivity against others. Seek assistance from other organizations that have been successful in reducing costs while simultaneously enhancing quality. Keep an open mind by strategically evaluating creative ideas you might have otherwise not considered. Form business affiliations with competitors, and merge clinical resources and management talent. These strategies will benefit your organization, as the success of a new product or service will likely yield profits that can create a win-win situation for all.


Branding a culture of service and quality excellence is paramount in an era where your customers can review publicly reported data on both service and quality performance. Instilling an expectation of excellence among all team members with each patient interaction will enhance the public's image of your facility and promote a loyal customer. Be creative, know your patients, identify the strategy, and execute!! Remember, it's always more profitable to hire valets than to get a parking space at the front door.


Richard Hader


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