C-Suite Conversations

What healthcare leaders need to know now

Former ACHE chair Christine Candio charts a nimble, independent course for St. Luke's Hospital

By | April 11 th,  2017 | chief executive officer, American College of Healthcare Executives, Cleveland Clinic, Modern Healthcare, nurse, St. Louis, Blog, chair, Christine Candio, safety, quality, St. Luke's Hospital, Top 25 Women in Healthcare | Add A Comment

 

One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2017. Furst Group and NuBrick Partners, which comprise the companies of MPI, sponsor the awards.

 

In the St. Louis area, St. Luke’s Hospital is the only independent hospital – and President and CEO Christine Candio is OK with that.

 

“I have always believed there is a place for independent organizations,” she says. “The differentiator for St. Luke’s is it is a large, advanced community hospital, and we have a strong network of care throughout two counties. That makes a difference. We have the entire continuum of care – including our own skilled nursing facility.”

 

But that doesn’t mean St. Luke’s isolates itself, Candio notes.

 

“We are collaborators, which enables us to continue enhancing the services we provide our patients to improve the health of the community. St. Luke’s is the exclusive St. Louis affiliate of Cleveland Clinic’s Sydell and Arnold Miller Family Heart & Vascular Institute, which we’re very proud of,” she says. “We also continue to expand our imaging services through a partnership. And St. Luke’s Rehabilitation Hospital is a joint venture with Kindred Healthcare. We are also starting to belong to different clinically integrated networks.”

 

Having said that, Candio admits that independent hospitals need to regularly evaluate themselves and their objectives.

 

“There are some key questions that independent organizations need to continually reflect on, and we do that here,” she says. “Do you have the essentials to remain independent? I believe we do. Do you have collaborations and partnerships? Yes. Are you trying to be all things to all people? No, we’re not.”

 

Being independent, says Candio, keeps the organization flexible, a point she lightens with a reference to a couple nostalgic Claymation characters from TV.

 

“We best serve our patients being nimble and responsive to our community’s needs,” she says. “You have to be like Gumby and Pokey – bendable and pliable. We have that here.”

 

As the former board chair of the American College of Healthcare Executives, Candio has been a national leader among her peers for many years. She lived on the East Coast most of her life but found the opportunity at St. Luke’s too good to pass up.

 

“First and foremost were the quality outcomes of the organization. That was key,” she says. “The independence of the hospital was an attraction as well. I like to say that we are our own system with one hospital, and our team member engagement is phenomenal. Each individual here is so committed to serving our patients and their families and caring about one another. We have exceptional medical professionals; the teamwork among them is stellar.”

 

Through her work at ACHE, Candio brought a national perspective to the organization. And national attention has followed.

 

St. Luke’s has the best safety score of any St. Louis-area hospital in Consumer Reports’ ratings of U.S. hospitals.

 

“I do believe that, as a healthcare industry, we are always on a constant journey of improvement, and we have to focus on zero harm,” she says. “Human beings make mistakes. As leaders, we have to ensure that we have all the right systems in place and a strong platform for people to work effectively and safely. When mistakes happen, we have to first look at where the process failed and go from there.”

 

St. Luke’s was already a strong and safe organization when she was appointed president and CEO in January 2015, she says. “But my philosophy is always, how can we get stronger and not rest on our laurels?”

 

Candio’s leadership is imbued with her early years of experience as a nurse and a nursing leader.
“To be an effective leader, you need to always keep an ear to the ground and an eye to the future,” she says. “I keep an ear to the ground through rounding with purpose – talking with our team members and our patients. It’s amazing what you learn when you take the time to do that.”

 

She also participates in monthly meetings with a rotating group of about 20 staff members in nonmanagerial roles to update them about what is going on at St. Luke’s and to provide an open forum for feedback. She tries to travel to all of St. Luke’s locations in the sprawling St. Louis metropolis as well.

