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Classic content from 2015 Top 25 Women in Healthcare: Maureen Bisognano from the IHI

By | October 30 th,  2015 | Healthcare, Triple Aim, hospitals, IHI, Maureen Bisognano, Modern Healthcare, Blog, CEO, Institute for Healthcare Improvement, leadership, MOOC, safety, upstream, quality, Top 25 Women in Healthcare | Add A Comment

 

Classic content from 2015: One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2015.

 

For the last 20 years, it’s been common for healthcare executives to look to the aviation industry for both inspiration and best practices in improving quality and safety. But Maureen Bisognano, CEO of the Institute for Healthcare Improvement, thinks perhaps we should look beyond the horizon for the next step.

 

“Twice this year, IHI has led a study tour down to NASA,” says Bisognano, who is retiring at the end of the year. “When you walk into NASA, there is a wall that tracks the journey of a space shuttle from when it comes onto the launch pad until it returns safely back home.”

 

That board also tracks every near-miss, equipment failure, employee injury and fatality that has happened across the shuttle program. And when teams see that wall, that gets them thinking about the depth of the details in such transparency.

 

“Nobody in healthcare understands safety that way,” she says. “If we make an analogy to healthcare, the left side of the map might answer questions like: Have we safely admitted patients into the hospital? Do we understand everything about that patient’s care and life outside the hospital, and have we brought that knowledge to the people who will be caring for that patient in the hospital?”

 

The other side of the board, Bisognano says, could provide responses to the question, “Have we safely guided this patient back into the community with access to medications, food and care?”
Looking at healthcare issues from a different angle is standard operating procedure at the IHI, which can usually be found on the cutting edge of health innovation. And, while it is true that the healthcare industry is adjusting to some of the biggest changes in its history under the Affordable Care Act, it’s Bisognano’s belief that the current disruptions are small compared to what’s coming down the pike.

 

“I think leadership is in the midst of a transition,” she says. “Leaders are going to be out in the community in ways they never were before. They’re going to begin to understand what it’s like to live in a particular neighborhood –how can their hospital or physician practice or ACO create health in that environment? They’re going to be looking way outside the walls of the organization. I think they’re going to be challenged by managing multi-professional teams, because there is no way that healthcare can be provided by a specific discipline anymore.”

 

Those are bold words, but Bisognano says that scenario is the end result of what it means to move “upstream” into a community to deliver care, a concept that has been around for years but is gaining new urgency as hospitals and health systems seek to prevent readmissions. And data is the key to that, Bisognano notes.

 

 

“The notion of ‘upstreamism’ means that people are going to be engaging with data and technology in ways that they never did before,” she says. “We need roles like ‘upstreamists’ and ‘extensivists.’ Upstreamists are people who say, ‘I will look at all of the population health data, and I will help us to think about what kinds of interventions will have the greatest impact on health by looking way upstream.’ ”

 

In a new project called One Hundred Million Healthier Lives, Bisognano and the IHI are having the chance to put a grand notion like that into practice by partnering with community organizations as well as a number of healthcare providers across the country.

 

“As an example, I’m seeing in some communities that the upstream data is telling the healthcare system that the biggest impact it could have is to work on getting homeless veterans into permanent housing,” she says. “In another community, we’re looking at the healthcare system partnering with others to work on the health of children under 5, because the children of that community are not healthy right now.

 

“By ignoring that population, these children are going to experience a future 70 years of bad health and lots of unnecessary cost and burden on the healthcare system. But if we put our focus and attention on those kids, we’re hopefully buying them and the healthcare system 70 years of good health.”

 

IHI’s sphere of interest extends far beyond North America. Bisognano and the IHI have long studied other nations’ healthcare systems, and she is quick to note that U.S. healthcare providers can get quite an education from other nations.

 

“I have the great fortune to be in a position to work in different countries all over the world. I see opportunities for us to learn from other countries – some low- and middle-income countries – and certainly from countries like Sweden and Denmark,” she says. “With the speed of change needed here, leaders who can look up and look out will be able to incorporate new models, new ways of thinking in a way that gets to the Triple Aim much more quickly.”

