Newman's Notions | March 2019 | FREE
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The suite spot

Some hospital administration acronyms are explained.

There is a mysterious space within every hospital where most employees fear to tread. It is a suite of offices inhabited by the dreaded Cs. This misunderstood and mysterious breed of administrators is responsible for forging the path, setting the tone, and keeping the forces of chaos at bay. Whatever happens behind those crimson drapes is usually opaque to the mere mortals who toil away in the hospital. But today we pull back those curtains, shine the light beneath the boulder, and introduce you to the all-star members of the “C Suite.”

Illustration by David Rosenman
Illustration by David Rosenman

CBO: Chief Bureaucracy Officer. It might seem odd to start with the CBO, but rest assured that no hospital can exist without one. They know the pathways through the byzantine morass of committees, policies, procedures, programs, centers, offices, and the most dreaded of all, project charters. Don't even consider bring forward a new service line or metric without the CBO to shepherd it along.

CHO: Chief Hysteria Officer. Sometimes things can get crazy in the hospital. Patient elopement? Lost revenue? Excess falls? Increased rate of pressure ulcers? Low HCAHPS scores? Like Henny Penny's fear of the falling sky, your CHO is ready, at the drop of a hat, to fill the hallways with perturbation, consternation, and agitation. There is no funding problem, no family controversy, no abnormally colored water coming from the sink that cannot be made better with some good old-fashioned panic.

CFO: Chief Fun-ancial Officer. The C-suiters are a joyous bunch. Need access to a pro sports event? How about tickets to the opera? Or perhaps you just want to have a nice cozy dinner for twenty? Need your pet project funded, and some extra FTEs on the side? The CFO will have you covered. And don't worry, if you're not a C-suiter, the CFO is also there for you: There's Taco Tuesday and free turkey on Thanksgiving.

CDO: Chief Disinformation Officer. From our friends at the Soviet hospital of outstanding outcomes comes a recent addition to the C Suite, the CDO. There is no report that is too small to twist or too large to spin. Your hospital is #1 for something. It might be for inpatient podiatry services among mid-sized, not-for-profit, riverside, Mountain-Time-Zone hospitals, but guaranteed the CDO will promote it. You'll see it on a banner in the airport. If you want to share your fabulous outcomes, or perhaps just your fair to middling ones, see the CDO and you'll be treated like a “top” performer. The CDO is beloved, just ask him.

COO: Chief Obstruction Officer. The COO may sound like a dove but without a doubt is more like a hawk. There is no project so essential, so vital, so important, that it cannot be undermined by the COO. The COO may work closely with the CBO, but like yin and yang, no matter what you want to do, the COO will find a reason to make sure it doesn't happen.

CNO: Chief Napping Officer. You knock on the CNO's door and there is no response. You hear a noise like a chainsaw dancing with a sledgehammer. The note on the door says “Construction Zone.” But in fact it's the sonorous respiration of the CNO. Everyone likes a nap, and it's the CNO's duty to take one for you. The latest paper on the benefits of sleep for patients, and another on the value for housestaff, is music to the ears. Frequently the CNO is trained in sleep medicine.

CEO: Chief Execution Officer. The job of the CEO is fairly straightforward. When something goes wrong, the CEO is there to apply some frontier justice. Someone needs to be rebuked? Call the CEO. A program slashed? CEO. And when the time comes to break out the guillotine, the CEO will be there to break the bad news about termination. Always keep the CEO happy. You never know whose head will be next on the chopping block.

CYAO: Cover Your A** Officer. The hospital should never be left hanging. It's fine to have an army of lawyers, but when push comes to shove, it's the CYAO that keeps everyone out of trouble, especially the CYAO herself. She'll always favor extra testing but be the first to point out that she warned against overutilization of resources. The CYAO works very well with the COO to make sure nothing happens that can go wrong, ever.

CMO: Chief Metrics Officer. The CMO is an essential member of any team, but a truly exceptional CMO can do so much more. Want to know toilet paper usage on the fifth floor? The CMO can tell you. Number of surgery admissions on rainy days in winter months? See the CMO. The CMO lives and breathes data, whether the source is reliable or not. The CMO works hand in hand with the CDO.

New in 2019, a variety of officers have been added to the suite, though the CBO has not yet finished with the approval process due to the ministrations of the CDO. In brief:

  • The CIO (Chief Idiocy Officer) oversees all meaningless and annoying projects.
  • The CAO (Chief Antagonism Officer) won't tell us what he does. (Do we have a problem with this, punk?)
  • The CUP works with drug testing.
  • The CBGB oversees all elevator music.
  • The CIEIO works with the Department of Agriculture.
  • The CGI looks just like a real administrator but is not real.

If you have any questions, please forward them to the Chief Non-Responding Officer, who will be sure to get back to you soon.