What healthcare leaders need to know now

 

Personal experiences drive Susan DeVore’s efforts to transform healthcare from the inside out

By | September 20th, 2017 | Blog | Add A Comment

 

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Susan DeVore: “Anybody who’s interacted with our healthcare system has experienced the fragmentation, the lack of coordination and the misaligned incentives. It makes it very hard to navigate. ”

 

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

 

Healthcare is personal.

 

Even though Premier Inc. is one the largest and most successful companies in healthcare, focusing on performance improvement, its CEO, Susan DeVore, has personal as well as professional reasons for seeking to transform the healthcare industry.

 

Her mother died of hospital-acquired sepsis, and her grandson had a major health scare in dealing with a severe hip infection that appeared during a hospitalization. She says her family is far from unique in that regard.

 

“Anybody who’s interacted with our healthcare system has experienced the fragmentation, the lack of coordination and the misaligned incentives,” DeVore says. “It makes it very hard to navigate. And when you have people who are vulnerable or fragile and put them in that system, there are opportunities for things to slip through the cracks that can have significant implications. There are things in your life that happen to you that you’ll never forget.”

 

The experiences have left her determined to make a difference in the quality and safety at America’s health institutions, although she maintains that we nonetheless have “tremendous healthcare” in this country.

 

“It does drive me,” she says. “It does keep me focused on the importance of this work. We want to solve problems before they become unsolvable. Premier is doing important work, and to be able to do it in scalable ways across the country for current Americans and future generations are what get me up every day. This is the best possible place that I could be to try to help drive that transformation.”

 

While there is much uncertainty and confusion over the future of healthcare, DeVore says she doesn’t think government is well-suited to steer the changes that are needed; they have to come from within the system.

 

“I don’t think government can solve the challenges. I don’t think insurance companies by themselves can solve the challenges,” she says. “I actually think healthcare has to be reformed and transformed from the inside.”

 

And Premier, which works with more than 3,700 hospitals across the country, handling everything from data analytics to national collaboratives to group purchasing, hopes to accelerate the pace of change in the industry.

 

“We have a big footprint,” admits DeVore. “About 85 percent of our healthcare systems would say we’re a strategic partner or an extension of themselves, as opposed to a vendor of services or technology. And, because we sit inside the healthcare systems, and because we have a tremendous amount of data and insight, we can collaborate and innovate with them, and have them be our test bed for ideas.”

 

That footprint is growing. Premier recently purchased Lincare’s specialty pharma business and also bought two continuum-of-care companies. It has expanded its collaboration with pharmaceutical giant Merck on chronic care and also has launched a partnership with the American Society of Anesthesiologists to test methods to tackle the opioid epidemic. They’ll work to address post-operative pain management in a number of Premier-affiliated hospitals.

 

“We can help advance policy changes and we can help advance how hospitals improve,” DeVore says. “When I came to Premier 13 years ago, I saw this incredible relationship with healthcare systems, with lots of data, and the ability to have an impact that is continuous as opposed to episodic. It’s a model that doesn’t exist in a lot of other places.”

 

The awards that Premier has garnered don’t exist in a lot of other places either. It’s a past winner of the Malcolm Baldrige National Quality Award and, for the past 10 years running, has been named one of the world’s Most Ethical Companies by the Ethisphere Institute.

 

While Premier has flourished under DeVore’s leadership, she’s nonchalant about her own achievements. During talks with college students (and with her Premier staff as well), she is known to ask them what their superpower is, with the notion that passion unlocks stellar work – and superpowers working together in a team lead to great innovation. But ask her about her own superpower, and there’s nothing flashy about her answer.

 

“I think my superpower is the ability to assimilate and solve puzzles, and navigate around, under and over problems to get to the end goal,” she says. “I’d describe it as a navigation skill. I’m trying to see things that aren’t easy to see and to put the puzzle pieces together in a different way to solve problems or capture opportunities.”

 

With healthcare’s convoluted issues looking like a damaged Rubik’s cube, Premier’s healthcare members are probably glad she’s on the case.

 

 

 

 

Furst Group parent company acquiring Salveson Stetson Group

By | September 15th, 2017 | Blog | Add A Comment

 

Furst Group logo SSG logo

 

Salveson Stetson Group, a multi-specialty retained executive search firm that was recently named one of America’s top executive recruiting firms by Forbes, announced today that it has signed a letter of intent to be acquired by Management Partners Inc. (MPI), the parent company of Furst Group and a human capital consulting company based in Rockford, Ill. Following the transaction, which is expected to close by year-end, the firm will continue to operate as SSG under the leadership of co-founders Sally Stetson and John Salveson, who will also take on additional executive responsibilities for MPI.

 

Salveson Stetson Group will join the MPI family of companies, which includes Furst Group, ranked by Modern Healthcare as one of the nation’s top 10 healthcare search firms, and NuBrick Partners, MPI’s leadership consulting company. Together, the three firms will offer clients a wide range of executive search, assessment and leadership solutions.

 

Furst Group and Salveson Stetson Group are both members of IIC Partners, one of the top 10 retained executive search groups in the world with 54 offices in 36 countries.

 

“We are thrilled to be welcoming the Salveson Stetson Group team to the MPI family,” said Bob Clarke, CEO, and Sherrie Barch, President, of MPI. “The firm’s reputation and culture provide a perfect complement to ours. While there is obvious synergy for the work of both firms in healthcare and life sciences, this unlocks many new opportunities and industries for all of us. We envision a future that is much greater than the sum of our parts.”

