Alex Lan: systematic management integrating personalized services and medical ethics
“As a non-physician, there are plenty of things that I don’t know,” said Mr. Alex Lan during an exclusive interview with AME at the Chief Executive Officer (CEO) office in the Hong Kong Adventist Hospital—Tsuen Wan (Figure 1), “so I talk and listen to different clinical professionals of the hospital and learn from them.”
All roads lead to Rome
Currently serving as the CEO of the two Adventist Hospitals in Hong Kong, not as everyone might expect, Alex started off as an accountant in a local church and spent the early years of his career in internal auditing. Being devotedly attached to learning, Alex further earned a master’s degree in Software Engineering at Andrews University in the USA and set foot in the healthcare arena by joining the Adventist Health Services Asia as the IT Coordinator, where he initially developed and implemented IT system for hospitals. It was because of this position that he had the chance to get to know different hospitals (Figure 2).
“At that time, there was a vacant position of financial controller (at the Adventist), for which I applied due to my Accounting background, and luckily I got the job!” It was within a short period of time that Alex got promoted to be the Vice President for Finance. After a few years, the two Adventist hospitals merged, a point where Alex was allowed to move to the Administration side and gradually ascended to the position of CEO a year ago.
Alex’s versatile background has caught much of our attention. We are thus curious to know if it assisted or hindered his way to take on the hospital management role. “Having worked in finance, I got the chance to understand the whole organization well, for instance, how the CEO located different resources and what sort of business it ran. I had an overall view of the organization. As a non-physician, there are plenty of things that I don’t know, so I talk and listen to different clinical professionals of the hospital and learn from them. I often talk and listen to doctors and nurses and see how they do things. And as I realize my limitations as a non-clinician, I do a lot of research beforehand” said Alex.
All roads lead to Rome. Alex’s story tells us that no matter where and when you begin, hard work is all it takes to lead you to the road of success.
The daily routine of a CEO
A typical day of Alex begins with two “readings”. First, he reads patient’s statistics and gets to know the number of patients seen the day before, and the number of currently hospitalized patients. Then, he reads reports written by duty managers and sees what is going “on” and what is going “wrong” in the hospitals. If time allows, he would “make rounds” in various departments and mingle with managers, doctors, nurses and other supporting staff who he tried to build relationship with and show support and care to.
There are two campuses of the Adventist Health in Hong Kong, one in Tsuen Wan, another one in Stubbs Road. Alex, therefore, works in pair with the Chief Financial Officer (CFO), Mr. Simon Sim, to take charge of both campuses. Alex explained, “Every week, I roughly spend 3.5 days in the Tsuen Wan campus, which is now expanding from 125 beds to 300 beds. I spend the rest of the week, i.e., 1.5 days, in Stubbs Road. On the other hand, the CFO spends 3.5 days in the Stubbs Road campus and 1.5 days in Tsuen Wan. Basically, he takes care of the Stubbs Road campus, whilst I look after the Tsuen Wan campus.”
Maintaining hospital standard through accreditations and multicenter trainings
As a Christian, non-profit healthcare organization, Adventist Health Hong Kong is recognized as one of the top private hospitals in Hong Kong that has been providing high quality healthcare services to the local community, expatriates in Hong Kong and overseas patients. What is behind the fame is a team of dedicated professionals who are committed to bringing the best to people in need.
As a matter of fact, the high-quality services of Adventist Health Hong Kong are proven by a number of accreditations from several remarkable international organizations. It was accredited twice by the Australian Council on Healthcare Standards (ACHS) in 2010 and 2014 respectively. Since 2000, it has received full accreditation from the Trent Accreditation Board annually. Technically speaking, both accreditations require gradual and continuous improvement. In other words, hospitals have to keep making progress if they have to remain accredited. Therefore, it is a good indicator of the hospital standard not only in local, but international perimeters. In order to obtain the accreditation, there is a set of standards that hospitals have to meet, which however raises every year and might be slightly different regionally due to local medical and clinical practices. Accreditation thus helps benchmark hospitals and guarantees the maintenance of high safety standard and clinical quality.
