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2016 Top 25 Minority Executives in Healthcare--Bruce Siegel: Diverse leadership is a must on the road to equity of care

By | December 14 th,  2016 | America's Essential Hospitals, Center for Health Care Quality, Equity, population health, Top 25 Minority Executives in Healthcare, C-suite, healthcare disparities, Modern Healthcare, president, risk adjustment, safety net, Blog, boards, CEO, diversity, Johns Hopkins, academic medical centers | Add A Comment

 

Classic content: One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Thirty years ago, Bruce Siegel had what he calls “a rude awakening,” running headlong into the perplexing spider web of health disparities as a young MD. It’s been something that he’s spent his entire career trying to solve, albeit not with a stethoscope.

 

“I went off to medical school and started my internship, and I was stunned by what I encountered,” says Siegel, now president and CEO of America’s Essential Hospitals. “I worked in the clinic at our hospital, and it was just a tidal wave of diabetes, heart disease and lung cancer. Most of it was preventable. And the other thing I noticed was that it was mostly affecting communities of color.”

 

It was a frustrating experience, one that led Siegel to pursue a master’s in public health at Johns Hopkins University and try to find public-policy solutions to the nagging issues he saw as a physician. “I felt like I was running an assembly line that never ended. I’d see 200 people with these problems. I’d send them back out and they’d be back a month later.”

 

The New Jersey Department of Health helped pay for Siegel’s education at Hopkins, so he owed them some time when he graduated. He did so well that he eventually became a very young state commissioner of health, then parlayed that experience into running New York City’s health system and a Tampa, Fla., hospital. His early years in leadership after being a clinician were rocky, he admits.

 

“It was a crucible in many ways,” he says. “Sometimes, it was very uncomfortable and I was probably in over my head at points. But it’s where I began to learn that leadership is about giving people space. I really think a leader’s job is to create a safe space for talented people and tools to help them move forward. If I’m giving orders, then I’m failing.”

 

Siegel joined America’s Essential Hospitals in 2010 after eight years as a professor and the director of the Center for Health Care Quality at George Washington University. But at each step of the way, his thoughts went back to those diverse patients in the clinic who found little hope in healthcare. “I had so many patients of color for whom the system simply wasn’t working, but I didn’t understand why.”

 

In recent years, Siegel has begun to see a change as he leads the nation’s essential hospitals, his association’s term for public and other non-profit hospitals with a safety-net role. The association’s members often are a driving force, he says.

 

“It’s great to be in the company of change agents,” he says. “Our members have leaders who care about these problems and are working to fix them. Equity is now front and center in the American agenda. We’re not there yet, but at least today we have the tools.”

 

At times, it’s still a tough slog, he notes. One of the must-haves on the road to equity is diverse leadership, and the effort to improve that is stalled. Medical schools are failing to enroll minority communities, and boards have been far too quiet on the lack of diversity, Siegel says.

 

“I don’t think our boards of directors are demanding this,” he says. “They need to be unequivocal that this is an expectation, not just a nice thing to do. But I don’t think our hospitals are going to look diverse in the C-suite if our boards don’t.”

 

Lack of diversity, Siegel says, is short-sighted because it is harmful to patients and harmful to an organization’s bottom line.

 

“The slow walk on diversity is just bad business,” he says. “We’re not going to succeed if our leaders don’t fully understand the lives of our community and their priorities.”

 

America’s Essential Hospitals is working with the Robert Wood Johnson Foundation on a population health project, and Siegel sees a disconnect between some healthcare executives and the communities they try to serve. “I’ve been in communities where, if you ask the CEO, he or she will talk about chronic disease management as their main concern on population health. But if you ask the people, they’ll say their most pressing need is a safe street for them to walk on, and safe playgrounds for their children. We’re not going to get to population health without addressing what people think of as health.”

 

In the same way, he adds, population health can’t be attained if you weaken the academic medical centers which comprise much of the association’s membership. The AMCs, with their three-legged stool of clinical care, education and research, sometimes feel the ACA is applied like a wildly swung ax, Siegel says.

 

“These are places in America that do what no one else does,” he says. “They attract the sickest people who have the greatest social and economic challenges. Home may be a homeless shelter. English may not be their first language. These patients may have a harder time navigating the healthcare system, and they may be readmitted through no fault of the hospital.”

 

Siegel’s association is pushing Congress for a risk adjustment for these hospitals, which, he notes, had an aggregate operating margin slightly in the red for 2014. Compare that to, say, the pharma industry, which banks about 20 percent profits each year.

 

“To me, the future of healthcare is that hospitals will be at risk for dollars they get. I accept that,” Siegel says. “We’ll do everything we can to make that better, but we also need the regulators and the payers to do their part.”

