Taking on the Mountain
"What more do you want me to do? I am doing everything I can to help this hospital!" was the statement of the young physician at a recent roundtable discussion at the NRHA conference. More than the words, were the urgency, the frustration, the desperation and the desire to do whatever she could to make a difference in the hospital and make it more vibrant and productive in the community. Also contained in the words were the weight of the mountain bearing down upon rural hospitals, and where do I get the strength to move this mountain off of me?
This mountain can be identified as two primary things.
The first is the will of everybody else. It seems everybody has a better idea and way for you to do things, and they are not content in just generating a discussion to share ideas with you, they are forcing you to comply with their laws, rules and ways of doing things. If you want to run your hospital in your community, you will do it our way! It does not matter that they are out of touch with the world you live in, they know better, and they are going to make you better by telling you how to do it, and punishing you if you don't. It is an issue of them controlling your destiny. This does not negate the fact that reform is needed because the healthcare landscape is changing and the old ways are as outdated as the old technology.
The second area is the wisdom of everybody else. Without a doubt the thinking level and understanding of all things healthcare is rising in exponential levels. And to some degree, we can begin to major on minors and ignore the more important priorities. What is sophisticated and appropriate for complex urban healthcare centers can become so overkill for the rural world it becomes foolish. With three nurses on the floor, how much data and reports do you need to generate to monitor their every move and action they take to increase the efficiency of the organization and reduce waste?
The frustration comes when you try to conform to the image of a mountain that does not represent the plain you live in, when you are trying to be something that you are not genetically created or designed to be. The rural healthcare world is a community that is unique to itself, it is not a skyscraper that reaches to the skies, but a tree that yields its fruit to the community. The staff, the physicians, the leadership generally have bloomed where they are planted, they have grown and responded to the needs of those around them.
The strength of the branches of this tree need to be reinforced with the latest technology, better ways of leadership, a stronger and clearer vision of their community and reaching them and their needs. Yielding fruit to the community is the surest way of increasing that elusive commodity called money that is needed to sustain the life of the hospital. It is the life of the hospital that needs to be blessed, strengthened and developed into new ways, and this can only be done by the personal leadership of the hospital, which includes administration, physicians, the board and staff.
When you take away the green color of the sustainability movement that is sweeping the land, you end up with one core concept: utilizing renewable and recyclable resources! Rural healthcare has been sustainable before sustainable was popular, maybe not in recycling every piece of paper, plastic and pop can, but the mindset of how they have utilized their resources, done more with less, and out of necessity brought forth new ideas to meet their needs is the heart of sustainability.
The essence of my article on realignment was not to just go with the new, whehter it is a building, technology or way of doing things, but to bring forth better thoughts on how to revitalize the business operations by seeing the flow within the facility and making the internal adjustment, additions, expansions needed. This principle pervades all aspects of the organization, not just the physical facility. And it is this sustainable mindset that says 'what do we have and how can we better use it' that answers the question "What more do you want me to do?" The answer is to be you. To dig deep into your potential and find new expressions of how you can reach out and touch your community. This is a big mountain, and it is bearing down, and the challenges are getting more intense, but the answer is not to be conformed to the mountain, but take what you need from the mountain and use it to build your hospital.