In a much-watched video on YouTube, a white-coated technician—using technical gobbledygook no human being could possibly understand—discusses the wonders of the fictitious “turbo encabulator.” The video is confusing, and hilarious. For Paul Kelley, CBET, it also contains certain truths.
“Sometimes, I think that’s what we sound like to administration when we talk tech,” says Kelley, director, biomedical engineering and green initiative, Washington Hospital in Fremont, Calif. “They have no idea what we’re talking about.”
Most, if not all, biomedical engineering professionals would agree that while successfully communicating with a facility’s senior executives—the so-called C-suite—is a goal worth pursing, it can be problematic.
In many respects, the relationship between the C-suite and its technology management department correlates to the size of the organization and department, says Ken Maddock, vice president of facility support services for the Baylor Health Care System in Dallas. “The bigger the department, the more face time it will probably have with the C-suite,” he says. “But, I think a lot of my colleagues are struggling with this.
Maddock calls it a “never-ending story,” adding that many biomeds think their departments are under-recognized and are basically invisible to their hospitals’ executive teams. It doesn’t help, he says, that in a typical 300-bed hospital, the technology management department has a huge impact on the facility’s budget but has a relatively small number of staff, compared with, say, the several hundred nurses walking the hospital halls.
“So there’s a kind of inferiority complex that develops,” he points out, “and it leaves technology management professionals wondering how they can become that guy who has an inroad to the executive leadership team.
“At the same time, I think that ‘problem’ may be a bit overrated,” he adds, “in the sense that if you do your job right, and interact correctly with the right leader above you—whether he’s in the C-suite or not—that’s probably OK. You don’t need to be in front of the C-suite all the time.”
What is the C-Suite?
As Kelley says, the C-suite as traditionally defined consists of those with a C at the start of their title, such as a chief executive officer, chief medical officer, chief financial officer, chief medical information officer, or chief operating officer.
“But I’m not sure that definition works anymore,” he says. “Now it seems to be anyone in upper management. In our hospital, we have the CEO, our associate administrators, all of our chiefs, the CNO [chief nursing officer]. They are ultimately part of the group that makes the big strategic and budgetary decisions.”
Whatever the definition, most biomeds, particularly those with department-wide authority, think that securing lines of communication with the C-suite is important for several reasons.
The most obvious has to do with resources, Maddock says. The thinking goes that if a technology management department works well with top executives, resources the department needs will be more readily acquired.
Additionally, since many in-house departments fear outsourcing, there’s a belief that establishing a strong connection with a hospital’s leadership team could prevent the responsibilities of a biomedical technology director and his or her team from being outsourced. On the other hand, Maddock says, a third-party organization might figure that forging a good relationship with their C-suite will help preserve its contract.
There’s also the need to make sure that a department’s goals and objectives are aligned with those of the hospital, says Vickie Snyder, director, biomedical engineering, for Fairview Health Services in Minneapolis. “Most organizations lay out strategic goals at the beginning of the fiscal year, so we have to ask ourselves how we are going to adapt what we do to fit into those goals. We have to make sure we’re connecting with the C-suite.”
In the end, Kelley says, administration and departmental goals have to be the same. If the administration’s goal is to improve throughput everywhere in the institution, for example, the biomedical engineering department must be responsible for ensuring that equipment is up and running and operating reliably.
While the ultimate goals of the C-suite and a hospital’s biomedical engineering department should be the same, poor communication between the two could result in those goals getting murky as they filter down the chain of command. And while the goals as understood by the department may not conflict with those of the administration, they may not effectively support them.
A department concerned with retaining a particular vendor that works well with it, for example, may not be helping achieve the greater goals and objectives of the organization. Sometimes a vendor relationship will have to take second place to the overall direction of the organization, Maddock points out.
Maddock says that in his case, while having a relationship with top management is partially about resources, it’s more about helping set the direction of his organization regarding health care technology. “In other words,” he says, “many departments are the victims of the health care technology direction their organizations take. They may not be thinking about how if you standardize certain types of equipment, you’ll make support cheaper and more efficient.
“There’s no reason why a health care technology management professional shouldn’t be giving input on what he considers to be a more effective device,” Maddock adds. “And when you have that relationship [with the C-suite], you can be a player in setting the direction of technology development within the organization.”
Creating departmental visibility is certainly one way of getting noticed by the C-suite. But visibility is not necessarily the easiest thing for biomedical technology professionals to accomplish. For one thing, it seems go against the nature of many biomeds, Snyder says.
