By Steven G. Ullmann, PhD
What a year, in fact, it’s been two years (and I hope it’s not a third year). COVID has had a huge impact on our personal lives, our professional lives, our healthcare system, our education system. It is interesting to think that over the past 40+ years of my teaching and research career, I have used an in-depth classroom exercise teaming my students into the role of a health care system C-Suite watching a pandemic unfold, asking teams how they would manage, how they would lead. I could never have imagined that this exercise would become a reality.
But the problems we have endured over these many months provide important insights into how we move forward in 2022, as they underscore the importance of a common vision for the health system and its different elements, the professionals who serve it and the education system. process that provides critical thinking concepts and methodologies needed to manage, lead.
What have we learned in healthcare education as we go along? It is imperative that we incorporate disaster preparedness and recovery into our health care education programs. Thousands of health organizations were completely unprepared to deal with the health crisis we have just experienced. All aspects of healthcare management and leadership become critical in times of crisis and these issues cut across the disciplines of healthcare management education. Let’s step back for a moment and assess where we need to adjust our thinking going forward.
The Institute for Health Improvement came out a few years ago with the triple purpose of achieving a significantly positive patient experience, obtaining population health metrics, and achieving those quality metrics in a cost-effective way. And now a fourth objective has been added and that is the quality of work life experience of healthcare workers, administration, clinicians and staff. The Pandemic has really made us understand the importance of this fourth objective. As such, our courses must also reflect on these aspects of health care delivery.
So let’s start with human resource management because there hasn’t been a greater impact of COVID than this area. Clinicians and staff provided support to our patients when their own lives were at risk, a risk far greater than we could have imagined. Family structures of employees have been affected and family health issues have in turn impacted the ability of health personnel to work. Childcare issues impacted the ability of health care workers to work when their young children were out of school. Add to that the shortage of protective supplies to keep healthcare personnel as healthy as possible, a function of a supply chain shortage and the ethics associated with distribution decisions. Human resource management, supply chain, health care ethics are all aspects of our educational programs. The resulting organizational behavior in times of crisis becomes much more complex as structures and interactions under stress require appropriate adjustments.
Budgeting and financing, always difficult in the delivery of health care where the margins are thin to begin with, requires much more innovative thinking in terms of improving revenue, or at least maintaining revenue and controlling costs. Therefore, the principles of operations research and Lean-Six Sigma methodologies of process improvement become all the more important. Flexibility and ensuring waste minimization become important in times of increased financial stress. Supply chain efficiency becomes critical. Everything must be done in compliance with the law, an increasingly complex area.
Ultimately, we must remember that we are dealing with people: those who manage, those who provide clinical services, those who provide support services, those who provide medical supplies and devices, those who advise and, ultimately it is our patients and their families, the people, all of whom should be treated with compassion.
There are other areas of healthcare management and leadership education that will be important to address over the next year and beyond. From areas such as health technology, advances in areas such as telemedicine, finally reimbursable, to artificial intelligence (with the caveat artificial intelligence is subject to biases that need to be understood). The complexities of pharmaceutical pricing, pharmaceutical research, development and production, value-based purchasing, persistent shortages of life-saving medicines, questions about how to distribute ethically and public relations to make deal with these various aspects of the industry are important.
Ultimately, we need to understand how to be strategic in our thinking. We tend to be reactionary, perhaps especially given the unique circumstances associated with COVID. But it’s not an environment where we can just be tactical. It is becoming essential to understand how the healthcare industry will be impacted by significant demographic shifts, the aging of our population, coupled with the increasing attention of governments to contain spending at the federal, state and local levels. These are critical elements that will impact health care providers. Moreover, as insurers and employers place increasing pressure on physicians and health systems to provide quality care at reduced costs or to be excluded from health care networks altogether, providers will need to consider the how to adapt to the healthcare environment…in 2022 and beyond. It is essential that health care management and leadership training reflect these needs.
Dr. Steven G. Ullmann, Professor and Chair of the Department of Health Management and Policy, Director of the Center for Health Management and Policy, and Special Assistant to the Provost of Miami Herbert Business School, University of Miami, may be contacted at (305) 284-9920 or Sullmann@miami.edu.