Checking the Pulse on Hospital Administration–An Externship

I certainly wanted to stay as productive as possible during these past four weeks of winter break.  Thanks to the assistance of Career Services, I had the opportunity to spend three days conducting an externship with Terry Hamilton ’89.  Mr. Hamilton, an economics major in his time at Wabash, is President of St. John Macomb-Oakland Hospital in suburban Detroit.  My exposure to the world of healthcare prior to this externship was limited to visiting a grandparent in a hospital, going to a check-up, or as a hospital volunteer in high school.  Administration may not be able to be seen from your back in a hospital bed; rather, it is what makes the process as seamless as possible (even though it may not always be all that seamless).

As a morning-time ritual, Mr. Hamilton and I reviewed two important sets of documents.  The first is a daily census of the hospital.  In my time at St. John’s, the hospital was experiencing numbers nearing capacity.  Upon my arrival, there were 22 patients in the emergency room who were going to be admitted to the hospital, but were waiting on a bed.  It’s great news for a hospital administrator when it comes to knowing “business is booming,” but by the same token, one cannot hope for high patient satisfaction ratings when waiting 12 hours or more for a room.  An important number that we looked at when it came to the operations of the emergency room is the LWBS, or left without being seen, number.  In the recent days of heavy patient volume, there were, at times, 10 to 15 patients who had checked-in to the emergency room, but had decided to leave before being seen by a physician.  By using linear regression through Excel, we were able to look at the number of ER visits and how that correlated to the number of LWBS patients.  With the equation you find from that linear regression, the question becomes: what number of ER staff will it take to minimize the LWBS number?

The second document set is a detailed safety report from the previous day.  Another great tool that St. John’s utilizes each morning is a “safety huddle,” where representatives from each department meet to discuss what occurred in the past 24 hours that was unsafe for patients.  This can range from falls to putting the wrong identification wristband to a delay in care.  It’s a great way for staff to constantly ask what can be done to better serve patients, and question what can be learned from situations where something does go wrong.

A side of the healthcare system that I didn’t know about prior to my visit was the role of a hospital president as a liaison between the hospital and physicians.  In the case of St. John’s, physicians at the hospital are not employed by the hospital, but instead choose to practice medicine there and choose to send their patients there.  Hospital administrators are forced to walk a tightrope and hold contract negotiations as though they were the GM of a professional sports franchise.  Essentially, the administrator must keep physicians happy in order to ensure that patients are happy and being treated with the utmost of care.

The experience reminded me, yet again, what great opportunities I’m afforded as a Wabash student.   I want to extend my thanks to Career Services, Mr. Hamilton for his kindness and time taken with me, and the entire staff of St. John Macomb-Oakland Hospital for making me feel so welcome and providing such a great environment for me to learn and observe.


Patrick Bryant ’16