 

The Triple Aim, of course, is one of the IHI’s signature initiatives – improving the patient experience, improving population health, and lowering healthcare costs. It has been adopted by numerous hospitals and health systems. Through its conferences, research and open school (265,000 students in 73 countries), the IHI has multiplied its influence over the past two decades. Now, it is partnering this fall with the Harvard TH Chan School of Public Health to offer a free massive open online course (MOOC) that Bisognano hopes will attract more than 30,000 physicians and nurses in the next year.

 

Through all of these channels, Bisognano hopes the IHI will play no small role in preparing next-generation leaders. “I’m so encouraged with the students who are learning improvement. They see improvement as just a way of life, so they don’t feel the frustration. They also don’t tend to get as burned out because, when they see a problem, they have the tools to improve it.”

 

 

Maureen Bisognano looks beyond the healthcare silo for improvement

By | October 16 th,  2015 | Healthcare, Triple Aim, hospitals, IHI, Maureen Bisognano, Modern Healthcare, Blog, CEO, Institute for Healthcare Improvement, leadership, MOOC, safety, upstream, quality, Top 25 Women in Healthcare | Add A Comment

 

One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2015.

 

For the last 20 years, it’s been common for healthcare executives to look to the aviation industry for both inspiration and best practices in improving quality and safety. But Maureen Bisognano, CEO of the Institute for Healthcare Improvement, thinks perhaps we should look beyond the horizon for the next step.

 

“Twice this year, IHI has led a study tour down to NASA,” says Bisognano, who is retiring at the end of the year. “When you walk into NASA, there is a wall that tracks the journey of a space shuttle from when it comes onto the launch pad until it returns safely back home.”

 

That board also tracks every near-miss, equipment failure, employee injury and fatality that has happened across the shuttle program. And when teams see that wall, that gets them thinking about the depth of the details in such transparency.

 

“Nobody in healthcare understands safety that way,” she says. “If we make an analogy to healthcare, the left side of the map might answer questions like: Have we safely admitted patients into the hospital? Do we understand everything about that patient’s care and life outside the hospital, and have we brought that knowledge to the people who will be caring for that patient in the hospital?”

 

The other side of the board, Bisognano says, could provide responses to the question, “Have we safely guided this patient back into the community with access to medications, food and care?”
Looking at healthcare issues from a different angle is standard operating procedure at the IHI, which can usually be found on the cutting edge of health innovation. And, while it is true that the healthcare industry is adjusting to some of the biggest changes in its history under the Affordable Care Act, it’s Bisognano’s belief that the current disruptions are small compared to what’s coming down the pike.

 

“I think leadership is in the midst of a transition,” she says. “Leaders are going to be out in the community in ways they never were before. They’re going to begin to understand what it’s like to live in a particular neighborhood –how can their hospital or physician practice or ACO create health in that environment? They’re going to be looking way outside the walls of the organization. I think they’re going to be challenged by managing multi-professional teams, because there is no way that healthcare can be provided by a specific discipline anymore.”

 

Those are bold words, but Bisognano says that scenario is the end result of what it means to move “upstream” into a community to deliver care, a concept that has been around for years but is gaining new urgency as hospitals and health systems seek to prevent readmissions. And data is the key to that, Bisognano notes.

 

 

“The notion of ‘upstreamism’ means that people are going to be engaging with data and technology in ways that they never did before,” she says. “We need roles like ‘upstreamists’ and ‘extensivists.’ Upstreamists are people who say, ‘I will look at all of the population health data, and I will help us to think about what kinds of interventions will have the greatest impact on health by looking way upstream.’ ”

 

In a new project called One Hundred Million Healthier Lives, Bisognano and the IHI are having the chance to put a grand notion like that into practice by partnering with community organizations as well as a number of healthcare providers across the country.

 

“As an example, I’m seeing in some communities that the upstream data is telling the healthcare system that the biggest impact it could have is to work on getting homeless veterans into permanent housing,” she says. “In another community, we’re looking at the healthcare system partnering with others to work on the health of children under 5, because the children of that community are not healthy right now.

