One in a series of profiles of Modern Healthcare’s Top 25 Women in Healthcare (sponsored by Furst Group)
Outcome vs. strategy: which takes the lead?
Deborah Proctor, president and CEO of St. Joseph Health System in Orange, Calif., makes it clear where she stands on that age-old business dilemma.
“One of the things that I learned in my career is that most people will develop a strategy and then measure how well they’re accomplishing that strategy. To me, that’s an insufficient process,” she says. “I think you have to first determine what outcomes you’re trying to achieve and then develop strategies to get to those outcomes.
“But you keep measuring the outcome and you adapt the strategies if they’re not getting you to the outcome.”
Proctor’s belief in outcomes colored the strategic plan that she and her staff created in 2006, and she made sure it was tangible and accessible for all St. Joseph employees.
“Instead of sharing strategies like improving financial performance or aligning with physicians –which are certainly important – we focused on talking to employees about outcomes,” she says.
St. Joseph identified three goals “that every employee could relate to,” says Proctor:
**That the employees of our system would strive to provide perfect care.
**That the communities served by St. Joseph Health System and its hospitals would be among the healthiest in the nation.
**That every encounter with patients, community members, and one another would be a sacred encounter.
“Perfect care” sounds like an unattainable goal but, to Proctor, who began her career at St. Joseph Hospital in Orange, California as a registered nurse, it has to do with focus.
“Obviously that’s a very tough standard to live up to,” she admits. “But what are you going to say, that I want to give people the best care 90 percent of the time? I don’t think we can say the aim is anything less. Perfect care doesn’t mean perfect outcome, but it means that everything that’s within our control will be done exceptionally without errors.”
Proctor’s insistence on a culture of safety stems from her experience in another health system.
“We were having a strategic meeting and, in the middle of the meeting, one of the physicians got a phone call that informed him of an unnecessary death had occurred in one of our facilities,” she remembers. “From that time, it really became a focus area for me.”
To make it tangible, St. Joseph Health System set out to improve its record with ventilator-associated pneumonia, which was straggling behind more than 60 percent of other U.S. hospitals. In one year, it moved up to the top 10 percent in the country.
“Quality,” she says, “has always been given an equal standing with finance in terms of what executives are held accountable for on their goals.”
If Proctor sounds like a decisive executive, it’s because she is. But the faith element of her career is never far below the surface.
“My faith is a critical part of my life,” she says. “That ability to have coherence between my personal values and what I’m doing at work – to me, there’s nothing better because it’s so much more than a job.”
And St. Joseph Health System’s mission, “extending the healing ministry of Jesus in the tradition of the Sisters of St. Joseph,” is key to Proctor’s motivation.
“I use all my best business knowledge. But to me, working in a faith-based system is more fulfilling because I’m very clear about our mission and what we’re trying to accomplish – which then makes the business decisions have more relevance and meaning.”