Yes, in an ideal world you would think that administrators would listen to what physicians have to say. Here is some constructive criticism:
1) Leave physicians in place for longer than just a couple of years, along with the administrators. As it stands now most hospital CO's are only there for a couple of years at best, this stands the same for department chiefs and as such the one thing that they are most concerned with is punching their ticket to the next assignment and not stepping on anyone's toes. No one person is at a station long enough to want to invest the effort, pain and energy into implementing changes to a huge system.
2) Loose the "rank" system of the military. Having nurses that outrank the physicians and as such think that they don't have to follow orders or having nurses mandate patient care policy is ludicris. These become the dreaded "clipboard carriers" that are the bane of our existence.
3) Start taking JHACO for what it is worth.... NOTHING... JHACO is a private organization that was started to accredit hospitals, your hospital pays JHACO to accredit it and as such it has a vested interest in passing it's customers. Medicare standards are much more sensible. Clip board carriers love JHACO because it gives them power. Not only that, JHACO holds hospitals accountable to a minimum standard and then to their own standards.
4) Run it like a company, not like the government. In a military facility they have a fixed budget that is not based on production. They want to cut expenses to maximize this budget and patient care comes last. Our OR rooms close down from 15 to 6 at 1500 and 3 at 1800. In the real world, when a surgeon wants to do a case, he gets to do a case, at our facility, you have to beg and plead to do your case.
5) No cookie cutter medicine. CHCS II was just rolled out at our facility and it is geared (horribly at that) to a Family Practice Doc, not a surgical clinic. It is cumbersome, crappy and inefficient.
