What healthcare leaders need to know now


Armada aims to bring the Baldrige process to Swedish

By | August 14th, 2014 | Blog | Add A Comment


Tony Armada: “To see the impact you can make on the lives of the people who entrust their care to you is an awesome privilege.”


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


Anthony “Tony” Armada’s physician father and pharmacist mother emigrated from the Philippines with their children, some suitcases, and a few thousand dollars. The impact they’ve made on healthcare in their adopted country has grown exponentially over the last several decades.


“Everyone is passionate about what they do, right?” says Armada, with a laugh, from his office at Swedish Health Services in Seattle, where he’s the CEO of one of the Northwest’s largest health systems. “The more you can make meaningful changes for the benefit of others, the better off you are.”


Armada’s parents saw all of their children make a difference in healthcare. Armada’s oldest brother owns a research consulting firm that works with pharmaceutical companies. Two other brothers are physicians and his two sisters are nurses.


“Delivering care and being a servant leader are just in my genetic code,” he says. “To see the impact you can make on the lives of the people who entrust their care to you is an awesome privilege.”


Previously, Armada had been a leader with several of healthcare’s premier organizations throughout his career, including Kaiser Permanente, the Baldrige Award-winning Henry Ford Health System, and Advocate Lutheran General Hospital and Children’s Hospital. Those experiences have informed the mantra by which he operates: “Always the best.”


“I come at this from a very simplistic vantage point,” he says. “What’s really cool about ‘always the best’ is that it’s individual as well as organizational. I always encourage people I engage with to reflect on that time when you actually bested your best: What did that feel like?


“It’s very energetic – it comes with a passion. And then people start getting onto this bandwagon of always wanting to best their best.”


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Georges Benjamin advocates for a better health system

By | August 7th, 2014 | Blog | Add A Comment


Georges Benjamin: “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.”


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.


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Foresight is the key to David Lopez’s leadership

By | July 14th, 2014 | Blog | Add A Comment


David Lopez: “Once you’ve established what you need to get accomplished, you’ve got to keep after it. You don’t let little things deter you.”


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


Over the last several years, as many hospitals and health systems across the country were building patient towers for their acute-care needs, David Lopez, the outgoing CEO of Harris Health System in Houston, was quietly shifting his organization in anticipation of some of the changes that the Affordable Care Act has brought.


He didn’t expect more revenues from inpatient services; he worked to build a strong wellness program and to ramp up primary care heavily. There’s a reason for that.


“If you look at our statistics, 64 percent of our patients have no insurance,” he says. “For us, more volume on the acute-care side means we spend more money. For us, it’s not about generating more revenue. It’s about managing our costs.”


Harris provides 35,000 admissions every year, but Lopez notes that outpatient visits have reached 1.4 million annually, with an additional increase of 300,000 expected in the next 18 months.


“If the patient can be taken care of in a primary-care setting or another setting, the best way to lower your cost overall is to avoid the admission,” he says. “You’re better off doing that than looking at the patient as a potential revenue opportunity.”


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Nancy Schlichting of Henry Ford reflects on the journey to quality

By | October 28th, 2013 | Blog | Add A Comment


Nancy Schlichting: “There are a lot more women working in our health systems, but not very many women leading them.”


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


The journey to winning the Malcolm Baldrige National Quality Award was just as important as the final destination for CEO Nancy Schlichting and the Henry Ford Health System.


The honor, bestowed by the office of the President of the United States, goes to a limited number of organizations each year for quality and innovation. Yet Schlichting suggested it as a goal to her team a full seven years before the system won the award in 2011. In fact, Ford didn’t merit a site visit from the Baldrige investigators until the year it won.


“I started bringing the Baldrige application process to our team because I wanted us to get better as an organization focusing on the important things,” says Schlichting. “The framework helps you to be a strong organization, and it forces you to become more integrated.”


Yet midway through those years, she and the organization had some doubts.


“At the same time we were going through the Baldrige process, the U.S. had its economic collapse. It was a very challenging period,” Schlichting remembers. “There were moments along the way where I think my team thought we should take a year off, but I said no because it really was more about the journey than the award.”


As the system persevered, Schlichting says she took another look at how Ford was presenting its story to Baldrige.


“I remember talking to Bob Riney (Ford’s president and chief operating officer) and said, ‘I don’t think we’re telling our story right. I don’t think people understand us. We have to include the fact that we’re in Detroit. We’re a unique safety-net organization, yet we have all these expanding suburban markets. We work differently than a lot of organizations.’ ”


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Nursing roots important to Judith Persichilli as she leads one of the largest U.S. health systems

By | August 14th, 2013 | Blog | Add A Comment


Judith Persichilli: “One of the Trinity CHE values is courage, taking risks. Our founding congregations came to this country with 50 cents in their pockets to take care of people.”


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


“When I wake up in the morning and look in the mirror, I see a nurse. I don’t necessarily see a healthcare executive.”


Those words don’t belong, say, to the CNO of a small Midwest hospital. They’re coming from Judith Persichilli, who serves as interim president and CEO of Trinity/Catholic Health East, one of the largest health systems in the country. (Prior to the merger of Trinity and Catholic Health East, Persichilli was president and CEO of CHE.)