Adventist Health operates around the world. Just in the United States alone, there are close to a hundred of hospitals and clinics that are striving to provide whole-person healing and wellness for different communities. This broad network brings plenty of advantages to each center by multicenter collaboration, exchange and trainings. Alex elaborated, “The multinational trainings are carried out regularly. When I first started, I was sent across various hospitals to look at how they operate. When we decided to go into ACHS, we sent our colleagues to the Sydney hospital to acquire the related knowledge. Every year, the presidents from about 10 regions including Japan, Korea, Hong Kong and Taiwan meet one another to share thoughts and ideas. These are the privileges that many other private hospitals do not have.”
Learning from mistakes, prioritizing patient’s safety
To be the hospital CEO, one of Alex’s key tasks is to dispose potential bombs. Speaking of that, Alex shared with us a memorable case during his tenure—on one occasion, a patient receiving intravenous treatment was dispensed a wrong dosage of medicine by two registered nurses (RN) due to changed packing. Whilst one of the RNs was new to the hospital and not accustomed to the new packing, the other one was too into guiding the new RN and not aware of the different packing. A mistake was made. Instead of affixing accountabilities in the first place, the hospital immediately took remedial measures by getting their specialists to perform several tests and examinations on the patient, and sending him to Australia for further checkup to ensure no side effect or damage was caused. As luck would have it, no permanent harm was done to the patient.
Success does not consist in never making mistakes but in never making the same one a second time. Thus, the best thing to do is to admit one’s mistake and learn from it. “Human is not a reliable being. We are affected by emotions and surroundings. From this case, we realize the importance of having both experienced nurses to do the double checking before dispensing any medicine. There are many things that we cannot control, so instead of persisting in the variable human factors, we look at the system and see what we can do to better help our staff,” said Alex.
To run a good hospital, Alex thinks the key lies in patient’s safety. Therefore, they have invested a lot in the prevention of infection and have set up policies to prevent surgeons from operating on the wrong patients or wrong sites. Medication safety is one of the key aspects too.
The Adventist’s management style
Whilst “safety” is the key element of a good hospital, “being humble” is the required attitude for a successful hospital management.
The management style of the Adventist is more or less westernized. To Alex, hospitals in Western countries are generally more open-minded. Instead of throwing one’s weight around, they favor communication among different professionals. “We have to admit that we were not born to know everything, especially when we are facing the complexity of the actual operation of a hospital. Therefore, the key is to trust our colleagues,” said Alex. In some hospitals, especially those in Asia, where doctors are the administrators, they tend to think they are the cream of the crop due to their considerable training experience. With an accounting and IT background, Alex is humble and eager to learn from others, whereas doctors or surgeons are usually trained to be very decisive. Therefore, if the administrators use the same approach to manage as they operate on patients, it could be problematic.
To further spread the warmth and care to the community, the Adventist is collaborating with public hospitals in various forms. To deal with the overwhelming demand of medical services, they are lending beds to public hospitals to ease the problems of bed shortage. To cope with the excessive demand for diagnostic services, they are providing supplementary diagnostic services, for instance, Magnetic Resonance Imaging (MRI), Computed Tomography (CT) and the like. Besides, it is to our surprise that the Adventist is offering substantial discounts to patients referred from public hospitals, who can save up to 40% of the medical expenses. Not only do they enjoy discounts, the waiting time is much shortened too. A cancer patient can now consult an oncologist in 3 weeks after the diagnosis. Furthermore, they have been working closely with Yan Chai Hospital for several charitable programs like percutaneous transluminal coronary angioplasty (PTCA) and lithotripsy treatment. Other collaborative projects include vaccine injection, colonoscopy cancer screening project, Fecal immunochemical test (FIT) and so on.
Assessment and evaluation
Needless to say, every hospital went through moments when patients were not satisfied with the services provided. We are thus interested to know how the Adventist deals with complaints and feedbacks.
In Alex’s hospital, there is a duty manager who will respond to patient’s comments or complaints in every shift. Upon receiving complaints, they will usually acknowledge the complainants within 3 days. Technically, duty managers and department managers are the first line of handling the complaints. On top of them are senior nursing officers. If the complaints concern professional performances of the medical services, doctor consultants will intervene to review the cases and see if the complaints are valid. When it comes to the problems of clinical practices, they will try to seek secondary opinion. If patients are still unsatisfied, the cases might be passed on to Medical Council as they supervise physicians. All in all, the Adventist values and pays high attention to all comments and complaints from patients.
