Nearterm Blog

How do healthcare financial management professionals influence employee focus?

We all want to contribute to the success of our respective organizations. A mentor of mine once imparted to me a simple management tenet that helped me over the years to do just that. He said, “Employees determine what is important based on how you spend your time”. Because my mentor was a brilliant healthcare leader and a great human being, I took this seriously and felt compelled to interpret his subtle advice. Here is what he really told me:


    • When people embrace importance, they act accordingly. In the workplace, when employees recognize that what they do is important and/or that their work will result in something important to their organization, they get engaged. This translates to creativity, harmony, efficiency, ownership and stability.


    • When people are asked to participate in tasks and activities that are not perceived as important, the result is very different, particularly in light of the generational diversity in the workplace today. If you want to test that, ask a GEN Y employee to do something without some explanation of purpose and why it is important. Or for baby boomers, a great example was the scene in the old movie “Cool Hand Luke” where a prisoner was repeatedly asked to dig a hole then fill it back in again to “break” him. It was not important and so the prisoner continued efforts to escape until his death, certainly not the behavior the warden was after.


  • The key question then, is how do employees determine what is important? It is less based on things like what a manager writes in a memo, what the manager says or posts on the wall. It is how the manager spends his/her time. Here are a couple examples:


    1. In patient financial services, account documentation is an important part of the work process. In our revenue cycle consulting practice, we review work samples as part of our discovery process. That means looking at accounts. When we find absent or poor documentation and ask the business office manager about it, we find that they do not routinely look at a sufficient sample of accounts to have made the observation on their own. Employees no longer think it’s important so either discontinue writing up account history or do a hap-hazard job. Spend more time randomly reviewing account stratifications and discussing findings with employees. It becomes important and documentation improves.


  1. Most hospital controllers and hospital chief financial officers would concur that maintaining logs is an important function. At the beginning of the fiscal year, they tell the accounting staff it is important and back it up with a memo or email. Fast forward as other priorities emerge over the course of the year. The CFO spends time working on the bond issue or the new building project and deploys the accounting staff accordingly. The accounting staff perceives those issues must be important and does a great job supporting those initiatives. Now it is time to do the cost report, the logs are summoned and we learn they have not been maintained since the second quarter. Nobody asked to see them or otherwise spent time on the logs all year.
  2. The idea is to consider how you spend your time in the context of how your presence influences what people think is important. We can’t be everywhere and certainly there is nothing wrong with job descriptions, emails, memos, verbal direction and other communications. Just bear in mind that at the top of the communication hierarchy is “how you spend your time”.


In overview, you might want to reflect on how you have invested your time and presence over the recent month. Another effective way to assess what employees think is important is to ask them casually and privately, then listen carefully to what they say (not a survey that gives them a lot of time to construe what you want to hear in lieu of what they really think). Perhaps the result would represent an opportunity for you to rethink or fine-tune your management practices as I did.