 

“When we met MPI’s Bob Clarke and Sherrie Barch as new members of IIC Partners, we knew immediately that they were exceptional leaders and business people,” said Stetson. “We realized that joining forces would strengthen both of our firms, drive new business growth and expand our reach and capabilities.”

 

“By joining with MPI, Salveson Stetson Group becomes a much richer resource to our clients,” said Salveson. “We are excited to have the opportunity to offer our clients a broader set of talent and leadership development solutions through adding NuBrick Partners’ and Furst Group’s capabilities to our portfolio of services.”

 

IIC Partners’ Executive Director Christine Hayward cheered the move. “This demonstrates the true partnership and compatibility that our member firms enjoy,” she said. “I’m proud that IIC Partners is helping our members innovate and grow strategically in a rapidly changing marketplace.”

 

 

 

 

Staying independent – Christine Candio outlines three key questions for stand-alone hospitals

By | August 31st, 2017 | Blog | Add A Comment

 

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Christine Candio: “We are collaborators, which enables us to continue enhancing the services we provide our patients to improve the health of the community.”

 

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

 

In an interview with Christine Candio, President and CEO of St. Luke’s Hospital, the former ACHE chair talked with us about the independent course that St. Luke’s has chosen to maintain. According to Candio, being independent keeps the organization flexible, which she highlighted with a reference to a nostalgic, beloved TV duo.

 

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

 

Candio goes on to say that it’s imperative that independent healthcare organizations continually evaluate performance and objectives in an effort to deliver outstanding quality. As part of this evaluation, she suggests three questions that should be considered:

 

“Do you have the essentials to remain independent? Do you have collaborations and partnerships? Are you trying to be all things to all people?”

 

Candio says that it’s important to reflect on these questions as you assess the value of remaining independent. Find out more about Candio’s leadership philosophies in the full article.

 

 

 

Furst Group adds industry veteran Megan Heim as vice president

By | August 15th, 2017 | Blog | Add A Comment

 

Megan Heim

 

Furst Group, a premier healthcare executive search firm, announces the expansion of its senior-executive team with the addition of Megan Heim, who is based in the burgeoning healthcare hub of Nashville, as vice president.

 

Heim joins the firm from with more than 20 years of experience in healthcare and consulting solutions.

 

“Megan Heim is well-known throughout healthcare as a thoughtful and innovative client-management executive and talent advisor,” says Furst Group President Sherrie Barch. “We are looking forward to watching her impact the industry with wisdom and integrity as we help our client partners develop their leadership teams.”

 

Heim brings extensive business and healthcare experience and has advised clients on hundreds of successful engagements including CEO, CFO, CNO, VP of Development, VPHR, Controller, clinical leadership roles, and many other senior-level positions.

 

Previously, Heim served as a division vice president for a top healthcare leadership services firm where she worked closely with many nationally recognized organizations to provide talent management and retained search services. For several years prior to that, Heim was a senior director at Optum Executive Health Resources where she partnered with hospital executives to ensure and improve compliance and financial performance. Heim also spent eight years with the industry’s largest healthcare research and advisory firm (The Advisory Board Company), where she held various roles from associate director to principal.

 

Furst Group is part of the companies of MPI. Its affiliate firm, NuBrick Partners, assists clients with leadership consulting, ranging from physician executive development to CEO and board services.

 

 

 

 

Hard work a key to Sally Hurt-Deitch’s quick ascent

By | July 31st, 2017 | Blog | Add A Comment

 

Sally Hurt-Deitch: “People want healthcare in their community. They don’t want to drive 20 or 30 minutes to receive care.”

 

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

 

The career trajectory for Sally Hurt-Deitch was set early – so it’s no surprise to see her as the Market CEO for The Hospitals of Providence, the Tenet Health system that dominates the El Paso market.

 

At her first job, fresh from earning her bachelor’s degree in nursing, Hurt-Deitch’s boss was close to retirement. So, on top of learning endoscopy and the operating room, and in addition to learning instrumentation and learning how to circulate, her supervisor put her to work on a host of other duties.

 

“She would come to me and say, ‘Sally, you’re young. You know this stuff. You just graduated from college. Go and do this for me,’ ” Hurt-Deitch remembers.

 

Her nursing preceptors told the bewildered rookie, “Just go do it.”

 

Thus, by the end of her first year, in addition to doing cases and being a clinical nurse, Hurt-Deitch got a crash course in how to run every aspect of a department.

 

“I was doing her payroll and her scheduling,” Hurt-Deitch says. “I’d done her operating budget and her capital budget. I had rewritten all of her policies and procedures. I’d gone through a Joint Commission survey and I was doing all of her Performance Improvement and Quality Improvement.”

 

An amazing story, yes? It gets better.

 

When Hurt-Deitch’s boss retired, a group of physicians went to the CEO of the hospital with a request: “We want Sally to be the new director.”

 

The CEO called her into his office.

 

“How old are you?”

 

“23.”

 

“I don’t know about this. I’ll tell you what. I’ll give you 6 months. Let’s see what you can do.”

 

Hurt-Deitch sailed through the tryout. She became the assistant chief nursing office two years later and, by the age of 27, she was the CNO.

 

“When my nursing boss retired, I never even thought, ‘I want this position.’ ” Hurt-Deitch notes. “It grew very fast.”

 

Hurt-Deitch was born and raised in the El Paso area and, except for a short period when she left to work in Oklahoma, has watched the region grow from a close-up vantage point. Healthcare is personal to her, an attitude that developed unconsciously when she was a child.

 

At the age of 10, her mother nearly died from idiopathic thrombocytopenic purpura, an autoimmune disease in which the person’s body destroys its own platelets and thus, the ability for the blood to clot.

