George Hampton, President of Tech Knowledge Associates
There are two unmovable forces in our industry: Regulatory Compliance and Financial Performance. They stand as individual elements in your program’s portfolio, regardless of your attention. In my organization, we work hard to educate and encourage our leaders to understand both concerns and find the agility to move between the two as necessary. In my career, I had no trouble absorbing the idea that getting our PMs done on time was important. This idea was instilled by years of working with my group, and fortified by successful Joint Commission surveys. We studied our completion numbers, reported our completion numbers, and set improvement goals. It is the norm and most programs I have studied have a leader who is well versed in the need for regulatory compliance. On the other hand, we have financial performance. This is where we are challenged to achieve a similar level of oversight with regulatory compliance. There are a couple components that I see as obstacles to a good understanding of financial performance.
Lack of Data
Access to timely financial information is essential. Frequently, I have seen political structures in health care organizations that limit this access to the leadership of the clinical technology program. The shop manager is typically handed a GL ledger or a profit and loss statement some time in the first two weeks of the following month and are asked, “What happened?” Most likely, the manager was not allowed to have any input in the annual budget process, so there was little to no strategic cost cutting planning. The manager is handed a budget completed by someone else with a set increase or decrease. This leads to a mindset that the financial month-to-month is a matter of chance and based on the various repair activities. Additionally, it causes the shop leader to focus even harder on the regulatory compliance activities because it’s the one area they can track, and use to support their value to the organization. Unfortunately, in our current environment this is not a healthy position and could lead to outsourcing.
Leadership Agility is defined as “the skills necessary for success in a complex business environment.” It is a conviction that some possess more than others, where we “step up” to new challenges and become more than we were the following day. By its very nature agility is a voluntary skill. One chooses to be concerned with their agility or one doesn’t. There are multiple organizations that can measure agility and there are numerous books to help an individual become a more agile leader, but the key is the personal conviction that new endeavors demand new skills. In this scenario, the obvious skill sets are financial analysis, cost containment, and inspiring team members. Many of us become leaders because we were good techs. When we are given the responsibility to manage we have a responsibility to learn more about the business elements. If you are in an environment like the one I described above, where you don’t build your own budget based on data, and you don’t have ready access to the monthly performance data regarding that budget, you will struggle to be a balanced leader. Your drive for agility should lead you to demand (respectfully of course) the data you need to truly lead your group.
What does this look like in practice? In our organization we, of course, expect our managers to stay on top of regulatory compliance. We measure that compliance bi-annually with a program quality review. Regulatory compliance is engrained in all of us and is seldom an area for surprises. What we work much harder on is teaching our managers to run the business of their shop or shops. We ask them to build their budget every year. This is a comprehensive budget from supplies to service contracts. This budget contains long-term cost-reductions strategies. Our financial planning contains strategic training plans for each technician. The budget has performance targets built in, and we review the submitted budget relative to those targets. We give our manager access to all their financial performance elements. They have monthly GL ledger sheets, actual to budget performance sheets, PO accruals, contract listings, and a trend report. We ask them to analyze variances to budgeted spending monthly and diagnose the cause for future planning. We do this not to beat them down or make their workload unbearable. We do this because it takes them to a new level of agility. As a leadership team, it is our goal to support the plans and strategies of our managers, not to dictate to them what they should be doing to troubleshoot our finances.
On the contrary, we want them to tell us what they plan to do. I don’t mean to sound like I am bragging, but I am very proud of my team. We are dedicated to self-awareness and improvement. My point in detailing all of this is that I believe this pursuit of balance is essential for success in our industry. I have been around long enough to see those who have it and those who don’t.
The deciding factor is not intellect; collectively, clinical technology folks are very bright. The deciding factor is the individual’s desire to learn skills they don’t currently possess and the strength and ambition to pursue that knowledge.
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