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Profiles in Leadership: Top 25 Minority Executives Ben Chu helps Kaiser Permanente make quality count

By | July 6 th,  2012 | American Hospital Association, change management, Furst Group, Healthcare, population health, health system, hospital, Modern Healthcare, physician, Blog, CEO, diversity, healthcare reform, Kaiser Permanente, leadership, chairman-elect | Add A Comment

Chu

 

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

 

Benjamin Chu, MD, MPH, MACP, oversees Kaiser Permanente Southern California and Hawaii as group president. In the seven years since he arrived, Kaiser Permanente has amassed many awards for quality. He also is chairman-elect of the American Hospital Association and will begin serving in that capacity in 2013.
Prior to joining Kaiser, he was president of New York City’s Health and Hospitals Corp., the largest public health system in the country. He also served as associate dean at both Columbia University and New York University.

 

Following is an edited transcript of the conversation:

 

You have a Bachelor’s degree in Psychology. What spurred you to go for an M.D.?

 

I think I always was going to be a doctor. Unlike a lot of people who have a core basic science orientation, I was always more interested in the human side of medicine. Psychology, child development, and anthropology are more in line with things I was thinking about. As you know, in medicine, there are a lot of behavioral and developmental aspects. In order to be effective, you have to understand the cultural determinants of health. All of these factors led me to pursue work in a field where I could actually help people. There is a whole sociology and culture of medicine that one cannot fully understand unless viewed from the psychological perspective.

 

You spent most of your life out East before moving to California. What spurred that move, and has it worked out as you expected?

 

I was running the NYC public hospital system under Mayor Bloomberg. It was an incredible experience and an incredible job. We were doing very innovative things in that system. It is a huge system that cares for 1.3 million NYC residents. When the opportunity arose to move to California and run a large chunk of Kaiser Permanente, the prospect piqued my interest. How far can you take a systems approach to delivering on improving the health of the population under the care of a large system? In Southern California, Kaiser Permanente has 3.6 million members, three times the size of the population we were caring for in NYC. The nice part about it is that the components and pieces are linked in a large multi-physician group that only works with the health plan and the hospitals. The health plan allows for pre-payment for care of the population. There is an entire delivery system under us that allows us to decide how to parcel resources in order to achieve the goal of maximizing the health of the population we serve.

 

How do you get a big system like KP to deliver on its promise and to take healthcare to a whole different level?

 

That was both the challenge and the fun part of coming to KP & California.
I didn’t know many people when I was coming to Kaiser – primarily George Halvorson [chairman and CEO] and Ray Baxter [senior vice president for Community Benefit, Research and Health Policy]. It’s been an incredibly rewarding experience. We had to put systems in place – our electronic health record and other systems – to allow us to look at our performance in a very open, honest, and critical way. We had to reconfigure the system. KP had been better than average on quality and outcome for our members. Now, because of what we’ve been able to do with tools, reconfiguring our system, and getting complete alignment of our systems, components and people (including the 60,000 employees in Southern California), we are pretty close to leading the country on many metrics.

 


From Leapfrog to NCQA, KP across the board has achieved some remarkable ratings for quality.

 

There has been a steady progression over the last half dozen years. We’ve taken a systematic approach. We engaged every member of our staff, from doctors to non-doctors and from professionals to frontline workers, to get to that point. It has been very rewarding and a lot of fun to do.

 

The last six years coincide with your arrival. What role did you play in these changes? What role did you leadership team play? What did you look for when bringing a new leader on board?

 

To tell you the truth, I don’t think I have brought anyone new in, believe it or not. I spent time getting to know the people here. We have a wonderful leadership group, and there have been very few changes. The changes were largely to replace people who left. What would be the key to our success? It hovers around getting complete alignment over what we wanted to do.

 

Much of the alignment was around trying to make sure we did everything possible to benefit our members. It was not a financial decision. While financials are important, they aren’t driving our goals at this point. The larger point was to make sure everyone understood that at the end of the day, it is our members and patients, and how we perform for them, both in the individual aspect and aggregate aspect.

 

People rallied to this message of reaching for the higher mission. It’s hokey to think about in that way, but you’d be surprised. Everyone comes into healthcare to make a difference in another person’s life. One of the things we did as a leadership team was to galvanize everyone’s desire to make a difference and reminded people of this. I think this is the key to leadership overall. I am blessed to have a lot of incredible people working with me on much of this.

