Your Facility Crisis: Call the Fireman or the Guru?

Posted on February 23, 2011


A healthcare facility CEO has been tracking her facility metrics. Things seem a little off maybe, but not out of the norm and definitely not enough to call it a trend. Patient satisfaction scores are solid and there is still a little money in the bank for a rainy day. She hears a rumor a neighboring community hospital recently purchased a 40 acre plot in the middle of nowhere. She takes a few minutes one afternoon to make some sense of the situation. ‘Who can I bounce some scenarios off outside my organization?’

Problem solver or visionary? Fireman or guru?

The great grandmaster and chess world champion Garry Kasparov once noted: “Problem solving relieves people of the need to evaluate and be vigilant…The truest test of skill and initiative is when all looks quiet and you aren’t sure what to do or if you should do anything at all.” Kasparov calls this a Crisis Point. “Anyone with reasonable competence and adequate resources can solve a problem when presented as a problem to be solved.”

Your standard issue healthcare architect is a born problem solver. He is excellent at finding several creative solutions to an existing healthcare issue. You need X square feet, and he will give you three, four, seven schemes as options. But that is often as close as he gets to consulting in the client’s business because he needs the reason for the project translated into facts he can use, the ‘problem to be solved.’ The average architect has no business insight and is paralyzed until someone gives him parameters of the problem.

Unfortunately, this means the client must know enough about the problem, or that there even is a problem, and then define the problem in terms the architect can react to. Likewise, an engineer is also dependent in this scenario, and even more so a contractor, who cannot build a solution without the solution described and documented in detail.

But what if the administrator perceives an inaccurate problem? An RFP is written up; an architect designs a solution to the problem presented; a builder builds it and millions of dollars are wasted. Who can help explore her scenarios in a proactive, not reactive, way? A team with the creative firepower, engineering expertise, technical construction feasibility input, and real world budget numbers to test ideas financially, but a team with the healthcare business perspective to probe, compare, question and advise like a consultant.

If the situation your facility finds itself in is neatly contained, you can find yourself an expert to handle it. Suture the wound. Thousands of specialists want that task and compete for that work. However, most healthcare problems are complex and entangle themselves in the business side of care delivery, and not just financially. Like an ER doctor, their situation needs time-sensitive analysis, diagnosis and confirmation. Most people shy away from getting dirty like this, and want to be called in when the problem is cleaned up.

One of my professors in graduate school challenged us not to be problem solvers, but to be able to create our own projects. This is one very important reason I later pursued my business degree: it was the complement to my design training that allowed me to analyze and make sense of a business scenario before my creative design training was needed.

Administrators need to hire a team with critical thinking, the ability to synthesize diverse industry data—operational, design, cost, growth, research, competition—into creative, functional approaches. Most importantly, administrators need a team they trust to repeatedly call on to challenge themselves internally, to ask tough questions long before any project is conceived. A fireman can put out a fire, but hospitals want to avoid getting burned in the first place. Resources are too scarce and the market too competitive to rely on the methods of last decade or the last administration. If you have not already, it is time to search for your organization’s guru.