 

The challenges of America’s Essential Hospitals’ members are personal to Siegel. He and his sister were both born in a public hospital. Their mom emigrated to the U.S. from Haiti. “My family very much depended on a safety net when they came to America. So these issues are near and dear to me and my loved ones.”

 

 

2016 Top 25 Minority Executives in Healthcare--Patricia Maryland: Taking risks helps leaders grow

By | December 12 th,  2016 | Affordable Care Act, Patricia Maryland, St. John Providence Health system, Top 25 Minority Executives in Healthcare, C-suite, Modern Healthcare, risks, Ascension, Ascension Health, Blog, CEO, chief operating officer, diversity, leadership, Sinai-Grace | Add A Comment

 

Classic content: One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Patricia Maryland is talking about her role as chief operating officer for the Ascension Health system, but her message seemingly echoes the philosophy of her entire career: to grow, you must take risks.

 

“A major part of my role is leading through change,” she says. “The healthcare industry is going through tremendous transformation which requires leaders to challenge the way we deliver care.”

 

While Maryland has been honored with a number of awards during the four years she has served as COO and president of healthcare operations, she says the arduous role that preceded her promotion stretched her in ways that made her current success possible.

 

In 2007, Ascension asked her to leave St. Vincent Health in Indiana and move to Detroit to become the CEO of St. John Providence Health System and Ministry Market Leader for Michigan. The recession was just getting started; General Motors and Chrysler were restructuring their debt through bankruptcy. The economic pain that Detroit became famous for was just taking shape. As a result, St. John was hurting too.

 

“That was the most difficult time,” she says. “A number of our patients who were formerly employed ended up losing their insurance. We had to close hospitals. We had to consolidate programs and centralize services, and that was very risky. I had to lead through the change of reconfiguring the health system to create long-term sustainability given the external factors impacting the region.”

 

It was a difficult professional time. But on the personal side, Maryland says she was taking a risk there as well. “My daughter was going into senior year of high school; my son was going into eighth grade. My husband was transitioning his career as well. I knew I had to make sure my family was settled and comfortable back in Michigan after having been away for 4-1/2 years.”

 

Looking back, Maryland says the sizable risk proved to be more than worth it.

 

“When I took on the role in Michigan, it was larger and more complex than my previous role, and I was further challenged because it was during the worse of economic times. But I felt like I grew so much from a professional perspective. That role really provided me with the experience I needed to prepare for my current role as chief operating officer. If I didn’t have that kind of experience in leading through change, I don’t think I would be as effective in my role today.”

 

With success comes confidence, and Maryland is utilizing her voice as one of the most powerful healthcare executives in the country to take aim at healthcare disparities. Through a series of op-eds she’s written, she is candidly and forcefully encouraging healthcare organizations and patients to build on the momentum created by the Affordable Care Act and work toward equity of care.

 

“Part of what spurred this outreach is that the African-American community has really embraced the ACA,” she says. “I think we’ve made some great progress to expand healthcare access for many minority populations, but we know that coverage alone is not enough to eliminate healthcare disparities.”
To truly be effective, Maryland says, healthcare organizations need to help patients navigate health systems that can be difficult to utilize.

 

“We must mobilize the newly insured to connect them to preventive care,” she says. “It’s really important that we get them into the appropriate setting right from the beginning. If you can get into a system early enough, see a primary care physician on a routine basis, and comply with your medication requirements, you can have a better outcome.”

 

Maryland is seeing this prescription for good health lived out in her own family. As the oldest of eight children, she was the primary caregiver for her mother, who passed away from diabetes complications at an early age. Three of her siblings are genetically predisposed to diabetes as well, and they and Maryland are determined that their outcomes will be different.

 

“They’re working hard to stave off diabetes,” she says. “They’re exercising, following and complying with their medication regimen, and keeping their weight under control. They’re taking personal responsibility to do what they need to do to stay healthy.”

 

Not every family, of course, has an executive like Maryland to be its advocate. That’s one reason why Maryland also has long been a champion of diversity in the C-suite.

 

“We definitely need to address the pipeline issues of finding more individuals who represent the type of patient we are treating within our organization,” she says. “But it’s also making sure that those who are in leadership roles have the cultural competency to be able to manage populations to which they are providing care.”

 

Such leaders, though, need to have the attributes of servant leadership, Maryland adds.

 

“The nature of our work requires humility,” she says. “The fact that we are taking care of people at their most vulnerable state, when they are entrusting their lives to us, requires a different kind of leader.”