 

Obviously we had to put in the systems to give us the information to know if we were making a difference in people’s lives. Once we got that in place and held that mirror up, the ideas came flowing out, and we could tap into this wellspring of creativity and desire to do the right thing. I am a doctor by training in a non-clinician role right now, but it is a pleasure to see that marriage of clinical outcomes and my public health background on population health outcomes come together in a delivery system.

 

As you look at your role at the American Hospital Association as chairman-elect beginning in 2013, do you get the sense that part of what they are looking to you for is to help other hospitals across country pick up on what Kaiser has done and get the quality scores up and make a difference nationally?

 

If you actually talk to the hospital leaders and members of the boards across the country, there is an enormous amount of energy working to find ways of taking care of their communities. Part of this is the quality agenda. Thousands of hospitals have joined the hospital engagement networks that are forming right now and are trying to learn from each other and optimize the quality of care given in the hospitals themselves. Hospitals are beginning to see that they play a pivotal role in their communities.

 

Rather than be passive and wait for people to get sick and come in, there is a role to be played more upstream – to make a difference in the community’s fabric and in its health. Some of it has a lot to do with impacting the developing ACOs. It is an often misunderstood, yet often used, term. The idea is to get an organization and care delivery system to care for a population and try to go as upstream as possible to find strategies that lead to good health and mitigate things that lead to bad health, not just treat emergency situations. It means partnership with providers who work in the upstream levels. Doctors who see patients in an outpatient setting tied to the hospital or in their practices – we need to link the two together.

 

There is a lot of energy in the hospital world. One of the reasons I was asked to chair in 2013 is that there are tremendous, yet uncertain, changes that are happening. There are also these powerful positive forces that can help hospitals and health systems come together in a better way to take better care of their communities. I think I was asked to chair so we can engage in a system-wide and country-wide dialogue to help each other overall.

 

Given the uncertainty around reform – does that make leadership harder for you and the people running hospitals round the country?

 

It depends on what you mean by harder. It certainly makes it much more interesting. The pathways to choose are much more ambiguous. In uncertain times, leadership needs to focus energy on the right things. I think that is why the AHA is working with our member hospitals to determine the higher-order outcome. If we dive into the weeds and get into the arcana of legislation and stay there, we will get lost. That is not to say reimbursement and policy changes aren’t important, but if that is all we think about, there is no ability to guide organizations through a field of uncertainty.

 

If you can’t pick up your head to see where you are going, you cannot mobilize physicians and institutions to move in the same direction, and we will be mired in the field and will not get anywhere. That is the difference between someone who is good operationally and a leader who can engage people in dialogue to get everyone to a place where we want to be.

 

There seems to be a growing consensus among healthcare leaders that we are on a course of change that will continue whether mandated or not.

 

I think that is absolutely correct. Healthcare is changing in a good way, I think. I know people worry about losing the good things in uncertain times. When you think about what we are capable of doing and how many people we are capable of doing things for, I am convinced that with a little change in perspective and focus, we can utilize the dollars we spend in healthcare and create a lot more healthy communities. It is a journey in a lot of ways – a very uncertain journey. I think the focus is changing. Payment reform is happening. A lot more transparency is coming. There will be changes to tell us how we are really doing. Once you are confronted with that information, it is a compelling force driving changes that could get us to a better place.

 

I think that in the best framing of what is happening now, that is the direction the country’s healthcare systems is headed. Probably the direction the world’s healthcare system is headed. Even though we are making a difference, how do we know we couldn’t be making a bigger difference? When you think of disparities in healthcare and how uneven results are, I think in this day and age, there is little the systems cannot tackle. We won’t all get there at the same time, but if we focus right, there’s a lot more good that we can do.

 

There seems to be an increasing interest in physician executive leadership. As a doctor and physician yourself, what is your take on that?

