“An opportunity to deal with matters conceptually”
This issue, I have decided to take the interview with “doctors” section not from the perspective of a doctor, but rather of those who play a large part in hospital operations. Šárka Kulkusová’s story, however, has given me plot twists and surprises at a number of levels. Meet a lady whose mission is to connect and communicate knowledge, and through sharing and teamwork move things forward. She has held numerous management positions within pharmaceutical and medical device companies for over 15 years. She studied Healthcare Management at the Advance Institute. She ended her career in a regional role, but at that time she was already battling burnout syndrome. Once she discovered that a career within corporations did not fulfil her, she swapped corporations in the capital city for working where she lives and in a sector which is currently fulfilling her. For a year now, instead of selling medical devices she has been dealing with all strategic purchases for the hospital where she works. She has time and energy to spend on her family life and five-year old daughter. She is continuing her studies too, taking a course in Authentic Leadership. The history of Rudolf and Stefanie Hospital in Benešov goes back to 1898. At the beginning of the 20th century, the hospital operated a unique tuberculosis ward in Benešov, one of a small number in Austria-Hungary, and another important milestone in the hospital’s history is the boom in laparoscopy during the 1980s when the hospital was at the cutting edge of the field. While in the past patients insisted on seeing experts in Prague, today in contrast many Prague residents travel for treatment outside the city. The benefits include shorter appointment and waiting times, a personal approach and a more intimate, almost family environment with care at least comparable to university hospitals.
A year ago, you swapped a corporate environment for the public sector, while remaining within the healthcare sector. How did you perceive this change?
Healthcare is a constant presence throughout my whole career, and I am very pleased I took the opportunity to stay in the field. The leap from one of the largest healthcare corporations in the world to the public sector was a big one. At the very beginning, it felt like it was a completely different world, but with each new day I came to realise, and I am still discovering, that both worlds have a lot in common. The experience of working in an international, frequently culturally very diversified, team has undoubtedly helped me to quickly adapt to different environments. I was able to exploit this experience, for example, in the process of hernia centre certification by an American independent accreditation company, something our hospital acquired last year.
I see a certain difference as compared to the corporate sector in the flexibility of decision-making – we deal with problems here and now, using more direct processes, with less meetings, planning and reports. On the other hand, healthcare is subject to loads of regulation, the legislative framework isn’t always entirely simple and this naturally places demands on both medical and non-medical staff, and the job of management is to set up conditions within the organisation such that the administrative burden and processes are as efficient as possible while remaining in line with all regulations. Another large area is company culture, which, regardless of whether you are in the corporate or public sector, is very important in achieving good results whether in terms of care provided or in terms of economic parameters. My colleagues and I perceive this area as highly important. I see further space for development and investment in the computerisation of processes, opportunities for sharing and data harmonisation between hospitals within the one overall authority leading to greater efficiency both in purchase and, for example, in the spectrum of care provided. To be honest, this was probably the greatest surprise for me. Each hospital has its own different IT system, but unfortunately the systems can’t always communicate with each other, even within one hospital. Working with data thus takes a long time due to the absence of a single system of analytical tools and so on. One positive is that with EU grant programmes, hospitals have an opportunity to deal with these often costly investments, even at the overall authority level. After working in the hospital for a year, my greatest reward is the feeling of a job done well, and the purpose behind what I do. As in my previous jobs, I’ve been really lucky in my high quality team and colleagues, something which is an important factor for me since the positive and clearly grasped results of teamwork are my greatest motivation.
Many forty-somethings are looking at leaving corporations and seek out other ways of working which will fulfil them more. What was the crucial moment for you?
There were definitely a number of factors involved. I had been gradually losing enjoyment from my work. Corporations are usually highly focused on performance, and with increasing globalisation it isn’t always possible to deal with matters in the way which is best at a local level. After 10 years, I had the feeling that I had nothing more to offer the company. Paradoxically, I had begun to have these feelings at a time when I was doing well professionally, I had a team which was working well and we had great results. I was ever more looking at what next, how to continue… I knew that I had to change a number of things in my life, but I didn’t have a clear idea of how to do so, and probably for the first time in my life I couldn’t even clearly define it myself. After leaving the corporation and numerous medical issues, I prescribed myself a holiday of a number of weeks with my daughter, and I put the direction of further professional steps on ice. By chance, immediately upon returning from my travels, I found out about a newly opened position in a hospital near my home. Intuitively, I felt that this was an opportunity I wanted to take on, and I was successful and landed on my two feet in the public sector. I was very attracted to being able to be there at the genesis and having the power to influence how parameters and purchase management processes would be set up within the hospital. The opportunity opened for me to deal with matters conceptually within a local environment where the main parameters aren’t just numbers and performance, but with great stress placed on a personal approach both towards our clients and in the quality of care provided.