 

“My father was amazing,” Hurt-Deitch says. “He would sneak us up a back staircase at the hospital so we could go see her. He was a football coach and I can remember my mom doing her exercises with my dad coaching her: ‘You’re going to do this. You’re going to come back.’ Watching how he acted around her was very inspiring to me. I had a deep desire to care for people. I think my mother and her experience provided a lot of fuel for that fire, but I think nursing inherently was my calling.”

 

Hurt-Deitch got to see her mother completely come back from the disease, and her mom has had a front-row view to see her daughter become one of the powerful Latino executives in the country.

 

The El Paso region is unique in that it is still a border community, one whose economy is still very much based on homeownership as opposed to another economic driver. But Tenet itself has invested more than $1 billion into El Paso in the last 10 years, and Hurt-Deitch says the county has a consumer mindset to healthcare that is no different than the rest of the U.S.

 

“We are the community choice for healthcare, which is a hugely positive thing – we have about 50 percent of the total market share,” she says. “But people want healthcare in their community. They don’t want to drive 20 or 30 minutes to receive care. They want it right around the corner. The days of having a family physician and going every year for your checkup are disappearing. So, you’re seeing the free-standing ERs and the urgent-care centers proliferating because people are wanting to be treated per health episode, not for their long-term health needs.”

 

As the Market CEO, Hurt-Deitch oversees the CEOs who lead the three Providence hospitals and one micro-hospital. And, like her early years in healthcare, she utilizes some unorthodox ideas to develop her team.

 

“We trade positions. One month a year, I will leave and become the CEO of one of our other hospitals. The other CEOs will do the same,” she says. “We can identify a lot of best practices this way. It also helps us to establish stronger relationships with our medical staff and the other directors. At the same time, we may have instances where we need each other to step in and run a meeting for us in our absence.”

 

In doing so, Hurt-Deitch is infusing her leadership team with the same type of liberty she experienced as a rising star in her 20s.

 

“I have to be open to listening to them and accepting what they’re saying and allowing them enough freedom to do what they need to do in their hospitals,” she says. “You can look at The Hospitals of Providence and look at the results. What it would show you is a team that is connecting with the community from every standpoint.”

 

 

SIDEBAR: Embracing cultural diversity: A personal story

 

 

At the recent 2017 Congress presented by the American College of Healthcare Executives, Sally Hurt-Deitch was part of a panel on “Building An Inclusive Culture: Whose Job Is It?” Her years in El Paso, a predominantly Hispanic region, and her experiences as a healthcare executive gave her plenty of points to ponder.

 

“El Paso creates this very interesting dynamic because it is a minority-majority community,” she says. “When you’re raised in a minority community, you’re not raised to see color. Your friends were your friends. It was a very inclusive environment, and I was not exposed to anything different until I left El Paso.”

 

Being looked at differently because of her ethnicity happened when Hurt-Deitch took a job in another state with a large Native American population. At her first meeting with her governing board, one of the directors asked her, “So, what tribe are you from?”

 

Everyone in the room was a bit stunned and Hurt-Deitch managed to say, “Excuse me?”

 

“Yeah,” the trustee went on. “Are you Cherokee? Choctaw? Chippewa?”

 

“There was no malice in it,” Hurt-Deitch says. “He wasn’t trying to malign me in any way. And I laughed and said, ‘I’m from the tribe of Mexicans. We’re from way south of here.’ But there was also a part of me that thought, ‘Who says something like that?’

 

“I don’t think I ever fully embraced the true meaning of cultural diversity until that point in time.”

 

 

 

 

Diversity fuels Karen Lynch’s leadership at Aetna

By | July 24th, 2017 | Blog | 20 Comments

 

Karen Lynch: “I have a perspective of optimism, and the glass is always half-full.”

 

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

 

A commitment to diversity usually starts at the top of an organization, and Aetna President Karen Lynch is pleased that her employer is routinely recognized for the fact that its board is 40 percent female. But she knows there is more to be done.

 

“If you look at the studies that have been published, 73 percent of medical and health services managers in the U.S. are women, but only 4 percent of healthcare CEOs are women. So, clearly, we have some growth to move forward on,” she says.

 

But her thinking goes beyond gender diversity.

 

“When I think about diversity, it’s also about ethnic diversity. It’s about ‘Do we have diversity with veterans and LGBT and multigenerational, multicultural talent?’ I think there’s more to be done there as well.”

 

Make no mistake, though – Lynch is “quite proud” to be the first female president of Aetna.

 

“It’s such a great honor,” she says, but quickly adds, “As you can imagine, I didn’t get here by myself.”

 

Healthcare executives often talk about the importance of mentors and sponsors in their career. Lynch points to one from her childhood as a foundation for success in life – the aunt who raised Lynch and her three siblings after Lynch’s mom committed suicide. Lynch was 12 at the time.

 

“My aunt grew up in the Depression,” Lynch remembers. “Her parents came over from Poland. They were ailing, and she took care of them. She worked in a factory her entire life. Her husband passed away early on. She took care of her only son, and then she took on the responsibility of all four of us.”

 

Lynch says her aunt – and life itself – helped imbue her with resilience and a positive, constructive attitude. She says she met her father once, but does not regret his absence. “I think it’s made me the strong person I am today. I have a perspective of optimism, and the glass is always half-full.”

 

When Lynch was in her 20s, her aunt died from emphysema and breast and lung cancer, the result of heavy cigarette smoking. Nonetheless, her positive impact on Lynch had already been formed.

