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What healthcare leaders need to know now

Leadership lessons: 'Empathy is the engine of innovation'

By | June 17 th,  2015 | Gary Hamel, Healthcare, patient satisfaction, Harvard Business Review, health system, Blog, CEO, Lakeland Health, leadership, empathy | Add A Comment


Management expert Gary Hamel offers a compelling story in Harvard Business Review about how a health system in Michigan used the so-called "soft skills" to not only improve patient satisfaction scores but to achieve clinical improvements.


"Empathy," declares Hamel, "is the engine of innovation."


The empathy movement has been gaining ground in recent years, perhaps epitomized by Cleveland Clinic's powerful video series. Hamel spoke to the system CEO at Lakeland Health in Michigan who came into the role and soon discovered that things were in worse shape than he expected.


With patient satisfaction scores mired between the 25th and 50th percentiles, the CEO created a strategy called "Bring Your Heart to Work" and set a goal to bring scores to the 90th percentile in 90 days.


It actually worked -- Lakeland's scores jumped to the 95th percentile. In one anecdote, hospital security was ready to call the police when a despondent husband reacted angrily to his wife's terminal diagnosis. A junior nurse stepped in and hugged him. He broke down in tears and the situation was defused.


“Beyond the improved satisfaction score," the executive noted, "there was a clinical benefit. We are in the business of saving lives, of enhancing heath, of restoring hope. When we touch the hearts of our patients we create a healing relationship that generates a relaxation response, lowers the blood pressure, improves the happy neurotransmitters, reduces pain, and improves outcomes — for both the patient and the caregiver.”


There is a neat personal revelation embedded in the story, but Hamel concludes, "If you want to innovate, you need to be inspired, your colleagues need to be inspired, and ultimately, your customers need to be inspired."


Hamel provides plenty of leadership inspiration for management teams, and food for thought too. To read the full article, click here.



Women executives strengthen leadership teams

By | April 30 th,  2015 | Furst Group, Healthcare, women in leadership, executive, Modern Healthcare, Blog, CEO, diversity, leadership, Top 25 Women in Healthcare | Add A Comment


By Bob Clarke and Sherrie Barch

Furst Group


Welcoming women leaders to your leadership team with women executives is a prudent thing to do because a diversity of opinions and experiences can only make your organization stronger. But, according to a recent article by the Associated Press, it makes good business sense too.


The story explores a 12-year initiative at Sodexo to increase gender diversity. A company study in 2014 demonstrated that business units dominated by men at the top earned less profit than those led by equal numbers of men and women.


That dovetails with a McKinsey study last year which also found that companies with leadership roles equally divided between men and women reported above-median profits, according to the AP.


One need only to look at the honorees on this list - the Top 25 Women in Healthcare - to see that the news story confirms what we have known for a long time: both gender diversity and ethnic diversity are essential to success in the mission and business of healthcare today.


In our conversations with women leaders, though, we know there is still much work to be done. We need more women CEOs and board members - and more female C-suite leaders in all departments.


A report by CNNMoney last month found that women hold only 14.2 percent of the top five leadership roles at companies listed in the S&P 500. Worse yet, the study found that those 500 companies only had 24 women CEOs (4.8 percent). "Corporate America," CNN concluded, "has few female CEOs, and the pipeline of future women leaders is alarmingly thin."


In this, we'd advocate that healthcare has an opportunity be the industry that leads the way to a better leadership outcome for our country.


All of this explains why we at Furst Group are pleased to once again be celebrating the Top 25 Women in Healthcare, our sponsorship with Modern Healthcare. Winners were announced in this week's issue of Modern Healthcare and we urge you to save the date of Aug. 20 to join us in Nashville, Tennessee, for a gala honoring the Top 25 Women, who are some of our industry's best leaders regardless of gender. Details on attending are here.


Quality, safety fuel Pujols McKee's drive at The Joint Commission

By | October 6 th,  2014 | chief medical officer, Furst Group, Healthcare, Penn Presbyterian Medical Center, physician engagement, Top 25 Minority Executives in Healthcare, executive, Modern Healthcare, patient-centered care, patient safety, physician, Ana Pujols McKee, Blog, diversity, leadership, The Joint Commission, quality | Add A Comment


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


Ana Pujols McKee’s passion for quality and safety existed long before she joined The Joint Commission as executive vice president and chief medical officer. She previously served as the CMO and associate executive director of Penn Presbyterian Medical Center, in Philadelphia, and as a clinical associate professor of medicine at a teaching hospital in Philadelphia. Pujols McKee has championed for years the need for transparency and patient-centered care.


“I’ve had my own personal experience with injury as a patient, and I think what began to propel me in this area were some of the unfortunate patient injuries I had to deal with as a chief medical officer. Seeing up close how deep the injury extends to the patient and family is truly overwhelming,” she says.


The physicians and nurses who are involved in an incident when a patient is harmed suffer too, she is quick to add.


