Roundtables

to consolidate many different hospi- tal-based quality, safety and infection control departments into a single systemwide department with a single management structure. When we have initiatives for new measures we do them as a system and we develop the processes as a system. If there's new technology or something new for the EHR, we imple- ment it across the whole system. Dr. Slonim: e best decision we made was to make sure that we were engaging clinicians in the conversation about healthcare reform. By allowing the clinical voices to be heard, we are better able to identify alternative solu- tion sets that advanced our redesign efforts. I think that the worst decision had more to do with the timing than the decision. I think we should have moved faster on some initiatives to achieve the full benefit of the interven- tion. Healthcare is moving very quick- ly; when you're thinking about doing something, keep your priori- ties in mind and be aware of when it needs to be executed. Q: what advice do you have for other CMOs for 2014 and beyond? Dr. Arredondo: As leaders, we oen underestimate the importance of com- munication and transparency when we face challenging issues. Important and difficult issues will have to be explained many times. ose whom we lead do not expect us to be perfect, and they understand that leaders are fal- lible because they are human be- ings. Don't be afraid to admit errors or mis- judgments, the trust and respect that you will earn for this painful ad- mission will serve you in the long run. Dr. Mossallam: I think you have to really look at utilization practices. With regulatory issues like the read- mission reductions and the two-mid- night rule, ensuring the best and most timely utilization practices would be key for any administrator. Engaging the physicians is also key. Moving to a team based approach is necessary to stay ahead of the curve. Dr. Orr: You need a uniformed ap- proach. It's sometimes tempting to say OK to making a contract for 50,000 lives in an ACO and then deciding to throw quality programs in, add some of the top doctors and see what hap- pens. at's a mistake, because it does nothing to prepare the rest of the or- ganiza- tion and confuses the doctors. It comes down to treating all patients fairly and consistently, regardless of payer status. You need that consistency across the whole organization. Dr. Shabot: Our healthcare system would be markedly improved if patient safety was the core value of all healthcare decisions. Memorial Hermann's board has set safety as the organization's core value. If we're starting a new program, then doing it safely and at the right hospitals is what we do. If we can't do it safely, we don't do it. Memorial Hermann has won many nation- al and state awards for quality and safety and has grown hand over foot all while complications and their associated costs have gone down. If we focus on quality and safety, the finances and growth will follow. Dr. Slonim: I think being a physi- cian leader requires education, skills and experiences that are not taught in medical school. You have to be prepared for the job. My advice is to make sure you're prepared and get in the game. Make sure your interests and the interests of the patients you represent are being heard at the table as healthcare is being redesigned. n "It's a welcoming change to hold doctors to standards like in other industries and have them provide the work they do." -Dr. Jeremy Orr, CMO, Humedica Five CMOs Discuss Challenges, Changes and Advice 6

• Cover