Allow me to begin by saying that there is hope. Though it may sound cliché, or like an old Van Halen song, the best of both worlds is becoming the norm. When writing job descriptions or envisioning the ideal program leader, inevitably there is merit to having both strength in business and strength in a clinical background.
Times they are a-changing, as the lines blur, opening the doors for a revolutionary new type of leadership, the hybrid model of administrative leader. From the outside, there is a deeply ingrained us-them mentality between hospital administration and providers of stroke care. I listen as my colleagues in medicine vent their frustrations with processes and resources, and as my nursing colleagues blame the C-suite for the ills of the world.
As an administrator, I witnessed, and to be transparent, participated in the painful email chains asking for a dictated note, to enable the hospital to bill for a patient stay. I have thrown my hands up in frustration when neurosurgery shared with dismay that they had no supplies available to place a life-saving EVD, only to find that the supply-chain didn’t know to order more because they were being pulled from the shelves and not charged, essentially disabling the automation.
I have cried in frustration when I was informed of another hospital acquired infection, a fall with injury, or a significant delay in care resulting in harm. As a bedside nurse, I grumbled about the duplicate charting and the impossible nurse/patient ratios. How can they expect me to turn my 6 or 7 patients every two hours, do a complete neuro assessment and chart and round every hour, get them up to ambulate and eat three times a day, bathe them, check their blood glucose, teach them about their diagnoses and risk factors, give them their medications, and keep them safe?
Click on the image below to watch our recent AI Neuroscienes webinar, and hear our esteemed panel of neuroscience partner experts discuss the challenges they face as neuroscience administrators, the clinical and financial benefits they’ve seen since implementing AI at their respective institutions, and what they see as the future of neuroscience and artificial intelligence.
The physician who is performing back-to-back interventional procedures for an acute stroke or an APP who may be writing the note for a third stroke alert or consult of the night should be focused on clinical outcomes and provision of care. However, the implications of delayed, incomplete or vague documentation can impact the ability to bill for or obtain sufficient reimbursement for their efforts. No note means no revenue. In order to have the funds to pay the salaries of providers, hospitals have to collect more than they spend.
Administrators who have experienced the challenges of providing safe and expeditious care can be empathetic with the front line. They are in a unique position to advocate for the resources and processes to optimize both patient care and financial stewardship. For example, making the financial case for budgets to include convenient tools and equipment for dictation, human resources such as scribes or auditors who can screen documentation in real time to allow for augmentation, correction or completion, can maximize revenue capture and provide improved quality of life for physicians and APPs.
Advocating for resources that will expand the benefits of advanced stroke care, such as large vessel occlusion detection software, can assure that the latest in AI can assist with patient selection. Enabling strong decision-making can allow utilization of system resources to maximize patient outcomes and minimize futile care and wasted resources. Consider a case of an air ambulance transport from a spoke hospital to the hub, to find upon arrival that a patient is ineligible for interventional treatment.
The patient could have stayed in her local community close to family where the hospital was perfectly capable of providing the appropriate level of care. Time, money and emotional capital were resources that did not have to be squandered. The educated clinician leader can provide this insight and demonstrate financial stewardship when designing the system of care and allocating the technological resources for their program.
Dare we put on our rose-colored glasses? Have we found Dr. Everything’s Gonna be Alright? In the past, hospitals ran a risk when placing the responsibility of budgets and policies that may impact patient care and disengage providers, in the hands of those who never provided direct patient care. Just as healthcare systems have begun Including education for nursing leadership for new nurse leaders, some have found it essential for hospital administrators to have a clinical orientation. Administrators are shadowing at the bedside, experiencing what their clinical teams encounter in their daily work. It isn’t just about nurses getting into leadership.
More physicians are returning for their MBA or MHA and becoming stroke program medical directors, chief quality and even chief medical officers. Frequently they need these leadership roles or training in business to qualify or be considered for promotion or more tenured faculty appointments such as full professorship. In non-academic health care systems, it is the physician who understands the business of healthcare, including the connection between quality and outcomes, and generating net revenue, who rises to the top of the administrative ladder. Working together, physician and nurse leaders with business acumen are the future, and the future’s so bright, I gotta wear shades!