 

The lesson we’ve all learned is that in order to take on the larger tasks, the triple aim, all of the key pieces must be aligned. Physicians and other healthcare professionals have to be integrated into the whole system. We are trained to be separate. Even though hospitals are a part of the action where people are treated and where doctors do what they do, they are still only a piece of the puzzle. To integrate the perspectives, many places are looking towards physician leadership, whether as an administrator or at a Medical Director/CMO level.
We need voices there and to be open and honest about the larger goal. We cannot just see hospitals as a doctor’s workshop. That will only get us so far. Obviously, we want someone to care for patients and bring their expertise. However, it is not just a single doctor, but multiple healthcare professionals. We want to see the larger role for the community.

 

We need to make decisions on the deployment of resources and make a bigger difference than just delivering the best care in the ER. I’m not saying the best care shouldn’t be delivered in the ER, but when you think about it, it may not be the optimum expenditure of resources if you only concentrate on the ER.

 

In my opinion, there should be more doctors at senior levels of health systems. Having everyone’s perspective is important and makes a difference.

 

You spent time working in the office of Sen. Bill Bradley. What insights from that time guide your perspective in today’s healthcare climate?

 

I’m not sure there is a tremendous amount of insight but, when I worked for Senator Bill Bradley, it was one of the last times for major Medicaid expansion. The American with Disabilities Act was passed the year I was there; we passed the Medicaid Best Price legislation for pharmaceuticals, and expanded Medicaid to children up to 133% of the poverty line and pregnant women up to 185% of poverty. That was really the last big expansion before the children’s health program came in.

 

When I think of that era, it was a time of greater bipartisan collaboration. I worked for a Democratic senator when the first George Bush was president. There was a lot more collegiality. That’s not to say that cannot happen again, but I’m hoping after the upcoming, probably raucous, presidential campaign, that people will be more realistic in looking at the problems of our country and figure out how to solve them.

 

Even if we concentrate on legislation, that’s not always where the action is. Many core changes are already starting to happen. Core systems changes are being worked on. I don’t think there is a way back. From the hospital perspective, one of the opportunities was finally being able to count on some sort of payment for care of the significant portion of uninsured patients that would come in to the ER and hospitals. This includes upstream care and hospitalization. From the community and hospital point of view, that was one of the best parts of healthcare reform. I hope that will continue. I know it presents problems for many aspects of the healthcare world, the Medicaid expansion, as well as the exchanges, but I hope that some sort of increase in uninsured care will continue. We will always muddle our way through. We always have muddled our way through, based on my experience with Senator Bradley. It was not always clear then (1989-1990).

 

Healthcare organizations, particular in the inner cities, are creating senior housing, opening banking centers, farmers’ markets, and developing other innovative systems and ideas such as free surgery day. Some might think it’s a bit far afield of healthcare, but it seems to be a growing part of preventive care. Is this part of the equation at Kaiser Permanente as well?

 

Every one of KP’s medical centers runs a farmers market. In fact, we run the only farmers market in Los Angeles. This is illustrative of what I was talking about earlier – the tremendous amount of energy spent in the hospital world trying to figure out how we go upstream. The medical model is individual – one person at a time. When someone is sick, you care for them and send them back out. This is an important function for every community. The underlying premise is that the sum of all the good one-on-one work will translate into a healthier community. Clearly, this model leaves huge gaps. The medical model really is not directly focused on the population’s and the community’s total health.

 

There is a broader understanding that what makes a person healthy or not is as much about the health of the community and total health of the environment as it is to prescribing the right medicine. Eighty percent of the determinants of health are not linked to care. Smoking, exercise, drug use – these are things people need to think about if we are going to make a greater impact on the community and population health.

 

At Kaiser, we have a theater troupe that goes into grade schools to do thousands of performances on healthy eating to influence kids on eating habits. Collectively, if 5,000 hospitals and health systems can get it together and start moving upstream together, it could be a very powerful force. To become a vibrant part of the community is key. We helped invest in parks. We have beautiful weather in Southern California, but unless you have good outdoor spaces, people will stay in their homes or in their cars to go from place to place. The built environment in the community makes a difference. Do people have the choice to make better decisions? We need to provide spaces to make better decisions.