 

“My aunt was a very strong woman,” Lynch recalls. “She didn’t let anything get in her way. She instilled values in us like, ‘You can do anything that you set your mind to. And don’t let anyone tell you that you can’t do anything.’ ”

 

Her influence is evident in Lynch’s career arc. And it was, in part, her aunt’s illness that led her ultimately to a career in healthcare after a stint as an auditor for Ernst + Young.

 

“I remember sitting in her hospital room thinking, ‘I don’t know what questions to ask the doctors. I don’t know what to do to care for her,’ ” Lynch says. “I’ve made it my life mission now to bring the services to individuals so they can answer those questions when someone’s in need. Or, better yet, how do we keep people healthy in the first place?”

 

Lynch leads by example in that vein. She is a lifelong runner, although she has added spinning to her regimen to ease the pounding on her knees.

 

“If I’m going to run a healthcare company and advocate health, it’s important for me to remain healthy.”

 

Lynch says her training at Ernst + Young prepared her for leadership in two ways.

 

“One important lesson I learned was how to be an effective communicator with people at all levels of an organization,” she says. “When you’re an auditor, you have to talk with the most senior leaders of an organization as well as the front-line people. I had to learn quickly how to adapt my communication style.”

 

She also learned how to take opportunities as they emerged, she says.

 

“When you’re in public accounting, you’re thrust into situations that are uncomfortable and uncertain, and you have to quickly adapt and be flexible,” Lynch says. “I think those skills are equally important as a senior executive, because you never know what might come your way on any given day.”

 

Lynch and her organization have had to deal with a lot of uncertainty over the past year as the potential merger of Aetna and Humana fell through. The experience, however, hasn’t altered the company’s strategy, she says.

 

“Humana would have helped to accelerate our strategy, but that strategy remains the same – to be consumer-focused, transforming relationships with providers, focusing on the local community and building the next generation of talent,” she says.

 

Lynch says health insurers in general need to own their mistakes, but adds that payers don’t promote themselves enough in regard to the positive outcomes they quietly foster among their members. She recounts the story of one female college student she worked with who was anorexic. Lynch’s organization helped the young woman get into a treatment facility. She got help, returned to school and graduated from college. She signed up with Teach for America and has gone on to have a successful career.

 

“Those are the kinds of things we do that no one knows we do,” Lynch says.

 

“Maybe we’re too modest, but we need to tell our story because we are doing some phenomenal things across the nation.”

 

 

SIDEBAR: U.S. health includes mental health

 

 

Aetna President Karen Lynch has always been quite active in charity work. That stems, in part, from her aunt who raised Lynch and her three siblings after their mother committed suicide.

 

“My aunt talked about and instilled in us the importance of giving back,” Lynch says today.

 

She says she sees the importance of that in her work every day.

 

“I have a passion for holistic healthcare and taking care of the whole person,” she says, “because with every chronic condition, many people are also suffering from a mental health condition. There are a lot of co-morbid diagnoses.”

 

Her mother informs that passion as well.

 

“Because my mom died by suicide, I believe very strongly in promoting mental health awareness and making sure people have access to the services that they need.”

 

Lynch found a strong partner in that endeavor in her husband Kevin, who founded the Quell Foundation two years ago to eradicate the stigma of mental health disorders.

 

“He gives scholarships to children who have been diagnosed with a mental health disorder, and also to kids who want to go to college to work in the field of psychiatry or psychology. And I personally fund the scholarship for kids who have lost a parent through suicide.”

 

This year, the Quell Foundation will provide $200,000 in scholarships to young people across the country. It’s one more motivation Lynch cites for doing what she does in her career.

 

“I get up every single morning,” she says, “trying to think about how we can have a positive impact on people’s lives and make this healthcare system better.”

 

 

 

 

Sue Schick’s ‘pay it forward’ philosophy has deep and powerful roots

By | July 19th, 2017 | Blog | Add A Comment

 

Sue Schick: “I know that not all women have the benefit of a supportive environment to get to the next level.”

 

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

 

Sooner or later, anyone who spends time around Sue Schick is going to hear her philosophy for life: Pay it forward.

 

Throughout a long and successful career in healthcare, the chief growth officer for UnitedHealthcare Community and State has lived by that mantra, and its powerful, catalytic effect on her and those around her can be traced back to a pivotal experience she had as an undergrad at Randolph-Macon College in Ashland, Va.

 

At the end of her junior year, Schick saw no financial way possible to stay in school even though her grades put her at the top of her class. “It was the ‘80s, and we were in a recession,” she says. “I had been raising a lot of my own money for school, and my parents were doing all that they could to help, but my family was in a real financial pinch. My plan was to take two years off and work.”

 

She met with her adviser, who also was her economics professor, and informed him of her plan. “He was pretty distressed. He said, ‘You can’t leave.’ I said, ‘I can’t stay.’ I just couldn’t see any way around it.”

 

Three weeks later, Schick was back home and about to start work as an administrative assistant. She was in the kitchen and her mom handed her the mail, which included a letter from Randolph-Macon.

 

“I thought it was my separation letter from the college,” she remembers. “Instead, it was this letter saying I could stay because they found a scholarship for me. I started screaming at the top of my lungs.”

 

Schick went on to complete her senior year and spoke at her graduation as the valedictorian of her class. Two years ago, she spoke again as the guest of honor at the Randolph-Macon commencement, the very year her adviser, Ed Schmidt, was being honored by the school for his retirement after 48 years at the college. She shared the story of her scholarship and her vow to pay the school’s generosity forward, and got to hug Schmidt for his efforts to find a way for her to remain in school. “He didn’t remember the exact details of it,” she says. “I was one of many students he found a way to help.”

