The Ontario Hospital Association’s HealthAchieve is one of the major health care conferences on our annual calendar. Here are 10 revealing moments from this year’s three-day event:
1. Metaphors really stick. Don Berwick, former administrator of the U.S. Medicaid/Medicare program, spoke about the Choleteka Bridge in Honduras. An engineering marvel, it was considered one of the strongest bridges in the world. The year after it was built, Hurricane Mitch struck and washed out more than 150 bridges in the country – but not the Choleteka. The only problem is, the hurricane actually moved the path of the river to render the bridge obsolete. Speaker after speaker picked up on this metaphor in relation to health care delivery.
2. Performance pay is a stupid idea. OHA hospitals have been moving towards “performance” or “at risk pay” in recent years. It essentially means that a portion of an executives’ pay is contingent on the hospital reaching certain pre-established goals. Not only does this demean the executive by suggesting they would not act in the organization’s best interests otherwise, but means the goals get dumbed down – or what Berwick says “makes timidity logical.” Berwick says he prefers goals that are difficult to reach. When Berwick said he is not a fan of performance based pay, a significant portion of the packed audience broke into spontaneous applause. The OHA may want to revisit this policy.
3. “Benchmarking is the cream of the crap.” – Mark Britnell, Chairman and Partner, KPMG Global Health Practice. Say no more.
4. Several speakers emphasized the importance of “Senior Friendly Hospitals,” including the importance of early mobilization. Getting seniors mobile in hospital can shorten the length of stay, shorten duration of delirium and improve the return to independent functioning. Nobody mentioned that many Ontario hospitals are presently eliminating physiotherapy positions to balance their budgets.