In Part I of the Service Line Management (SLM) series, we recommended the organization of service lines around patients with similar disease states, such as cancer or heart disease, or around patient populations with unique needs, such as women, children, or geriatrics. We also recommended that the service line is designed in a matrix structure to include all departments encountered by the patient during his/her journey of care.
Successful matrix management requires that a service line leader coordinate resources and information flow through multiple departments that may be outside the service line leader’s direct line of authority.
Effective service line leaders should possess the typical business skills of a good manager, but in a matrix organization, political skills are a higher priority, and managerial skills must accommodate the reality of indirect authority.
This article will describe how these key skills should be applied for effective service line leadership.
Creating a Vision for the Service Line
To move people who are used to departmental thinking toward a shared vision of seamless, patient-focused care, the service line leader must develop and clearly articulate a vision for the service line.
But the vision cannot be a personal view, so the service line manager must recruit the leaders of multiple departments to contribute to the elaboration of the service line’s goals and objectives.
The vision should address;
- The population to be served;
- Scope of care and services;
- Desired patient experience;
- How the service line will improve the health of the patient; and,
- How the service line will contribute to reducing the cost of providing excellent patient care.
An excellent vision does not use amorphous terms to describe the end state but provides clarity that enables people to envision something new and distinctive when compared to the status quo. The vision should motivate people to transcend their current experience and engage them in setting goals and objectives that will transform the patient experience.
The scope of care should describe the elements of the patient experience, beginning with the patient points of entry and ending with the termination of care. The description should include the types of care and services required to serve the patient’s needs along the continuum of care.
Gaps in service should be identified, and strategies developed to fill the voids—thus creating a system of comprehensive patient care. A visual model depicting the components of the service line is often helpful to describe the vision and assists the service line leader in gaining support for this new model of care.
Collaboration for Community Care
Today’s service line leaders should have the ability to shift their thinking from traditional hospital-centric care to comprehensive community care. This shift requires the service line manager to look well beyond the walls of the hospital and collaborate not only with physicians, but also with other community healthcare agencies and services—many of which are non-traditional—to reduce the burden of illness and lessen the cost of care for a particular patient population.
For instance, a cardiovascular service line administrator may need to collaborate with local schools and restaurants to offer heart-healthy food options to lower the incidence of heart disease. He/she may also need to join forces with the local nursing homes and other healthcare providers to standardize patient education and teaching materials for congestive heart patients reducing the likelihood of readmission to the hospital.
Additionally, the service line manager will need to engage community resources to provide services that the health system does not provide. For example, some patients may require assistance with meal preparation, a service not usually provided to outpatients by health systems. One method of doing this is to form a “community collaborative,” bringing together representatives from services throughout the community periodically to discuss and plan patient care.
This group’s goal is to align the hospital and community’s resources to capture the synergy of the collective system.
Relationships as the Lifeblood of the Service Line
Collegial relationships must be cultivated to recruit others to achieve the service line’s objectives. The skills of engagement and collaboration are essential in forging these relationships. For instance, close collaboration between the service line leader and other department heads is required to build a budget for the service line. Finance departments typically report revenue and expenses in the department in which they are accrued, so the service line leader must engage the department head and finance department to develop new ways to track the service line’s financial contribution to the organization.
Organize for Trust and Influence
Service line leaders must use informal and formal means of interaction to build trust and influence attitudes. Rounding is an effective informal way to build better relationships. Organize your day to include time to visit individuals, departments, and services—both inside and outside the hospital—that are included in the service line. Rounding increases your visibility, as well as the visibility of the product line, and is an effective way to engage others and build goodwill.
Building relationships with staff and physicians when there is no burning platform is like making, as Steven Covey would describe it, deposits into their “emotional” bank accounts.Positive relationships build trust and confidence in the leader and when if the leader makes a mistake, a “withdrawal” can be taken in the form of tolerance or forgiveness.
Formal communication is also important and occurs in meetings and presentations. Make sure that meetings have agendas that include plenty of time to listen and get feedback, as well as time to engage in discussions with your colleagues about their ideas for improvement of the service line.
Service Line Management: Reduce Costs, Improve Quality and Patient Experience
The service line model is an effective way to organize patient care services to improve the patient’s experience, improve the health of patients, and to reduce the costs of providing excellent care.
However, its success relies heavily on the political skills of the service line manager to develop a vision for the service line, engage community resources, and build relationships to gain support for a new model of managing patient care across the healthcare continuum.
End of Part 2 of Service Line Management.
In the next article, we will provide tips on working with physicians in a service line model.