Top executives recently convened to share ways they personalize healthcare for their organization's workforce, patients, and the broader community.
During the recent HealthLeaders CEO Exchange in Napa, California, healthcare CEOs discussed ways they are addressing workforce vitality, change management, disruptors in healthcare, and promoting health equity and diversity, equity, and inclusion (DEI).
Humanizing healthcare was a common thread weaved throughout the challenges and solutions shared during the discussion. Here are three takeaways that executives shared to make healthcare more personal for their hospital and health system's workforce, patients, and broader community.
1. Embrace vulnerability and open communication
Executives discussed creating an organizational culture that embraces vulnerability, including how leaders can be more personable with the workforce and keep communication open.
One executive said organizations can conduct virtual calls or in-person "no-agenda" lunch meetings for leaders and staff to share personal stories, get to know one another, and to have open dialogue about what's going on in their lives.
Ways leaders can keep communication open with the workforce can include sending out a weekly five-minute video to staff to check in and keep them updated on organizational news. Leaders can also use this as an opportunity to start conversations around staff member mental health and well-being, as well as share available resources.
Several leaders shared that their organizations are intentional about not only having leaders round to help out, but to also create a stronger connection with the frontline staff and creating more opportunities for feedback and open communication. During rounding, the leaders not only help with tasks, they also talk to the workers, asking questions to find out more about staff members' professional and personal lives, and how they can help.
2. Learn from and accept imperfection
To fail is part of the human experience. Executives spoke about the importance of acknowledging failures as a learning opportunity. One leader said leadership should share their "spectacular failures" and use them as lessons about why an initiative didn't work and look for solutions and strategies to move toward success.
Another executive talked about using pilot programs instead of waiting for an initiative to work perfectly before rolling it out. This can save time and introduce new programs in the organizations at an earlier time, when the need is still prevalent. It also gives leaders and staff the opportunity to share feedback about what works and what doesn't in the initiative, and how to address those issues with a faster, streamlined strategy.
One executive shared that their organization adopted an agile-adaptive thought process, in which they rapidly learn, fail, and fix initiatives while they are rolled out.
It's also important to reach out and learn from people from other industries, an executive shared, which can create more learning opportunities and present different points of view.
3. Promote collaboration and partnership
Another way CEOs can help to humanize healthcare is to create an environment that fosters collaboration with staff members, health organizations, community resources, and the communities they serve.
Another executive mentioned that hiring diverse staff created more opportunities for new leaders, new business, and collaboration on organizational strategies.
Executives shared that hospitals and health systems should partner with outside organizations to promote health equity and connect with the communities to create health equity and DEI initiatives. This can include convening community teams such as banks, educational institutions, politicians, and community resources. Addressing healthcare access will also create community trust in the hospital and health system's workforce.
Hospitals and health systems should also look at other systems as potential partners and less as competition when it comes to serving their communities' needs. Not every organization can succeed in every area, so creating partnerships and joint ventures are ways to help create and maintain healthcare accessibility.
One executive spoke about the opportunity to partner with independent physician groups to grow the organization's footprint. This can also help independent physician groups who want to avoid private equity transactions.
Another executive said that when provider organizations partner to meet the community's needs, it also can help mitigate competition with disruptors. One executive said community partnerships can create strong relationships between organizations to help address larger initiatives to address healthcare access and disparity, health equity, and social determinants of health.
Stay tuned in the coming days and weeks for more key takeaways from the CEO Exchange.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
Through the end of May, 47 hospital CEOs left their posts so far this year, which is an 81% increase from departures in 2021.
The C-suite is not immune to the ongoing Great Resignation. According to a recent report released by Challenger, Gray & Christmas, hospital CEO departures are continuing to climb.
In May, 11 hospital CEOs either retired or left their current posts for new positions. This brings the total to 47 hospital CEOs departing from their positions through the end of May 2022.
This is an 81% increase from May 2021, which saw 26 hospital CEOs make exits.
Reasons for the departures could include finding better opportunities, deciding to retire, or fulfilling a postponed retirement following the pandemic.
According to Andrew Challenger, SVP of Challenger, Gray & Christmas, "The CEO exodus continues. Economic conditions, rising inflation, and recession concerns are making boards rethink leadership and leaders rethink if they want to take on these challenges."
"Inflation, staffing shortages, and possible recession concerns are giving more cause for companies to reevaluate leadership. This, after years of companies trying to figure out the right formula to attract and retain talent and create a culture of inclusion, issues that often start at the top," Challenger said in a previous statement.
CEOs changes across all industries are up to 668 departures through the end of May, the highest January through May total since the firm began tracking monthly CEO changes in 2002. 150 CEOs departed from their posts in May, a 22% increase from the 123 who made exits in April.
Government and non-profit entities, followed by technology companies, have seen the greatest number of exits, with the technology sector announcing increased job cuts in May.
"The ready capital that was available to Tech companies the last few years is starting to slow, and job cuts are following. Generally, new leaders are brought in during a period of uncertainty. Former leaders often remain with the company for a period of time, either as a consultant or continue as a Board Member or Chair to maintain institutional knowledge and have the appearance of a seamless transition," Challenger said.
Mary K. E. Maples, Esq. talks about her leadership transition and shares what she hopes to address as interim president and CEO.