“What we don’t always talk about is what we now refer to as ‘the second victim,’ and that’s the clinician and staff that are injured as well. It’s a tough situation.”


Being able to make strides in that area, Pujols McKee says, has been one of the highlights of her career.
“When you work at an organization and you start to see those injuries decrease, and you start to see your infection rate come down and you start to see (patient) fall rates come down, there is nothing more rewarding than that – to know that you’re making a difference.”


From the time she was a child, she says, she knew she wanted to not only become a doctor but to run a large clinic – “all those altruistic dreams of taking care of people and making people well,” she says with a chuckle.


Pujols McKee’s prospects on the surface looked daunting – the world in which she grew up had some prejudicial obstacles blocking her way. She remembers constantly visiting a high school counselor to obtain information on college admission, only to have the woman continually tell her that she was busy or had no guidance for her.


“One day, I walked in on her as she was sitting in a circle with students who all were white, along with a gentleman in a suit,” she relates. “She jumped up from the chair and started to dismiss me when the gentleman said, ‘No, let her come in. Remember? I told you I was looking to recruit minority students.’ ”


It was, she says, a devastating experience, but not uncommon. “I have been told similar stories from many people of color. I’m not unique in any way. This is the way things were back then – and I believe they are, in some situations, not very changed.”


Besides being a driven student, Pujols McKee says, her parents were a strong cheering section. In her Puerto Rican family, her father was an electrician and her mother was a teacher. Together, they taught her the importance of perseverance as she grew up in the South Bronx.


“If I came home and said, ‘They closed the door on me, Dad!’, my dad would say, ‘Go right back out and open it.’ ”


She is hopeful that the changing face of The Joint Commission, which she joined in 2011, opens many doors for hospitals to achieve their full potential.


“When I got to The Joint Commission and I started to see how Dr. (Mark) Chassin, our president, was transforming our organization, I found it extremely exciting,” Pujols McKee says. “He has boldly said that accreditation is really the floor for transformation. We want to help organizations go above and beyond that.”


To that end, The Joint Commission enterprise has expanded its offerings by adding a new affiliate to its portfolio, the Center for Transforming Healthcare, to help health care organizations improve patient safety through the use of Robust Process Improvement™ tools including Lean Six Sigma and change management. The commission also partnered with the American College of Physician Executives to begin an academy for chief medical officers.


“One of the things I’m doing at The Joint Commission is leading a strategic initiative to support our physician leaders and provide them with the skills and resources that they need,” she says. “We recognize the need to support physician leaders as critical since, when we see a high-performing organization, we almost consistently see a high level of physician engagement.”


Pujols McKee’s own journey from clinician to C-suite executive has been typical of physician leaders, she says – one that included some growing pains.


“In today’s world, there’s so much transition that has to occur in an organization from the administrative to the clinical side,” she says. “I think we’re coming close to a time when it’s almost impossible to make that transition without being mentored or being part of a succession plan that includes spending time with finance, quality, and the operations team.”


Such transitions, she says, need to thoughtfully include more diverse leaders to improve healthcare and to more accurately represent the diverse communities they serve.


“The pipeline for future physician leaders has a fair number of women, but in terms of African-Americans and Latinos, the outlook is not very promising. There are some who believe that until we improve diversity in health care leadership, disparities in health care are not going to be fully addressed.”


Bernard Tyson: Workers will share in healthcare costs, but cost shifting is not sustainable

By | September 18 th,  2014 | chairman, Furst Group, Healthcare, Top 25 Minority Executives in Healthcare, executive, Modern Healthcare, Bernard J. Tyson, Blog, CEO, diversity, Gen KP, healthcare costs, Kaiser Permanente, leadership, millennials, Vision 2025 | Add A Comment


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


At a recent New York Times conference on healthcare, Kaiser Permanente Chairman and CEO Bernard J. Tyson drew applause when he said that healthcare costs can’t continue to be shifted onto the backs of American workers, who have seen few wage increases in the last 20 years.


It’s one thing when a consumer activist or patient advocate makes a bold statement like that; it’s quite another when the words come from one of the most powerful healthcare executives in the country. In a conversation the following week, he elaborated on that point.


“You have the American people seeing the cost of living going up every year and seeing the cost of healthcare going up three or four times the cost of inflation,” Tyson said. “They see no real wage increases and then they get stuck with the added cost that’s been shifting to them from employers and insurers.


“That is not a long-term solution.”


What does seem to be working is the Kaiser Permanente business model, in which the organization serves as both health plan and healthcare provider, with capitation helping to fund the delivery of care and hospitals viewed as expense centers rather than revenue generators.


“One of the moral obligations that I believe I have as a leader in the healthcare industry is to bring a lot of transparency as to why I believe our model is the best way to go,” Tyson says. “It’s a system that doesn’t pay for volume, that isn’t motivating people to produce more of something in order to get paid. What we have been able to do for almost 70 years is align the incentives of the financing mechanism with the hearts and minds of physicians and other caregivers who continually sign up to do the right thing.”