 

Like many clinicians turned leaders, Candio says she moved into administration because she wanted to have a positive impact on a broader population of people. Her own experience as a hospital patient as a child spurred her desire to serve. She was even what was then called a “candy striper” hospital volunteer as a youth. The influence of those years has not left her.

 

“We are honored to work in healthcare – it’s a blessing,” she says. “People are letting you into their lives during their most vulnerable times, and that is a sacred honor. That has always touched me.”

 

 

SIDEBAR: Cheering on the home team

 

Christine Candio’s biggest adjustment in St. Louis has nothing to do with healthcare.

 

It has to do with setting aside a place in her heart for a sports team besides the Boston Red Sox.

 

When she was jokingly asked at the end of her St. Luke’s job interview, “What’s your favorite baseball team,” the words, “Boston Red Sox” passed her lips before she even had time to think.

 

Some in the room looked surprised. Candio closed her portfolio and joked, “Well, I guess this interview is over.”

 

So, when she and her husband were picked up for dinner that evening by the physician who had asked the question, two St. Louis Cardinals caps were waiting for them in the back seat.

 

“It was priceless,” she says. “I do root for the home team now.”

 

 

Top 25 Minority Executives in Healthcare–Delvecchio Finley: Leaders understand that medical care is only part of the solution to disparities

By | December 29 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

 

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

 

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.

 

 

Top 25 Minority Executives in Healthcare--Ketul Patel: A sense of mission fuels the best leaders in healthcare

By | December 22 nd,  2016 | CHI Franciscan Health, chief executive officer, Top 25 Minority Executives in Healthcare, Hackensack University Medical Center, health system, Kenya, Modern Healthcare, SafetyFirst Initiative, Blog, Catholic faith, Catholic Health Initiatives, clinician, collaborative, leadership, mission, safety, Ketul Patel, patient experience, quality | Add A Comment

 

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

 

Every month or two, CEO Ketul J. Patel journeys to the convent where the Sisters of St. Francis live and spends some time with the religious women who provide the missional context of the organization Patel leads, CHI Franciscan Health in Tacoma, Wash., part of the Catholic Health Initiatives system.

 

“I leave energized every single time I go there because of the amount of passion they have for this organization,” he says. “I have always felt that faith-based organizations have an extra touch of focus and mission than others. I couldn’t have asked for a better set of sisters to work with.”

 

Patel was raised in the Hindu faith but went to Catholic grade schools and high school growing up in Johnstown, Penn., 60 miles east of Pittsburgh. In an earlier role, he also worked for several years at a Catholic hospital in Chicago run by another group called the Sisters of St. Francis, this one based in Indiana.

 

“The Catholic faith has made a pretty substantial imprint into not only my career, but my life,” he says. “It’s given an extra allure to this type of organization for me.”

 

It’s also given a sense of urgency to the strides Patel hopes to make in reshaping CHI Franciscan and the other CHI hospitals he oversees as senior vice president of divisional operations for the Pacific Northwest Region. His goal, he says, is to have a top-performing organization with a mission-based focus on quality, safety and patient experience.

 

“We want to have a system of the most talented providers and innovative services in the Pacific Northwest,” Patel says. “Because of that, we just went through a significant structural reorganization to focus on those areas.”

 

Chief among the changes is the SafetyFirst Initiative, what Patel calls “a system-wide effort aimed at eliminating all preventable safety events.”

 

“We’ve branded it throughout the entire CHI system, and we’re seeing declines in serious safety events at all of our hospitals that have implemented SafetyFirst. It’s something our clinical staff is very proud of.”

 

The sense of service that Patel believes is a necessity for healthcare leaders comes from his parents, he says. Patel was born in Kenya, as were both his parents. His father is a retired physician. His mother, who passed away last year, was a nurse.

 

“When my father was practicing in Kenya, he would take my mom, brother and me to some remote areas of East Africa and provide care,” Patel remembers. “A lot of it was done under the umbrella of what was then the Lions Club.

 

“I have some very vivid memories – people who were missing hands, people with significant diseases with no access to care. The impact of that was substantial and that’s what prompted and inspired me to get into this type of role.”