Nursing, Persichilli says, “has always been in my heart. It still is.” In fact, there is no shortage of executives on Modern Healthcare’s list of the Top 25 Women in Healthcare who have a background in nursing, including Persichilli.


Why do many nurses become successful healthcare executives? Persichilli says she thinks she knows.


“The education of nurses prepares them to be leaders,” she says. “You’re educated across the continuum; you understand the clinical process. You need strong relationship and communication skills as you’re dealing with physicians and other allied health professionals to promote a plan of care. At the same time, you are responsible in many instances for the communication with the family and significant others of the patient.”


While Persichilli leads an organization with $12.8 billion in operating revenue, she says healthcare workers at any level can make a significant difference in safety and quality in an era in which cost has become a driving concern.


“With healthcare reform, I truly believe that people with clinical knowledge – including, of course, physicians – have the skills to make the right decisions about the clinical process of care and actually lower the cost of care overall. They will make the right decisions about where patients can safely be taken care of with the highest quality.” Read more…



A devastating injury failed to derail Karen Daley’s remarkable career

By | August 2nd, 2013 | Blog | Add A Comment


Karen Daley: “Everyone’s health and safety is at risk with these injuries. It really is about what’s right across the board for a safer work environment.”


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


Karen Daley loved being a nurse, and she was a good one. But all that changed one day in 1998 when she was stuck by a needle while treating a patient. From that one needle stick, she contracted HIV and hepatitis C.


Her clinical nursing days were over. Over the next couple of years, she would undergo exhausting treatment regimens. But she was determined that the incident would not end her healthcare career.


“I learned how resilient I was physically and emotionally,” says Daley today, now president of the American Nurses Association and one of the 2013 Top 25 Women in Healthcare as chosen by Modern Healthcare. “It was a grueling time. I was constantly worried about fatigue, falling and exposing others to my blood, and I had little appetite because of the drugs. I looked sick.”


Yet while she underwent treatment, she plunged into advocacy, petitioning the U.S. Congress to change laws to reduce the odds that other nurses would have to face what she was going through. The laws were eventually changed to mandate use of safety-engineered sharps devices that could prevent similar injuries. Now, more than a decade later, compliance isn’t where it could or should be.


“We had to educate the healthcare system that these injuries and associated bloodborne pathogen exposures were preventable,” Daley explains. “Not only were they losing workers to these injuries, they were risking the goodwill of workers who learned over time that these were injuries that should not have occurred.”


In hospitals, she says, “prevention often is not seen as a viable strategy because it often costs money on the front end versus money you may or may not have to pay on the back end.” Read more…



Marna Borgstrom: In healthcare and life, relationships matter

By | July 29th, 2013 | Blog | Add A Comment


Marna Borgstrom: “How people execute is based mostly on organizational values. And those have to be values that people lead by.”


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. Read more…



Personal experiences add passion to Maureen Bisognano’s drive for patient-centered care

By | July 18th, 2013 | Blog | Add A Comment


Maureen Bisognano: “Boards and leaders mostly look at averages. By looking only at averages, they're tolerating a level of bad performance that they wouldn't if they better understood variation.”


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




Maureen Bisognano asks a lot of them. She asked many questions when she was a nurse, and when she ran a hospital. Now, she asks plenty as the President and CEO of the Institute for Healthcare Improvement, the renowned organization that helps the healthcare industry improve the quality and safety of care.


Leadership in these areas, Bisognano says, has to start at the top.


“Many boards and leadership teams still don’t understand the meaning of these quality measures, in cost terms, and in terms of the impact they have on patients,” she says. “Leaders get a quality report that is red, yellow or green — self-defined colors that don’t tell them nearly what they need to know When I go to visit a board or a senior team, I ask them four questions to provoke them to think at a deeper level.”


Here are Bisognano’s four questions, with some of her comments for annotation:


**Do you know how good you are as an organization? “It’s knowing this qualitatively and quantitatively, not just in terms of red, yellow or green. Do you hear what patients are saying? Do you have patients at the board meetings? Not just patients who have been harmed, but ones who have had a great experience, because boards need to know where to reinforce quality as well as where to push for better quality.”


**Do you know where your variation is? “Boards and leaders mostly look at averages. So they don’t know if they’ve got some performers in their organization who are superstars and some who are really poor performers. By looking only at averages, they’re tolerating a level of bad performance that they wouldn’t if they better understood variation.”


**Do you know where you stand relative to the best? “Most leaders don’t know the answer to this. They look at their own data and they may not realize that there are other organizations in their state, in the country, or in the world that are doing dramatically different, dramatically better. And that provokes thinking.”


**Do you know your rate of improvement over time? “If you’re looking at static numbers, and thinking that they’re getting better, you may never know what the rate of improvement is. So I suggest to leaders that they always look at the rate of improvement over time.”


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

By | July 1st, 2013 | Blog | Add A Comment


Irene Thompson: “UHC is all about performance improvement for the academic medical center.”


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

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

By | June 10th, 2013 | Blog | Add A Comment


Helen Darling: “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.”


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.


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