Profiles in Leadership: Top 25 Minority Executives Michael Ugwueke helps Methodist South turn around

By | June 5 th,  2012 | Furst Group, health system, hospital, Methodist South, Modern Healthcare, Blog, CEO, Memphis, leadership Michael Ugwueke, Methodist North | Add A Comment

Ugwueke

 

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

 

Michael Ugwueke is CEO of Methodist South and Methodist North hospitals in Memphis, Tenn., where he also serves as senior vice president of the Methodist Le Bonheur Healthcare system. He came to Methodist in 2007 from Provena St. Joseph Medical Center in Joliet, Ill., where he worked as vice president of operations. Ugwueke, who came to the U.S. from his native Nigeria as a college student, turned around the troubled Methodist South facility, instituting a 30-minute emergency-room guarantee to the community in the process. His success led his bosses to add Methodist North to his responsibilities. Following is an edited transcript of the conversation:

 

Do your ERs still have the 30-minute guarantee in place?

 

Yes, we’re still doing it. When I first got into town, Methodist South was not very highly regarded. We were trying to turn the hospital around. There were a lot of issues stemming from perception of poor quality, low volume and low employee morale.

 

And one of the things that occurred to me is that most of our patients – over 80 percent – came through the emergency room. To make any noticeable impact, change had to start from the emergency room. When we went about trying to improve the turnaround process in the ED, that equally meant that we also needed to improve the turnaround process for major ancillary departments, specifically the lab and radiology departments. We wanted to make sure we streamlined our operations to remove all bottlenecks that affect quality and efficient delivery of service to our ED patients.

 

The 30-minute guarantee was part of my overall strategy, because what I really wanted to do was to create a new story about Methodist South. I knew that if we were able to create a new story, it would eventually take over and the old story of Methodist South would gradually die away.

 

So we took the 30-minute guarantee very seriously, and made it happen. That was almost five years ago, and it hasn’t stopped. Back then, we saw 37,000 visits a year. We ended 2011 with more than 61,000 visits and, with the current first quarter trend, we’re probably going to end up with 69,000 in 2012.

 

It helped to change the whole dynamic of the hospital, not just the emergency department. The operating room has to be efficient, the floors have to turn over very quickly, and everything from the laboratory to housekeeping is critical in our success.

 

There’s a sense of pride for all the associates who were involved in this initiative, especially when they hear from their family or other members of the community.

 

Tell me about your role and Methodist’s role in domestic violence prevention. How did that come about?

 

Community involvement is very, very important to me, but my involvement in working to end domestic violence came about strictly by accident. There was a nurse at another hospital who was killed in the parking lot when she came to work by an ex-boyfriend who was stalking her. It became a big news story here. It prompted one of our doctors, Todd Motley, to start talking about incidents of domestic abuse he believed were happening to some of his patients. He created a program so that victims of abuse could call his office for an immediate appointment, receive some shelter and notify the police. He came to me and it didn’t take but a minute for us to get behind what he was doing.

 

So we ask our associates to donate clothes and toiletries, among other things, to help these women. But Todd Motley is the brains behind this.

 

You recently paid a visit to the White House. What will you remember from that day?

 

It’s the first time l’ve ever been there. I lived in D.C. for a brief period of time and always said, “I’ll do this, or I’ll go there,” and I never did.

 

Steve Cohen, the congressman from my hospital district, extended an invitation from the White House to meet with key minority business leaders to brainstorm about job creation and various other opportunities. So about 20 business leaders from Memphis sat down with the White House staff. I was truly honored to be invited as part of the delegation that met with them.

 


Where have you learned the most about leadership? And from whom?

 

Actually, it started at home. My dad was the primary person in my life that I felt believed in me and provided guidance to me as a kid growing up in Nigeria. I watched him as he struggled to raise us up with limited resources; he was my inspiration in every way imaginable because he was looked upon in the community as a leader even without a formal education. Having the guts to leave your country at the age of 21 to come to the U.S. where you don’t know anyone, and believe that you’re going to survive with no money – that came from my dad’s ability to instill in me the knowledge that the world did not owe me anything and I had to create opportunities for myself.

 

My dad did not have a formal education. He was self-taught but was able to become a foreman in a construction company and eventually was able to start his own construction business. He wanted to make sure all his kids had the opportunities for education he didn’t have. I was very fortunate to have such a person in my life during my formative years.