 

“By ignoring that population, these children are going to experience a future 70 years of bad health and lots of unnecessary cost and burden on the healthcare system. But if we put our focus and attention on those kids, we’re hopefully buying them and the healthcare system 70 years of good health.”

 

IHI’s sphere of interest extends far beyond North America. Bisognano and the IHI have long studied other nations’ healthcare systems, and she is quick to note that U.S. healthcare providers can get quite an education from other nations.

 

“I have the great fortune to be in a position to work in different countries all over the world. I see opportunities for us to learn from other countries – some low- and middle-income countries – and certainly from countries like Sweden and Denmark,” she says. “With the speed of change needed here, leaders who can look up and look out will be able to incorporate new models, new ways of thinking in a way that gets to the Triple Aim much more quickly.”

 

The Triple Aim, of course, is one of the IHI’s signature initiatives – improving the patient experience, improving population health, and lowering healthcare costs. It has been adopted by numerous hospitals and health systems. Through its conferences, research and open school (265,000 students in 73 countries), the IHI has multiplied its influence over the past two decades. Now, it is partnering this fall with the Harvard TH Chan School of Public Health to offer a free massive open online course (MOOC) that Bisognano hopes will attract more than 30,000 physicians and nurses in the next year.

 

Through all of these channels, Bisognano hopes the IHI will play no small role in preparing next-generation leaders. “I’m so encouraged with the students who are learning improvement. They see improvement as just a way of life, so they don’t feel the frustration. They also don’t tend to get as burned out because, when they see a problem, they have the tools to improve it.”

 

 

With King vs. Burwell decided, bold leadership becomes a mandate for healthcare delivery and financing

By | June 29 th,  2015 | Furst Group, Healthcare, Supreme Court, Bob Clarke, health systems, hospitals, King, King vs. Burwell, affordable care, Blog, Burwell, CEO, leadership, transparency, quality | Add A Comment

 

By Bob Clarke

CEO, Furst Group

 

The King vs. Burwell decision once again had healthcare leaders, both payers and providers, holding their collective breath to see if years of work would be undone. Now that the Supreme Court has weighed in, by a surprising 6-3 margin, to uphold the ACA and its subsidies, there still remains a lot of work to do. So the question for the healthcare industry is, how can CEOs and boards best demonstrate leadership to their organizations and their communities going forward?

 

Regardless of where one falls in the political debate, this decision was anxiously anticipated by all. Our industry has had more than its share of uncertainty over the years and having this decision behind us will allow for the great work that organizations have done thus far to continue. Without a doubt, patients and families are seeking access to quality care at an affordable cost, all wrapped in a package of transparency. Significant strides have been taken toward this goal but the threat of constant change and disruption of the payment system doesn’t allow an organization to focus or to plan too far ahead.

 

However, we have seen some leaders be very bold and stake their future on this continuing trend. They have been very proactive in creating services and pricing schemes that are consumer-oriented. Their vision has allowed for open discussions with others about potential partnerships and collaborative models. These are trends that need to continue.

 

These are times of uncertainty, to be sure. Bold leadership, however, seizes on this as opportunity. Teams that come together to think about what can be realized serve their organizations and constituents far better than teams that focus on market protection and guarding the status quo. The latter often find themselves holding on to a model that quickly becomes outdated and stagnant.

 

Patients want and deserve excellent care in a system that is far less complicated than what we have had in the past. May the evolution (or rather, the revolution) of healthcare continue and bring our delivery and financing system to a level that was only dreamed about not too long ago.

 

 

Profiles in Leadership: For Gail Donovan, the details matter

By | August 16 th,  2011 | business, profile, Top 25 Women, urban, executive, hospitals, interview, Modern Healthcare, New York, operational effectiveness, value-based purchasing, article, Blog, chief operating officer, electronic medical records, Gail Donovan, leadership, Continuum Health Partners, COO, quality | Add A Comment

One in a series of profiles of Modern Healthcare’s Top 25 Women in Healthcare (sponsored by Furst Group)

 

As the daughter of a surgeon and an operating room nurse and now as one of the leading healthcare executives in the nation, Gail Donovan has been around hospitals all her life. So when she says she’s a bit worried about healthcare reform, one tends to listen more intently.