 

Maryland says her mentors Tony Tersigni (President and CEO of Ascension) and Bob Henkel (President and CEO of Ascension Health) have been her role models for servant leadership. In fact, it was Tersigni who identified her as a potential CEO leader within Ascension after observing her leadership style at DMC Sinai-Grace Hospital. Sinai-Grace also was where she’d unknowingly caught the attention of authors James Kouzes and Barry Posner, who ultimately featured her in their book “The Leadership Challenge” because of the work she did in transforming Sinai-Grace by challenging the process of how care is delivered. During this time, she was able to effectively garner the support from the Jewish community to assist in the transformation.

 

“You never know who’s paying attention to you,” Maryland says. “So always do your best – and do it with grace.”

 

 

2016 Top 25 Minority Executives in Healthcare: After a complex merger, Ruth Brinkley works to build a new culture at KentuckyOne Health

By | November 28 th,  2016 | merger, Top 25 Minority Executives in Healthcare, Modern Healthcare, Ruth Brinkley, Blog, Catholic Health Initiatives, CEO, CHI, diversity, leadership, Louisville | Add A Comment

 

Classic content: 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.

 

 

Medical care is only part of the solution to health disparities

By | August 24 th,  2016 | Healthcare, public policy, Top 25 Minority Executives in Healthcare, Modern Healthcare, safety net, Atlanta, Blog, CEO, diversity, Duke University, Harbor-UCLA Medical Center, health disparities, leadership, public housing, safety, Alameda Health System, quality | Add A Comment

 

Delvecchio Finley doesn’t shrink back from a challenge.

 

That’s one of the reasons his last two jobs have been leading California public health organizations with different but significant issues. But as he surveys the changes needed not only within his own health system but throughout the nation as a whole, he is adamant that healthcare is only part of the solution for what ails the U.S.

 

“Even though access to care and the quality of care is important, access to stable housing, food sources, education and jobs play a greater influence collectively on our overall health,” says Finley, CEO of the Alameda Health System. “I think the evolving research in the field is making it a lot more evident to all of us that those issues are significant social determinants of health.”

 

The interconnectedness of all those factors makes health disparities harder to eradicate, Finley says, but one way to begin is to address the lack of diversity in healthcare leadership and the healthcare workforce as a whole.

 

“Making sure that our workforce is representative of the community we serve – that people who are coming to us for care aren’t just the recipients of that care but can also play a major role in providing or facilitating that care – is what starts to provide access to good jobs and stable housing, and in turn begins to build a good economic engine for the community.

 

“Thus, you’re reinvesting in the community, and that’s how we start to get at the root of this and not just through the delivery of the services.”

 

Finley has some life experience along those lines. He grew up in public housing in Atlanta, where access to healthcare was poor even though the actual care was excellent when he and his family received it. In his neighborhood, he says, the three fields of employment that offered paths to upward mobility were healthcare, education and law enforcement. He was a strong student, and enjoyed helping people, so he was eyeing a future as a physician during his undergraduate years at Emory University, where he earned his degree in chemistry.

 

“Upon finishing my degree, I realized that I loved science but wasn’t necessarily as strong in it as I needed to be to become a doctor,” he says. “But I still loved healthcare and wanted that to be something I pursued.”

 

He explored other avenues and ended up earning his master’s in public policy at Duke University. Finley was the first member of his family to graduate from college and to get a graduate degree as well, but not the last, he is quick to point out.

 

“The thing that I’m most proud of is that, while I was the first to graduate from college, that achievement has set a path for my cousins, nieces and nephews, who have continued to shatter that ceiling for our family.”

 

He says it was also within his family – and within public housing – where he first began learning leadership skills that would result in him becoming one of the youngest hospital CEOs in the country.

 

“I spent a fair amount of my childhood being raised by my aunt, and she was a force of nature,” Finley says with a laugh. “She served as president of the tenant association and she used that position to strongly advocate for reasonable services and humane treatment for people who were in a very challenging circumstance. I learned from her that we have a responsibility to use our gifts – and to use our voice and our station in life – to help people.”

 

That was certainly the impetus for taking the helm at both Alameda and his previous post as CEO of Harbor-UCLA Medical Center.

 

“Both of them are safety-net organizations that serve a disproportionately underserved community,” Finley says. “That resonates with me from both a personal and professional standpoint. They have both provided a chance to work with a team to get our hands around some of these issues because of the very important work and role that these organizations play in their communities.”

 

At Harbor, the bigger challenges were regulatory, not having good, documentable evidence of the quality and safety of the care that was being provided, “which we were able to fortunately surmount and proceed from there,” he says.