The healthcare industry has recently gone through a period where many hospitals were building new patient towers that executives needed to fill with inpatients to pay for. Readmission penalties have changed the rules. Now, consciously or unconsciously, a growing number of U.S. healthcare organizations seem to be emulating Kaiser Permanente as they acquire or create their own health plans in the reform era.


“In our system of care,” Tyson says, “you have the caregiver team all working together with aligned incentives where the physician is not making any more or less if he decides that the patient needs to be in a hospital or the patient needs to be at home with a nurse.”


Healthcare removed from the high-volume, fee-for-service environment has always been the goal at Kaiser Permanente, Tyson says.


“It’s in the DNA – it’s how the organization was built,” he says. “In his early years, Henry J. Kaiser’s mother died. He believed that she died prematurely because they were poor and couldn’t afford the right healthcare. Of all the businesses he created and all he did in his life, it’s pretty interesting that this organization is the standing legacy that continues to carry his name forward into the future.”


The future at Kaiser Permanente can be held in the palm of your hand, if that palm is holding a smartphone. The organization has invested heavily in information technology with the autonomy its capitation model has allowed.
“We are,” Tyson says simply, “the alternative to the mainstream delivery system that you see out there. We get a lot of people who come in to look at how we run our hospital systems.”


When a Kaiser Permanente member has to enter the hospital, whether through the emergency department or a planned admission, his or her electronic medical records are available 24/7 online throughout the system. That’s not a goal; it’s a present-day reality.


“It expedites getting to a diagnosis, and then determining what the treatment is,” Tyson says. “In the outside world, you can end up in the emergency department 12 to 24 hours before they figure out what’s going on. In our world, within 45 minutes or an hour, you can be in a hospital bed and we’re starting treatment. The whole point is to manage the quality of care and the logistics of care.”


With EMRs already in place at Kaiser Permanente, Tyson has the freedom to look down the road to make sure the organization is still a health care leader 10 years from now. To that end, he’s taken a particular interest in the younger employees who are part of his workforce, which numbers about 200,000.


“I have a particular interest in the millennials right now,” he says. “I feel that part of my responsibility is to make sure that the future generation of leaders is in the pipeline, contributing in very different ways than what I went through 30 years ago when I was growing up in KP.”


Gen KP, as the millennial group is called, has direct access to Tyson – no hierarchy. And Vision 2025, Kaiser Permanente’s future planning project, includes contributions from the organization’s future leaders. “I will tell you that having the millennials as part of that thought process is making us think very differently about the future. It’s refreshing.”


Looking more broadly, Tyson, who took the helm of Kaiser Permanente in 2013, hopes to make a wider impact in making healthcare more affordable and eliminating disparities in the U.S.


“I strongly believe that healthcare is unaffordable in large part because it’s siloed, and it’s running off the wrong chassis,” he says. “I would love to continue to contribute to the affordability agenda in this country.”


Like his comments about shifting healthcare costs, Tyson’s perspective on the topic leans toward an empathy for American workers.


“I think everyone breathing in this country should have the same equal rights and a level playing field for the ability to pursue life, liberty and happiness,” he says. “And the question I ask myself is, what is the role that healthcare can play in allowing people a good chance of doing that? We continue to have health disparities in this country; it isn’t a level playing field.”


Tyson said the changes brought by the Affordable Care Act can make a real difference in grading the surface of that field. “I think the elements are in place to put the pressure back on the industry in its transformation to produce higher quality care at a lower cost. And I know that’s possible.”


It’s a point Henry Kaiser would probably second.


Dignity Health’s Lloyd Dean leads from experience and welcomes ‘healthcare for all’

By | September 4 th,  2014 | Furst Group, Healthcare, Top 25 Minority Executives in Healthcare, executive, faith-based, health system, Modern Healthcare, Blog, CEO, diversity, leadership, Lloyd Dean, Dignity Health | Add A Comment


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


Lloyd Dean, president and CEO of Dignity Health, has an enviable track record in the volatile world of healthcare, where he made his reputation as a turnaround expert for his work taking the organization (then known as Catholic Healthcare West) from perpetual losses to profitability in the early 2000s. But what continues to make him a leader among his healthcare peers is his anticipation and forward thinking.


In 2009, the organization partnered with Blue Shield of California and a physician network for coordinated care. That put the organization way ahead of the curve on the accountable-care front. Dignity Health’s emphasis on outpatient facilities in the last several years also has earned the positive attention of investors. In addition, Dean led the system as it transitioned from an officially Catholic health system in 2012 to one that still honored its Catholic roots while also allowing for growth through partnerships with both faith-based and non-faith-based organizations.


Dean says such moves demonstrate that Dignity Health “possesses a culture that values innovation, future-focused thinking, experimentation and, above all, a bias for taking action.”