 

His family moved to the U.S. in 1979 when Patel was eight. His brother went into medicine – he now heads cardiac surgery at the University of Michigan – and Patel started pre-med courses to head down the same path at Johns Hopkins. He also took a job as a research assistant to Nobel laureate Christian Anfinsen and, while it was a wonderful experience, he says, he couldn’t summon the same enthusiasm for it that he had for a couple health administration classes he took. He was reluctant to tell his parents he didn’t want to be a clinician.

 

“I thought it was going to be one of the toughest conversations I ever had with my father,” Patel says now, chuckling. “Instead, my father said, ‘We’ve been waiting for you to say this. All these years, we didn’t think you wanted to be a doctor.’ ”

 

The move to the administrative side has been a good fit. Patel got his first VP role at 26 and hasn’t looked back. He came to CHI Franciscan from Hackensack University Health Network and Hackensack University Medical Center in New Jersey, where he served as executive vice president and chief strategy and operations officer.

 

Patel says his leadership style has evolved in his 20 years in administration. “You have to be a born leader, to some extent, but I think your leadership style and your abilities change as you are exposed to different areas and experienced with varying challenges.”

 

But one absolute imperative, he says, is to be a collaborative leader.

 

“People support what they help to create,” he says. “If a staff member feels they’re part of a decision-making process that is helping to move the organization in a certain direction, they’re going to unite behind that.”

 

He says he especially loves the ideas that come from clinicians. “They’re the ones who are at the bedside.”

 

Besides, he says, his parents always loved to tease him about the importance of the front-line staff.

 

“I’d be on the phone with them and my dad would say, ‘By the way, just remember that the only reason you have a job is because doctors bring patients to your doorstep.’ Then my mom would get on the phone and say, ‘Don’t listen to your dad. The only people who know what’s going on with the patients are the nurses.’

 

“I give them a lot of credit for that.”

 

 

2016 Top 25 Minority Executives in Healthcare--Gene Woods: The best leaders reinvent their organizations, and themselves

By | December 16 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 | Add A Comment

 

Classic content: 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.”

 

 

2016 Top 25 Minority Executives in Healthcare--Pamela Sutton-Wallace: Leaders need to challenge themselves to grow

By | December 1 st,  2016 | academic medical center, Pamela Sutton-Wallace, Top 25 Minority Executives in Healthcare, University of Virginia, Lean, Modern Healthcare, Blog, CEO, Duke University, safety, quality | Add A Comment

 

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

 

Pamela Sutton-Wallace earned many accolades while serving 17 years in the Duke University Health System and easily could have spent many more years there. But she wanted to prove she could excel in leading a healthcare institution, and that led her to University of Virginia Medical Center, where she was named CEO in 2014.

 

“I grew up in the Duke system and was afforded many opportunities to develop skills, knowledge and relationships to be successful in healthcare leadership,” she says. “In accepting the role of CEO at UVA, I wanted to challenge myself by applying these skills in a new environment where I believed I could bring value.”

 

Given her Duke pedigree, where she rose to senior vice president of hospital operations, it’s no surprise that her goals for UVA are high: to make it one of the top 10 health systems in the country. She inherited a strong structure, one with little to no debt on the books. But as she assessed UVA, she came away feeling it was a well-respected organization that nonetheless wasn’t getting enough attention for all of its accomplishments.

 

“UVA had this great reputation, but you didn’t see it referenced anywhere,” Sutton-Wallace says. “It wasn’t on Leapfrog and U.S. News & World Report. You didn’t see it on NIH listings. But I felt very aspirational, because all the underpinnings are here. We have some of the best faculty, some of the most innovative physicians, nurses and professionals I’ve ever met.”

 

From the moment she began talks with her supervisor at the University of Virginia, Executive Vice President Rick Shannon, who is known for his work in quality and safety, she was determined that quality, safety and service would be “the hallmark of care.”

