Another Hospital Putting on the Ritz

The usual definition of a hospital is an institution which treats the sick and injured,.  That is a messy business, so some hospital executives seem to yearn to be doing something a little more - shall we say - upscale.  For example, the Chattanoogan reported:

Erlanger Health System will launch in October one of the most ambitious employee training initiatives in its 120-year history. All 4,500 employees will participate in a new service excellence program based on the legendary Ritz-Carlton service model.

'This is not a program. This is the beginning of long-term cultural transformation,' says Erlanger CEO James Brexler. 'Our board and leadership team believe this initiative is one of the most significant developments in the continued evolution of Erlanger.'

The Erlanger Health System strategic plan, adopted by the board of trustees last year, identified service excellence as a priority. Funding for the initiative was approved in this year’s operating budget. The corporate university of Ritz-Carlton was selected to help take Erlanger’s patient experiences to the next level.

A hospital, of course, provides services to patients. However, it seems glaringly obvious that the sort of services required by the sick and injured, especially the critically ill, are very different than those people who go to four-star hotels. Providing care to a patient on a ventilator (breathing machine), for example, hardly resembles providing spa services to a wealthy hotel guest.

Furthermore, Erlanger Health System is a public, non-profit health system with a mission that involves service to the poor:

To deliver excellence in medical care to improve the health status of our region, while providing vital services to those in need, and training to health professionals through affiliation with academic partners

The Boston hotel in the Ritz-Carlton chain, its flagship property, boasts that it:

features hotel rooms and suites in Boston designed as sanctuaries of urban luxury.

Where is the parallel to providing health care services to "those in need" who are acutely ill and injured?

By the way, a few days after the Erlanger, Ritz-Carlton connection was announced, the Time Free Press noted questions about how the contract was awarded:

Erlanger officials defended the no-bid procedure Monday, saying the hospital was correct in bypassing a competitive bid process and awarding a 'professional services' contract to Ritz-Carlton.

'Tennessee law says government entities do not have to bid professional services,' hospital spokeswoman Susan Sawyer said.

Even early in the process, Whisman said, 'it was so clearly the Ritz going forward.'

'There was a lot of board support, executive-level support and steering committee support,' she said. 'Ritz had it all.'

Furthermore, how well the money will be spent may be difficult to find out:

In October, a Ritz-Carlton speaker is expected to lead several four-hour sessions, each of which will hold 400 employees, hospital officials said.

The bill for those sessions is $288,000. On Thursday, Sawyer said Ritz-Carlton prohibited the media from attending the sessions because of proprietary information the hotel chain prefers to keep secret.

It is not that the hospital system has money to burn, as the Chattanoogan just revealed:

Erlanger Health System officials reported a $1.3 million loss for July,...

In addition,

Admissions were under budget by 1.6 percent for the month and ahead of the previous year by 3.8 percent.

So, in summary so far, a public hospital system that is currently experiencing budgetary challenges is spending hundreds of thousands of dollars for the Ritz-Carlton luxury hotel chain to train its employees in secret sessions about "service excellence," and the hospital system's management thinks this is a top priority.

In my humble opinion, this illustrates a larger problem with the leadership of health care. Health care organizations are often lead by ultra generic managers, that is, managers trained in such fields as marketing, public relations, and finance, but without any experience or training in actually taking care of patients. (The supremacy of generic management is strange given that patient care itself has become so specialized.) The utter lack of gut feeling for what health care is really about seems to lead to managers thinking that hospitals are like automobile assembly plants, or in this case, like luxury hotels. I cannot but help believe that such ultra generic managers, who do not appreciate the values of health care professionals, and do not understand the health care context, are going to make some very bad decisions, and are an important cause of health care dysfunction.

I cannot help believe that the Erlanger CEO, Mr James Brexler, (whose most advanced degree was a "Masters of Public Affairs from North Carolina State University") was entirely off base when he was quoted:

'This is not a flavor-of-the-month thing,' continues CEO Brexler. 'This is a strategic priority and business imperative. We are committed to this. We are excited about it. Our staff is excited. Our physicians are excited. The results, we believe, will be evident to our patients and their families.'

True health care reform would make sure health care leaders actually understand health care and uphold its values.

PS - Long ago, we noted the trustees of another hospital system who seemed to think that Ritz-Carlton experience was perfect background for hospital executives.