He’s shown a similar decisiveness as he has championed the Affordable Care Act and been heavily involved in California’s health care exchanges, which have fared far better than other state’s systems.


“So far, so good,” says Dean. “The lessons learned in California are that, number one, if there’s a will to accomplish something at all political levels, it can happen and, number two, you have to involve the community.”


On the national scene, Dean has been a visible and vocal supporter of the ACA.


“In the healthcare field, we are going through not an evolution but a revolutionary change,” he says. “I, for one, think it’s long overdue. While it’s complex and while it’s difficult, the objective is sound and it’s something we should be pursuing – healthcare for all.”


Dean sees the ACA compelling healthcare leaders to change, or fall to the wayside.


“For five years, this change has been on a rapid pace, and I think it has caused us as leaders to look at being nimble and being flexible. We need to make sure we have people in place who have the key ability to adapt to rapid change and instability as we implement the Affordable Care Act.”


That includes the C-suite and the board, he adds.


“These are delicate and important times and the stakes are quite high,” he says. “Therefore, the times demand an open and transparent relationship between management and governance. The board must be involved and engaged in key strategies, decisions and investments early in the process. Educating the board on key issues impacting healthcare entities has been and continues to be an important accountability of management.”


In addition, the changing face of healthcare must become more diverse as population health is addressed, Dean says.


“The demographics of this country are changing,” he says. “There are more minorities, and we need to ensure we have leadership that is representative of the nation and of our communities.”


Health disparities are something that Dean was immersed in from the day he was born. His parents were from Alabama but migrated north to Muskegon, Mich., to find work. Dean was one of nine children.


“My father worked in a factory, but it was an on-again, off-again kind of thing,” he says. “Mom was a housekeeper keeping us on the straight and narrow. We were on welfare many times; I know that system well.”


In junior high, Dean was bused to a middle-class white neighborhood, where his fellow students would miss classes because of doctor and dentist appointments, things unheard of among his family and his African-American neighbors.


“My father was the dentist, and I kid people that my mother was the nurse. But I also saw the impact of not having healthcare. I watched people in my community suffering and perishing from diseases. My colleagues at the school didn’t seem to be having those kinds of difficulties. Even as a teenager, you begin to think, ‘There’s got to be a better way.’


“It shaped me in a profound way.”


His father contracted black lung disease and emphysema from working in the factory. But not before he and Dean’s mother impressed upon their children the importance of education.


“Even though we didn’t have any money, education was important, so that gave me a way out,” he recalls. “Also, religion and faith were always very much a part of my family – when I think about my healthcare career, 24 years have been spent in faith-related systems. So I’m truly a product of my environment, and that motivates me.”


Being around the millennial generation also provides a welcome spark, Dean says.


“We’ve got young physicians and other talent coming into our organizations with a different perspective on lifestyle and what is important to them,” he says. “They come with a greater sense of community responsibility and less emphasis on huge corporate structures. In terms of cultural attributes and leadership opportunities, I’m finding that younger people are advancing at a much more rapid pace. Expectations are higher with the current generation.”


At 63, Dean can relate to such expectations, for they resonate with the ones he says he put on himself in a successful career that he is far from ready to close the door on.


“I think about how fortunate I have been to be working in healthcare in this country at a time when reform is actually happening,” he says. “I just hope I have used the blessings God has given me to help others receive quality health care regardless of economic status or ethnic origin.”


Dean doesn’t think much about legacies – there’s too much left to do, he says – but hopes his personal imprint on those he’s impacted will be just as strong as the professional one.


“I hope my family, friends, colleagues and those I have met along my journey will say, ‘He made us smile, and always treated us with dignity, kindness and respect.’ ”


Georges Benjamin advocates for a better health system

By | August 7 th,  2014 | Affordable Care Act, Furst Group, Georges Benjamin, Healthcare, politics, Top 25 Minority Executives in Healthcare, executive, health system, Modern Healthcare, Blog, diversity, leadership, public health, affirmative action, APHA | Add A Comment


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


Georges Benjamin had a wonderful experience as a military physician, eventually rising to become chief of emergency medicine for Walter Reed Army Medical Center in Washington, D.C. But the diverse environment he experienced in those days bore little resemblance to what he encountered when he returned to life as a civilian.


“I was a beneficiary of a time when we had active affirmative action programs and had a significant number of minority students in my medical school classes as well as my residency,” he says. “There were many leaders who were part of a minority when I served in the military. When I went out to the private sector I noticed that I was far too often the only minority leader in the room. Thankfully, that’s begun to change.”


Today, as the executive director of the American Public Health Association, Benjamin is a strong advocate not only for the public health workers his organization represents, but also for diversity at every level of a company.
“In a country like ours, which has such a variety of experiences, the value in having a diverse workplace is that people bring in different ways of thinking,” he says. “We bring our experiences to the problem-solving process, and I think it helps create different solutions.”