 

Thus, UVA uses the Lean method and real-time, root-cause problem solving to address six areas of concern in its Be Safe Initiative. If an issue is reported in any of those areas, from a pressure ulcer to an infection to a staff injury, Sutton-Wallace and her leadership team visit the unit/department in question to ask what happened, whether the team faced barriers that led to the issue, and whether it was preventable.

 

“In two very short years, we have been able to achieve demonstrated improvements,” she says. “That’s exciting to me. That’s why we do what we do.”

 

Sutton-Wallace took a circuitous path to end up doing what she does. Although she was a candy striper as a youth – her mom worked as a medical transcriptionist for close to 40 years in a small Baltimore community hospital – her initial interest was in politics.

 

“I was three years into working on a Ph.D. in political science,” she says, “and I realized I didn’t want to teach and do research in the political space for the rest of my life.”

 

 

She took a job working in underwriting at Blue Cross Blue Shield of North Carolina. It was during that time that Hillary Clinton was attempting to create a model for universal healthcare during her husband’s administration. Sutton-Wallace became inspired by that and went back to school, earning a master’s in public health at Yale, a curriculum that still pays dividends to this day, she says.

 

“At Yale, I had to take just as many epidemiology and biostatistics research method courses as health policy and management courses,” Sutton-Wallace notes. “I was in a classroom setting that taught clinical aptitude. The majority of students weren’t clinicians, but you came to understand disease pathology and the whole notion of population health.”

 

Her background has afforded her good conversations with clinicians, she says, because she doesn’t approach situations from a strictly financial angle.

 

“I’m very invested in what the quality is, and what are the outcomes associated with care,” she says. “Public health has always been about population health.”

 

Of course, finances are always one facet of the picture, and that is quite clear at academic medical centers, including UVA, which will face unprecedented financial challenges given the changing climate for healthcare providers.

 

“How are academic medical centers, which have often relied on very slim margins, going to continue to invest in research and education?” she says. “That’s really challenging, because we still have an insatiable appetite for new technology and new discoveries, and we still want to train the best and the brightest new clinicians. But we don’t necessarily have the income streams in those missions to cover those costs.”

 

It’s a dilemma that CEOs nationwide are trying to solve, even those like Sutton-Wallace who didn’t initially aspire to a healthcare career. Because of that, Sutton-Wallace says she enjoys speaking to students and young professionals about her journey, including that interrupted path to a political-science doctorate.

 

“My best lessons came from making mistakes,” she says. “You learn a lot about yourself. You learn resilience, you learn the power of mentors to encourage you, and you learn how to integrate those learnings into improved performance.

 

“You also learn not to be discouraged if things don’t work out exactly as you’ve planned. Half the battle is figuring out what it is that you don’t want to do.”

 

 

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.

 

 

A sense of mission drives Ketul Patel at CHI Franciscan Health

By | August 10 th,  2016 | CHI Franciscan Health, chief executive officer, Top 25 Minority Executives in Healthcare, Hackensack University Medical Center, health system, Kenya, Modern Healthcare, SafetyFirst Initiative, Blog, Catholic faith, Catholic Health Initiatives, clinician, collaborative, leadership, mission, safety, Ketul Patel, patient experience, quality | Add A Comment

 

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

 

Every month or two, CEO Ketul J. Patel journeys to the convent where the Sisters of St. Francis live and spends some time with the religious women who provide the missional context of the organization Patel leads, CHI Franciscan Health in Tacoma, Wash., part of the Catholic Health Initiatives system.

 

“I leave energized every single time I go there because of the amount of passion they have for this organization,” he says. “I have always felt that faith-based organizations have an extra touch of focus and mission than others. I couldn’t have asked for a better set of sisters to work with.”

 

Patel was raised in the Hindu faith but went to Catholic grade schools and high school growing up in Johnstown, Penn., 60 miles east of Pittsburgh. In an earlier role, he also worked for several years at a Catholic hospital in Chicago run by another group called the Sisters of St. Francis, this one based in Indiana.

