Joe Fifer

It just comes naturally to finance folks. 


Continuous performance monitoring is in the DNA of finance people. It’s who we are and what we do. Therefore, it only makes sense that we should be key players in the performance initiatives now helping drive the industry toward value.

By taking steps to improve performance, we reduce not only variation, but also wastefulness. Driving the waste out of health care will be a vital part of meeting the value-based challenges we face. Through our efforts in finance, we can inspire others throughout our organizations to follow our lead in reducing waste. In addition to inspiring our colleagues, we can also work directly with them.

Collaboration with clinicians will be a pivotal part of performance improvement going forward. HFMA’s Value Project research has already shown the powerful results that can be produced when this sort of collaboration happens. For example, New York-Presbyterian Hospital’s patient safety initiative includes regular meetings that bring hospital leaders across departments together to collaborate on clinical issues and performance. This ongoing initiative boosts quality and patient safety throughout the hospital. Such examples demonstrate the transformative power of removing waste and improving quality and safety.

John Byrnes, MD, one of HFMA’s incoming board members, is chief medical officer (CMO) at Sisters of Charity Leavenworth Health System and an expert on performance improvement. For years, he has written articles in hfm and other periodicals highlighting the critical need for finance people to get more involved in the clinical conversation—both to understand it and to add value to it by bringing financial thought processes and discipline, and a quantification of quality improvements. Hence, value. John reminds us that even “basic” performance improvement steps aren’t always so basic. In our April issue, John’s piece on managing medical directors encourages readers never to assume that common-sense tactics are in place for continuous improvement monitoring. Instead, John encourages HFMA members to actively pursue conversations with CMOs and service-line vice presidents to verify that steps exist to meet organizationwide performance priorities. I couldn’t have said it better myself! This is exactly the kind of proactive spirit with which performance improvement should be undertaken.

On this topic, I would be remiss if I did not mention that one of the speakers at ANI this month will be Don Berwick, regarded by many as the father of continuous improvement in health care. An expert on “good people trapped in bad processes,” Don’s ideas and opinions are always sure to be vibrant and interesting. I can’t wait to hear them!

It’s my hope that this issue of hfm will provide you with exciting new resources for thinking about performance improvement. I also hope that you’ll find—as I do—that this kind of work can be fun and rewarding for financial managers and CFOs. It brings finance people closer to operations, which is always invigorating. It’s always good to be where the action is in a healthcare setting! We are just beginning to see the positive impacts of making continuous improvements. I’m excited to see where the future takes us.

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