The Exec: Transforming Healthcare Access With Sara Criger

The senior vice president of Allina Health's operations and acute care services shares what initiatives she has championed and supported during 2022 and discusses what she will be focusing on in the new year.

Editor's note: This conversation is a transcript from an episode of the HealthLeaders Podcast. Audio of the full interview can be found here and below.

Sara Criger has more than two decades of experience leading as a hospital president. Ten years ago she joined Allina Health, a nonprofit health system based in Minneapolis, which serves patients in Minnesota and western Wisconsin through 11 hospitals and more than 90 clinics.

In April 2022, she was promoted from senior vice president of operations to SVP of operations and acute care services for the health system, which includes offering executive leadership and support to 11 hospitals and key clinical service lines for the system, including the Allina Health emergency medical services, Allina's mental health and addiction services, and cardiovascular clinical service lines.

In a recent podcast interview with HealthLeaders,  Criger details the important initiatives she has championed and supported during  2022 and shares what she will be focusing on this year.

This transcript has been edited for clarity and brevity.

HealthLeaders: What drew you to work in healthcare?

Sara Criger: My personal background is part of what drew me into healthcare. I grew up one of five children in Michigan. My parents were committed community members and in professions that they loved. In fact, my dad was a superintendent of a construction company, and [when I] probably was 11 or 12, I remember he was in charge of building a hospital in Michigan, and we used to go check on the job when I was a kid. The irony is, 10 years ago, I joined Alina and was running Mercy Hospital. We were doing construction and I found a pamphlet from my dad's work and that hospital that he built was Mercy Hospital.

My mom also influenced me growing up. She was a pediatric nurse and got into leadership later in her career, running a homecare agency, and [she] worked for the Red Cross. I thought I was going to be a nurse and decided I would pursue that in my adult years. I worked while I went to school so while I went to school to be a nurse and got trained to be a clinic medical assistant and worked with a private practice on the East Coast.

While I went to college, I realized a couple of things. Nurses have to do a lot in the science area, and science was not a strength for me. But, also, in the private practice that I worked for, I started to get engaged in not only doing the work, but how could I help us as a clinic be better overall. The leaders in the practice saw that interest and said, "Hey, you'd be good at leadership, can we give you a caveat leadership role?" So I moved up and decided at that point to switch my curriculum to a business major with [a focus in] healthcare and human resources.

Between my family history—I have one sister who died of diabetes and whose sons also have diabetes, [and] another family member who struggled with mental illness—healthcare is very personal, and it's very real. It's a calling. We come into healthcare, many of us having had experiences that give us a strong passion for what we do and make a personal commitment to make a difference, and to help the system be better for our community.

The opportunities I was given to tap into that kind of commitment and passion [were] a gift. I had some time in the academic medical school setting, and then eventually did pivot over to more hospital leadership. Doors open when you love what you do, and you work with and for people who give you those opportunities to learn and grow.

HL: What innovative work have you led so far in your position as VP of Allina Health operations and acute care services?

Criger: The opportunity to step into the broader role has been an honor and a privilege for me to support the hospitals and to step into this having had such recent experience in a hospital setting.

At my level, I get to see and help champion a lot of what the frontline caregivers and the clinical program leaders are driving for the organization and help advance them, so I am not sure I can take credit for what innovative work I've led.

Coming through the pandemic, especially the last year, we've experienced extreme pressures on the system. People are coming back for care, many people delayed or postponed care during the pandemic, and they're sicker or they waited longer, and now they need us more than ever. This past fall, we've experienced a lot with the influenza season and RSV on top of COVID.

But access to care has been where we've had to be most creative and innovative. I'm proud of how the teams have done a lot to extend virtual care and telehealth. Our mental health and addiction services team has been able to not only protect the community and patients through the pandemic by offering virtual or telehealth care, but they've also been able to use that even as we've lifted our social distancing requirements to get access to care to people in rural communities or who live far away. Our ability to expand telehealth visits, consultations, even intensive partial hospitalization day programs virtually have been exciting to support and see take off and be able to address at a time when we have a crisis around mental health and addiction.

We're doing a lot in Allina to keep patients at home. So, in addition to telehealth and virtual care, we've been working to promote hospital at home as a mechanism for helping patients get discharged from the hospital sooner, or to avoid a hospital admission with a higher level of care in the home environment.

HL: What initiatives are you looking forward to championing in 2023? Are there any pain points you're specifically looking to address?

Criger:  Access to care issues are not going to resolve quickly; that's going to continue to be a challenge for us. Behind the access challenges are the workforce challenges. Recruitment and retention remain top priority, no question about it. Our goal is to make sure we are focused on the retention and the well-being of our workforce that's in place, and then continue to think about how to be creative in the recruitment space. How do we attract kids in high school into healthcare and get them thinking about what is available to them? How do we think about creating, in some cases with the schools, programs for training so that we have adequately trained and skilled people coming out to such a variety of job skills and opportunities?

One choke point right now with as many people having retired or left the field, is we have a lot more people that we're getting trained. We've got to expand [the size of our programs] with our academic and technical program partners and get more people through that. And then, addressing this changing workforce: What is the workforce of the future looking for?

One of the things that the pandemic and workforce has provided as another incentive is to change healthcare. The transformation of the healthcare system is something that many of us know needs to happen. We are a costly healthcare system in the United States, we don't necessarily get the outcomes we should for the cost we pay. And a lot of that is because we've had a reimbursement system that has focused on when people are sick or injured, versus how do we keep people healthy and promote wellness. [How do we] keep patients out of the hospital, out of the operating rooms, and the EDs?

We're excited about the opening of a mental health and addiction specialty center, a future state specialty center that brings a lot of our community partners in with our caregivers. Mental health and addiction services generally requires a partnership through many community-based services as well as healthcare services. In the Fridley, Minnesota community, we're going to be bringing together many teams to provide a whole different level of care with a mental health and addiction ambulatory specialty center, which is going to be innovative. I'm looking forward to the outcomes they're going to be getting with our partners.

HL: What has been your experience working and leading as a woman in healthcare?

Criger: I've been blessed over the years to have great leaders who allowed me to step up and try things. They saw my commitment, my passion, my potential, and gave me opportunities.

I have to admit, I didn't think much about it, as it relates to gender differences. One of the things that I've noticed, though, is early in my career, while healthcare was, as far as numbers goes, mostly females in staff roles, the positions of physicians, and oftentimes leadership roles, were held more predominantly by males. One of the things I would observe is that has shifted quite a bit through my career. It's easier to see the benefit of the gender balance. We need other diversity balance as well. We'll continue to work on that.

One of my favorite books is Sheryl Sandberg's "Lean In." [Women] think about strategically how to position ourselves a little bit more. We have such a tendency for inclusion, and that is such an asset. We also tend to be a little more reluctant to believe in ourselves and see ourselves being capable of doing something that maybe our male counterparts might go in and may not think twice about it. It's important to understand that and question ourselves about that, because awareness helps us think about things differently. We should recognize those traits and be there and help others. We have an obligation to do for others what has been done to support us.