Speaking of how to evaluate the performance of the medical staff, Alex said, “We have a competency checklist for every staff. New staff have to join a 2-day orientation program which allows them to have a deep understanding of our settings. Also, we have senior mentors to orientate junior nurses. Continuing Medical Education (CME) and Continuing Nursing Education (CNE) are conducted regularly. Moreover, there is a cultural program called ‘SHARE’ for customer services. As we are a Christian hospital, this program can reflect the compassion of Christ. Having sister hospitals over the world, we can access a wide range of training materials. With the support of overseas trainings, it is much easier for us to absorb the materials and create our own ones.”
Thinking out of the box
In 10 years’ time, Alex wants to open up to 500 beds in the Tsuen Wan campus, which has six floors and may need 2–3 years to fill them up. On the other hand, they will start the project of demolishing the old wing and building a podium. More space is needed for the future development of the hospital and the radiation therapy as well.
“Our vision is to be the regional hospital in New Territories West and there will be no more private hospital coming up in the future. We try to be comprehensive and at the same time provide personalized treatment. We will try to implement and install some customized software to record and to know what the patients like or dislike. Our competitors are of much bigger-scaled, so it is not easy to compete with them. Luckily, being small, we can do something they cannot, like providing personalized care and services related to cardiology, oncology and orthopedics” said Alex.
Messages to the youth
Alex concluded by giving two tips to young doctors and nurses in pursuing their dreams: first, don’t take yourself too seriously. Second—keep learning. He said, “I read a book or listen to an audiobook every month. We should keep learning to broaden our horizons.”
Introduction of Alex Lan
Mr. Alex Lan currently serves as the Chief Executive Officer (CEO) of the Adventist Health Hong Kong. With his education background in Software Engineering and Accounting, he has slowly worked his way up to become the Vice President for Finance (VPF) at Hong Kong Adventist Hospital from 1995–2000. After the amalgamation of the two Adventist campuses, he entered the administration side and became the Chief Operating Officer (COO) at the Hong Kong Adventist Hospital—Tsuen Wan from 2001–2015, and finally ascended to the position of CEO in 2016.
Introduction of the Adventist Health Hong Kong
Adventist Health Hong Kong is a Christian, non-profit healthcare organization served by a team of well-experienced professionals with a passion for excellence, the spirit of Christian service and a commitment to whole-person healing. It has been providing high standard of healthcare to the local community in Hong Kong.
The Adventist Health has branches all over the world, including the United States, Australia, Japan, Hong Kong, Taiwan and Korea. Just in Hong Kong, there are two campuses, one in Stubbs Road, another one in Tsuen Wan. Making good use of the state-of-the-art equipment and highly-skilled staff, the hospitals provide patients with attentive care in a safe and comfortable environment.
In 2010, the hospital was awarded the accreditation certificate by the Australian Council on Healthcare Standards (ACHS). In 2014, the hospital received the accreditation for the second time from the ACHS. Furthermore, the hospital has also received full accreditation from the Trent Accreditation Board every year since 2000.
Acknowledgments
Funding: None.
Footnote
Provenance and Peer Review: This article was commissioned by the editorial office, Journal of Hospital Management and Health Policy for the series “Meet the Experts: the Cutting Edge in Hospital Management”. The article did not undergo external peer review.
Conflicts of Interest: The authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jhmhp.2018.01.01). The series “Meet the Experts: the Cutting Edge in Hospital Management” was commissioned by the editorial office without any funding or sponsorship. Brad Li and Mike Cheung report that they are full-time employees of AME publishing company (publisher of the journal). The authosr have no other conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
(Interviewers: Brad Li, Mike Cheung, JHMHP, jhmhp@amegroups.com)
Cite this article as: Li B, Cheung M. Alex Lan: systematic management integrating personalized services and medical ethics. J Hosp Manag Health Policy 2018;2:4.
