How CEOs, Managers, and Healthcare Professionals can Join the Revolution: Turning Our Big Fat Mess into Safe, Quality Care!

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LynnTilted2014Author: Lynn McVey, Chief Operating Officer, Meadowlands Hospital, NJ

During a webinar with Beth Boynton, RN from I publicly confessed I was not always a big fan of nurses. That all changed the week I spent several overnights in ICU with my own Dad. I witnessed acts of compassion, kindness and love from nurses that truthfully, I never knew existed. I also witnessed fragmented, broken, divisive care coordination that cannot be fixed “as is”.

In my fantasy, care coordination will be achieved when we collapse the many over-specialized positions we created (EKG tech, aide, transporter, phlebotomist, etc.) and roll them into a 1:1 patient-advocate/nurse ratio for appropriate patients. This “patient advocate” model would mean the patient care is coordinated through only 1 or 2 nurses. This would probably improve care coordination more so than the 28 different staff members who walked into my dad’s room every day. Is it even logistically possible that those 28 caregivers communicate with each other?

What I learned from the feedback I’m receiving, and from groups like Confident Voices, is that there is a small but growing group of healthcare professionals who are passionate about fixing this mess “we” all created. We may be small right now, but we are mighty. We are healthcare leaders who publicly admit this is a big, fat mess that needs work, not talk. We may be in the “slow moving” phase right now but momentum is about to catch on. And when the “right now” day arrives, we will be ready.

I’d like every healthcare manager to get in the game. I’m amazed when managers are unable to articulate what The Affordable Care Act means to our industry. It’s more annoying when managers don’t know the metrics of their own department; even basic, essential metrics like volume or expenses.

I’d like to go to the top and invite every CEO to spend an overnight in ICU to experience the current discombobulated care coordination firsthand. One overnight in ICU will be a compelling lesson for a CEO to become a courageous champion to help propel this forward for all patients.

Lastly, I’d like to ask healthcare professionals to limit their employment to no more than one full-time job. Early in my career, the overtime attracted me above and beyond the need to keep patients safe. One hospital allowed me to work 40 hours straight, so I could attend college Monday through Friday. From 4pm Saturday until 8am Monday, I x-rayed patients in an ER. It was a long time ago and patient safety wasn’t in the headlines but hopefully, those schedules are no longer permitted.

Like I said, “We may be small right now, but we are mighty”.  Join the revolution.  Join the solution. Encourage everyone from CEO to Radiographer to admit this is a big, fat mess and we ALL need to change, for the safety of our patients.

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2 Responses to How CEOs, Managers, and Healthcare Professionals can Join the Revolution: Turning Our Big Fat Mess into Safe, Quality Care!

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  2. Beth_Boynton_RN_MS says:

    Thank you for your post, Lynn! Your honesty is VERY refreshing! I agree, we have a BFM (Big Fat Mess) on our hands and many colleagues in nursing and allied health have expressed frustrations…it feels at times like we are trying to turn a huge ship around in a hurricane! But if we can have honest conversations between the people that provide the care, the people that manage/lead the organizations, the consumers who seek care AND we all agree that the priority is safe care, we WILL succeed. Your suggestions offer some great starting places. I’d like to add a couple of thoughts…CEOs, CNOs, DONs, spend an overnight as Lynn suggests but don’t limit yourself to ICU units, go to your med-surg floors and EDs and LTCF rooms…and please don’t go to find fault with staff, go to find out how you can help and what they need to provide the kind of care you would want for yourself or loved ones. And start conversations with your managers about the ACA. I don’t know enough about it myself b/c I’ve always felt that it fell short in terms of fixing the real financial incentive…and as a nurse I see working FT for health insurance in a job that beats you up emotionally and physically so you can seek help from an industry with a terrible safety record is a big paradox! BUT, I could be wrong and I’d be glad to have a spirited discussion about what’s working, what’s not, what we can do to help, certainly the ACA arose from good intentions!

    And it WAS really good to hear your newly found respect for nurses. I see our work as very important and complex and we need leaders to understand and respect that so you can helps provide safe care and be honest when we can’t. We nurses need to bring concerns forward respectfully too and be willing to delegate, collaborate, and engage with leaders in co-creative problem solving. So much of what Lynn is saying speaks to continuity of care and adequate staffing. These are huge steps!

    In case anyone is interested, CE and recorded webinar will be available through Sept 2015.'s-Undercover-Experience.html

What are your thoughts?