 

“The Catholic faith has made a pretty substantial imprint into not only my career, but my life,” he says. “It’s given an extra allure to this type of organization for me.”

 

It’s also given a sense of urgency to the strides Patel hopes to make in reshaping CHI Franciscan and the other CHI hospitals he oversees as senior vice president of divisional operations for the Pacific Northwest Region. His goal, he says, is to have a top-performing organization with a mission-based focus on quality, safety and patient experience.

 

“We want to have a system of the most talented providers and innovative services in the Pacific Northwest,” Patel says. “Because of that, we just went through a significant structural reorganization to focus on those areas.”

 

Chief among the changes is the SafetyFirst Initiative, what Patel calls “a system-wide effort aimed at eliminating all preventable safety events.”

 

“We’ve branded it throughout the entire CHI system, and we’re seeing declines in serious safety events at all of our hospitals that have implemented SafetyFirst. It’s something our clinical staff is very proud of.”

 

The sense of service that Patel believes is a necessity for healthcare leaders comes from his parents, he says. Patel was born in Kenya, as were both his parents. His father is a retired physician. His mother, who passed away last year, was a nurse.

 

“When my father was practicing in Kenya, he would take my mom, brother and me to some remote areas of East Africa and provide care,” Patel remembers. “A lot of it was done under the umbrella of what was then the Lions Club.

 

“I have some very vivid memories – people who were missing hands, people with significant diseases with no access to care. The impact of that was substantial and that’s what prompted and inspired me to get into this type of role.”

 

His family moved to the U.S. in 1979 when Patel was eight. His brother went into medicine – he now heads cardiac surgery at the University of Michigan – and Patel started pre-med courses to head down the same path at Johns Hopkins. He also took a job as a research assistant to Nobel laureate Christian Anfinsen and, while it was a wonderful experience, he says, he couldn’t summon the same enthusiasm for it that he had for a couple health administration classes he took. He was reluctant to tell his parents he didn’t want to be a clinician.

 

“I thought it was going to be one of the toughest conversations I ever had with my father,” Patel says now, chuckling. “Instead, my father said, ‘We’ve been waiting for you to say this. All these years, we didn’t think you wanted to be a doctor.’ ”

 

The move to the administrative side has been a good fit. Patel got his first VP role at 26 and hasn’t looked back. He came to CHI Franciscan from Hackensack University Health Network and Hackensack University Medical Center in New Jersey, where he served as executive vice president and chief strategy and operations officer.

 

Patel says his leadership style has evolved in his 20 years in administration. “You have to be a born leader, to some extent, but I think your leadership style and your abilities change as you are exposed to different areas and experienced with varying challenges.”

 

But one absolute imperative, he says, is to be a collaborative leader.

 

“People support what they help to create,” he says. “If a staff member feels they’re part of a decision-making process that is helping to move the organization in a certain direction, they’re going to unite behind that.”

 

He says he especially loves the ideas that come from clinicians. “They’re the ones who are at the bedside.”

 

Besides, he says, his parents always loved to tease him about the importance of the front-line staff.

 

“I’d be on the phone with them and my dad would say, ‘By the way, just remember that the only reason you have a job is because doctors bring patients to your doorstep.’ Then my mom would get on the phone and say, ‘Don’t listen to your dad. The only people who know what’s going on with the patients are the nurses.’

 

“I give them a lot of credit for that.”

 

 

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.”

 

 

Pamela Sutton-Wallace looks to enhance UVA's stellar reputation

By | June 17 th,  2016 | academic medical center, Pamela Sutton-Wallace, Top 25 Minority Executives in Healthcare, University of Virginia, Lean, Modern Healthcare, Blog, CEO, Duke University, safety, quality | Add A Comment

 

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

 

Pamela Sutton-Wallace earned many accolades while serving 17 years in the Duke University Health System and easily could have spent many more years there. But she wanted to prove she could excel in leading a healthcare institution, and that led her to University of Virginia Medical Center, where she was named CEO in 2014.

