One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.
Mergers and acquisitions are complicated equations when just two organizations are involved. But three? That’s a daunting challenge for anyone. Small wonder that Catholic Health Initiatives turned to a veteran CEO like Ruth Brinkley to choreograph the complicated venture and lead the new KentuckyOne Health system.
Brinkley, who revamped the sprawling organization to survive and thrive under reform, says the bumps in the road are beginning to get fewer and farther between. “I’m a big believer in culture and the impact of culture on strategy and on building excellence,” she says. “One of the things we have consciously worked on since the very beginning was to shape a desired culture. I would say we’re 60 to 70 percent of the way there.”
KentuckyOne Health is comprised of the former Saint Joseph Health System, the former Jewish Hospital & St. Mary’s HealthCare, and the University of Louisville Hospital and James Graham Brown Cancer Center. It is a complicated arrangement. Catholic Health Initiatives is a majority owner of KentuckyOne. The other owner is Louisville-based Jewish Heritage Fund for Excellence. But the individual hospitals that were Jewish hospitals are still Jewish; the Catholic ones are still Catholic; and the university hospital remains secular. The partnership with the university was held up by former Kentucky Gov. Steve Beshear, who initially challenged a full three-way merger over concern that the public university hospital would be required to follow the Ethical and Religious Directives of the U.S. Conference of Catholic Bishops. And that, in turn, slowed down the process and the culture work by about a year.
Daunting? Absolutely. But Brinkley’s eyes were wide open from the beginning.
“I did expect this to be a big job, a big bite, so to speak,” says Brinkley, who left Carondelet Health in Tucson, Ariz., to return to Louisville and CHI. “I believe in the merger, in the vision of what we set out to do. When the days or the issues get tough, I go back to the belief in that vision.”
Brinkley had already achieved much in her career as a CEO and a lauded leader in Catholic healthcare for many years. Her resume was full. But the prospect of the merger energized her, moved her geographically closer to her children and grandchildren, and brought her back to her what she calls her extended family at CHI.
“The real draw was the excitement of the vision for this merger and what it was to accomplish. And it felt familiar. It felt good coming back to CHI. It’s always been a wonderful place to work. You see the mission come alive, and you see the values in people’s hearts.”
While the work of the merger more than filled her days, and many of her evenings, it was a temporary diversion from a personal tragedy.
“I had experienced a big loss in my life; my husband passed away when I was in Arizona,” she says. “Time is a great healer and work is a great healer, if you use it correctly. But I will also tell you that we all eventually have to pay the debt of grief. I like to say that grief can be delayed, but it won’t be denied. The work gave me something to focus on, but we each have to go back and deal with the issues we need to deal with, and I did that as well.”
Brinkley’s career has taken her from rural Georgia, where her grandparents raised her, to urban Chicago as a student and a nursing leader, to a number of other settings. So she is well-versed in the many types of populations that KentuckyOne serves, from Appalachia to Louisville. “The needs are very different across the state,” Brinkley says. “We try our very best to represent and reflect the communities we serve.
“We know that healthcare does not begin and end inside the walls of a hospital, so we’ve developed outreach programs to decrease the use of the emergency room for routine care, and to decrease readmissions. We’re starting to focus more on the social determinants of health.”
Brinkley says she learned many key lessons on leadership from her grandmother, who encouraged her to become a nurse, as she was growing up in Georgia – in fact, in 2009, she wrote a children’s book called “Grandma Said” to honor the woman who shaped her early life. But in Georgia, Brinkley also saw the sad results of those aforementioned social determinants, as family and friends dealt with suffering brought on by health disparities. Thus, she makes it a key priority to move her organizations upstream into the communities whenever possible.
“We know that a hospital only impacts 20 or 25 percent of health status,” she says. “The rest are social determinants. So, for example, at our St. Mary’s facility in west Louisville, we are starting a community garden. It’s a somewhat challenged area with a lot of immigrants. The city is leasing us 4 or 5 acres of land. We are going to engage the community and staff and hopefully be able to help people grow their own vegetables, because we had found through our community health assessment that this was a real need.”
Another need that Brinkley has been talking about for a number of years is the push to increase diverse leadership at the highest levels of healthcare organizations. Patients, she says, benefit greatly from diversity.
“It’s where our greatest opportunity is to serve the community,” she says. “It’s so important for our patients to have people in leadership who look like them and can relate to them. We have a lot more work to do, but we’ve made a good start at KentuckyOne.
“You have to let people know through word and deed that you understand their experience.”
With a wealth of experiences to draw from, Brinkley is trying to do just that.