In today’s political climate, he says, “we’re all kind of living in a type of echo chamber where we will only tune in and listen to people who agree with us. If you talk to yourself and answer your own questions, you’re less likely to get the most inclusive and innovative answers.”


Benjamin and the APHA are a non-partisan organization. They have both extolled and chastised Republicans and Democrats on issues that affect public health. But Benjamin says he’s seen a change in how politics can affect public health.


“Increasingly, politics is playing a role in healthcare, for better or for worse,” he says. “Many of my colleagues just want to follow the science, and we should. But public health practice is both an art and a science that often uses the policy process to make broad system change. That makes it political. It’s increasingly difficult to appeal just to science when people are camped out in their ideology, so we also have to convince them on the merits of the evidence when it does not line up with what they believe. I tell students we should not be afraid to engage in the political process and to be an advocate. Recognize also, that sometimes you have to compromise and that negotiation is the most powerful tool in your toolkit.”


Benjamin is a leader well-versed in the nuances of the D.C. beltway, and a student of its history. During a recent sabbatical at Hunter College, where he stayed in the former home of President Franklin D. Roosevelt, he spent time collaborating on a coffee-table book that compiled political cartoons on healthcare during the past 100 years. “The Quest for Health Reform: A Satirical History,” was released in 2013.


“The thing that struck me was really how the rhetoric against health reform has not changed all that much,” he says. “Some of these arguments against it have been around for a long time and have mostly proven to be false.”


If consensus around broad health reform was hard to achieve over the past century, Benjamin bore witness to at least a temporary change in the aftermath of the 9/11 attacks for a more narrow reform of the public health system. At that time, Benjamin was the secretary of health for Maryland and was thrust into the national spotlight as his state and the nation grappled with deadly anthrax-laced letters.


Funding and support for public health reform was increased, and APHA, which Benjamin joined in 2002, was supportive of the Bush administration’s national public health preparedness program. But when the recession hit a few years later, budget cuts forced many of these public health programs to be curtailed, Benjamin says.


“The potential was there to build our public-health defense in a robust and organized manner, but then the recession came, and resources were withdrawn,” he says. “We have our first Middle Eastern Respiratory Syndrome (MERS) cases here in the U.S. right now. We’re always going to have new diseases that emerge; having an adequate health and public health system to address them is our challenge.”


Public health, Benjamin says, “is a leadership exercise.” As such, APHA works with the Department of Health and Human Services on the report for the nation’s Leading Health indicators, and partners with UnitedHealth Foundation on America’s Health Rankings. It’s also been in the forefront of warning of health risks associated with climate change, and the need for sophisticated health information technology. “We are also strong supporters of the Affordable Care Act,” he says.


While Benjamin believes the U.S. healthcare system has made progress in reducing readmissions and hospital-acquired infections, his military discipline shines through when he talks about what it will take for the industry to get where it needs to be.


“What we’d like to do,” he says, “is get a health system that is predictable and raises the bar over time.”

Marna Borgstrom: In healthcare and life, relationships matter

By | July 29 th,  2013 | Connecticut legislature, Healthcare, Marna Borgstrom, Modern Healthcare, nurses, patient-centered, president, reimbursement, Smilow Cancer Hospital, Blog, CEO, children's hospital, health disparities, healthcare reform, leadership, Yale-New Haven Health System, Top 25 Women in Healthcare | Add A Comment


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


Marna Borgstrom was shopping for vegetables at a farmers’ market recently when an acquaintance approached her to say, “I just can’t thank you enough for the Smilow Cancer Hospital.”


It was a moment for the president and CEO of the Yale-New Haven Health System to reflect on why, ultimately, she was involved in healthcare. It didn’t matter that Yale-New Haven could boast that it was one of the largest systems in the country or that she’d enjoyed a productive career and interesting work that spanned more than three decades. It came down to one family finding the help it needed at a critical time. Just as all good healthcare does.


“Her kids went to school with my kids,” Borgstrom recalls. “And she was standing over the asparagus telling me about her husband’s diagnosis and the treatment. But she was really talking about all the talented people at Smilow who have been making a difference in their lives.”


Making a difference. That was the example she got from her parents, both of whom were first-generation Americans from families who did not have the benefit of much formal education. Borgstrom’s father became an ophthalmologist simply because the Army was doing manpower planning during World War II and they told him to go to medical school.


“When my dad was in private practice, house calls were de rigeur, and we’d all pile into the station wagon after church on Sundays and go to house calls to his patients, most of whom were older,” she says. “My mother would be home making a big Sunday lunch for us and extended family, and my dad’s older ethnically diverse patients would all feed us too, so we were rarely hungry when we got home.”


But what she and her siblings took away from those trips was much more than a full stomach.


“I think what we learned was that some of the real joys of healthcare are people and relationships. I have people who come up to me even now and say, ‘Your dad did my surgery.’ (He’s 90 years old and hasn’t performed an operation in 25 years.) And I don’t think that’s all that different from a lot of the people who work here now.”


