Notes, on Running a Hospital and ‘Goal Play’

Paul F. Levy ran the Beth Israel Deaconess Medical Center as CEO from 2002 until early January, 2011. Before taking on the position as CEO of the Harvard-affiliated hybrid hospital in financial straits, the MIT grad held leadership positions in the Massachusetts Water Resources Authority and Department of Public Utilities. Starting earlier, in 1989, he coached his daughter’s soccer team for a long time.

I have never met Paul Levy, an on-line colleague with common interests in health care delivery and patient advocacy, in person. I first learned of his blog from a physician at a nearby hospital who spoke highly of his blog. How fantastic, my friend considered, that the head of a large hospital writes openly on subjects like medical errors, budget constraints, and other issues. I took a look, then, at Running a Hospital, what is now Not Running a Hospital, and became hooked.

His new book, Goal Play! takes the message of teamwork on the soccer field to a big institution, where workers need get along and lives are at stake, every day. He uses selected stories to illustrate particular points. It’s not a long book, and reads easily. At one level it’s a simple message, if you – as a coach or CEO – identify and work with each person’s strengths, you can develop and cultivate those assets and lead the group to success.

At another level, Levy gets somewhat deeper. He writes on culpability, examination and self-examination. One focus – as a coach might consider how best to respond to a player’s fumble or a game lost – is on medical errors. Blaming individual doctors or nurses for singular events can be counterproductive, he argues through selected stories. Rather, a culture of fear of reporting or admitting errors can be harmful. Because some mistakes arise from failures at a systemic level, a responsible leader might choose to examine what went wrong, to learn from the error and lessen the chances of its happening again.

My favorite part might sound dull, in terms of hospital administration, but it speaks to any person with scoliosis or, say, a broken arm. Levy details when, upon review of complaints at the orthopedics clinic having to do with average waiting times of 3 hours, the hospital assembled a “team” (aka a committee) to figure out why it took so long for patients to see the orthopedists. Through a systemic analysis and finding unduly long waits for x-rays that held up a multi-step process, the average wait time for orthopedics patients was reduced to 1 hour. You go, committee like that!

So I’m glad for that small improvement in the lives of orthopedics patients at one large medical center in Boston, and for a book on how thoughtful leadership of a hospital can make a difference. Goal Play! articulates how positive, team-oriented guidance and genuine concern for employees’ well-being can have a positive impact on the lives and careers of valued health care workers and their patients.

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