Volume 1

The Yin-Yang of Hospital Management

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The hospital-physician relationship is like the Chinese philosophy of yin-yang. It describes two opposing and, at the same time, complementary aspects of a phenomenon. You need both elements to remain in balance with each other in order for the overall system to be healthy. The hospital needs the physician (for patient admissions) and the physician needs the hospital (to admit patients to). Without one component, the system collapses. One of the most challenging issues for any healthcare administration is the development and continued maintenance of a positive, productive and mutually beneficial relationship between the hospital and its physicians. Because of this, every undertaking by the hospital even if it only involves the physicians peripherally, but especially a clinical documentation initiative, should involve the medical staff – the authors of the documentation in question.

Both physicians and hospital managers have a need for high quality health information. Therefore, you can use a clinical documentation initiative to establish a common ground between the management team and the medical staff.  According to research conducted by the Commonwealth Fund, physicians believe that poor quality documentation practices are common in healthcare and are linked to decreased quality of care issues. Because of physicians’ interests in technology, the electronic medical record might be an ideal place to build an understanding of the need for high quality clinical documentation.

Chapter 5 continues along this path by highlighting stories from hospitals that worked to overcome relationship challenges with their physicians. Stories about how one hospital made some key renovations by keeping in mind the importance of administrators’ exposure to patients are included. In addition, how some hospitals have put the American Hospital Association’s (AHA) recommendations for hospital managers to perform administrative grand rounds are described.