Those warm memories help keep her going when faced with issues like the 2013 Connecticut legislature taking $550 million out of hospital-based reimbursement over a biannual budget, as it did the night before she paused to discuss her selection as one of the Top 25 Women in Healthcare as chosen by Modern Healthcare.


“They’re taking as much out of hospital reimbursement in 24 months as the entire industry in the state is taking under the sequester in 10 years,” she noted. “When you make dramatic cuts and you make them too fast, what you cause is more reactionary behavior than thoughtful behavior. Our system happens to be the largest provider system in the state, and we also are the largest providers of care to the medically indigent, so we got whacked disproportionately in this.”


No one in the industry, she adds, is arguing the contention that healthcare costs too much and that it is not always delivered in the appropriate way. Borgstrom says Yale-New Haven will weather the storm, but Connecticut healthcare as a whole may be damaged irreparably.


“I’ve said to members of the legislature here that there are some hospitals that will not make it with these cuts. And the irony is that some legislators think we will go in and buy them. We aren’t everybody’s savior. It’s a bad business strategy. So what the legislature may have to do in the next two years is go back and put money back in the budget to help the organizations that are really struggling. It just doesn’t make sense.”


Compounding the issue are an aging population and health disparities in the state.


“We have an older-than-average population, and we also have more people below the federal poverty level, ironically, in a very wealthy state, than most states in this country,” Borgstrom says. “A lot of what we see are diseases in the elderly that come from years and years of excess, and what we see in the younger populations are diseases and problems that come from socioeconomic disparities.


“Those aren’t going to change this year or next year just because somebody decided they were going to pay us less.”
The solutions that the healthcare industry is searching for under reform are pretty comparable from hospital to hospital, state to state, she adds.


“In this industry, I would contend that everybody has similar strategies,” Borgstrom says. “We’re all trying to get better on the value equation, we’re trying to build scale because it will help us with our business model, and we’re trying to integrate and align with other providers, most notably our physicians.”


The difference, she says, is in execution.


“The holy grail is in execution, and how people execute, I think, is based mostly on organizational values. And those have to be values that people lead by.”


In Yale-New Haven’s case, Borgstrom can rattle off those values pretty quickly: patient-centered, integrity, respect, being accountable, being compassionate. She learned them from her mentor, former CEO Joe Zaccagnino, who saw leadership qualities in her early on.


“He was somebody who gave me real and real-time feedback about what I was doing and how I was doing it. Sometimes, it really stung,” she allows. “But I knew he was not giving me the feedback for any other reason than to make me better at what I did and how I was perceived at doing it.”


Ultimately, she succeeded Zaccagnino as president and CEO when he retired in 2005. She’s been the architect of numerous major projects at Yale New Haven, including a children’s hospital, the cancer hospital and the recent acquisition of St. Raphael Hospital, a 520-bed facility that was teetering on the brink of bankruptcy. The Sisters of Charity of St. Elizabeth in charge of the hospital ultimately decided that Yale-New Haven was the best fit among St. Raphael’s suitors even though they gave up their Catholic affiliation in the process, a move that Borgstrom calls “one of the most courageous I’ve ever seen.”


Yet she is quick to deflect credit and to use self-deprecating humor to minimize it. “I’m the orchestra conductor,” she says. “I don’t do a whole lot. I just stand up in front and try to keep everybody playing and singing in harmony.”
One key, she says, is hiring good talent and then getting out of their way. Another is ensuring that the staff has a work-life balance that they are comfortable with, a prominent discussion especially among women leaders since the publication of “Lean In” by Sheryl Sandberg.


Borgstrom said she recently interviewed a candidate for an executive role and spent most of the time on that topic. The woman had become the breadwinner for her young family. She wondered if Yale-New Haven would be a good fit since she would have to move away from the support of extended family.


“What I said to her is, there’s no one answer to this, but I fundamentally believe that you cannot be a good executive if you aren’t happy and also able to manage your personal life. Because long after these jobs are gone, the people who will hopefully be in our lives will be that partner we’ve spent significant time with, our children and our extended family.


“If it’s the right person, the right job and the right organization – and both parties live up to their end of the bargain – I think you can have a successful and happy career and personal life. And happy is really important.”


Quality, safety at crux of healthcare delivery for UHC's Irene Thompson

By | July 1 st,  2013 | Healthcare, Modern Healthcare, patient safety, AHRQ, Blog, CEO, Hospital Engagement Network, Irene Thompson, leadership, UHC, academic medical centers, quality, Top 25 Women in Healthcare, University HealthSystem Consortium | Add A Comment


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


The University HealthSystem Consortium has a lot of ground to cover as a leading representative of academic medical centers, but it’s chosen to delve deep into matters of quality and safety under the direction of President and CEO Irene Thompson, who has been chosen as one of the Top 25 Women in Healthcare by Modern Healthcare.


