Beginning in October, under the Patient Protection and Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) will impose penalties on hospitals with high readmissions for patients with congestive heart failure, myocardial infarction and pneumonia. The penalties, which will recover CMS provider payments, are motivating hospitals across the country to find ways to lower their readmission rates.

If your OR physicians are frustrated and your nurses aren’t speaking up, there is a solution: get them to talk. It’s been said that healthcare is an illustration of the cutting edge of human knowledge. But a problem sweeping the nation’s ORs points to an issue more reminiscent of a high school social drama than a hospital: fear of speaking up. 

How new EMTALA guidelines regarding on-call physicians are giving hospitals greater flexibility to work around shortages. It’s 3 a.m. Do you know where your on-call physicians are? Hospitals are just now beginning to grasp the implications of changes to the Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA) that the Centers for Medicare and Medicaid Services approved in October.

Your employees aren’t performing the way you’d like? Author Steve Kerr says the problem may be your reward systems. Most businesses are replete with undesirable behaviors that stem from disregarding the fundamental principles of organizational reward systems. Figure 1 (page 64) shows some common dysfunctions along with their predictable consequences. 

Are your executives and managers experiencing data overload? A balanced scorecard system may be the answer. The massive amount of data hospitals and large healthcare systems collect continues to mound higher and higher. Many executives have a positive attitude about this—the more data, the more informed their decisions will be, right? Not exactly. 

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