 

The difficulties that Finley and his team at Alameda have had to address are different, he says. “A lot of it was short-term economic hardship combined with the growing pains of going from a historical health system that had grown exponentially through recent acquisitions of two community hospitals. We’re just beginning to stabilize and right-size the ship.”

 

The elements for achieving lasting change, both for the health system and the community, are within reach, he says. Alameda’s skilled nursing facilities recently outperformed a lot of private organizations in earning a 5-star rating from CMS, something Finley hopes can be replicated systemwide with a new strategic plan that promotes greater “systemness” and a focus on access, quality, patient experience, and innovative approaches to care delivery.

 

Alameda Health System is also a benefactor of the a state Medicaid Waiver called Medi-2020, which is a partnership between CMS and the State of California that aims to promote continued transformation of the safety-net delivery system for Medi-Cal recipients. And, internally, Finley plans to bring more Lean management processes to Alameda in the next fiscal year.

 

He had begun to explore Lean several years ago when he was at Harbor-UCLA. He and leaders from a number of systems – including Alameda – took trips to watch Lean in operation at ThedaCare in Wisconsin, Virginia Mason in Washington, and Denver Health in Colorado.

 

“I appreciated that Lean wasn’t just a performance improvement methodology and the flavor of the day, but it was an operating system,” he says. “I think my other takeaway from the trip was that Lean is very hard to do. You’re going to have fits and starts, but if you commit to it, it can lead to some very transformative outcomes for your organization and for the community you serve.”

 

Transformative outcomes? Finley personally knows a thing or two about that.

 

 

Debra Canales strives to put people first in the mission of healthcare

By | August 17 th,  2016 | Debra Canales, Top 25 Minority Executives in Healthcare, Catholic healthcare, chief administrative officer, executive vice president, integrated talent, Modern Healthcare, Providence Health & Services, taking risks, women leaders, Blog, chief people and experience officer, diversity, human resources, leadership, medical assistance, mission, Trinity Health | 1 Comments

 

One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Shortly before making the move into faith-based healthcare, Debra Canales remembers giving her former boss the business book “Jesus, CEO” by Laurie Beth Jones. He was grateful for the gift – but hid it in a brown paper bag.

 

“He didn’t feel safe,” Canales remembers now. “It was a pretty revealing moment.”

 

Years later, Canales is earning bouquets of accolades for her bold, holistic leadership at Providence Health & Services in Seattle, where the spiritual aspect of healthcare and work is welcomed as a natural byproduct of being human.

 

“What continues to draw me to healthcare is being able to bring my whole self to work as I center myself and think about a bigger purpose,” she says. “Leadership is not just from the neck up.”

 

Canales’ heartfelt worldview is expressed in very tangible ways at Providence, where in just two years as executive vice president and chief people and experience officer she helped achieve a 50 percent increase in women in senior leadership roles. She also led efforts to provide monetary assistance for employees coping with the high cost of healthcare premiums.

 

“I came to Providence because, when I talked with Rod Hochman (Providence’s CEO), he put people as the number one pillar of his strategic plan,” she says. “That was significant. It was a deeply rooted commitment, and part of that was shaping our talent strategy to be reflective of our communities.”

 

The medical assistance program offers free or reduced premiums tied to household income and the federal poverty level. Caregivers (which is what Providence calls all of its employees) who are at less than 250 percent of the federal poverty level pay no premiums or deductibles and are given seed money to cover out-of-pocket costs. Employees at 250 to 400 percent of the federal level get a 50 percent break on coverage.

 

“When we think about extending and revealing God’s love to the poor and the vulnerable, we need to take care of our own and extend that compassionate service to them as well. There has been an outpouring of gratitude and support, especially from a lot of single mothers and fathers,” Canales says.

 

On the practical side, she’s seeing reduced turnover levels as staff members choose to stay, as well as the highest level of employee engagement and satisfaction in a number of years.

 

“It goes back to our integrated talent strategy – we want to lift up our people as one of the most important elements in how we extend our mission,” she says, “We want to continue to build those enduring relationships with our caregivers and take care of what’s important to them so that they can, in turn, extend that experience to all who come through our doors.”

 

The mission of Providence is key to Canales’ passion.

 

“Mission is the number one factor for us,” she says. “In our engagement surveys, people say that is what brought them here and what keeps them here. It’s that yearning for something more in terms of spirituality and connectivity – the charisms of mind, body and spirit. That is certainly what differentiates us from a Fortune 50 company.”

 

Before she became a respected leader in healthcare, Canales had plenty of experience among such corporate heavyweights. She rose through the ranks as a human-resources executive in retail (R.H. Macy’s Inc.), food service (Yum Brands/PepsiCo), and high-tech (Hewlett Packard/Compaq). She moved into healthcare with Centura Health, then spent more than 10 years at Trinity Health, where she rose to chief administrative officer.