“If you’re looking to improve a hospital,” she says, “needless to say, you need to get into the way healthcare is delivered.”


UHC’s Patient Safety Net, for example, is a real-time, Web-based reporting system that has long been a part of its offerings to its members. In 2012, however, UHC entered into a collaboration with Datix, a U.K.-based developer of patient safety technology solutions, to create “a broader suite of patient safety tools,” Thompson says.


West Virginia University Healthcare was the first member to begin using the new software, and Johns Hopkins followed suit. UHC is ready to roll out the product on a wider level to members of its alliance, and demand is great, Thompson says.


“The members who have been on our older platform have been very eager to transition onto this new one,” she adds. “They’re very excited.”


In fact, UHC’s Performance Improvement patient safety organization was among the first PSOs recognized by the Agency for Healthcare Research and Quality (AHRQ).


“This is a natural outgrowth of what UHC is all about, which is performance improvement for the academic medical center,” Thompson says.


UHC also was named as a Hospital Engagement Network in an initiative by the Department of Health and Human Services Center for Medicare and Medicaid Innovation. As part of HHS’ Partnership for Patients program, UHC has been working since late 2011 to increase safety and quality by taking aim at two benchmarks:


**To reduce hospital acquired infections by 40 percent by the end of 2013, and


**To reduce preventable hospital readmissions by 20 percent by the end of 2013.


“It’s going extremely well,” Thompson says of the work. “We’re seeing great results in terms of

change among our members so we’re very pleased to be part of it, and very excited. I think CMS is pleased, too about the results that we’re achieving. We have about 80 hospitals participating and many of our institutions have exceeded the end goal already.”


Thompson had been president and CEO of the University of Kansas Hospital Authority for 10 years before joining UHC in 2007. It was those experiences in the hospital setting, she says, that made her an advocate for safety.


“I saw firsthand how patients and families suffered loss—loss of independence, loss of function, loss of life,” she remembers. “As frightened and vulnerable patients entered our level I trauma center, I saw the trust they placed in our hospital to treat injuries from an automobile accident, a fire, or a violent act. Witnessing the profound impact that our focus on quality and safety had on patients and their loved ones made me determined to spearhead initiatives to provide the highest quality of care possible.”


When she moved from serving on UHC’s board to leading the organization, Thompson saw the potential that the alliance of non-profit academic medical centers could have.


“UHC has a proud tradition of providing outstanding membership value and leadership for academic medical centers. Yet unprecedented change in the health care industry required us to think more boldly about how to position the organization to best serve members’ needs in the future,” she says.


Yet, personally, the shift in culture between the two jobs was enormous. At Kansas, her schedule was packed, and doled out in 15-minute increments. “It was a very dynamic and complex job, and I loved doing it,” she says. “You never know what you’re going to be addressing in a day – it could be anything from a broken elevator to a fire in the operating room.”


As UHC’s very visible leader, Thompson spends a lot of time on the road, interacting with and visiting the CEOs of UHC’s member institutions. “It’s certainly an experience that’s unique in this field,” she says. “There aren’t that many national posts where you get the opportunity to work with so many outstanding people. And the fact that I had been one of their peers makes it much easier for them and for me because I understand what they’re dealing with.”


In Chicago, Thompson has worked hard to get others who are in a position to make a difference involved in the American Heart Association. She has met with healthcare leaders in the Chicago area to encourage their support of the Chicago Heart Ball, a major source of funding for research and programs. She also hosts benefit events in her home and is one of the charter members of the Go Red for Women program, which focuses on raising women’s awareness of the unique warning signs of heart disease in women.


Thompson also has paid attention to the well-being of her own team as well. For the 10th year in a row, UHC was named to the Honor Roll for the Center for Companies That Care. No other company has been so honored.


The center cited the community involvement of UHC employees as one reason for the honor – more than 90 percent engage in monthly service programs. Flexible and work-from-home scheduling also were mentioned as traits that UHC excelled in.


“UHC is very engaged in what the new workforce wants,” Thompson explained. “We have many opportunities for them to participate in community involvement, and our new offices are designed to encourage openness and create energy.”


But the hard work remains as Thompson says UHC has evolved from a quiet little association to a powerful industry alliance. She says healthcare reform remains a moving target.


“There is action in terms of people recognizing they need to deliver care in a more efficient way,” she says. “But when you look, for instance, at the insurers, there are very few contracts that would reflect accountable care or population health – their systems don’t allow them to account for it. So there is a lot of talk but, truthfully, not much action.”


And, under reform, Thompson says academic medical centers may have higher hurdles to clear than other providers.


“Among AMCs, the research and the academic side have relied upon the hospitals over the years to support some of their activities that are either not funded or insufficiently funded by other sources. As the revenue is reduced at academic medical centers, they seem to be taking a bigger hit in certain areas than other hospitals. It puts at risk the whole tripartite mission of the academic medical center.”