 

A number of other people also have been very instrumental in my life. I’m forever grateful to Michael Covert. I met Covert when I was working at Sarasota Memorial Hospital in Florida. He provided me with lots of growth opportunities and was my first formal mentor. When he left the hospital to become the CEO of Washington Hospital Center, he asked me to come with him as one of his executive team members. He was very instrumental in mentoring me and providing needed guidance as I continue to take on additional challenges within the hospital. The second person is my current System CEO Gary Shorb – he is one of the people who nominated me for this award. He is a wonderful mentor and the reason why I came to Memphis; he too has provided me with lots of growth opportunities. He is a servant leader who is extremely passionate about patient care.

 

What makes a good leader?

 

For me, a number of things make up a very good leader. A leader is someone who is willing to step up and do those things that most folks are unwilling to do, to have the intestinal fortitude to make tough decisions, who is visionary and willing to lead from the front. A leader creates the environment that empowers others to equally step up and lead.

 

You have to make sure that you have clarity in your organization with total transparency in all communications with your associates as well as other key stakeholders. For example, we conduct four town halls a year to ensure that everyone is on board with our goals and objectives. We share the results of our activities during these sessions – good, bad and ugly – so everyone knows exactly what is happening at any given time. It takes away the “we” and “they” mentality which ultimately leads to trust.

 

What are the keys to building a good team?

 

No one can do anything by themselves. In my early years, I realized the importance of teamwork. There are certain guiding principles one develops. In my case, I like to have a very diverse team that reflects the community we serve.

 

I also like to pick out people who are much smarter than me and passionate about making a difference because that’s what it takes to do this kind of work. I inherited the leadership team here; my philosophy is not one of blowing things up and bringing in all new people without giving the existing team members the opportunity to prove themselves. I like to believe that most leaders, given the opportunity with clarity in expectations and support, can get the work done. I like to make sure they understand the reasons behind the new vision and what implications it has on their success. Obviously, you give everybody a chance, and some will self-select when they realize that they’re better suited for another environment.

 

But I try to build my team in four ways:

 

The first is to try to create a culture of accountability, to be very clear with the goals of the organization. We set clear priorities and expectations with timelines and metrics to gauge and measure our progress. All my leaders have actionable plans that support their goals and priorities for all of their areas. To be effective, one has to know their business in and out and able to explain positive or negative variations from their goals.
We track our goals on a quarterly basis, and plan for where the metrics need to be on a monthly basis in order for us to accomplish our 90-day goals.

 

It’s very important in developing a high-performing team that you have a sense of trust. You have to create a level playing field – no one has a monopoly on good ideas. Everybody’s goal is shared with everyone. There are no hidden agendas.

 

Second, is to create a culture of rapid execution of ideas. We don’t want analysis paralysis with several meetings and no results. We try not to wait till we have 100% of the data before execution of great ideas, What typically happens is that if we are comfortable with 70 percent of what we need, we will go ahead with our plans, with the expectation that we may have to refine and course-correct as needed. If you try to wait till everything’s perfect, you’ll never get off the ground.

 

When we started the 30-minute guarantee for our emergency department, we met every afternoon. We shared yesterday’s data – everybody knew exactly how we did, and then we made immediate changes to address variations from our targets.

 

Third, is leadership and associate engagement. I strongly believe that the engagement factor with your team is important. I conduct 90-day meetings with all new associates to ensure that we are still meeting their expectations and I often meet with leaders and seasoned associates to learn about their challenges to ensure that we are providing adequate resources and tools that they need to accomplish their goals. In addition, it provides me the opportunity to recognize their efforts. You need to devote time to this and make those connections.

 

Fourth, is total transparency in everything that we do – data and results are shared liberally, with clear understanding of our strengths and shortfalls with no excuses. We do this during our town hall meetings, annual retreats and operational efficiency presentations by department leaders.

 

You’ve spent a lot of time at faith-based institutions. How different are the challenges there?

 

For one thing, the mission is very clear. There is very little ambiguity as to what the mission is. I believe that the difference is how we go about providing care for everyone regardless of their ability to pay. Also, we invest a lot in the community, trying to improve the health of our community – as you well know we don’t expect for anyone to reimburse us for the things that we do in the community. By virtue of being a faith-based organization sponsored by the United Methodist Church, you feel like you have the moral authority to look at things in a slightly different way. At the end of the day, my expectation is that we are going to treat the patient holistically in a patient-, family-centered environment. We do the best we can with limited resources to make sure people who ordinarily don’t have access to healthcare have the opportunity to experience excellence in healthcare.