 

Today, Schick is a Randolph-Macon trustee and is chair of the student affairs committee.

 

“I work really closely with students,” she says. “I not only help students get scholarships, but I also help them find jobs and internships. I galvanize alumni to help serve and support students. I do this because some people helped me, and made a difference at a pivotal moment in my life when things could have gone a completely different way.”

 

Schick’s community involvement extends to a number of non-profit organizations, including the March of Dimes—her son was born without ears and hearing that was marred by blocked canals. The March of Dimes came alongside her family through a long process of corrective and reconstructive surgeries and, today, her son has near-normal hearing and ears. She has also committed much time and energy to the Susan G. Komen breast-cancer organization and the Juvenile Diabetes Research Foundation. On the business and governmental side, she served as Chair for the Pennsylvania Commission for Women, championing female leaders.

 

“I have a special focus on paying it forward to women in business, because there were role models and other businesswomen who helped me,” she says. “It’s especially an opportunity to help young women in their careers. I led that commission for the governor for three years. I know that not all women have the benefit of a supportive environment to get to the next level and add even more value in an organization.”

 

For her part, Schick says she has felt supported throughout her career at UnitedHealthcare, where she leads the growth of the Medicaid business.

 

“I was in commercial insurance for 25 years,” she says. “I was the CEO of our Pennsylvania market when the CEO above me, at Community and State, came to me and said, ‘What do you know about Medicaid?’ ”

 

Schick says she knew next to nothing about Medicaid, but learned a lot about it over the next three years alongside her regular duties.

 

“They gave me a chance to learn the business,” she says of her bosses at UnitedHealthcare. “I learned Medicaid, and then moved full-time into Medicaid. They took a chance on me. They gave me the opportunity to learn and then, when I was ready, gave me an expanded role.”

 

The learning curve has continued for her the last couple years – she was part of a select group of healthcare leaders chosen to participate in a new master’s program at Dartmouth College about the future of healthcare. The group included a payer leader (Schick), plus health-system executives, surgeons and health-policy experts learning from each other. She graduated last month with a master’s in healthcare delivery science.

 

“I’m a little old to be back in school,” she jokes, “but it was a great opportunity to participate with a cohort of senior leaders in healthcare. It brings together Dartmouth’s medical school, the engineering school and the business school. The program is at that intersection of system transformation and where healthcare delivery is going in the future.”

 

And the future, she says, is collaboration and innovation. “There’s no way that we at UnitedHealthcare could do this ourselves. We all need to work together as part of the system.”

 

The bonds she developed with her fellow leaders have been vital too, she adds. “Just as important as the degree are the relationships we forged. We learned to walk in each other’s shoes. I left with a deeper understanding of what’s most important to these leaders in healthcare delivery on the provider side, and they are deepening their understanding of the payer side. That, I think, is transformative.”

 

Now that she’s back from the Ivy League, rest assured she’ll use any opportunity to pay forward that experience as well.

 

 

SIDEBAR: The lessons of mindfulness

 

When Sue Schick’s son was 7, he changed her outlook on business—and life—forever. Her son is an adult now, but Schick often shares the story to drive home a point larger than parental involvement.

 

Schick was home one night helping her son with his homework. In between problems, she’d pause to check emails and other work-related matters on her handheld device. At the end of the night—one that she thought was successful and productive—she asked her son what he he’d learned that evening. His answer wasn’t about arithmetic.

 

“I learned you love your Blackberry,” he said.

 

The answer, understandably, cut Schick to the quick, and changed her behavior. But she saw how much a relationship or even a conversation could be derailed by a lack of presence or mindfulness.

 

“To me, that lesson applies in other areas of my life as well. What happens when you have a busy mind when you are meeting with someone?” she says. “What I have found since then is that, if I am fully present and engaged, then my relationships are stronger, I’m more productive, and it reduces my stress. I think it leads to a more fulfilling life. Believe me, I am not declaring victory on this – we are all pulled in so many different directions.

 

“But, for me, it’s been a personal lesson that, when I am present, when I am focused on being here now, my life is better.”

 

 

 

 

Tejal Gandhi galvanized as merger of IHI, NPSF multiplies efforts around patient safety

By | July 17th, 2017 | Blog | 1 Comment

 

Tejal Gandhi: “We think culture is driven through leadership. The C-suite needs to take ownership and drive this culture of safety.”

 

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

 

The merger of the Institute for Healthcare Improvement and the National Patient Safety Foundation is now official, and Tejal Gandhi, who led the NPSF, couldn’t be happier.

 

“The reason for the merger was really based on mission,” she says. “IHI had been wanting to strengthen its efforts in patient safety, and that was part of its new strategy that it had been thinking about. And we on the NPSF side felt we had been doing some meaningful work in safety, but we’re small and wanted to expand our reach. It was a perfect union.”

 

In the new structure, Gandhi, a frequent honoree as one of the top leaders in healthcare, moves to a new role as chief clinical and safety officer for IHI. “I’ll be overseeing all of the safety efforts and, more broadly, getting engaged on some of the IHI’s other efforts across the spectrum of quality.”

 

In this, Gandhi will lean on her experience as the former executive director of quality and safety at Brigham and Women’s Hospital, and chief quality and safety officer at Partners Healthcare.

 

The patient-safety movement includes dozens of groups, with many different approaches and agendas. As a result, sometimes the approach and effectiveness can be fragmented. Gandhi says she hopes the merger, which combined two respected entities, can help focus future work.

 

“We want to be a single unified voice,” she says.

