Special areas of skill development for a resident hospital administrator

Communication skills

As per George Bernard Shaw, ‘The single biggest problem in “communication” is the illusion that it has taken place’. Communication skills are, as they say, the bread and butter of a hospital administrator. It includes proficiency in written, verbal and non-verbal communication. Acquiring communication competence has four stages, i.e. unconscious incompetence, conscious incompetence, conscious competence and unconscious competence.¹

Verbal communication.Effective verbal communication is consistent, clear and courteous.² Both the sender and receiver of a message must understand the purpose of the message and the expected outcome of the exercise. It is equally applicable to written communication.

Written communication. The skill of written communication plays an indispensable role in the professional life of a hospital administrator and strengthens him/her to communicate the intended message to the receiver with minimal or no distortion. A hospital administrator has to make several types of written communications as a part of his job. These include drafting minutes of a meeting, administrative proposals, quasi-legal orders, circulars and memos, to name a few. The tone and tenor depend upon the nature, purpose and intended audience. Unlike verbal communication, where there is a scope for clarification due to its dynamic nature, written communication is not amenable to immediate rectification once it is made. Hence, understanding the when and how of its use is a special skill.

Non-verbal communication. Facial expression, eye contact, gestures, personal appearance, tone, volume of voice (paralanguage), body language, touch, proxemics and silence are various non-verbal forms of communication that complement verbal communication. It helps to infuse intent into the verbal message.

Information management

Having information is power. However, one must have reliable sources, preferably more than one. It is mandatory to verify and qualify the information. Sensitive information must be communicated to the concerned person only maintaining its confidentiality.

Decision-making skills

A hospital administrator has to invariably make decisions based on the possible alternatives at hand. Individual discretion sometimes makes a distinct impact on the outcomes. Defining the problem is the first step, followed by understanding and analysing it with the possible alternative solutions available. One can choose an alternative based on the rationale of the existing evidence of its merits. Intuition, though important, must be the last resort in decision-making.

Training skills

In a rapidly evolving healthcare landscape characterised by technological advancements and dynamic care delivery, training programmes play a pivotal role in fostering organizational effectiveness. A hospital administrator must hone comprehensive training skills, including its need assessment, design and development, delivery, and evaluation of effective training and assess its effectiveness.

Research skills

Research in hospital administration is devoted to addressing the dynamic, ever-changing needs of stakeholders in healthcare. The hospital administrator strives to deliver care with fewer resources and to unleash the hidden healthcare capacity within existing facilities in order to make healthcare organizations efficient and effective. It is essential to explore various domains of performance management systems, viz making the workplaces enjoyable, training and development, employee satisfaction, performance appraisal and career progress, etc. to improve the services provided by healthcare workers. Hence, it is imperative to direct the administrative research not only to aspects of service provision and delivery but it must also holistically embrace the quality of service.

Information technology (IT) skills

These are crucial for managing the administrative activities of the hospital and should include awareness of cybersecurity, understanding of electronic medical records (EMR) systems, health information exchange (HIE) systems, healthcare analytics and telemedicine.

Skill of understanding legal issues

Knowledge of landmark judgments in various legal matters pertinent to a hospital is crucial for hospital administrators. It helps in understanding how the Courts of Law construe the rules, acts and administrative procedures followed in a hospital. One should try to cultivate a habit of making a repository of such landmark judgements to be used in times of need.

Self-management skills

These are the foundational skills that act as a pillar to excel in the rest of the soft skills. These include: (i) time management, (ii) ability to work under pressure; (iii) prioritizing the work— goal setting; (iv) working without supervision; (v) self-motivation; and (vi) taking responsibility.

Emotional intelligence and empathy

Emotional intelligence is an asset and plays a key role in the career of a hospital administrator. It enables us to understand ourselves as well as others and guides us to manage. A hospital administrator must be aware of his workforce since each employee strives to accomplish certain professional aspirations in their career, either using their competencies or those of others. Incapable achievers follow the individuals as their role models with similar traits who achieved success by deliberate utilisation of other’s skills. Capable achievers find their role models who stood proud on the summit in their career with due valiant repertoire of their refined skills. An administrator will come across both kinds of employees, hence, it is essential to identify the motives of the staff and their selected path to reach success in their career.

Empathy is a learned intellectual process that requires an understanding of feelings.⁵ Empathy is a two-stage process: (i) The understanding and sensitive appreciation of another person’s predicament or feelings and (ii) communication of that understanding back to another person in a supportive way.⁶

Teamwork

It plays a vital role in healthcare, where various disciplines work together for a common objective. A hospital administrator must know that he/she is not the only one in the workplace and that other people too have ideas and feelings and all are working towards the same common outcome. It is imperative to give adequate credit to the contributions of a team member and taking credit for other’s work is unethical and antithetical to the concept of a team. A hospital administrator must understand his workforce and be able to identify and implement best practices. His ability to take feedback both positive and negative from his team members goes a long way in bringing improvements at the grassroot level of the system. As hospital administrators ascend to higher positions in the organizational hierarchy, they may experience a disconnect from frontline realities. To deal with this, they must proactively establish and sustain open feedback channels, ensuring a two-way flow of communication.

Lead by example

A hospital administrator must lead by example. The most inspiring example in the career span of a hospital administrator could be his adherence to the style of Management by Walking Around (MBWA) in both patient care and other hospital areas. He must lead and accompany his team members during physical rounds of these areas to help them understand the problems which operate at the ‘field-level’ and guide them in thinking and implementing actionable solutions.

Skill of introducing innovations in hospital processes

Innovation can be defined as invention, adoption and diffusion. It may be a novel idea, product, service, or care pathway that has clear benefits when being compared to what is currently done. Usability and desirability are the two characteristics of successful innovation.⁷ Introducing innovations in hospital processes requires effective communication and collaboration skills to explain the benefits of the innovation clearly and persuasively to stakeholders, including staff, patients, etc.