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What healthcare leaders need to know now

Nursing roots important to Judith Persichilli as she leads one of the largest U.S. health systems

By | August 14 th,  2013 | Catholic, C-suite, Catholic Health East, clinical process, faith-based, health system, hospital, Lean In, Modern Healthcare, nurses, president, Sisters of Mercy, Blog, CEO, healthcare reform, leadership, nursing, safety, work-life balance, quality, Top 25 Women in Healthcare, Trinity | Add A Comment

 

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

 

“When I wake up in the morning and look in the mirror, I see a nurse. I don’t necessarily see a healthcare executive.”

 

Those words don’t belong, say, to the CNO of a small Midwest hospital. They’re coming from Judith Persichilli, who serves as interim president and CEO of Trinity/Catholic Health East, one of the largest health systems in the country. (Prior to the merger of Trinity and Catholic Health East, Persichilli was president and CEO of CHE.)

 

Nursing, Persichilli says, “has always been in my heart. It still is.” In fact, there is no shortage of executives on Modern Healthcare’s list of the Top 25 Women in Healthcare who have a background in nursing, including Persichilli.

 

Why do many nurses become successful healthcare executives? Persichilli says she thinks she knows.

 

“The education of nurses prepares them to be leaders,” she says. “You’re educated across the continuum; you understand the clinical process. You need strong relationship and communication skills as you’re dealing with physicians and other allied health professionals to promote a plan of care. At the same time, you are responsible in many instances for the communication with the family and significant others of the patient.”

 

While Persichilli leads an organization with $12.8 billion in operating revenue, she says healthcare workers at any level can make a significant difference in safety and quality in an era in which cost has become a driving concern.

 

“With healthcare reform, I truly believe that people with clinical knowledge – including, of course, physicians – have the skills to make the right decisions about the clinical process of care and actually lower the cost of care overall. They will make the right decisions about where patients can safely be taken care of with the highest quality.”

 

The merger of CHE and Trinity created a huge, national Catholic health system. Previously, some other Catholic systems merged with secular counterparts, but Persichilli said that doesn’t mean they’ve abandoned their faith-based roots.

 

“The other systems that have merged may organize themselves differently, but they still have a faith orientation within their organization,” she says. “We have decided, based on the heritage and the tradition of the women religious who sponsored the healthcare entities that formed into a system, that our system would be Catholic. That doesn’t mean we won’t be welcoming to secular relationships that share our vision and values.”

 

In fact, prior to the merger, Persichilli was part of a team at CHE that made the difficult decision to sell Sisters of Mercy Hospital in Pittsburgh to the University of Pittsburgh Medical Center system. The move enabled CHE to create a foundation that enabled the sisters to continue their work with the homeless, a population that depended on the faith-based care in the community.

 

“One of the Trinity CHE values is courage, taking risks,” she explains. “Our founding congregations came to this country with 50 cents in their pockets to take care of people. Mercy was an excellent hospital, but UPMC was so large. The situation gave us an opportunity to say, what are the unmet needs? How can we continue this ministry that was started more than 100 years ago by the Sisters of Mercy?”

 

Persichilli says she believes similar crossroads are in the future of many communities.

 

“I think we’re going to be making more of these decisions in healthcare as you look at the community needs assessments that are required under healthcare reform.”

 

Reform, she adds, resonates with the work that faith-based systems have been doing for years.

 

“That’s who we are in Catholic healthcare. It’s not just CHE and Trinity – that’s who we are. Sometimes it means saying, there’s enough acute care. How can we creatively develop the structures and the financial foundation to meet the unmet need? It definitely pulls us into environments that perhaps other people don’t want to go into – the homeless, the vulnerable.”

 

While it’s a well-known fact that the U.S. spends more than any other country on healthcare with less than stellar results, Persichilli says the belt-tightening prevalent in the industry doesn’t have to make quality decline at all.
“I spent three weeks with Catholic Relief Services in Uganda visiting AIDS clinics and looking at their ‘hospitals,’ ” she says. “And I came back to the United States with the understanding that, even in a time of constraint, we live in an era of abundance. We have to figure out how to tap that strength, to do things better at a higher quality and a lower cost.”

 

One idea on how to do that? Better communication.

 

“We can do it. It’s there. It will take people in the provider sector and the payer sector to talk to one another, not past one another.”