 

The NPSF released a major report in December 2015 called Free From Harm: Accelerating Patient Safety Improvement Fifteen Years After To Err Is Human, which outlines eight steps that the healthcare industry can take to significantly reduce mistakes and injuries in the healthcare setting. IHI’s muscle will allow for a broader discussion of the themes in that report. In addition, in conjunction with the American College of Healthcare Executives, IHI/NPSF recently released an executive “blueprint” to help healthcare leaders implement real, not theoretical, steps to reduce safety events under their watch.

 

“We think culture is driven through leadership,” Gandhi says. “The C-suite needs to take ownership and drive this culture of safety. We’ve been saying this for 15 years but haven’t necessarily given the C-suite the real tools to do it.”

 

The blueprint is designed to help change that. “If you look at data around the safety culture, we have a lot of room for improvement,” she says.

 

“There’s still about 40 percent of people who answer surveys who say they are worried about punishment if they speak up about an issue.” A wide range of CEOs, safety officers and researchers convened to decide what would go into the blueprint.

 

“We’re very excited about the work,” she says. “It includes practical strategies and tactics for organizations to drive toward a culture of safety. And then, with the partnership of ACHE to help disseminate it, we have a lot of follow-up education planned.”

 

Gandhi also is taking her knowledge to the board room, knowing that directors can set the tone for healthcare organizations. Last October, she was asked to join the board at Aurora Health Care, a major Wisconsin health system.

 

“They wanted a physician, and they wanted someone who very much understood quality and safety,” Gandhi says. “I think Aurora has a great track record already in quality and safety, and they were enthusiastic about taking it to the next level. Given my new role at IHI, the opportunity to bring new ideas will be really exciting.”

 

Some of Gandhi’s ideas, thankfully, are catching on in patient safety, like looking at patient care in all settings, not just the hospital.

 

“When I started out in patient safety, my research area of interest was patient safety in the ambulatory setting,” she says. “We have constantly been pushing the fact that we need to think about safety across the entire care continuum. I think we’re finally seeing a shift now. People understand that it’s not just a hospital issue.”

 

IHI/NPSF currently has a grant from the Moore Foundation to conduct research on patient safety in the home, and Gandhi lists other areas that need scrutiny as well, from primary care to ambulatory surgery to dialysis centers.

 

Behind all these activities stands the need for transparency, which Gandhi has called a paramount attribute in a culture of safety.

 

“We’re making progress, but we have a long way to go – I feel like I say that about everything in safety,” she explains. “Compared to 15 or 20 years ago, there’s much more transparency about errors. There’s transparency about errors when they happen with disclosures and apologies, transparency with the public with data about mortality, infections and readmissions being available, and there’s transparency between clinicians or within and across organizations. But it’s far from perfect.”

 

Yet with all the progress, Gandhi remains wary about errors on another front – electronic health records.

 

“I’m a firm believer that EHRs can provide safety benefits through things like decision support and data accessibility,” she says. “We’ve seen many studies on the benefits of EHRs for quality and safety. But the flip side is that a lot of those studies were done in places that had customized, home-grown EHR systems developed with the end-user in mind. Most EHR systems aren’t like that. And we’ve seen examples of these systems actually creating unintended consequences or new errors.”

 

Gandhi says the IHI-NPSF merger is important because safety remains a bedrock issue that the healthcare industry has not fully come to terms with.

 

“I have spoken to many clinicians who say they would never let a loved one stay in a hospital without them present at all times,” says Gandhi, herself an MD. “But it’s unrealistic to think that’s a solution. Not everyone has a clinician in the family, and even those who do cannot avoid risks entirely. We need to improve safety for all patients in all settings at all times.”

 

 

SIDEBAR: Eight recommendations on safety from ‘Free From Harm’

 

Tejal Gandhi, MD, mentioned the report, “Free From Harm,” contains eight key goals for “achieving total systems safety”:

 

  • Ensure that leaders establish and sustain a safety culture.
  • Create centralized and coordinated oversight of patient safety.
  • Create a common set of safety metrics that reflect meaningful outcomes.
  • Increase funding for research in patient safety and implementation science.
  • Address safety across the entire care continuum.
  • Support the healthcare workforce.
  • Partner with patients and families for the safest care.
  • Ensure that technology is safe and optimized to improve patient safety.
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    Nancy Howell Agee and her team help rejuvenate a region with Carilion’s success

    By | July 11th, 2017 | Blog | Add A Comment

     

    Nancy Howell Agee: “I want to make sure our caregivers are able to put our patients first and get their work done without any obstacles.”

     

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

     

    Roanoke, Virginia, used to be a train town. Railroads carved their tracks into the community on the edge of the Blue Ridge Mountains, and Roanoke’s manufacturing of steam locomotives helped make a name for the Norfolk & Western Railway. Even the first hospital came into existence because train workers needed care.

     

    Like many such towns dependent on one industry that dot the mountains and the plains and the prairies around America, decay began to seep in when the trains started disappearing. But the Roanoke region, at least, has experienced a rebirth, and one of the people responsible for the city’s turnaround has had a close-up view all her life. That would be Nancy Howell Agee, the CEO of Carilion Clinic, a health system that has soared under her leadership and that has partnered with Virginia Tech for an economic rebound that’s pretty rare these days.

     

    “Years ago, when I looked out of my office, I looked out at a brown field and a flood plain,” she says. “Now, I look at a thriving medical complex that includes a medical school and a research institute.”

     

    The medical school, developed with Virginia Tech, has quickly become the most competitive in the country, with 4,500 applicants vying for 42 openings each year. The research institute, another joint project with Virginia Tech, didn’t even exist eight years ago, but now has more than $80 million in funded research and is getting ready for an expansion that will double its size.

