Thoughts About Top Leadership Teams in Healthcare

Rick Johnson, for HealthLeaders Media, October 17, 2008

When you're at an event featuring some 40 C-level leaders, you can bet that you'll walk away with more than a few nuggets of wisdom to consider and even some strategies you can try to implement.

So it was with this year's Top Leadership Teams in Healthcare conference. As a healthcare reporter, it's one of the events I look forward to each year—and not just because I get a free stay at a luxury hotel like the Drake here in Chicago. This is my best opportunity to interact with some of healthcare's best CEOs and find out what their challenges, concerns, and outlooks are for the industry.

It's the culture, stupid
I often here that healthcare needs a cultural transformation, but Al Stubblefield, president and CEO of Baptist Health Care Corporation, actually led northwest Florida's largest health system through one that included receiving the prestigious Malcolm Baldrige National Quality Award. During his keynote address, Stubblefield says he couldn't change the corporate culture until he and his C-suite staff embraced significant change to the way they led and ran the business.

"I tell people I was one of the outstanding mediocre hospital administrators in the country," says Stubblefield. He and his leadership team took a deeply critical look at the organization and came to a simple but profound realization—that they might not be able to outspend competitors like Ascension and HCA, "but we could out-serve them."

Baptist Health Care began a long journey to transformation that began with Stubblefield's roadmap, a checklist that might look easy on paper, but any leader knows is difficult to implement:

  • Define the culture
  • Live the culture
  • Pick good people
  • Give them the freedom to do their jobs
  • Provide resources and support
  • Commit to accountability and timely correction

"You got to let them know the culture is non-negotiable," says Stubblefield.

But the change was much less about the leaders than it was about Baptist Health Care's staff, who responded to Stubblefield's call to action with enthusiasm that began an ongoing dialog between the employees on the frontlines and senior executives.

Just one of the tools Stubblefield shared with the audience: He wanted all employees to feel like partners in Baptist Health Care's success, so he implemented his "bright ideas" campaign and set lofty goals for managers. This program required more than just employees making suggestions because Stubblefield set quotas for supervisors to implement them. In fact, early on he set the bar high by requiring that management implement one bright idea for each of Baptist Health Care's 5,000 employees. And far from being a management gimmick, he says the system continues the program and last year implemented 14,000 employee bright ideas.

Stubblefield went on to discuss the personal changes in leadership that he had to be willing to make—such as getting out of meetings in the executive offices and make interacting with employees a priority.

But the bottom line is that Stubblefield didn't just change, he gave a measure of control to Baptist Health Care's employees and told them, let's dramatically change this organization for our patients.

"We've had a pretty phenomenal ride, including winning the Baldrige Award," he says. "But it took me being willing to change."

Green bricks and mortar
My friend and colleague Philip Betbeze facilitated a finance panel that he called "Laying Waste to Waste." I frequently admire the way Betbeze can make healthcare finance understandable and even interesting. This discussion with six senior hospital and system leaders was no exception. He's going to write a detailed story about the panel in an upcoming issue of HealthLeaders magazine, but here's just a glimpse of the dialog.

Jerry Arndt, senior VP of business services at Gundersen Lutheran Health System in La Crosse, WI, talked about ongoing construction projects at his facility and how Gundersen is making strides toward value-based construction and has began an energy renewal program.

"We are on the path of action steps that will have us on 100% renewable energy by 2014," Arndt says. "We need to reduce the amount of energy we are consuming right now—and we have a program that will reduce energy consumption in existing facilities by 20%."

Gundersen's CEO Jeffrey Thompson, MD, noted that developing an energy renewal program is not just good business—it is also a way to make a meaningful and lasting connection with the community. To this point, he says the system received some good press about its HealthGrades' score, but two weeks later there was another story in the paper about the system's renewable energy program that resulted in "10 times the amount of interest in the community."

"While they thought it was nice we aren't killing patients, they thought it was great we aren't killing trees," he joked. "If you want to connect with your community and staff in a positive way, that's an area to focus on."

New medical staff models
Before I sign off, I just wanted to share a few words about the panel I facilitated for the Top Leadership Teams in Healthcare conference and awards. I had a terrific line-up of speakers who candidly shared their successes and struggles with medical staff alignment. I'm looking forward to crafting a story about it for HealthLeaders magazine, but one thing struck me most about our conversation: For the organizations attempting to recreate their medical staff models, it is not just some business scheme to give the CEO more control. If anything, it is just the opposite.

The changes we are seeing today that involve the traditional medical staff model transforming, sometimes to the clinic model, are really about better aligning the goals of physicians and the organization so that the medical staff and administrative staff can work in unison to serve patients more effectively and efficiently.

My thanks to the panelists for sharing their time and expertise:

  • Kelby Krabbenhoft, president and CEO of Sanford Health
  • Daniel Blue, MD, president of Sanford Clinic
  • Edward Murphy, MD, president and CEO of Carilion Clinic
  • Nancy Howell Agee, COO of Carilion
  • James Leonard, MD, president and CEO of Carle Foundation Hospital
  • Bruce Wellman, MD, president and CEO of Carle Clinic Association

Rick Johnson is senior online editor of HealthLeaders Media. He may be reached at
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