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JANUARY / FEBRUARY 2003

FEATURES

Hygeia partnership focuses on leadership, quality

In November, HMI and Hygeia Hospital, a leading private hospital in Athens, Greece, held a three-day educational program to kick off their new partnership. Consisting of a one-day quality workshop and a two-day clinical and administrative leadership course, the event was the first step in an ongoing relationship, forged last May, to focus on training and education in support of Hygeia Hospital’s major goal – to become a regional leader in clinical excellence.

“This was a very successful first effort,” said Dr. Harvey Makadon, director of health systems at HMI. “We were very pleased that the physicians and other health care providers were so engaged in the process, discussing their challenges and expressing their desires to create a clear, structured strategy for quality to deal with changes in the health care environment in Greece and around the world.”

Hygeia faculty and staff participate in a train-the-trainer program. From left to right: Dr. Dionisios Razis, medical oncologist; Ekaterini Panoutsopoulou, director of nursing education; Dr. Harry Paskalis, director of the Intensive Care Unit; and Dr. Dimitrios Linos, lecturer in surgery at Harvard Medical School and Hygeia’s director of international academic affairs.

The HMI team included Dr. Sharon Kleefield, director of health care quality, and Betsy Brown, director of clinical services, who led and facilitated the quality workshop. Drs. David Cochran and Gordon Moore of Harvard Pilgrim Health Care led the clinical leadership sessions along with Makadon.

Developing strategies for success
According to Cochran, who is senior vice president for strategic development at Harvard Pilgrim Health Care, “Hygeia is a very successful hospital in a changing medical market. I think it was extraordinary that, in a time of strength, they recognize the value of learning about and planning for the next set of changes to ensure their position as a leader in Greek and European health care.”

The purpose of the leadership training was to help participants understand the value of creating a strategy, building a brand, and positioning Hygeia in the Greek healthcare market. It was also designed to impart the value of finding a competitive advantage in the marketplace to assure their leading position. Finally, the program emphasized the value of information technology as a key underpinning of any strategic development direction.

Cochran, Moore and Makadon led sessions that included topics critical to the success of the organization, such as strategic planning, brand positioning, staying number one, and competing for customers. They also covered hospital management issues such as control between insurance and doctors, and the business and clinical case for quality performance measurement.

Facing issues such as competition and pressure from insurance companies, similar to those faced by the U.S. in the last decade, the Hygeia providers and managers want to know how to be proactive rather than reactive to the changes, to manage costs and offer better quality at lower prices than their competitors. "The environment at Hygeia is ideal for this kind of strategic thinking," Makadon said. He noted that the Greek participants were open and honest about current strengths and limitations, and the need for all levels of their organization to embrace a global strategy.

Improving quality as a team
The one-day quality workshop was also met with enthusiasm, according to Kleefield, who led the “train the trainer” quality program. The program was oversubscribed with 22 participants, including eleven physicians and surgeons in a variety of specialties and a diverse group of other providers, including nurses. She added that many of the participants were young managers eager to find quality improvement tools for their departments.

Workshop participants discuss strategies to improve quality at Hygeia Hospital.

In the workshop, HMI faculty train participants in the principles of quality management, provide them with the tools to tailor the workshop to their organization, and credential them to go out and teach colleagues. Participants learn to identify barriers to improving quality of care and service, develop solutions to minimize these barriers, work as teams across the organization, and identify priority areas in which to apply a model for clinical quality management.

According to Kleefield, the Hygeia participants are already forming their teams and beginning to develop their plans. During the next six months, Kleefield will consult with the teams remotely and follow up in the spring to review principles, evaluate progress and establish future goals.

Brown, a nursing specialist, was happy to see many nurses involved in the workshop and committed to finding new ways to improve quality. After spending an extra day on rotation with the nurses gaining their perspective, Brown sees nurse participation as vital, given the role they play and the current critical nursing shortage in Greece.

Other participants agreed. "Because of their in-depth experience as caregivers, their viewpoint and participation was valued by other workshop attendees," Brown said, adding that nurses in Greece as in many countries may not be accustomed to taking part in strategic planning, but are beginning to embrace that role enthusiastically.

Kleefield said, “What we hoped to clarify was how quality cuts across all parts of an organization and how to structure and measure it against an evidence-based standard so that everyone is speaking the same language and focused on the same mission.”

One participant said that the workshop was extremely valuable because it was finally giving structure to concepts that Hygeia has been talking about and struggling with for several years.

According to Makadon, the three-day program is a good foundation for future joint HMI-Hygeia programs, which will unfold over the next three years, including continuing medical education courses, educational exchanges, and further strategic planning.