Note: For much more on the benefits of collaboration between finance and clinical leaders, see “The Business of Caring: Promoting Optimal Allocation of Nursing Resources,” a report by HFMA, the American Nurses Association and the American Organization for Nursing Leadership.
By taking the right approach to collaboration, healthcare finance and clinical leaders can improve outcomes for their patients and their organizations. During a presentation at HFMA’s 2020 Digital Annual Conference, a panel shared best practices for implementing a team approach that enhances the value of care delivery.
Pamela Cipriano, UVA Nursing
“Teamwork is really all about understanding each other, having that comfort level to have conversations, to be able to banter back and forth, to make sure you understand each other’s perspectives and to be sure that you ask questions and get the answers that you need to understand the concerns of each group,” said Pamela F. Cipriano, PhD, RN, professor and dean at the University of Virginia School of Nursing and former president of the American Nurses Association.
Cipriano joined Robyn Begley, DNP, RN, the CEO of the American Organization of Nursing Leadership, and Todd Nelson, FHFMA, director of partner relationships and chief partnership executive with HFMA, in highlighting key steps that can improve the sometimes-fraught relationships between finance and clinical leaders.
Robyn Begley, AONL
1. Ensure the team’s top priority is bolstering care quality and patient safety. Those with a background in finance could have worked in a variety of industries, Nelson noted. “The reason that I went into healthcare finance in particular — the reason that many folks in healthcare finance did — was a belief in improving the quality of patient care and patient safety.” That motivation gives finance leaders common cause with clinical staff and sets the stage for collaboration.
2. Include clinicians, finance and administrative staff on the team. “Don’t go off and do things in a silo with your finance people over here, your clinicians over there and the administrative folks who are in charge of the operations part in another area,” Nelson said. “Get together on the team because you’re going to learn from each other, you’re going to have those discussions and those debates that are important for a positive outcome.”
Todd Nelson, HFMA
3. Ensure mutual understanding of key concepts. Pivotal themes include the cost implications of clinical decisions, processes that are necessary to improve quality and patient safety, and the importance of both quality outcomes and cost efficiencies. “Really understand the implications of the clinical decisions that get made, whether that’s a supply issue, a methodology, a training issue,” Nelson said. “If you have the team together, you’re going to understand those better and you’re going to put in the right processes.”
4. Cross-train leaders to understand issues and be conversant about different perspectives. This approach is about “making sure that we have the ability to defer to others, to listen to their expertise,” Nelson said.
There’s value in “having a different set of eyes on processes that maybe we just sort of take for granted,” Begley said. “Some of those sacred cows or things you just do because you have to do them — it’s really refreshing to have somebody come in and take a look [at them], be able to share and feel comfortable that their perspective will be respected.”
5. Clarify the language used by each discipline and agree on definitions of key terms. For example, finance leaders might be comfortable using the term ratio in the context of analyzing financial statements, Nelson said. “When you use the term ratio with your clinical colleague, and it’s used really against them from a metric or benchmark perspective, that’s not a happy term. It doesn’t lead to a really positive discussion.”
6. Encourage rounding. Finance leaders should not worry that these interactions will lead to gotcha! moments, Nelson said, or opportunities for clinical staff to say, “See, because you took away those funds, this is what happened.” Rather, they’re a chance to better understand how financial decisions affect the delivery of care.
7. Don’t try to improve everything immediately. Being selective about quality initiatives is prudent, Nelson said. “You’ve got to start somewhere. Don’t try to boil the ocean.”
“You can’t fix everything at once,” Cipriano said. “But with everyone focused on quality for the patients, that’s a really important starting point.”