This week’s Longwoods newsletter (www.longwoods.com) lists instances of LHINs “starting to show some muscle” in enforcing balanced budgets for hospitals. The tally of resolved vs. delayed agreements from the London, ON, area is on the Longwoods Healtcare Blog. There is specific mention of a resolution, whereby the South East LHIN lent one of its area hospitals the shortfall to balance the budget for 2008; and of a conflict, whereby the North West LHIN and the Thunder Bay Regional Health Sciences Centre dig in on there competing positions.
The people working in these negotiations must feel like Gary Sinise in Apollo 13 when he is trying to simulate the landing procedure while not exceeding an unprecedented voltage level. In the movie (and the real story), he does it, which provides more evidence that the impossible is attainable when we work together.
What if the impossible is really impossible?
I can guarantee you that the word “impossible” has come up in the discussions and negotiations between Ontario’s hospitals (legally bound to budgets) and funders (LHINs whose job it is to enforce this accountability). I am equally certain that, in the end, some of the things deemed “impossible” were so in actuality, while others were not. The only way to separate the two is discussions (apparently still ongoing in Thunder Bay) that remain open and solution-focussed amid a cloud of rising tension. This is no mean achievement.
Unfortunately, “out-of-the-box” solutions are not always there, but they won’t even be entertained if there is a breakdown in the shared goal, which is getting a sustainable health care system in place. If a situation is truly unmanageable, then there is a responsibility to find a solution together. It demands a different approach than traditional “us vs. them” negotiations. A healthy dose of mutual trust will be necessary for resolutions or re-evaluations.
I am intrigued by the cost savings at Quinte Health Care from implementing third-party (Murphy Walsh) consultant recommendations for improved quality of life for nursing staff. Such experts can add tremendous value in honing systems. Of course, time tells whether the dollar return on these efficiencies will help with the budget shortfall. People also have to embrace the changes, and time also tells whether the changes are actually workable for the staff. One hopes that there is a peppering of “sell” in the “tell” for any change required.
It is an exchange that is short and sharp, but you can tell that very quickly the focus has shifted to absolutely the right area.
The reason this stands out for me is that it is an example where the person who actually has “the answer” is able to convey it to others, and the others are actually listening. This is a phenomenon that I would suggest is rarer than it should be. Understandably, it is tough to replicate because it demands that:
1 – there is an absolute answer;
2 – someone actually knows it;
3 – others listen; and
4 – others believe the person who is telling them the answer.
I hope to focus this blog on examples when the (objectively) correct information makes it through. Yes, there will be times that it doesn’t, and we can certainly discuss those, too. I hope to find a suitable tag/title for this moment; something like “moment of truth,” maybe M.O.T. The quest for the John Aaron moment is on!
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