 

She’s become known for leading the charge to make human resources valued as a strategic partner for CEOs, for positioning corporate cultures for change management, and for facilitating resiliency. Yet while taking risks has paid off for her, it was not easy, she allows.

 

“A lot of my movement in my career has been to volunteer for the opportunities no one wanted to take,” she says. “I’ve worked for some very strong, driven bosses. I was always trying to work toward a shared understanding – that’s been my whole approach throughout my career.”

 

It’s an approach some would call courageous. In that, she says, she was influenced by her Aunt Trini, the sister of her grandfather, who was the provincial of a convent – a religious woman who had a lot in common with the Sisters of Providence, who began the health system where Canales now works.

 

“I keep her picture near me as an inspiration,” she says. “When things are hard, I look at her photo and it gives me that confidence to do what’s right. One of my hallmark traits is standing on principle. That’s not always been popular. But for me, that conviction and integrity gives me confidence and self-assurance.”

 

Canales says the woman she was in her 20s climbing the corporate ladder is far removed from the peace she now experiences, influenced not only by Catholic faith but also by the teachings of Buddhist nun and author Pema Chodron.

 

“Back then, I couldn’t take as many risks,” she says. “I could not be as vulnerable as I wanted to be. I followed the success pattern to get promoted and, for me, that was what was more important at that time. It was not always authentic. That’s not who I am now.

 

“In the long run, my wholeness is what I value. It’s a freeing sensation to be able to live life in this way, and to help set others free as well gives me such joy.”

 

 

Gene Woods' influential leadership poised to enhance Carolinas HealthCare System

By | July 27 th,  2016 | American Hospital Association, Top 25 Minority Executives in Healthcare, ACHE, governance, healthcare disparities, Modern Healthcare, Blog, Carolinas HealthCare System, CEO, Christus Health, diversity, Equity of Care Committee, Ernie Sadau, Eugene Woods, Gene Woods, leadership, National Call to Action, safety, quality | 1 Comments

 

One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

It’s the little things that tell you a lot about people.

 

After CHRISTUS Health nominated Eugene “Gene” Woods, its chief operating officer, for Modern Healthcare’s Top 25 Minority Executives in Healthcare awards, the respected executive took a position as president and CEO of Carolinas HealthCare System. But when Woods was presented the award at a Chicago banquet six months later, two tables of CHRISTUS people, including President and CEO Ernie W. Sadau, flew in to show their appreciation to Woods. It was a classy move that revealed volumes about the character of both CHRISTUS and Woods.

 

“CHRISTUS Health was honored to support Gene’s acceptance of this award for the same reason we nominated him—because we firmly believe that his time at CHRISTUS had a positive impact on our ministry,” Sadau says. “Our relationship was truly a symbiotic one, and we wanted to honor that and cheer Gene on to his future endeavors.”

 

Woods helped lead CHRISTUS’ international expansion, expanding in Mexico, and establishing flagships in Chile and Colombia, where he was able to use his Spanish fluency (his mother is from Spain) to communicate with the teams there.

 

“I really enjoyed working with Ernie, the sisters and the whole CHRISTUS team,” Woods says. “We were able to diversify the organization and reposition CHRISTUS internationally. But I’ve always had the goal of serving as the CEO for a large nationally recognized organization committed to being a model for redefining healthcare in the next decade. And that is why I am so excited to be leading Carolinas HealthCare System. It has the depth and breadth of capabilities to chart a new course.”

 

Carolinas is not a turnaround situation. It’s a historically successful healthcare provider and the second largest public healthcare system in the nation, serving patients through nearly 12 million encounters each year. But, during his interview, Woods says board chair Ed Brown quoted the famous adage that, “What got us here won’t necessarily get us there.”

 

Woods says his opportunity is to inspire his Carolinas team “to set a bold agenda for change that outpaces the industry and brings true value to individuals and communities.” In so doing, he says, he’ll be following in a tradition of innovation at the system.

 

“What I appreciate about Carolinas is that there have been a number of pivotal crossroads in our history where leaders could have tried to hold onto the past. Instead, they took the risk of reinventing the organization, and that’s really the reason it’s been so successful.”

 

Success in leadership has been a staple of Woods’ storied career, from serving as president of the ACHE club at Penn State University, where he earned both bachelor’s and master’s degrees, to his positions with the American Hospital Association, where his term as chair begins in 2017 and where he also serves as chair of the Equity of Care Committee.

