Hospital safety records, CEO pay increasingly linked

Focusing only on the financial end of the business is no longer the only worry for those in hospitals' top jobs.

By Beth Wilson, AMNews correspondent. Nov. 26, 2007.

Five years ago, it was rare to find a hospital CEO familiar with ventilator-associated pneumonia. Not anymore.

As more hospitals link their chief executive's pay or bonus to safety measures, more top administrators are not only aware of the problem but also well versed on how to prevent such illness.

"This is a period where hospital administrators have to shift what they are accountable for," said Exempla Healthcare CEO Jeff Selberg, who oversees a three-hospital group in Colorado. "We used to think that the clinical staff takes care of patients."

Selberg said he and other CEOs believed it was their job to focus on the financial end of the business. But with hospitals moving toward transparency, it is becoming every CEO's job to ensure personally that medical care is delivered properly and that systems are in place to improve patients' safety.

Although that seems a natural part of any top hospital administrator's position, that expectation is clearly spelled out today in a way it was not before.

For Selberg, his bonus is based on an overall mortality rate that takes into account how often postsurgery blood clots, central-line infections, bed sores, patient falls and cardiac arrests outside intensive care occur. The people he answers to also consider the rate of ventilator-related pneumonia, among other factors, when deciding his bonus.

Years ago, senior leadership teams may have viewed ventilator-associated pneumonia as an unavoidable medical complication, said Maureen Bisognano, the executive vice president and chief operating officer of the Institute for Healthcare Improvement.