You’ve swapped Prague for Benešov. What are the specific features of your hospital?
Benešov’s Rudolf and Stefanie Hospital can boast a very long history – this year we’re celebrating 120 years since we were founded. We currently have around 830 employees, making us the second largest employer in the region. We have 20 specialised departments which provide both outpatient and inpatient care. The spectrum of care we provide is set in line with the hospital’s regional status, with Internal Medicine, Surgery, Orthopaedics, our newly renovated Gynaecology and Maternity ward, and our ENT department including sleep laboratory forming our principal departments. Our objective is to provide primary care. We have opened a new inpatient rehabilitation ward where care is provided to patients following joint replacements and others – conceptually it builds on our Orthopaedics division, which performs the full range of joint replacements. It is certainly not our ambition to build up highly specialised centres. For our clients whose conditions require specialised treatment, we secure specialised care at Na Homolce hospital, with whom we concluded a Memorandum of Cooperation last year. We provide patients with care in a pleasant family environment in which we place emphasis on a personal approach and close multidisciplinary co-operation. It is no exception for patients from more distant regions to seek us out, especially within ENT, orthopaedics and our Gynaecology and Maternity ward. Last year, our hospital became the only certified Center of Excellence in Hernia Surgery in the Czech Republic (COEHSTM), joining ten other Centers of Excellence in Hernia SurgeryTM around the world. In November 2017, we successfully renewed our Spojené akreditační komise, o.p.s. (Joint Accreditation Commission – SAK) accreditation, and we were very pleased to once again be awarded the title of Best Central Bohemian Region Hospital 2017 in the safety and satisfaction of outpatients and inpatients. Personally, I see as very positive the fact that despite dealing with a lack of staff like every healthcare facility, we have not as yet been forced to limit care as a result.
What is your vision and mission for your new position?
Along with my colleagues, I have many plans in my new position, and I trust that we will be able to gradually implement them. Personally, I am really looking forward to one new project: creating our hospital charitable foundation. Another goal is to build a new complete rehabilitative care wing, and the complete renovation of our Internal Medicine wing. My personal goal is the computerisation of the purchase system across the hospital, which will allow us to work more efficiently. Another objective is to gradually boost co-operation between individual hospitals falling within the one authority, and not just in terms of purchasing. I will definitely be satisfied if we manage to maintain current quality, especially in the field of medical devices and medicines, without having a negative impact on the hospital’s budget. Working in healthcare is very fulfilling and it brings me joy that I can work, and perhaps even help a little, in moving forward the hospital in the region where I live and where I was born. I am glad I can apply what I have learnt in business, and thanks to sharing experience with my colleagues move things forward for the better. Work in my new team enriches me enormously, and allows me to continuously learn.
Let’s move on to your Masters of Healthcare Administration studies.
I would highly recommend studying Masters of Healthcare Administration to anyone in a management role in the healthcare sector, and also to doctors in management roles. The programme gives students a comprehensive overview of contemporary healthcare. I was very pleasantly surprised by the high quality of teachers, structure of lectures and I also see added value in the high quality and diverse selection of students. Programme participants come from various segments – hospitals, insurance companies and suppliers, allowing for fascinating discussions, and the acquisition of real, practically applicable knowledge.
Work–life balance is major topic not just for healthcare personnel, but also managers. How are you managing in this regard?
If I were to give it a school-type grade, then I’d give my past year a B. I believe that everything that happens to people in their life has some significance or meaning, and in my path I have finally learnt to spend time on myself. I have a strong and stable family life, for which I thank my great parents. Contentment in my private life is very important for me, because when one’s working and personal life are imbalanced for a long time it creates negative consequences which sooner or later will make themselves apparent. I am a person who can’t do nothing, and as such I spend my leisure time actively with my daughter, partner, friends and family. I love good food, I really enjoy cooking which is a kind of relaxation for me, and if I can combine good food with travel, then that’s just ideal.
Your final message…
I probably can’t change the direction of the wind, but I can certainly set up the sails on my boat so I can always sail to where I want to go.
By Linda Štucbartová
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