 

But his interest in healthcare actually stems from two childhood incidents that showed him both the promise and the challenge of the healthcare industry.

 

When he was 10 years old, he was with his mother, sister, aunt and uncle in a car that slammed into a brick wall at a high rate of speed.

 

“Miraculously, we all survived,” he says. “I don’t remember the impact. I just remember that, as soon as the accident happened, it seemed like everybody was instantly there to care for us. It was just an amazing moment.”

 

A later encounter with medical care ended tragically.

 

“One of my aunts died in a hospital of a medication error. She had three young children,” Woods remembers. “It was something that could have and should have been avoided. To this day, I think about what life could have been like for her kids if that didn’t happen to my Aunt Carmen.”

 

Thus, patient safety has been a key priority for Woods throughout his career—in fact, his first management job in a hospital was as a director of quality. He recognizes the industry still has a long way to go on that front but says the latest AHA statistics show the trends moving in the right direction. Between 2010 and 2014, the AHA says hospital-acquired conditions decreased by 17 percent, saving 87,000 lives and $20 billion in healthcare costs.

 

“The goal is to reach zero harm, and I believe the field is on the right track in that regard,” he says.

 

While he also believes much progress is being made in diversifying senior leadership in healthcare, he’s very firm on how that needs to become a bigger priority at the board level.

 

“Our boards do not reflect the communities we serve,” he says flatly. “One of the biggest levers in diversifying an organization is when the board declares that it’s a priority. That was done at CHRISTUS and again here at Carolinas. I think it is an obligation of governance.”

 

What gives him optimism is the work of the AHA Equity of Care Committee, where it’s been demonstrated how diversity leads to improving healthcare disparities. In fact, more than 1,000 health systems recently signed the AHA’s National Call to Action pledge to eliminate disparities. Woods says the goal this year is to have 2,000 systems sign the pledge.

 

“That pledge includes improving collection of race, ethnicity and language preference data so, as we’re studying disparities in care, we have the right data set to use for that,” he says. “The pledge also includes increasing cultural competency training and increasing diversity in governance and leadership. You can’t solve for population health issues without solving for the disparities in care that exist and, in some cases, very dramatic disparities.”

 

After many years as a leading voice in healthcare, Woods remains bullish on where the industry is headed. In a recent talk to students at his alma mater, he told them the opportunities are brighter than at any time in recent memory.

 

“It’s an exciting time to be in healthcare because, in some respects, we’re all learning together,” he says. “Young people have an opportunity to bring an innovative spirit to their careers. But we can never forget that it’s about patients and communities. If you’re in it for those reasons, you’ll be successful.”

 

 

Bruce Siegel: Hospitals need to listen to their communities to tackle health disparities

By | July 18 th,  2016 | America's Essential Hospitals, Center for Health Care Quality, Equity, population health, Top 25 Minority Executives in Healthcare, C-suite, healthcare disparities, Modern Healthcare, president, risk adjustment, safety net, Blog, boards, CEO, diversity, Johns Hopkins, academic medical centers | Add A Comment

 

One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Thirty years ago, Bruce Siegel had what he calls “a rude awakening,” running headlong into the perplexing spider web of health disparities as a young MD. It’s been something that he’s spent his entire career trying to solve, albeit not with a stethoscope.

 

“I went off to medical school and started my internship, and I was stunned by what I encountered,” says Siegel, now president and CEO of America’s Essential Hospitals. “I worked in the clinic at our hospital, and it was just a tidal wave of diabetes, heart disease and lung cancer. Most of it was preventable. And the other thing I noticed was that it was mostly affecting communities of color.”

 

It was a frustrating experience, one that led Siegel to pursue a master’s in public health at Johns Hopkins University and try to find public-policy solutions to the nagging issues he saw as a physician. “I felt like I was running an assembly line that never ended. I’d see 200 people with these problems. I’d send them back out and they’d be back a month later.”

 

The New Jersey Department of Health helped pay for Siegel’s education at Hopkins, so he owed them some time when he graduated. He did so well that he eventually became a very young state commissioner of health, then parlayed that experience into running New York City’s health system and a Tampa, Fla., hospital. His early years in leadership after being a clinician were rocky, he admits.

 

“It was a crucible in many ways,” he says. “Sometimes, it was very uncomfortable and I was probably in over my head at points. But it’s where I began to learn that leadership is about giving people space. I really think a leader’s job is to create a safe space for talented people and tools to help them move forward. If I’m giving orders, then I’m failing.”

 

Siegel joined America’s Essential Hospitals in 2010 after eight years as a professor and the director of the Center for Health Care Quality at George Washington University. But at each step of the way, his thoughts went back to those diverse patients in the clinic who found little hope in healthcare. “I had so many patients of color for whom the system simply wasn’t working, but I didn’t understand why.”