 

In terms of diversity in healthcare, what kind of changes have you seen since coming to the U.S.?

 

No doubt there’s been some improvement, but we still have a ways to go. As long as we are still talking about disparity in care among different groups, we know that we are not there yet. I think the gap is closing within the ranks of supervisors and middle managers. The area of greatest opportunity is within the director level and senior teams.

 


Is leadership harder today given all the uncertainty around reform?

 

It will be easier to say yes, but I am certain that every generation of healthcare leaders probably thought that things were harder for them. I think that healthcare reform definitely presents lots of challenges which are opportunities in disguise. Regardless of the outcome of the Supreme Court ruling, changes have been made throughout the industry because the payment model that we have is just not sustainable. The challenge is having one foot on the throttle and the other foot on the brakes as we move from a fee for service to value-based purchasing.

Profiles in Leadership: Top 25 Minority Executives Sam Ross just wanted to be 'the black Marcus Welby,' but life had bigger plans

By | May 22 nd,  2012 | Bon Secours, population health, health system, hospital, physician, Samuel Ross, Blog, CEO, leadership | 2 Comments

 

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

 

As a young man growing up in Texas, Samuel Ross says he wanted to be “the black Marcus Welby,” a family physician who returned to his hometown and found great success, just like the ‘70s TV doctor portrayed by Robert Young.

 

While Ross did indeed become a family physician in private practice, real life had different plans for him. He eventually served as chief medical officer, among other jobs, at Parkland Hospital & Health System in Dallas before becoming CEO of the Bon Secours Baltimore Health System. He also oversees Bon Secours’ Kentucky facilities and its system-wide Supply Chain.

 

And, far from the middle-class patients Welby tended to, Ross’ experiences in the poor neighborhood surrounding Bon Secours sometimes have less to do with the medicine he studied, and more to do with population health. In the last twenty years, including time under Ross’ watch, Bon Secours has built apartment buildings for seniors and opened a banking center for the community. They don’t teach much about that in medical school.

 

“These ideas came from the community,” noted Ross. “I’ve been influenced by the concept of Community-Oriented Primary Care that came out of South Africa by Dr. Sidney Kark. He built a number of facilities with the notion of one-stop shopping for the poor related to social determinants.”

 

Bon Secours was on the brink of closing a couple years ago. Its safety net for the poor was fraying badly as residents without insurance comprised a disproportionate amount of the patients. In fact, Ross determined that 50 patients alone accounted for 2,287 visits in a three-year period.

 

The state of Maryland came through with funding to right the ship, and Ross and his organization have done the rest. Ross is putting a focus on patient safety and quality and has announced plans to hire more physicians and other staff to develop a “primary care medical home.” Bon Secours has invested many dollars and a lot of hours in the community. “This is about the charism of the Sisters of Bon Secours to extend healing and compassion and liberation,” Ross said. But Ross is far from done and is determined that Bon Secours make a lasting impression, because the hospital – and West Baltimore – have been down this road before.

 

“A lot of people and foundations and government agencies have come in before and tried to make things better for the community,” Ross said. “But when the money runs out and the programs go away, a lack of trust develops in the community. We need to be partners working with them, not doing it for them.”

 

The needs are great in Baltimore, where the Sisters of Bon Secours came more than a century ago to begin to care for the sick. A study by the city of Baltimore and Johns Hopkins determined that life expectancy for a resident of West Baltimore is 20 years less than someone who lives in the affluent neighborhood of Roland Park.

 

“That’s unacceptable,” Ross said.

 

So Bon Secours went to the neighborhood and asked the residents what their needs were. The response wasn’t what the hospital expected.

 

“Getting rid of rats and trash – that’s what people said was important,” Ross related. “There were a lot of vacant houses where those things were a problem for the whole neighborhood. So we helped the community get rid of those houses and build community gardens. Housing was a major concern too, and that’s where the senior apartments came from.”

 

Ross hopes he and his staff have learned from their own and previous generations’ mistakes.

 

“Oftentimes, we go in to the community with our statistics and say, ‘Here’s what the stats say your problems are.’ But the people don’t always agree. You can talk about heart disease and diabetes all you want, but first you have to get rid of the rats and trash.”

