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CHALLENGES

Evaluating the vulnerability

of your job

by Raphael C ohen*

indispensible. And to know
what is indispensible the
most effective approach is to
compare output versus cost.
Because the cost is easily and
already measured the only
thing that remains to be
measured in this equation is
the output, hence the need for
indicators.

How will this affect you? If
you cannot demonstrate that
what you are doing is worth
your salary, your job is or, at
one point or another, will be
at risk. To check your
exposure, identify the
indicators that should be used
to measure what you deliver.
There are two kinds of best! In an environment This is the first challenge. Do
people: those who have lost governed by accountability, not fall into the trap of
their job and those who will this is no longer enough. Your measuring activity volumes.
(one day) lose their job. The employer is now (or will soon For instance, measuring the
only question is 'when'?. be) demanding measurable number of patients treated in
This might sound cynical, but results in exchange for your a hospital used to be a good
in today's fast-changing salary. This evolution cor- enough indicator. Because it
environment, nothing will responds to the transition only measures a volume of
stay the same, even in the from a "culture of efforts" to a activity, it does not measure
public sector. Civil servants "culture of results". efficiency. The final purpose
are unfortunately not immune
of a hospital is not to
to the trends affecting society. Even
public
sector
maximize the number of
organizations are affected by patients, but to treat patients
One of these trends is the this trend calling for at the lowest reasonable cost
growing accountability in all accountability and efficiency:
while having satisfied
aspects of our life. better use of public money
patients and doctors. A more
Accountability is the liability means more measurable out- relevant indicator could, for
to be called on to render an put for the money spent. The instance, be the operating
account. Accounts are by world economic crisis expenses of the hospital
definition measurable. This reduced (and will continue to divided by the number of
means using indicators to reduce) government income
satisfied patients. Because
verify the return on (lower
while
taxes),
such a ratio only takes into
investment (= the output or increasing their disburse- account the "satisfied"
the result). Since the salary ments to salvage some patients (or their family), it
paid is an investment and not vulnerable economic sectors. expresses the real finality of
a gift, your investor/employer This means less money the hospital. Jam not trying to
is expecting something back available to pay current say that this proposed
in return. Until recently, a budget expenses, which indicator is the right one for a
presence and "best efforts" necessarily leads to budget
were generally considered to cuts. Governments are not hospital, but only to show
that the choice of indicator
be good enough: you are at different from companies: MUST express the final
your desk and you do your they cut what is less
20 4 2009 Diva

www.divainternational.ch