Archive | October 14, 2008

Management by Walking Around – At Night!

(Post by Dan Dunlop)

Recently I wrote an article for Healthcare Advertising Review about “living the brand” at Lexington Medical Center in West Columbia, South Carolina. In the article, I talked about Lexington’s CEO, Mike Biediger, and his habit of walking the halls of the hospital each day – spreading culture along the way. As he walks the halls, he is also mindful of opportunities to improve quality and service delivery within the hospital.

There’s an interesting article in the October 2008 issue of HealthLeaders that takes the concept of management by walking around to the next level. The article, titled “The 24-Hour Executive,” presents the case for executives doing evening rounds to gain insights that will eventually lead to quality improvements in their organization. The point is that at night, you’ve got an entirely different organization. Staffing is limited; there are fewer physicians on duty; and there may be fewer nurse supervisors working. In essence, you’ve got a different hospital at night and on weekends than you have during a typical weekday. Doing rounding at night can reveal opportunities for quality improvements that may not be relevant during the day.

For this story, Maureen Larkin interviewed Ramanathan Raju, MD, the chief medical officer and executive vice president of medical and professional affairs for the New York City Health and Hospitals Corporation. To find the article online, visit

If you’re interested in more information about the benefits of rounding at night, check out the recent article from the New England Journal of Medicine, May 15, 2008. The article is titled “Like Night and Day – Shedding Light on Off-Hours Care” by David J. Shulkin, M.D.