 

Yet in the boardroom and in the community, Ross says he draws many lessons from his days as a family physician – he was a solo practitioner for five years before friends at Parkland convinced him to create a primary care clinic.

 

“The life of a family physician is really about right relationships,” Ross said. “It’s through those relationships that opportunities and success come. You can’t accomplish anything alone. Communication is critical, especially when you’re trying to impact an organization and a community.”

 

Ross says he was an accidental leader at first, but has grown to embrace the role.

 

“I didn’t want to become an administrator,” he said. “People saw leadership things in me that I didn’t necessarily see in myself. But administrators and clinicians do speak a different language, and I saw that as a physician leader I had the ability to translate for them. I was able to discern the interests of both sides.”

 

The obstacles Ross has faced in Baltimore are a long way from the made-for-TV crises that Marcus Welby faced each week, but Ross sounds a bit like his hero as he assesses the challenges, not only in Baltimore but in the industry as a whole.

 

“I’ve heard it said that leadership is optimism beyond the available data,” he said. “If you look at the situation here in the U.S. with all the uncertainty around healthcare reform, you could become paralyzed in the face of the facts. But if you’re doing the right things with patients and their families in mind, you should be in a good position to adapt to whatever comes along.”

Profiles in Leadership: Jeffcoat at ease under reform’s pressures

By | August 23 rd,  2011 | Boise, delivery, finance, Healthcare, reform, Saint Alphonsus, Top 25 Women, health system, hospital, Idaho, leaders, Modern Healthcare, operational effectiveness, patient safety, president, Sally Jeffcoat, wellness, Blog, CEO, clinical, leadership, operations, preventon, quality | Add A Comment

 

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

 

A lot of the dialogue about healthcare reform is focused on cost, but Sally Jeffcoat, president and CEO of Saint Alphonsus Health System in Boise, Idaho, says she thinks there’s an equally important element that is being overshadowed.

 

“Health reform has really taken shape in the form of financing reform, but what we haven’t done yet is the care-delivery reform that’s required,” she says. “This gets to the heart of operational effectiveness: how are we going to reorganize care delivery that shifts patients to lower cost environments so that we can still deliver better quality than what we have today?”

 

To do that, she says, some of the responsibility needs to shift to the patients.

 

“A focus on prevention and wellness is where we need to reform the system because, right now, there really aren’t any incentives and reimbursement for that type of care,” Jeffcoat says. “It’s difficult to manage the transition unless we reward our providers to deliver that kind of care and we shift some of the risk for those expectations to those patients and populations that we are trying to serve.

 

“Healthy behaviors are really where we can address some of the problems of our healthcare system today.”

 

All of that speaks to change, and that is something that Jeffcoat is comfortable with herself. A native Texan whose father was an Army surgeon, she worked for many years in her home state and Arizona, rising to a CEO position in the Ascension system, before taking her current role with Trinity Health.

 

“I’ve had the blessing of working in organizations that have a strong management development program, but I would not have been able to advance if I wasn’t willing to take on different roles that I had to grow into, or move to different locations,” she says. “Working in different environments shapes you as a leader, because you learn from the positive and negative experiences and integrate them into your leadership style.”

 

Strategic vision tops the list when Jeffcoat lists the qualities that rising female executives need in today’s environment. But vision must work in tandem with operational effectiveness, she says.

 

“You need to have the ability to take strategic vision and operationalize it,” she says. “You need to be connecting the dots from strategy to effective implementation to be successful. I also think the ability to communicate vision – the what and the why – is important for a female executive. If you can’t get people wrapped around the why, it makes it more difficult to implement your vision.”

 

Jeffcoat is known for her dedication to quality and safety, traits that were shaped not only by her pivotal role in Ascension’s “Journey to Zero” program but also by her history as a nurse.

 

“It’s so important to never get too far away from the bedside or from direct patient care,” she says. “I probably get a lot of my satisfaction from being able to interface directly with the caregivers who are on the front lines. The other thing I derive from that is the teamwork it takes to produce the kind of high reliability that we are all trying to achieve as an organization.”

 

And a clinical background, she says, can sometimes help a female leader shine.

 

“It’s important to have the business skills necessary to perform a CEO role. But some of the characteristics of women leaders that bring a balance, such as compassion and collaboration, are very important, particularly in an industry in which 50 percent of the workforce is made up of clinical caregivers.”