 

Persichilli says industry executives need to know their numbers, but also understand that healthcare goes beyond costs.
“No matter what, you need to know that you’re doing really important work. You have the privilege of taking part in and changing people’s lives. When I was a nurse, I used to say, ‘Let’s all stand together and ask the question: ‘What difference did you make in the lives of your patients today?’ ”

 

That kind of attitude is especially important to people at the beginning of their healthcare careers, she adds.

 

“Once you bring meaning to your work,” she explains, “you go about it with such commitment and passion that it’s hard not to be recognized. And once you’re recognized, you’re appreciated. Once you’re appreciated, you’re promoted. And once you’re promoted – if you bring that same passion and commitment forward – you will reach an executive level.”

 

Persichilli mentors a number of young female executives, but says she doesn’t get sucked into the “Lean In” debate.

 

“Work-life balance transcends gender when it comes to these executive positions,” she says. “I don’t ever step into somebody’s life and say, ‘You should do this or that.’ I always tell younger women, ‘It has to feel comfortable for you.’ And if it doesn’t feel comfortable for you and your career is going to be stalled as a result, understand the choices you make and be happy that at least you can make them.”

 

Today, she notes, stress about family isn’t confined to children – it could just as easily be about caring for one’s parents as part of the “sandwich generation.”

 

“If it’s too stressful and the children or your parents are not being taken care of the way you want, it’s not going to do anyone any good at work or at home. So understand who you are and what’s important to you. I don’t have any children, but I can tell you there’s nothing more important than raising good kids.

 

“I don’t have the answers here. I just know that, if you’re uncomfortable, own it and figure it out.”

 

Helen Darling: A strong voice for employers in the healthcare debate

By | June 10 th,  2013 | Furst Group, glass ceiling, Healthcare, mentoring, National Business Group on Health, payers, executive, health insurance, Lean In, Modern Healthcare, patient safety, president, providers, Sheryl Sandberg, 100 Most Powerful People in Healthcare, Blog, board of directors, CEO, employees, employers, Fortune 500, healthcare costs, healthcare reform, Helen Darling, leadership, marketplaces, national debt, quality, Top 25 Women in Healthcare | Add A Comment

 

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

 

The healthcare industry is undergoing major changes, but Helen Darling says the providers and payers who comprise much of the industry aren’t doing enough to control costs and improve quality. Her words carry a lot of weight – she’s the president and CEO of the National Business Group on Health, which represents many of the large employers in the U.S.
Darling says her membership would like to see big improvements in safety, quality and costs, but have doubts about whether that could actually happen in an industry with limited competition.

 

“With our healthcare system, there are no countervailing forces that will essentially force organizations to reduce costs and improve quality and safety,” she says. “We saw very little attention paid to patient safety until the federal government took this tiny amount of money and said, ‘We’re going to hold this back if you don’t meet certain Partnership for Patients goals.’ And that did get people’s attention, but that’s what it took.”

 

Darling’s non-profit organization represents many Fortune 500 and other large companies, serving as a united voice on healthcare policy and offering solutions to healthcare issues in the marketplace. She says her membership is concerned about where healthcare is headed.

 


“All you have to do is look at every report written concerning the national debt or the annual deficit and see that healthcare is the driver,” she says. “It’s not Social Security. It’s not education. It’s not feeding children. It’s all about healthcare.”

 

Darling herself has led a storied career, directing studies at the Institute of Medicine before becoming the health legislative aide for U.S. Sen. Dave Durenberger (R-Minn.). She later worked as a senior executive for Mercer, Xerox and Watson Wyatt (now Towers Watson) before agreeing to lead NBGH. She is a member, and co-chair for ten years, of the Committee on Performance Measurement of the National Committee for Quality Assurance and is Vice Chair of the Board of the National Quality Forum.

 

Patient safety, she said, is a key concern for her and NBGH.

 

“There’s nothing like statistics having to do with patient safety to galvanize attention to the problem,” she says. “Just think about the amount of harm or death because somebody, for example, gets an infection. Even if they don’t die, they suffer. I’m sure everybody knows families of someone who got C-Diff or MRSA in the hospital. All you have to do is look at the data and see how much human suffering and wasted cost are behind healthcare associated harm.”
The lack of progress on that front, she says, is perplexing.

 

“What I don’t understand, to be honest, is why there isn’t more of an outcry,” she adds. “If somebody eats a hamburger that has some contamination, it’s all over the television. If a plane goes down, people are on it for days in the 24/7 news cycle. And yet every day, in hospitals across the United States, people are being harmed and in some instances are dying from conditions that are preventable and avoidable.”

