Robert Fromberg
Editor-in-Chief, HFMA
I recall years ago sitting in an editorial board meeting listening to a discussion of how to bring administrative and clinical leaders together. The board oversaw content of a publication for hospital leaders that consisted mostly of articles solicited from academics and provider executives. The board wanted to highlight the need for clinical and administration leaders to collaborate. To that end, the board suggested that a future issue of the publication be in two parts--one part by a hospital executive and one part by a physician leader.
It didn't take too long for the board to realize that this approach re-enforced the separation of these two groups rather than encouraged collaboration. But the fact that the first impulse was to keep the two groups separate shows how deeply entrenched the barrier between clinicians and administrators is--or at least is perceived to be.
Several months ago, HFMA held a couple of focus groups of nurse leaders to understand ways HFMA might bring together this group with financial professionals. The results suggested that the relationship between these two groups was at times, hmm, shall we say frosty. Not that there weren't a few stories of successful collaboration, but HFMA received the clear signal that if we wanted to educate nurse leaders about business issues in health care, we needed to frame the issues clearly within the context of patient care. And we might meet some resistance.
Since then, we published an article by HFMA President and CEO Dick Clarke about finance-nurse collaboration that got a very positive reaction. We've held several audio webcasts on issues of joint concern between nurses and finance, including budgeting and cost management, in collaboration with AORN (the Association of Perioperative Registered Nurses) and AONE (the American Organization of Nurse Executives). And, along with AONE, we have launched a monthly publication for nurse leaders on business issues called The Business of Caring. In addition, HFMA's Chairman Joe Fifer, with his hospital's CNO, will be speaking at the upcoming AONE annual meeting.
The response to these activities has been surprising and gratifying. Attendance at the audio webcasts has been growing steadily. And check out these comments from nurses about The Business of Caring publication:
"That new HFMA newsletter is wonderful...it is so needed right now...it's like a treasure trove of compact needed information."
"...very excited about the publication."
"...something nurse executives really need."
All of which tells me that when there seems to be some friction between two groups, that is not so much a signal to avoid conflict (keep to opposite sides of the magazine) as it is an opportunity. Not an opportunity for a group hug, perhaps, but an opportunity because the parties in conflict seem to want to explore the nature of the conflict. Conflict does have a certain inherent appeal. Any novelist will tell you: you need conflict to achieve resolution.
