Retirement: What Does it Mean?

I had a nice conversation with Sister Mary Jean Ryan last week. If you don't know why that was a privilege, you don't know who Sister Jean Ryan is. If that's the case, and you're in healthcare leadership, you just haven't been paying attention the past 30 or so years. The Franciscan Sister of Mary has actually spent 25 years (but who's counting?) as the first ever president and CEO of SSM Healthcare, the 15-hospital, four-state health system based in St. Louis.

A couple of days after we spoke, the 73-year-old retired, and just like that, one of the last sister CEOs was gone from running the day-to-day operations at one of the nation's most lauded health systems.

It really wasn't a surprise. Her retirement had been previously announced, and her successor has been groomed for years. In fact, Sister Mary Jean insists that she's not actually retiring—just transitioning.

"I don't consider what I'm doing to be retiring," she said.

She's relinquishing the president and CEO title but is remaining chair of SSM's corporate board. She also has three international trips—to Hong Kong, Singapore, and Sweden—coming up in quick succession as part of her effort to spread the gospel about quality in healthcare.

"If this is retirement, I'm going to go back to working," she jokes.

As I talked to her, she was busy whipping her home office into shape, grumbling softly about computers, modems, and other trappings of the home office lifestyle.

In case you don't know, Sister Mary Jean is kind of like one of those pop stars for whom no last name is necessary—at least within healthcare leadership circles. Her most lasting legacy outside SSM will be her pioneering work in the area of healthcare quality.

Inside, she says, "if people only remember that everything I tried to do was for the patients we serve and our employees, I would be happy with that. I've tried to convey to our people that I would never make a decision that involved the whole system if it didn't benefit the whole system. Everyone within the system gets their turn at benefiting more. I hope that people have understood how important that was."

Sister Mary Jean began her healthcare career as a nurse more than 45 years ago and recently celebrated her 50th anniversary as a member of her order. She's most well-known in healthcare for her embrace of continuous quality improvement philosophies to achieve excellence in healthcare quality.

"I look on 1990 as a pivotal year, because that is when we made decision to have a formal continuous quality improvement way of doing our work. It's not a program, because programs come and go. It's a way of life."

In 2002, the system became the first healthcare organization in the nation to receive the prestigious Malcolm Baldrige National Quality Award. Since that time, Sister Mary Jean has worked tirelessly to share SSM's lessons with others in healthcare and in other industries. But learning the lessons involved in the Baldrige quest wasn't always easy on the ego, she says, especially at first. Most organizations try for multiple years before they win a Baldrige award, and SSM was no exception.

"The Baldrige people put it to us this way: 'You want to be exceptional but we don't see that. You've compared yourself to the average.' As a result, every single year, we've refined and always look for improvement."

But what's best about Sister Mary Jean is not the awards and, yes, fame, that have come from SSM's journey under her watch, but her philosophy on leadership.

"You can talk about leadership and most people would talk about executives, but it exists at every level of the organization," she says. "Our employees go home, and when they get home, they become, in effect, the CEO or COO—and every other position—of a small corporation called a family. They do the planning, the teaching, in service education, transportation, maintenance, and long-range planning. We don't want them to come back to work and lose that leadership they've exhibited, because that's a waste of talent."

As a result of this philosophy, SSM has organized its CQI work under team-based leadership groups that other health systems are only learning, fitfully, to employ now. I'll let her explain:

"We rate highly the work that goes on in teams, and our employees rate it highly, too," she says. "We continue to rely on these people who come to work every day wanting to do a good job in housekeeping, maintenance, accounting, and nursing, and they all come up with great ideas."

With Sister Mary Jean's retirement from the president's office, she says she knows of only a few, "maybe half a dozen," senior leaders who are also member of religious orders in healthcare anymore.

"Our congregation was only in healthcare. That was our focus. We got very good at it," she says. She speaks in the past tense, because her order is no longer recruiting for vocations, and as the sisters age, their numbers become fewer and fewer.

"For those of us who are from congregations of women, this has been our life," she says. "What we recognize and appreciate is that for people we work with, it's not their whole life. They go home to spouses and children and have something beyond the workplace. Not to say they're less dedicated, but it is not their whole life. It's good that it isn't."

SSM has a new leader, but he's a familiar face. William "Bill" Thompson has been with SSM or its predecessors for 31 years, and was named Sister Mary Jean's successor.

He lists improving quality and safety for patients; making services more efficient; and improving the quality of care at the same or lower cost as his chief strategic objectives as he takes over. "I've been preparing for this role for two years," said Thompson. "It's a privilege, and it's also an awesome responsibility."

"He's going do things a whole lot better than me," she says. "He's as committed to quality as I've been and he will find ways to make that even better, and I expect him to. If things aren't better for him having been there, then we've both failed."