 

Darling encourages the executives she represents to serve on the boards of hospitals (something she herself has done), and her group offers them a patient safety toolkit. She encourages trustees to press for frequent safety reports to be given to the CEO and the Board of Directors.

 

“Historically, hospitals have a risk-management report, and they might have a quality report if, say, the Joint Commission did its audit and found something. The risk-management report will say things like, ‘There was a patient fall this month and we have booked $3 million as part of the liability reserved to take care of it.’ That’s it. Historically, there has been no root cause analysis, no report on what changes they’re making to stop that from ever happening again. That is changing but it isn’t fast enough or universal.”

 

To be fair, a few of the major employers who make up NBGH’s membership have similarly been criticized for their reaction to healthcare reform, including some who have changed terms of employment that make fewer employees eligible for health insurance. But Darling says health insurance has never been an automatic benefit for the workforce.

 

“At any given time during the year, we have 60 million people without coverage, and most of them are working people. Health insurance has always been a perk,” she says. “It’s never been something that everybody has, and it is very much related to wages. The irony is, the people with the lowest wages get the least benefits. But I don’t think it’s going to get worse. If the insurance marketplaces work the way they’re supposed to work, we will be better off in terms of coverage (although not in terms of the costs of health benefits coverage on a net basis).”

 

But the penalties for lack of coverage will need to change before that happens, Darling adds.

 

“The penalty is not as much as it will cost people to get the coverage. They can’t tell people they have to have a package that will cost, on average, $7,000, and then tell them the penalty for not buying coverage is $1,000. They’re going to have to change the package because it makes the subsidies much richer. They will bankrupt the country on that one.”

 

Still, she says she’s confident that the gap will be bridged.

 

“All that needs to be sorted out, but I actually think we will have more people covered. Nobody will be happy about a lot of the details. In the end, I think more states will look a little more like Massachusetts.”

 

Darling has been selected numerous times by Modern Healthcare as one of the Top 100 Most Powerful People in Healthcare in addition to her new award as one of the Top 25 Women in Healthcare. The Modern Healthcare article announcing the Top 25 Women was headlined, “Beyond the Glass Ceiling,” and Darling said she thinks some of that ceiling is self-imposed among women.

 

“I belong more to the Sheryl Sandberg ‘Lean In’ school,” she says. “I’ve been hiring men and women and mentoring them for a long time. I still see significant differences in the way men and women assess themselves, in the way they think about their careers and their families.”

 

She laughs as she relates a humorous story she heard on the radio recently. “It said that if women miss a child’s school event, they are just wracked with guilt. But if a man merely drops the child off at the event, he feels like he made a major contribution. That’s pretty funny, and pretty accurate.

 

“And as long as that’s true, women won’t always be able to have the same kind of executive career that men do. They can have the combined benefits of living in both worlds but as long as executive careers require the kind of 24/7 commitment to work that most do, women and men will have to choose what balance or lack of balance they really want.”

As Chief Administrative Officer Shirley Weis prepares to retire, her fingerprints are all over Mayo Clinic's success

By | May 30 th,  2013 | women in leadership, C-suite, CAO, governance, John Noseworthy, Lean In, Mayo Clinic, Mayo Clinic Health System, Minnesota, Shirley Weis, Blog, CEO, Denis Cortese, Destination Medical Center, leadership, Mayo Clinic Care Network, provider, payer, Rochester, Top 25 Women in Healthcare | Add A Comment

 

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

 

It’s a busy time at Mayo Clinic. Plans for the new Destination Medical Center are in full swing. New affiliates are being added to the Mayo Clinic Care Network. A new partnership with Optum Labs is taking the venerable institution into the realm of big data. So why would Chief Administrative Officer Shirley Weis decide to retire now?

 

Because, she says simply, that’s been the plan all along.

 

“One of the hallmarks of Mayo is excellent succession planning,” she says. “We’ve put even more attention into it in recent years, making sure that we have a good stable of folks ready from all different backgrounds of diversity and talents.”

 

And, for those keeping score at home, she says, you’ll notice a pattern to their planning. Weis was named to the No. 2 role at Mayo about halfway through the tenure of then-CEO Denis Cortese, MD. Weis is leaving four years after John Noseworthy, MD, succeeded Cortese. Mayo’s initiative of staggering C-suite entrances and exits keeps disruption to a minimum.

 

“People don’t understand that Mayo has a term-limit process for these top jobs,” Weis says. “Usually, you’re in these roles for about six to eight years as CEO, CAO or department chair. It’s one of the ways we keep ideas fresh. In some settings, you’ll see people who are named to a role and they’re in it for 30 years. That may work for some organizations but I think that after six or seven years, you’ve done what you came to do.”

