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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.”

Profiles in Leadership: For Gail Donovan, the details matter

By | August 16 th,  2011 | business, profile, Top 25 Women, urban, executive, hospitals, interview, Modern Healthcare, New York, operational effectiveness, value-based purchasing, article, Blog, chief operating officer, electronic medical records, Gail Donovan, leadership, Continuum Health Partners, COO, quality | Add A Comment

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


As the daughter of a surgeon and an operating room nurse and now as one of the leading healthcare executives in the nation, Gail Donovan has been around hospitals all her life. So when she says she’s a bit worried about healthcare reform, one tends to listen more intently.


“Hospitals are like running 40 different businesses,” says Donovan, Executive Vice President and Chief Operating Officer of Continuum Health Partners, Inc. “As a large provider system, our hospital emergency rooms care for 250,000 visits a year in our system and we have very large ambulatory services handling more than 3 million visits a year. I love being able to provide access and to make sure that, as much as possible, we’re able to meet the needs of the very large and diverse communities we serve.”


While she agrees that changes are necessary, Donovan says some of the details, like value-based purchasing, need to take into recognition the realities that urban hospitals and systems wrestle with every day.


“We know how to run financially distressed hospitals because we’ve had to learn how to do that, and move from operating in the red to operating in the black, all the while we’re trying to improve and demonstrate improvements in quality,” she says.


It’s the details that matter to Donovan in reform and in healthcare in general.


“The absolute top quality that an executive needs to have is operational effectiveness,” she says. “Essentially, you must be grounded in details and be able to be not just productive but effective in managing the details of your work and your job.


“It’s through this that you can then have strategic vision. I don’t think you can really have strategic vision unless you understand what you’re managing today.”


Donovan and her team long have been visionary about the need for electronic medical records, but she credits her board with having the courage to invest more than $100 million in EMRs even as the system was struggling to provide basic core services. With an eye to the future, Continuum is well-positioned for whatever reform may bring, but Donovan wonders where the funds to help urban hospitals with compliance will come from as value-based purchasing expands from six core measures to 30 or 40.


“For urban hospitals to potentially be penalized and have reimbursement taken away could take a very fragile healthcare structure and create significant problems and an inability to maintain services.”


Many urban hospitals, Donovan says, are capital-starved and have a high dependence on Medicare, Medicaid and the bad-debt charity care pools.


“If those dynamics are altered without having a proper definition of safety-net facilities, like a number of my institutions are, then that dynamic could completely upend our ability to meet the needs of the very large communities we serve.”


Despite that sober warning, Donovan clearly enjoys her chosen field. To varying degrees, she has been serving since she was 12 and first became a hospital volunteer. She interned in health administration before going to graduate school and did a residency as part of her graduate degree that was “pivotal,” she says.


“I still strongly advise graduate students to seek internships and residencies. They’re called different things now, but exposure early on to a number of different organizations and their components led to job opportunities for me.”


She also credits luck in finding professional mentors who championed her early in her career.


“I was usually the youngest in the room – and the only woman,” Donovan says. “I think that has changed in certain settings, but there continues to be a lack of women in the most senior of positions in hospitals and healthcare systems.


“I think we’re changing that, but it’s a little bit slower, perhaps because of some concerns about work-life balance. As a mother, I know that if I did not have a supportive husband who had greater flexibility, I wouldn’t have been able to put in the time and the commitment to do what I needed to do professionally as well as support my family.”


Her professional reach has extended far beyond her system. She was president of the Metropolitan Health Administrators Association before it became the New York chapter of ACHE. And, with Susan Waltman, Executive Vice President and General Counsel for the Greater New York Hospital Association, Donovan spearheaded emergency preparedness measures in the wake of 9/11 that the Joint Commission has adopted as standards for all U.S. hospitals. Such responses, applicable to natural disasters as well as terrorist attacks, go beyond medicine, she says.


“So much of emergency response ends up dealing with adequate communications structures and systems,” she says. “And even in a sophisticated environment like New York, that continues to be one of the top challenges. So one of the outgrowths of the post-9/11 work was ongoing emergency preparedness that includes all the municipal structures and systems with the provider community.


“It’s why my job is fun,” she adds. “I actually love my job. Always have.”

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