“As a group, we tend to be made up of introverts,” she observes. “We really love our tools, and feel kind of uncomfortable without our gadgets. So reaching out and communicating with a vice president, for example, can take us out of our comfort zone.”
Yet, Kelley says, he knows of colleagues who will “sit in the basement complaining about how no one upstairs knows what they do and what an important job they have. I used to give presentations called ‘get out of the basement,’ and its message was that not only is it physically necessary [for biomeds] to get out of the basement, but they have to get out of the mind-set of being buried down there, as well.”
Kelley was brought to Washington Hospital about 15 years ago to set up an in-house biomedical engineering department. One of the things he did over time was to cultivate an important working relationship with the hospital’s chief operating officer.
“Over time, by promoting the department, I helped him learn about what we were doing, and he realized that I was a reliable source that could be trusted,” Kelley says. This was information, he adds, that ultimately made its way up to the hospital’s CEO.
Now his hospital administrators have “a better understanding of what we do,” Kelley says. “They see us a trusted resource, and know that if they give us something to do, we’ll get it done, and get it done right.”
Maddock harks back to the issue of resources in talking about the need for biomeds to increase their department’s visibility. “Sometimes it just comes down to where you fall in the race for resources,” he says. “You need to be visible in order to get what you need.”
There’s also the basic question of department morale. A biomedical engineering department head who has a team that is never seen and or talked about could have a team that stops caring, Maddock says. “But to me, if your team and its leaders step out of their comfort zone and offer value beyond the closely defined scope of their jobs, then visibility will take care of itself.”
Biomeds can interact with their executives, and vice versa, by a variety of different ways.
Formal, regularly scheduled meetings are a given in most organizations. In Snyder’s case, she meets with her C-suite once a month to discuss issues ranging from staffing and resource management to how well her department is doing in implementing the hospital’s overall customer service initiative. She also has a “very hands-on” vice president of support services who wants to attend her staff-level meetings. That vice president is fairly new, Snyder says, so he’s making an effort to connect with her and her staff. He’s also interested in issues related to customer service, she adds, and wants to get a first-hand look at the people who are providing that service.
Kelley interacts with the C-suite through a chain of command that starts with his chief and proceeds up to his CEO. He also attends division meetings every other week, and is part of several subcommittees, such as the medical equipment subcommittee.
Departmental interaction with executives occurs at a less formal level as well, whether through e-mail, telephone calls, or even a chance meeting in the hallway. “All these encounters build relationships,” Snyder says. “And once you’re able to get more comfortable with each other, you’re better able to go to them and talk about harder things, both personally and professionally.”
Maddock suggests it’s unnecessary to try to build a relationship with every top executive. “If you have someone in your chain of command who is really good, who you can maintain a casual relationship with, and who you can trust to represent you well [within the C-suite], then that’s another option. You don’t have to try to get in front of everybody.”
One of the things that Maddock, Kelley, and Snyder have all come to realize is that chief executives are extraordinarily busy people who don’t like to have their time wasted.
“One of the things you’ll hear a lot is the importance of getting in front of executives with presentations and metrics,” Maddock says. “But my experience is that you don’t build a relationship with metrics. You build the relationship first, and then present metrics as needed.”
Most executives don’t have the time for biomedical engineering department managers to prove their worth by presenting a bunch of data, Maddock says. “They assume you know how to do your job.” So when you’re asked to present data, he adds, “use data to show how you’re driving improvement, not to impress people.”
As Kelley notes, “A lot of people in our field are extremely technical. We’ll research something to death before we make a decision. If we’re selecting a new product, we’ll do tons of research, get the data, and produce volumes justifying why we should or shouldn’t do something. But guess what—the C-suite doesn’t want tons of data. They want the bottom line.”
And that bottom line will be whether the product is safe and cost-effective, Kelley says, and the sooner his team can get that message to the C-suite, the better.
Presenting volumes of data to the C-suite might make sense for outside providers, since the C-suite probably wants to see those metrics to make sure they are getting value from their contracts, Maddock says. “But not too long ago I had an executive tell me, ‘I don’t have time to look at this stuff—what am I going to do with it?’ ” For the most part, he adds, the executives don’t have the training to really understand the metrics.
“You’re the expert, not them,” Maddock emphasizes. But success in connecting with the C-suite depends on knowing the needs of the executives. “It’s really about being able to provide value in areas they think are important, and not necessarily the areas you think are important.” 24×7
Michael Bassett is a contributing writer for 24×7. For more information, contact [email protected].