Passing the buck

Portland, Maine— A Johns Hopkins’ study published in 2016 estimated there are at least 250,000 annual deaths in U.S. hospitals related to medical errors. The complex coding and billing systems in the U.S. contribute to the challenge of documenting the precise number of deaths that are traced to errors.

Medication errors are a significant component of preventable deaths due to errors in hospitals. There are tens of thousands of deaths related to medication errors every year in the U.S.

Although hospitals don't like to discuss this topic publicly, it is very real and virtually every hospital has experienced unnecessary deaths due to medical errors. The good hospitals and practitioners will try to learn from mistakes made to improve future processes and outcomes.

As CEO of a hospital, you have responsibility for everything that happens in the hospital. Like the captain of a ship, good or bad you are solely responsible. President Truman said it best, “The Buck Stops Here!” When outcomes are good, you have contributed to them based on the people you've hired and the policies you've put in place. When something bad happens, you own that, too, as the people hired and processes you've put in place have played a role in the outcome.

This true story is about the time I learned a lesson on the consequences of passing the buck.

A couple of decades ago at one of my first CEO appointments, the team I had assembled was coming together and performing very well. Admissions were increasing. We had hired some new physicians and the finances were improving. HR was humming and the clinical division was working together and taking care of our patients, living up to the great tradition of the organization.

There was a national shortage of nurses and our Medical-Surgical Unit had some openings for registered nurses. The pressure to fill open positions to eliminate overtime and agency costs was intense.