Unlike administrators at freestanding ASCs who often work alongside the facility's decision-makers in the OR, hospital surgical directors might go weeks or months without seeing key executives. When your time comes, you've got to be ready to get your ideas and concerns in front of those above you on the organizational chart.

Develop a presence
Regardless of what tops your priority list, the onus is on you to communicate those issues to the hospital hierarchy. "You can be as visible as you want to be," says Gail Egan, president of Lankenau Hospital in Wynnewood, Pa. "A mistake many managers make is to become so inundated with working hard that they don't take the time to publicize and share their ideas."

Ms. Egan recommends you volunteer information, be willing to talk at leadership assemblies and work to develop a public presence within your hospital.

Communication made easy
How can you foster better contact with your CEO? Here's what's worked at Lankenau Hospital.

• A day in the life. Hospital leaders schedule a day, a half-day or a couple of hours - whatever they can spare - to shadow a manager in each of the facility's departments. Ms. Egan says the experience is invaluable for getting a feel for what managers are dealing with on a day-to-day basis.
• Leadership assembly. All hospital managers meet monthly to speak directly to Ms. Egan and the hospital's vice president. Managers bring their departments' concerns or ideas to the assembly, and the hospital's executives provide updates on hospital policies and financials.
• Town-hall meetings. Ms. Egan holds these meetings, open to all hospital employees, twice a year. She starts with a 20-minute update before opening the floor to questions. To ensure she gives every employee a chance to attend a meeting, she schedules a session at 8 p.m. one night, and 4 a.m. and 9 a.m. the next morning.

Think like a CEO
How can you effectively communicate with your CEO if scheduled opportunities are not available? "Think like a CEO," says Deborah Bowen, executive vice president and chief operating officer of American College of Healthcare Executives. "Think of the challenges they face and understand your issue in terms of the hospital organization as a whole and not in terms of your department."

It's also helpful to be considerate of how many matters CEOs have on their plate. Look for the data behind the issue you're presenting, get to the bottom line and cut to the chase. "Getting your message across in an effective manner is really a matter of doing your homework," she says. "Talk to other people on the senior management team, talk to other department managers. You can't make your request an extra task for the CEO. Come to the table prepared with your own data and solutions."

It pays to follow the chain of command to get your message on the CEO's desk. But if that fails to elicit a response, be the proverbial squeaky wheel and you might get the grease.

When you do have the executive's ear, think about the staff you represent. "Don't do the ?I' thing," says Ms. Egan. "Talk about the needs or accomplishments of your team and not yourself."