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
The board overseeing the merger between Kaleida Health and Erie County Medical Center has selected a name for the new entity: Great Lakes Health System of Western New York. Great Lakes Health comprises Kaleida and ECMC, but also the University at Buffalo and physicians throughout the community. The organization represents a system of hospitals, healthcare providers, and specialty services in a two-county region.
The MetroHealth System will cancel its contract with one of the only two Medicaid managed care companies available in Northeast Ohio, a move that could force more than 4,000 patients to get new doctors. In letters to patients, the hospital system said that as of Nov. 1, MetroHealth, its community clinics and all of its doctors would no longer accept WellCare of Ohio health coverage.
UnitedHealthcare and Blue Cross Blue Shield of Florida were among six insurers the state picked to provide health insurance for nearly 4 million Floridians now without coverage. The insurance products will be offered to residents who have been without insurance for at least six months and will become available for purchase in early 2009. The Cover Florida program will be open to uninsured people ages 19 to 64 and is aimed at preventive and basic care.
For medical professionals who climb on board helicopters hundreds of times a year, the dangerous job can mean dark, urgent flights through uncertain landscapes, emergency landings, and medical equipment bouncing because of choppy winds. But air medical transport also grants it's the rush of saving the lives of people who might not otherwise have been reached in time. That is what has kept Mary Jo Dunne, 53, working as a flight nurse for 23 years on more than 2,000 flights with the University of Chicago Aeromedical Network, even as she hears all too frequently of medical helicopter crashes like the one that killed four people in Aurora, IL.
Blue Cross and Blue Shield of Massachusetts, anticipating further deterioration of an employer-based health insurance system and more competition from out-of-state, needs to rein in administrative costs. The 18- to 24-month effort is intended to keep the state's largest health insurer competitive as employers become less willing to absorb hefty annual premium increases.
UnitedHealth, America's biggest health insurer by revenue, has announced earnings that met analyst forecasts and, for the first time, broke out its investment portfolio to reassure investors it was sufficiently conservative to weather market gyrations. Looking ahead, however, chief executive Stephen Hemsley acknowledged that UnitedHealth will face significant challenges keeping members.
Jacksonville, FL-based St. Vincent's HealthCare plans to eliminate 100 staffed positions due to reimbursement decreases and cost increases. The positions are being eliminated as part of an expense management plan in which officials of the health system hope to improve strategic growth with a major investment of capital and operating funds, officials said.
Just a quick note about the goings-on here in Chicago at HealthLeaders Media's Top Leadership Teams events as I wrap up a busy day at about 11 p.m. Today I helped kick off the event at 9 a.m. with a panel entitled "Lay Waste to Waste: How to cut the cost of doing business."
What struck me during the event was the open sharing of successful ideas among a large group of panelists and a roomful of senior leaders in healthcare.
As many of you know, healthcare administration makes up 30 cents of every dollar spent on care, in large part because healthcare has been slow to adapt to techniques that can successfully cut the cost of doing business. But that doesn't mean that there aren't many who can teach valuable lessons about providing value to patients, which was essentially the focus of my panel. Of course, it's impossible to distill 90 minutes of lessons into a short blog entry, but our experts from Gundersen Lutheran Health System, Geisinger Health System and Firelands Regional Medical Center kept the audience rapt with attention with strategies they've used to help cut the cost of doing business in healthcare. It's easy to moderate such a panel when essentially, all you have to do is push the start button. The essence of what was said boils down to this: cutting the cost of care is essential to being able to provide healthcare to the largest portion of people. I'll share more later in the magazine but the fact that these people truly believe that cutting costs and improving efficiency—not necessarily in that order—is the best way to provide better and less expensive care and I truly admire their dedication to their nonprofit mission.
Tomorrow we'll distribute the Top Leadership Teams awards, which will truly be inspirational, as those teams share their success stories with the audience.
Like a lot of veteran physicians, Mark DeFrancesco, MD, MBA, began his career in a small practice with just one partner. Since his first days as an OB/GYN in 1984, however, his practice has grown organically and through mergers, and he now serves as chief medical officer for Physicians for Women's Health, a 155-physician group in Connecticut. His career path in many ways mirrors a trend we're seeing across the industry: Small practices are struggling and dying out in a wave of medical practice consolidation. +
When a health assessment showed that the community was having issues with preventable health issues and concerns, Exempla Healthcare in Denver decided to address things with a campaign that asked residents to "Be the One" to take control of their health. +
In the face of recent encouraging signs, economists are standing by predictions of a longstanding global recession. With consumer spending down and rising unemployment, you can expect that consumers will be cautious to part with their money. The conditions make it hard to speculate, but emerging global hospitals could face tough times, while established facilities try to stay afloat. +
