Guide To Hospital Leadership

By Dr. Arthur Hazlewood

This guidebook covers requirements for current and future hospital leadership with focus on the Dental Department. By means of briefly chronicling the evolution of hospitals dating back from the eighteenth century to their present corporate structure, it provides a context for understanding the role of the dental department in the hospital. The

• Language: English
• Publisher: Stratton Press
• Release date: Mar 5, 2021
• ISBN: 9781648953316

Dr. Arthur Hazlewood

Dr. Arthur I. Hazlewood is currently a management consultant, having held a number of leadership positions in dentistry, health care, international health and substance abuse. He established the New York City Health and Hospitals Corporation, Office of Dental Affairs, served as its Director of Planning and Program Development. He also served as Chair of the Department of Dentistry at Our Lady of Mercy Medical Center, Medical Director at Morrisania NFCC, President and Chair.of the American Association Of Hospital Dentists, President of the National Academies of Practice and Chair of Daytop Village Inc.(substance abuse organization)..

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Preface

This guide—which administrators, directors, potential directors, and staff will find useful—is based on more than forty years of management experience in the health-care sector as Assistant Commissioner of Health (bureau chief), medical director and president of the medical staff, dental director consultant to the local, state, and federal government, and as an executive board member in the private nonprofit sector.

This work is based on findings and information derived from observations and discussions, serving as an accreditation surveyor and more than thirty years as a program reviewer and program developer, manager/administrator, teacher, leader, and chairman in the hospital arena.

My current role as consultant has also provided additional insights. This book contains information emphasizing the leadership role and responsibility as envisaged by the Joint Commission (JC). In the face of increasing corporization of the hospital delivery system, I have included discussion of the concept of leadership, its requirements, tools, and training.

This guide uses a conceptual and strategic approach.

The recommendations are based on established principles, common practice, regulatory requirements, and the changing models of hospital delivery in order to apply to the broadest spectrum of institutions. Recommendations based on the author’s experience are included. The appendices include a limited number of sample documents, but the guide is not intended to serve as a cookbook or operations manual. This edition should be viewed as a primer that provides an overview of leadership responsibilities.

The purpose of the book is to provide the reader with fundamental information required to effectively lead a dental department in a hospital setting. It may also prove useful to anyone interested in the hospital as a location for training and delivery of dental services in the twenty-first century.

The guide is divided into four sections, plus an appendix, a substantial list of resources, and suggested readings.

The first section describes the role of the hospital as an institution. It traces the evolution of the hospital through four major stages dating back to the mid-eighteenth century and bringing it up to the present. Its purpose is to cite the evolution of hospitals from its early beginnings as a refuge to its current stage as a corporate entity. It is intended to provide a context for the discussion and recommendations that follow in the subsequent sections. It briefly describes the changing role of the medical staff over time.

This guide covers the legal structure, organization, and governance of hospitals. It includes descriptions of the administration and selected support services.

In the third section entitled Medical/Dental Staff, a wide variety of topics are discussed. The role and characteristics of effective leadership is explored. The chairman’s role, the processes of leadership, strategic planning, and credentialing are key topics.

Section 4 deals exclusively with the operation of the dental department and its relationships with the medical staff, administration, other departments, recruitment, financial management, and curriculum development.

Acknowledgments

Special thanks is due to Luceita Edwards for her editorial assistance in producing this guide, and to my wife as a willing advisor and patient reviewer. Dr. Neal Herman was a patient listener and aided in sharpening my focus. His review of the Introduction section was especially helpful.

Introduction

This edition of the guide will focus intensively on the necessary components of leadership generally and will provide specific references to hospitals and the health sector. The writer is convinced that the leadership practice in the health and hospital sector is both art and science, requiring knowledge of very specific information and the ability to deploy it appropriately. The volatility of the health-care sector challenges the demands of leadership on a daily basis. Its importance is exemplified by the increased emphasis in the Joint Commission standards. The lack of opportunities for dedicated leadership training available to clinicians constitutes a problem that demands greater participation of clinicians in management, planning, and decision-making.

Hospital leadership groups, the governing body or board, chief executive officer, other C-level management, and the leaders of the medical staff are expected to participate in institutional leadership. They all play a major role in achieving the goals and meeting the standards of the institution.

Organizationally, the systems are becoming less vertical and organization more horizontal and team oriented. The leadership role is important in defining institutional culture, an important factor in meeting standards and achieving goals. As a result, many hospitals and hospital systems are creating specific leadership training programs, which vary in length, scope, and intensity. In its standards (LD.01.07), the Joint Commission recommends that the board, as the governing body, provides leaders with access to information and training in areas where they need additional skills or expertise. Standard LD.01.05.01 addresses a number of key points regarding the role of the medical staff. Two of these points are worth noting as having particular application to the medical staff.

The organized medical staff is self-governing.

The organized medical staff is directly accountable to the governing body.

The framework for the above-listed standards is based on the following assumptions:

Changes in the hospital delivery system require knowledgeable, informed, sophisticated leadership.

There is need for change in leadership roles.

Additional requirements beyond management responsibilities.

There is a difference between leadership and management responsibilities.

The trend toward value-based reimbursement requires a collaborative leadership involving both clinical leadership and administrative staff. A balance is needed to provide high-quality services at lowest cost.

Purpose

This guide is based on the premise that the hospital environment is constantly changing and evolving. It is an increasingly complex environment. Financing health care and the management of hospital budgets continue to be a challenge. Programmatic changes involving new technology are ongoing, as are cost-reducing shifts in programs developed, often in response to changing regulations. Therefore, the role of department chairpersons in hospitals requires individuals who are knowledgeable, efficient, and competent. Department survival may depend on the competence and effectiveness of the department’s leadership. This guide is intended to provide essential information and strategies that will prove useful to both