How do you effectively manage a healthcare facility?

Effective Healthcare Facility Management

To effectively manage a healthcare facility, implement a structured approach focusing on quality improvement, care coordination, staffing optimization, and infrastructure management while prioritizing patient outcomes and safety.

Organizational Structure and Leadership

• Establish a Hospital Emergency Executive Control Group that sets overall incident priorities, provides management decisions, and prioritizes use of hospital staff and facilities to ensure the best possible care for the greatest number of patients 1
• Implement a care management team approach, ideally including physicians, nurses, and/or social workers, to coordinate healthcare services across multiple providers and settings 1, 2
• Designate specific functional roles including clinical labor designee, non-clinical labor pool designee, and staffing office to coordinate all staffing needs 1
• Create clear lines of authority with initial authority managed internally by the healthcare facility under the direction of an incident manager 1

Quality Improvement Framework

• Adopt Continuous Quality Improvement (CQI) as a disciplined approach to problem solving, focusing on leadership, planning, quality control, and quality improvement 3
• Implement a customer-focused, data-driven approach that empowers employees to meet patient needs 3
• Develop a multifaceted quality improvement initiative that includes error prevention, restructured patient safety governance, root cause analysis processes, and a lessons learned program 4
• Use evidence-based practice to improve patient outcomes and return on investment for healthcare systems 5

Staffing and Workforce Management

• Determine daily staffing needs through a central staffing office that coordinates both clinical and non-clinical labor workforce 1
• Assign patient care based on staff abilities and experience, managed by the most experienced clinician available 1
• Provide training for staff as they move into expanded roles, including medical management and personal protection 1
• Implement a proactive workforce education and health and safety protection program to better prepare employees for challenges 1

Infrastructure and Safety Management

• Create isolation spaces for infectious disease management, with protocols for phased expansion of these spaces during epidemics 1
• Develop plans for cohorting patients on wards/wings during infectious outbreaks 1
• Ensure appropriate personal protective equipment (PPE) is available for healthcare facility decontamination teams, with Level C equipment (splash suits, gloves, boots, air-purifying respirators) as the minimum standard 1
• Establish fatality management plans that interface with community mass fatality protocols 1

Care Coordination and Management

• Implement care management as an essential component of coordinated healthcare delivery for people with chronic diseases and complex healthcare needs 1, 2
• Ensure patients and/or surrogates actively participate in formulating individual care plans 1, 2
• Link care management to the primary or continuing medical care of the patient 1, 2
• Monitor care management with respect to under- and overuse of services to prevent conflicts of interest 1

Financial Management and Resource Allocation

• Address the complex and contradictory incentives operating within healthcare organizations that can impede quality improvement efforts 1
• Recognize that government as purchaser may be the most effective driver in quality improvement through performance indicators and financial incentives 1
• Align incentives between clinical leaders (production function) and business leaders (management function) to support quality improvement initiatives 1
• Implement audit and feedback systems to support healthcare workers in optimizing resource utilization 1

Common Pitfalls to Avoid

• Avoid separation of quality improvement programs from the "business" of the organization, as this limits effectiveness 1
• Prevent conflicts of interest in care management by monitoring for under- and overuse of services 1
• Address the potential for contradictory incentives between hospital administrators (who need to fill beds) and managed care incentives (which encourage reduced utilization) 1
• Ensure that the health facility emergency control group has clear lines of authority during crisis situations to prevent confusion and inefficiency 1

By implementing these evidence-based strategies, healthcare facility managers can create organizations that deliver high-quality care, maintain financial sustainability, and foster a healthy work environment for staff 6.