 

“I grew up in the Duke system and was afforded many opportunities to develop skills, knowledge and relationships to be successful in healthcare leadership,” she says. “In accepting the role of CEO at UVA, I wanted to challenge myself by applying these skills in a new environment where I believed I could bring value.”

 

Given her Duke pedigree, where she rose to senior vice president of hospital operations, it’s no surprise that her goals for UVA are high: to make it one of the top 10 health systems in the country. She inherited a strong structure, one with little to no debt on the books. But as she assessed UVA, she came away feeling it was a well-respected organization that nonetheless wasn’t getting enough attention for all of its accomplishments.

 

“UVA had this great reputation, but you didn’t see it referenced anywhere,” Sutton-Wallace says. “It wasn’t on Leapfrog and U.S. News & World Report. You didn’t see it on NIH listings. But I felt very aspirational, because all the underpinnings are here. We have some of the best faculty, some of the most innovative physicians, nurses and professionals I’ve ever met.”

 

From the moment she began talks with her supervisor at the University of Virginia, Executive Vice President Rick Shannon, who is known for his work in quality and safety, she was determined that quality, safety and service would be “the hallmark of care.”

 

Thus, UVA uses the Lean method and real-time, root-cause problem solving to address six areas of concern in its Be Safe Initiative. If an issue is reported in any of those areas, from a pressure ulcer to an infection to a staff injury, Sutton-Wallace and her leadership team visit the unit/department in question to ask what happened, whether the team faced barriers that led to the issue, and whether it was preventable.

 

“In two very short years, we have been able to achieve demonstrated improvements,” she says. “That’s exciting to me. That’s why we do what we do.”

 

Sutton-Wallace took a circuitous path to end up doing what she does. Although she was a candy striper as a youth – her mom worked as a medical transcriptionist for close to 40 years in a small Baltimore community hospital – her initial interest was in politics.

 

“I was three years into working on a Ph.D. in political science,” she says, “and I realized I didn’t want to teach and do research in the political space for the rest of my life.”

 

 

She took a job working in underwriting at Blue Cross Blue Shield of North Carolina. It was during that time that Hillary Clinton was attempting to create a model for universal healthcare during her husband’s administration. Sutton-Wallace became inspired by that and went back to school, earning a master’s in public health at Yale, a curriculum that still pays dividends to this day, she says.

 

“At Yale, I had to take just as many epidemiology and biostatistics research method courses as health policy and management courses,” Sutton-Wallace notes. “I was in a classroom setting that taught clinical aptitude. The majority of students weren’t clinicians, but you came to understand disease pathology and the whole notion of population health.”

 

Her background has afforded her good conversations with clinicians, she says, because she doesn’t approach situations from a strictly financial angle.

 

“I’m very invested in what the quality is, and what are the outcomes associated with care,” she says. “Public health has always been about population health.”

 

Of course, finances are always one facet of the picture, and that is quite clear at academic medical centers, including UVA, which will face unprecedented financial challenges given the changing climate for healthcare providers.

 

“How are academic medical centers, which have often relied on very slim margins, going to continue to invest in research and education?” she says. “That’s really challenging, because we still have an insatiable appetite for new technology and new discoveries, and we still want to train the best and the brightest new clinicians. But we don’t necessarily have the income streams in those missions to cover those costs.”

 

It’s a dilemma that CEOs nationwide are trying to solve, even those like Sutton-Wallace who didn’t initially aspire to a healthcare career. Because of that, Sutton-Wallace says she enjoys speaking to students and young professionals about her journey, including that interrupted path to a political-science doctorate.

 

“My best lessons came from making mistakes,” she says. “You learn a lot about yourself. You learn resilience, you learn the power of mentors to encourage you, and you learn how to integrate those learnings into improved performance.

 

“You also learn not to be discouraged if things don’t work out exactly as you’ve planned. Half the battle is figuring out what it is that you don’t want to do.”

 

 

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.”

 

 

Page 1/3