 

In recent years, Siegel has begun to see a change as he leads the nation’s essential hospitals, his association’s term for public and other non-profit hospitals with a safety-net role. The association’s members often are a driving force, he says.

 

“It’s great to be in the company of change agents,” he says. “Our members have leaders who care about these problems and are working to fix them. Equity is now front and center in the American agenda. We’re not there yet, but at least today we have the tools.”

 

At times, it’s still a tough slog, he notes. One of the must-haves on the road to equity is diverse leadership, and the effort to improve that is stalled. Medical schools are failing to enroll minority communities, and boards have been far too quiet on the lack of diversity, Siegel says.

 

“I don’t think our boards of directors are demanding this,” he says. “They need to be unequivocal that this is an expectation, not just a nice thing to do. But I don’t think our hospitals are going to look diverse in the C-suite if our boards don’t.”

 

Lack of diversity, Siegel says, is short-sighted because it is harmful to patients and harmful to an organization’s bottom line.

 

“The slow walk on diversity is just bad business,” he says. “We’re not going to succeed if our leaders don’t fully understand the lives of our community and their priorities.”

 

America’s Essential Hospitals is working with the Robert Wood Johnson Foundation on a population health project, and Siegel sees a disconnect between some healthcare executives and the communities they try to serve. “I’ve been in communities where, if you ask the CEO, he or she will talk about chronic disease management as their main concern on population health. But if you ask the people, they’ll say their most pressing need is a safe street for them to walk on, and safe playgrounds for their children. We’re not going to get to population health without addressing what people think of as health.”

 

In the same way, he adds, population health can’t be attained if you weaken the academic medical centers which comprise much of the association’s membership. The AMCs, with their three-legged stool of clinical care, education and research, sometimes feel the ACA is applied like a wildly swung ax, Siegel says.

 

“These are places in America that do what no one else does,” he says. “They attract the sickest people who have the greatest social and economic challenges. Home may be a homeless shelter. English may not be their first language. These patients may have a harder time navigating the healthcare system, and they may be readmitted through no fault of the hospital.”

 

Siegel’s association is pushing Congress for a risk adjustment for these hospitals, which, he notes, had an aggregate operating margin slightly in the red for 2014. Compare that to, say, the pharma industry, which banks about 20 percent profits each year.

 

“To me, the future of healthcare is that hospitals will be at risk for dollars they get. I accept that,” Siegel says. “We’ll do everything we can to make that better, but we also need the regulators and the payers to do their part.”

 

The challenges of America’s Essential Hospitals’ members are personal to Siegel. He and his sister were both born in a public hospital. Their mom emigrated to the U.S. from Haiti. “My family very much depended on a safety net when they came to America. So these issues are near and dear to me and my loved ones.”

 

 

Patricia Maryland: Taking risks helps leaders grow

By | July 8 th,  2016 | Affordable Care Act, Patricia Maryland, St. John Providence Health system, Top 25 Minority Executives in Healthcare, C-suite, Modern Healthcare, risks, Ascension, Ascension Health, Blog, CEO, chief operating officer, diversity, leadership, Sinai-Grace | Add A Comment

 

One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Patricia Maryland is talking about her role as chief operating officer for the Ascension Health system, but her message seemingly echoes the philosophy of her entire career: to grow, you must take risks.

 

“A major part of my role is leading through change,” she says. “The healthcare industry is going through tremendous transformation which requires leaders to challenge the way we deliver care.”

 

While Maryland has been honored with a number of awards during the four years she has served as COO and president of healthcare operations, she says the arduous role that preceded her promotion stretched her in ways that made her current success possible.

 

In 2007, Ascension asked her to leave St. Vincent Health in Indiana and move to Detroit to become the CEO of St. John Providence Health System and Ministry Market Leader for Michigan. The recession was just getting started; General Motors and Chrysler were restructuring their debt through bankruptcy. The economic pain that Detroit became famous for was just taking shape. As a result, St. John was hurting too.

 

“That was the most difficult time,” she says. “A number of our patients who were formerly employed ended up losing their insurance. We had to close hospitals. We had to consolidate programs and centralize services, and that was very risky. I had to lead through the change of reconfiguring the health system to create long-term sustainability given the external factors impacting the region.”

 

It was a difficult professional time. But on the personal side, Maryland says she was taking a risk there as well. “My daughter was going into senior year of high school; my son was going into eighth grade. My husband was transitioning his career as well. I knew I had to make sure my family was settled and comfortable back in Michigan after having been away for 4-1/2 years.”