     

    “It wasn’t easy; it wasn’t cheap,” Agee says. “We have a fabulous board who have stood with us through some tough times. I think where we are now is an amazing place. We recruited great talent and offered new services to the community. A lot has changed and, in the next 10 years, I think we’ll see even more evolution of that change.”

     

    The Carilion Health System became the Carilion Clinic in 2006 as leaders like Agee (the chief operating officer at the time) and then-CEO Ed Murphy saw the need to change its business model to safeguard its future. Agee says Murphy was a “visionary” in transforming the health system into a clinic. She sees herself as more of a “convener and collaborator,” but her fingerprints are all over the renovated system as well.

     

    “It was definitely an audacious goal at the beginning,” she allows. “We adapted the plan for what worked for us. But, nothing worth having comes easy. There’s a saying around here that you can take risks without being reckless. And what we kept at the forefront was, ‘How can we pay attention to our mission of improving the health of those we serve?’ It’s not just words written down some place – it’s really how we believe and how we live.’”

     

    Agee’s own life and career has had a similar arc of success. Her mom moved to Roanoke at the age of 16 from a coal mining town in Appalachia. She met another teenager and married him. A year later, Agee was born. They lived with Agee’s grandmother, who became a mentor to the young Agee.

     

    Her interest in healthcare began at the Christmas before her 5th birthday, when her gifts included a nurse’s kit – including a cap – and a puppy. “You can imagine how much my little puppy got poked and prodded and bandaged,” she says with a laugh. But her captivation with clinical work solidified at 15 when she was diagnosed with a bone tumor.

     

    “I ended up having five surgeries on my knee and was immobilized for the better part of two years, either in a wheelchair or on crutches,” she remembers. “I had extraordinary care from my nurses, and from a wonderful physician, and I wanted to be a part of that. I wanted to be like them.”

     

    Along the way to a storied career in healthcare – one that will see her become the chair of the American Hospital Association in 2018 – Agee became the first member of her family to graduate from high school and college.

     

    “My family was proud of me,” Agee says. “But, having said that, they weren’t too certain what to do about education. And so, I chose to go to nursing school first because it was cheaper.”

     

    She earned her bachelor’s degree from the University of Virginia and her master’s from Emory University, graduating from both with honors.

     

    Agee was a nurse and a nursing leader for years at the health system. She says she loved every aspect of clinical care, but eventually wanted to find a way to make a wider impact.

     

    “Being a clinician gives you almost instant gratification,” she says. “You assess what’s happening with the patient, you intervene and you see the results. In terms of my own evolution, I loved that part of healthcare. But eventually, I began to ask myself, ‘How do I make a difference to a broader degree?’ ”

     

    That led her to administration, but she carries those nursing roots with her in her efforts to be a servant leader.

     

    “I haven’t forgotten what it’s like to be at the bedside,” Agee notes. “I’m very visible – that’s important to me personally. I make rounds frequently. I go to all of our hospitals and facilities and talk to the staff. I also spend time with the patients to understand what’s happening with them.

     

    “I want to make sure our caregivers are able to put our patients first and get their work done without any obstacles.”

     

    It’s not just a business to Agee, who was born at the health system where she has spent her career.

     

    “I love this community,” she says. “I love our mountains. I think we’re a strong community, yet we’re humble. We are resilient – and we love what we do. When I leave Carilion, I hope our people will believe I wanted us to have joy and meaning in our work and that we made a difference in the communities we serve. I believe we can do that.

     

    “I found my place here.”

     

     

    SIDEBAR: Leaving the white coat behind

     

    When Nancy Howell Agee made the transition from nurse to executive, she continued to wear a white clinician’s coat – at least until she got some good (and blunt) advice from another executive.

     

    “One of my mentors said to me, ‘You need to make a decision here. Are you an administrator or a clinician? The fact of the matter is, you’re confusing people.’ That was good advice.”

     

    So, Agee ditched the lab coat. Now, at a time when many health systems have a tremendous need for clinicians to become organizational leaders as the industry continues the evolution to value-based care, she has a few helpful hints from her own journey:

     

  • You can’t do it all. “First of all, you must understand that doing more for more people means you have to give up doing something for a few, and that’s a big jump. You may have to mourn that as well.”
  • Ask great questions. “Be curious. Be disciplined about growing in leadership. Find opportunities to learn more, especially from mentors and advisors.”
  • Make time for your people. “I had a wonderful boss named Charles Crockett, who was the chief medical officer. He would appreciate and recognize people. If a resident or a faculty member was giving a talk or a presentation, he’d go, and ask questions and be thoughtful. He had a hundred other things to do, but he demonstrated such impressive leadership that way.”
  • Don’t forget what your core is. “We make decisions sometimes and they’re hard decisions, but are you doing it because it’s what’s best for the patient? That’s the real test. If that’s your motivation, I don’t think you’re going to go wrong with your decision-making.”
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    From lawyer to leader: Debra Cafaro’s turnaround of Ventas a remarkable, evolving success story

    By | July 7th, 2017 | Blog | Add A Comment

     

    Debra Cafaro: “Skepticism is crucial to being a successful lawyer, but in a company, you have to be more affirmative and positive. It’s much more like putting together a winning sports team.”

     

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

     

    If a Fortune 50 company needed a turnaround artist, few CEOs would be in as much demand as Ventas Inc.’s Debra Cafaro.

     

    Her early days at Ventas, when she was asked in 1999 to take over what was then a floundering healthcare real estate investment trust, were bleak beyond embellishment.