 

“Hospitals are like running 40 different businesses,” says Donovan, Executive Vice President and Chief Operating Officer of Continuum Health Partners, Inc. “As a large provider system, our hospital emergency rooms care for 250,000 visits a year in our system and we have very large ambulatory services handling more than 3 million visits a year. I love being able to provide access and to make sure that, as much as possible, we’re able to meet the needs of the very large and diverse communities we serve.”

 

While she agrees that changes are necessary, Donovan says some of the details, like value-based purchasing, need to take into recognition the realities that urban hospitals and systems wrestle with every day.

 

“We know how to run financially distressed hospitals because we’ve had to learn how to do that, and move from operating in the red to operating in the black, all the while we’re trying to improve and demonstrate improvements in quality,” she says.

 

It’s the details that matter to Donovan in reform and in healthcare in general.

 

“The absolute top quality that an executive needs to have is operational effectiveness,” she says. “Essentially, you must be grounded in details and be able to be not just productive but effective in managing the details of your work and your job.

 

“It’s through this that you can then have strategic vision. I don’t think you can really have strategic vision unless you understand what you’re managing today.”

 

Donovan and her team long have been visionary about the need for electronic medical records, but she credits her board with having the courage to invest more than $100 million in EMRs even as the system was struggling to provide basic core services. With an eye to the future, Continuum is well-positioned for whatever reform may bring, but Donovan wonders where the funds to help urban hospitals with compliance will come from as value-based purchasing expands from six core measures to 30 or 40.

 

“For urban hospitals to potentially be penalized and have reimbursement taken away could take a very fragile healthcare structure and create significant problems and an inability to maintain services.”

 

Many urban hospitals, Donovan says, are capital-starved and have a high dependence on Medicare, Medicaid and the bad-debt charity care pools.

 

“If those dynamics are altered without having a proper definition of safety-net facilities, like a number of my institutions are, then that dynamic could completely upend our ability to meet the needs of the very large communities we serve.”

 

Despite that sober warning, Donovan clearly enjoys her chosen field. To varying degrees, she has been serving since she was 12 and first became a hospital volunteer. She interned in health administration before going to graduate school and did a residency as part of her graduate degree that was “pivotal,” she says.

 

“I still strongly advise graduate students to seek internships and residencies. They’re called different things now, but exposure early on to a number of different organizations and their components led to job opportunities for me.”

 

She also credits luck in finding professional mentors who championed her early in her career.

 

“I was usually the youngest in the room – and the only woman,” Donovan says. “I think that has changed in certain settings, but there continues to be a lack of women in the most senior of positions in hospitals and healthcare systems.

 

“I think we’re changing that, but it’s a little bit slower, perhaps because of some concerns about work-life balance. As a mother, I know that if I did not have a supportive husband who had greater flexibility, I wouldn’t have been able to put in the time and the commitment to do what I needed to do professionally as well as support my family.”

 

Her professional reach has extended far beyond her system. She was president of the Metropolitan Health Administrators Association before it became the New York chapter of ACHE. And, with Susan Waltman, Executive Vice President and General Counsel for the Greater New York Hospital Association, Donovan spearheaded emergency preparedness measures in the wake of 9/11 that the Joint Commission has adopted as standards for all U.S. hospitals. Such responses, applicable to natural disasters as well as terrorist attacks, go beyond medicine, she says.

 

“So much of emergency response ends up dealing with adequate communications structures and systems,” she says. “And even in a sophisticated environment like New York, that continues to be one of the top challenges. So one of the outgrowths of the post-9/11 work was ongoing emergency preparedness that includes all the municipal structures and systems with the provider community.

 

“It’s why my job is fun,” she adds. “I actually love my job. Always have.”

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