 

Looking back, Maryland says the sizable risk proved to be more than worth it.

 

“When I took on the role in Michigan, it was larger and more complex than my previous role, and I was further challenged because it was during the worse of economic times. But I felt like I grew so much from a professional perspective. That role really provided me with the experience I needed to prepare for my current role as chief operating officer. If I didn’t have that kind of experience in leading through change, I don’t think I would be as effective in my role today.”

 

With success comes confidence, and Maryland is utilizing her voice as one of the most powerful healthcare executives in the country to take aim at healthcare disparities. Through a series of op-eds she’s written, she is candidly and forcefully encouraging healthcare organizations and patients to build on the momentum created by the Affordable Care Act and work toward equity of care.

 

“Part of what spurred this outreach is that the African-American community has really embraced the ACA,” she says. “I think we’ve made some great progress to expand healthcare access for many minority populations, but we know that coverage alone is not enough to eliminate healthcare disparities.”
To truly be effective, Maryland says, healthcare organizations need to help patients navigate health systems that can be difficult to utilize.

 

“We must mobilize the newly insured to connect them to preventive care,” she says. “It’s really important that we get them into the appropriate setting right from the beginning. If you can get into a system early enough, see a primary care physician on a routine basis, and comply with your medication requirements, you can have a better outcome.”

 

Maryland is seeing this prescription for good health lived out in her own family. As the oldest of eight children, she was the primary caregiver for her mother, who passed away from diabetes complications at an early age. Three of her siblings are genetically predisposed to diabetes as well, and they and Maryland are determined that their outcomes will be different.

 

“They’re working hard to stave off diabetes,” she says. “They’re exercising, following and complying with their medication regimen, and keeping their weight under control. They’re taking personal responsibility to do what they need to do to stay healthy.”

 

Not every family, of course, has an executive like Maryland to be its advocate. That’s one reason why Maryland also has long been a champion of diversity in the C-suite.

 

“We definitely need to address the pipeline issues of finding more individuals who represent the type of patient we are treating within our organization,” she says. “But it’s also making sure that those who are in leadership roles have the cultural competency to be able to manage populations to which they are providing care.”

 

Such leaders, though, need to have the attributes of servant leadership, Maryland adds.

 

“The nature of our work requires humility,” she says. “The fact that we are taking care of people at their most vulnerable state, when they are entrusting their lives to us, requires a different kind of leader.”

 

Maryland says her mentors Tony Tersigni (President and CEO of Ascension) and Bob Henkel (President and CEO of Ascension Health) have been her role models for servant leadership. In fact, it was Tersigni who identified her as a potential CEO leader within Ascension after observing her leadership style at DMC Sinai-Grace Hospital. Sinai-Grace also was where she’d unknowingly caught the attention of authors James Kouzes and Barry Posner, who ultimately featured her in their book “The Leadership Challenge” because of the work she did in transforming Sinai-Grace by challenging the process of how care is delivered. During this time, she was able to effectively garner the support from the Jewish community to assist in the transformation.

 

“You never know who’s paying attention to you,” Maryland says. “So always do your best – and do it with grace.”

 

 

After a complex merger, Ruth Brinkley works diligently to build a new culture at KentuckyOne Health

By | June 3 rd,  2016 | merger, Top 25 Minority Executives in Healthcare, Modern Healthcare, Ruth Brinkley, Blog, Catholic Health Initiatives, CEO, CHI, diversity, leadership, Louisville | Add A Comment

 

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.

 

 

Diverse governance is a key to population health

By | March 18 th,  2016 | American Hospital Association, Furst Group, population health, governance, Blog, board of directors, diversity, Trustee magazine, Deanna Banks | Add A Comment

 

Classic content from Trustee magazine and Furst Group:

 

"From allocating capital funds to improving community health status, the diverse makeup of the service area has to be factored into decisions, and trustees steeped in the unique factors of that diversity are essential..."

 

That's the beginning premise of a recent article in Trustee magazine from the American Hospital Association on why diversity in the board room is pivotal for organizations seeking to understand and equip their leadership teams to achieve success in population health.

 

Without diversity, notes Furst Group principal Deanna Banks in the article, "What you get is a group-think. You've got similar-minded people from a singular exposure making decisions on behalf of things for which they lack insight and understanding -- and sometimes empathy."

 

Kelvin Westbrook, chair of BJC Healthcare in St. Louis, shares a memorable experience he had years ago about the "shoe test."

 

"If you look under the table and you don't have a diversity of shoes, you're probably going to get a much narrower perspective on what can and cannot work."

 

To read the complete article, click here.