     

    The stock market halted trading of Ventas’ stock. The actions of management prior to Cafaro’s arrival became the subject of a government investigation for Medicare fraud. Ventas’ sole tenant, Vencor, filed for bankruptcy. The banks and the distressed-debt investors were trying to play both sides of the house and get paid back at the expense of the equity investors. To add insult to injury, the airlines lost her luggage and her clothing on Day One.

     

    So how did she and Ventas pull off a feat worthy of a Warren Buffett?

     

    “At the end of the day, it was the classic skills of maintaining liquidity, understanding how to negotiate to get some time from our banks and enable them to work with us,” Cafaro says. “We also had to think through a complicated solution for all the parties so that each could give up something but get something in return. Then, we had to get everyone on board with that plan.”

     

    It was hardly a quick fix.

     

    “That,” she says, “took several years.”

     

    Similarly, her own transition from lawyer to corporate leader was not a simple one, she says. “It’s very different from law, and the evolution of learning to lead and think organizationally continues for me,” Cafaro says. “When you’re in a law practice, you have a very flat organization and you have a fairly homogenous group of people who are highly educated, highly motivated and highly compensated. In a pyramidical company culture, there is a whole suite of skills that I had never been asked to develop, but which I discovered were necessary for success.”

     

    Those all were rooted in the importance of communication – understanding people, motivating people and recognizing people and their accomplishments often.

     

    “Skepticism is crucial to being a successful lawyer, but in a company, you have to be more affirmative and positive,” she says. “It’s much more like putting together a winning sports team and making the team perform better as a whole than the sum of its parts.” Cafaro knows a thing or two about sports. She recently purchased a minority stake in her hometown Pittsburgh Penguins, just in time to see them win the 2017 Stanley Cup for the second consecutive year.

     

    But her rough beginnings at Ventas have kindled her willingness to talk openly about how women executives don’t face a glass ceiling as much as what she calls a “glass cliff” – being forced to tackle difficult assignments straight out of the box and never getting another chance if they fail. Thankfully, Cafaro has never had to look back. Since 2000, Ventas has delivered 25 percent total shareholder returns; it holds a $35 billion portfolio. Even Vencor, initially its only tenant, emerged from bankruptcy and became the nation’s largest post-acute care company under its new name, Kindred.

     

    “Ventas operates at the exciting intersection of healthcare and real estate, each of which represents nearly 20 percent of our GDP,” Cafaro says. “In both, there are limited numbers of women CEOs even though research repeatedly shows that women-led companies produce better returns and that diverse groups of decision-makers create better outcomes. But I continue to be optimistic.”

     

    Cafaro and her team have worked hard to bring gender diversity into Ventas’ board of directors, which is now 30 percent female. That’s resulted in Ventas being recognized as a “Winning” company on the 2020 Women on Boards Gender Diversity Index and as a Corporate Champion by the Women’s Forum of New York.

     

    “Our organizations and stakeholders are stronger and more effective when we intentionally develop and recruit diverse leaders,” she says. “I have been very fortunate to have been supported throughout my career by many mentors who had different perspectives – and I learned from all of them.”

     

    Cafaro says her earliest mentors were her parents. Her father was a mail carrier who bought and sold coins as a side job to help pay for her education at Notre Dame. Her mother was a homemaker. “My parents – who were first-generation children of immigrant parents – were my role models,” she says. “They made so many sacrifices so my sister and I could have a better life. First, they believed in surrounding yourself with high-quality people who shared your values. Our skilled and long-tenured team at Ventas certainly follows that leadership lesson. The other lessons of leadership they taught me include: always doing my best, working really hard, treating everyone with respect and remembering to smile and show kindness.”

     

    Her team at Ventas represents another key element that helped the company stave off extinction: people committed to a cause.

     

    “When I got to Ventas, the staff was small, and many of them were not really suited for or interested in the challenges that were ahead – that’s not what they had signed up for,” she says. “So, we had to build a world-class team of people who were experts in the areas at issue and were able to work through them and come up with good solutions. It was difficult. It took a huge commitment by a lot of people.”

     

    Oh, there was one other factor in Ventas’ success.

     

    “You need luck too,” Cafaro notes with a laugh. “It always takes a little bit of that, and we got some.”

     

     

    SIDEBAR: The anatomy of risk

     

    One of Debra Cafaro’s early mentors, lawyer Howard Kirschbaum, says the Ventas CEO’s success is due in part to an innate sense around what risks are worth taking. Cafaro doesn’t disagree.

     

    “Taking risks has been an important part of Ventas’ success,” she notes. “Most people do not understand that, sometimes, the status quo is the riskiest approach. We all get comfortable with the idea that things we’re familiar with have less risk. And that is analytically false.”

     

    For example, individuals sometimes put all their savings into their companies’ 401K accounts, Cafaro says, and think it’s not a risky move because they are very familiar with their employer and the account. “But we know that diversification is better,” she adds.

     

    In the same way, risk helped Ventas grow. When Vencor, Ventas’ sole tenant, emerged from bankruptcy, it was a victory – but it also meant that all of Ventas’ holdings were limited to post-acute assets. Merger and acquisition is intrinsically a risky proposition but, in Ventas’ case, it allowed the company to diversify into four other sectors: private-pay senior living, hospitals, medical and outpatient office buildings and university-based life science innovation centers.

     

    “We’ve done at least 10 successful enterprise acquisitions,” Cafaro notes. “Because of where we started, with one tenant and one asset class, that ability to diversify through merger and acquisition has proven to be a great strength both for growth but also for risk mitigation. And that turns on its head some very conventional thought processes.”

     

     

     

     

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