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 suggested.
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.