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

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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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

Profiles in Leadership: Top 25 Minority Executives Kimberlydawn Wisdom overcame obstacles; now, she helps her community do the same

By | December 4 th,  2012 | Detroit, emergency medicine, Furst Group, Healthcare, executive, health system, hospital, Kimberlydawn Wisdom, Minority Executives, Modern Healthcare, Top 25 Minority Executives, Blog, Henry Ford Health System, leadership, physician leadership | Add A Comment


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


As a successful physician executive at Henry Ford Health System, Kimberlydawn Wisdom, MD, has attracted the attention of governmental leaders far and wide. Jennifer Granholm, then governor of Michigan, named her as the state surgeon general in 2003, a post she held for eight years. More recently, President Obama appointed her to his Advisory Group on Prevention, Health Promotion and Integrative Public Health. But the path to a medical degree was one that Wisdom had to clear of a number of obstacles.


First and foremost was the era in which she grew up, a formidable boulder indeed.


“In the 1950s and ‘60s, there wasn’t a plethora of physicians of color,” notes Wisdom, Senior Vice President of Community Health & Equity and Chief Wellness Officer of Henry Ford Health System in Detroit and an assistant professor for the University of Michigan Medical Center. “In my junior year of high school, my guidance counselor said I should choose a profession that was more suited for my race. For her, saying ‘I want to be a doctor’ was like someone saying, ‘I want to be an astronaut.’ She actually did want to ensure my success. But I think her sense was, ‘Let me bring you back down to something that’s manageable and achievable.’ “


Yet Wisdom’s mother, who grew up in the small community of Coatesville, Pa., did in fact have an African-American physician. And Wisdom became a caregiver for her mom at home as she dealt with severe migraines.


“During my childhood, she spent a lot of time in bed and I was regularly bringing her aspirin or some other type of pain medication,” Wisdom says. “It was very impactful to me as a young child to watch her go through that. But on another level, I could bring her water, I could bring her comfort. That began to ignite this desire to consider how I could care for people long-term.”


She was exposed to a wonderful hospital atmosphere from a tonsillectomy as a child, and soon had dolls and bears lined up in shoeboxes around her room, where she would tend to their medical needs. She graduated 20th in her high school class of 600, but her supportive parents weren’t so sure that marrying a young mechanical engineer was the best way to get through medical school. But when she crossed the stage to become an M.D., both her husband and parents celebrated together.


“They were all very proud,” she remembers. “It was a tremendous sense of accomplishment, and a tremendous sense of being thankful, because I couldn’t have done it without the support of family and without a strong spiritual grounding. It took a lot of prayer. I beat the odds in many respects.”


Despite her challenges, Wisdom says she had an idyllic childhood growing up in Mystic, Conn., the town made semi-famous by Julia Roberts’ first movie, “Mystic Pizza.” Those experiences, she says, have shaped her career as she sought to give her patients and her community the opportunities she was afforded.


“In part, I wanted to create a Mystic for the community in which I practiced, so they would have a safe place to grow up. So families could thrive. So people could reach their maximum potential, because they had a place where they felt they could achieve all that they were expected to achieve.”


But Wisdom has spent more than 30 years in Detroit at Henry Ford Health System – more than 20 as an emergency room physician – and she readily acknowledges that Detroit is worlds away from Mystic. As she saw the issues confronting her patients – violence, diabetes, obesity, teen pregnancy – she determined to take healthcare to them and not wait for them to come to her. Today, such goals are commonplace in any metro hospital, but back then her ideas were seen as unorthodox. Nonetheless, her bosses at Henry Ford told her to go for it.


“As an emergency medicine physician, the community comes to you in various states of disarray. I thought that, if I could go out and meet them where they are, I could have a greater impact,” she says. “When I look at many communities, so many people have not had the ability to realize their potential because they have made choices based on the choices they had available, not based on the best choices that would be ideal for them at any given time.”


So Wisdom started small, taking physicians, nurses and social workers out into the community, setting up shop in a community center or a faith-based organization. With each endeavor, Wisdom received more funding as she slowly and quietly attempted to address health disparities in the African-American community.


She and the health system now have major grant funding from the U.S. Department of Agriculture to address child obesity reduction. Several foundations fund her work in attempting to reduce infant mortality in the Detroit area, a region that has one of the highest rates in the country. A faith-based program she designed received funding from the National Institutes of Health, and she serves on the president’s group that advises his cabinet regarding the National Prevention Strategy, a wellness initiative created by U.S. Surgeon General Regina Benjamin.


The Ford system recently earned the Malcolm Baldrige Quality Award, one of the highest honors for any industry, in terms of service excellence, and has established the Wellness Center of Excellence, called “Henry Ford LiveWell” for short, that focuses on preventative and lifestyle health.


It’s a long way from dolls in shoeboxes, but Wisdom says that, if anything, her passion and excitement for healthcare have grown.


“Empowering people,” she says. “That’s what it’s all about.”