 

Among the tasks that Weis says she is gratified to have accomplished since she stepped into the CAO role seven years ago is changing the structure of the company.

 

“I have really felt proud of the fact that we were able to get our governance in good shape,” she says. “We went from being a holding company to an integrated operating company. Most of the things I wanted to get underway are now, in fact, underway and are in good hands.”

 

One of those key ventures is the Mayo Clinic Care Network, in which health systems and physician groups affiliate with Mayo, extending the clinic’s reach beyond its bases of the upper Midwest, Arizona and Florida to the rest of the country. The idea had been created during Dr. Cortese’s tenure but truly came into being about two and a half years ago under Dr. Noseworthy’s leadership, Weis says.

 


“We have built a very successful Mayo Clinic Health System in the upper Midwest but we understood that merger and acquisition was probably not the best course for us,” she says. “We came up with the idea to start building a network, but we also found more and more hospitals and physician practices approaching us – they wanted to be affiliated.”
Mayo is up to 18 affiliate agreements but Weis sees a limit to the system’s capacity.

 

“We do guard our brand jealously. It’s one of the most trusted names in healthcare and part of the promise we have to our patients,” she says. What helps, she adds, is that “the patients are very savvy and sophisticated. They understand that these groups are not Mayo Clinic – they simply have a connection to Mayo Clinic.”

 

Mayo staff are consulting via phone and doing some cases together electronically. “We think it’s going to be a real model for the patients’ network of care,” Weis says. “Eventually, there may be some insurance products that go on top of the network.”

 

The blurring of lines between providers and payers is accelerating in the healthcare industry, and Weis has been a key person to lead that charge at Mayo. She was the chief operating officer at Blue Care Network of Michigan, a large HMO, before coming to Minnesota.

 

”I feel blessed that I had 10 years of actual care delivery with my emergency-room background, and that I followed that with 10 years in the payer industry,” Weis says. “I wouldn’t trade that for anything. I think it’s helped the organization and, frankly, it is probably why I was selected for this job seven years ago.”

 

Weis says both providers and payers need to focus on what’s best for the patient – and both need to collaborate more.

 

“The payer world has the claims information but they don’t have a lot of rich clinical data. The provider world has the rich clinical data but they don’t know what happens after the patient leaves the hospital or the outpatient center, or after they pick up their prescription.”

 

No matter what happens with healthcare reform, Weis adds, “there’s no more money, so it makes it more incumbent on all of us to figure out how we’re going to meet those patients’ needs and how we can engage the patients better.”

 

Working with fewer dollars is something Weis experienced a few years ago during the recession when she put in place an administrative shared services program and an enterprise project management office, while also implementing cutting-edge tools for financing and reimbursement. All those things, and a few more, helped Mayo weather the recession without layoffs, though some employees shifted jobs and some changes were made to benefit packages and retirement plans.

 

Weis had originally come to Mayo in 1995 to lead the Clinic’s managed care division. She resisted the overtures from a recruiter for a time, but finally agreed to a visit.

 

“I already had a career path, thank you very much,” she says. “But I came to Rochester and started to meet folks, and I was struck by how patient-centered the organization was.”

 

As she got to know Al Schilmoeller, who was her first boss, she noted that one of his daughters was a pilot and another worked for the Department of Natural Resources. That convinced her that here was a man who knew how to support women in their varied career aspirations. She remembers that, she says, as she mentors early- and mid-career women and men.

 

“For women or men, for anyone to make it to the next level in your career, you have to be willing to take some risks,” she says.

 

But she notes that young executives who only know the sound-bite version of Sheryl Sandberg’s “Lean In” best-seller do need to consider work-life balance.

 

“I would not be where I am today if I didn’t have a supportive husband. Period. I see many people who want to have that balance, and the one thing I know for a fact is that you can’t always have it all. You can have it all in stages. But I do think that as long as women are in a traditional caregiver, chief household operating officer role, it’s tough to balance that.

 

“So, particularly with families with young children, I always encourage them to put those kids first because they’re only there for a few years. And then your career is still there.”

 

Weis came of age at a time when she often was the only woman on the leadership team, and she says progress has been made in gender equity – progress, but not equality.

 

“I’m a tennis player, and I think of the days of Billie Jean King when Virginia Slims was a sponsor with their slogan, ‘You’ve come a long way, baby.’

 

“We have come a long way. But I don’t think we’re there yet.”

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