WASHINGTON--With regional hospital partnerships on the rise, cancer
program administrators often find themselves charged with managing multi-institutional
programs melded together within a system. Three middle managers who have
been through such transformations offered their insider views at the Association
of Community Cancer Centers (ACCC) meeting.
Marija Bjegovich, RN, director of cancer services, St. Luke's Medical
Center, Aurora Health Care, Milwaukee, said that among the challenges of
such a task are internal and external competition; entity, community, and
system politics; pre-established referral patterns; staffing, payroll,
budget, and other operational issues; and discrepancy in quality standards
among units within the system.
To meet such challenges, the oncology administrator must pay special
attention to a number of areas, said Diane M. Otte, RN, operations director,
Oncology Services, Alegent Health, Omaha. Ms. Otte is also co-editor of
the PRR, Inc. publication Cancer Management.
Planning: While a general plan to merge institutions will have
been worked out, such things as how to amicably unite the cancer units
may not be detailed in advance. Thus it falls to the oncology administrators
and staff to plan the transition and make it work, something that requires
detailed thought and planning, not to mention some goodwill on the part
of all participants.
Still, she warned: "No matter how well you and your team plan,
things are going to happen that you weren't expecting."
Communications: This must be a constant concern. "You can't
communicate too much with your staff and your physicians. And the management
team that you report to can't communicate too much with you," Ms.
Otte said. She added that it is critical that communication with staff
and physicians be done in a timely manner so that it does not appear that
information is being withheld.
Patient care: "We must be careful not to lose sight of that
very important aspect of a strategy for success," Ms. Otte said. "We
all need to collectively look at how we can make patient care better. There
is nothing wrong with asking the patient about how we can improve care
or integrate services, rather than assuming we know the answers."
Keeping focused on the mission "that you're there for the patients
and that the services should revolve around them," is essential, added
Nancy E. Haas, RN, corporate director of the Merida Cancer Institute in
Mayfield Heights, Ohio, part of a system of four community hospitals in
the Cleveland area.
Staff involvement: This is partly time management, partly a juggling
act, by Ms. Otte's description. It's important to get staff input, particularly
about patient care, she said. The challenge is to create the time to get
the input, coordinate ideas, and make certain you have "adequate political
representation of staff involved from each side, all sides."
Flexibility: "You have to be prepared to have any given
thing happen on any given day and be able to deal with it," Ms. Otte
Networking: "Don't ever think you can stop networking with
your peers," she noted. Networking's importance ranges from learning
of future job opportunities to "figuring out how to publish a joint
annual report or some of those other nitty-gritty details that we have
to deal with on a day-to-day basis."
Senior management commitment: Without it, needed change won't
occur. "No matter how much you and your team are committed, if the
senior management team is not in sync with you and supportive, it is not
going to happen," Ms. Otte said.
A sense of humor: "I can't emphasize that enough,"
Ms. Otte said. "You need to be able to relate to your staff, your
physicians, and your patients with some degree of fun every day."
Ms. Haas concluded by noting that the benefits of such mergers are well
worth the effort. These include decreased duplication, standardized equipment,
joint program development, promotion, and marketing plans, and improvements
in oncology services.