Mary K.E. Maples, Esq., is hitting her stride just fine as interim president and chief executive officer for University Hospital (UH).
Maples had big shoes to fill in succeeding Shereef Elnahal, MD, MBA, who stepped down from his post as president and CEO at UH following a nomination from President Joseph Biden to serve as undersecretary for health for the Veterans Health Administration.
UH's mission states it is "committed to providing exceptional care to every patient, every time," while its vision highlights the organization's promise to partner with communities to improve health for generations to come. Additionally, the organization's core values include respect, reliability, teamwork, integrity, and stewardship, and Maples says she has worked to instill those into her work.
Maples, who has served as UH's chief legal officer and corporate secretary since 2018, recently spoke with HealthLeaders about her leadership transition and what she hopes to address as interim CEO, and she shares insights on her career path and leading as a woman.
This transcript has been edited for clarity and brevity.
HealthLeaders:Can you share a little bit about your background in healthcare and how you landed at UH?
Mary Maples: My background is a bit of a unique one for the healthcare industry. Way back when I graduated from college, I started working at the Central Intelligence Agency (CIA) down in Washington, DC. I was a government major in college and began there in the Office of Security post-9/11 when there was a real focus on developing a cadre of multidisciplinary security officers. I spent the first six years of my time there specializing in investigative work from media leaks to background investigations and things of that nature.
At the time I chose to go to law school at night as well, and once I graduated from law school, I transitioned to the Office of General Counsel, where, just like any other company or government agency, there are any number of legal issues that come up that are common, whether it's HR, budget, contracts, or administrative policies. I had about six years there as an attorney dealing with a variety of issues, such as litigation, congressional affairs, and the like.
I'm originally from New Jersey and had always wanted to get back to New Jersey. When my son was two, my husband and I looked for opportunities to come back home, and that's actually how I first began professionally getting involved with UH. I found myself in the governor's office as an attorney, and my job there was in part to engage with over 50 boards, authorities and commissions, and public entities in the state of New Jersey, UH being one of them.
I spent two and a half years in both Governor Christie's and Governor Murphy's office combined as an attorney and working with UH. I attended all the board meetings and committee meetings and got to know the executive leadership team and the board well. It was at a time when there was a lot of transition going on at the hospital, and it was certainly a great opportunity for me to understand the patient population that we serve, the mission of the organization, and how the business is structured.
The chief legal officer position became available, and as soon as it was posted I jumped on it because it was an opportunity to take what I knew of the hospital and join internally and become a part of it.
That's one of the things I think that's most consistent between my time at CIA and UH: These are mission-driven organizations dedicated to public service, and that's my passion. That's what's really me.
I've been here now for almost four years as chief legal officer, and now over the last month as the interim president and CEO. It's been a real passion project getting to know the hospital from the inside and looking for opportunities to use my expertise to elevate the work that we do here.
HL:How will your background help you in your role as interim president and CEO?
Maples: I find the practice of law is most fun and most interesting when as the lawyer you're a partner to business operations, helping them achieve their goals. That's always been my focus as an attorney, to partner with the non-lawyers as closely as possible and help achieve those business opportunities and those objectives. The transition from chief legal officer to president and CEO has, in my view, been quite a natural transition.
HL:Can you share any plans for the permanent president and CEO role?
Maples: I am still the interim president and CEO, and the board is doing what a board should do. They are engaging in a very thorough and thoughtful search for who the right leader is long-term for this hospital. That speaks to the focus on governance and fiduciary duties that our board takes very seriously.
HL:What current pain points are you looking to address and solve for UH's underserved communities?
Maples: I see two big areas that require simultaneous focus.
On the patient side, we are so proud to serve the community here in the greater Newark area. It's been a real legacy point of pride for us. During the pandemic, we were putting out a lot of messaging that we coined 'care around the clock,' because we did, and continue to, want to provide care around the clock to our patients. On that front, we continue to communicate with our communities about the care they need to return to get.
Even though some people may think the pandemic is over, for us in healthcare and talking with our patients, it's still a conversation that's front of mind to talk with them about the care they missed during the height of the pandemic, but also the care that they need to continue to get and grow so that the issues that they're suffering with can be addressed appropriately. We want to focus on how we can fill those gaps when we see them.
On the team side—we're a team-based organization, and we value teamwork. I talk a lot about our team here and I don't view myself as a leader with staff, I view myself as part of the team. And this team has been through an incredible amount of stress and strife over the last two and a half years, so I can't ignore that. I know that my teammates at some points are tired, are downtrodden, are feeling just exhausted, and so my job is to continue to listen, continue to hear what their concerns may be, and try to identify pathways that we can clear to help those conversations be productive.
In May, during mental health awareness month, we unveiled an employee wellness room because we talk about the time we want to encourage our employees to care for themselves and to take a breather when they need it. It's one thing to say, but it's another thing now to have a room where we say 'It's OK that you need that time, and here's a room where you can go and find a quiet space when you need that break.'
It's also reminding ourselves about why we got into this business in the first place. We're a mission-driven organization; healthcare is a vocation and these patients need us. We are people who chose to pursue a profession where we help people when they can't help themselves. There's real power in that. But it's something that maybe throughout the pandemic, with all of the strife and struggle that this nation went through, we can lose sight of at times. So it's my job to continue to keep that in focus.
HL:Could you share your perspective as a woman leader and how that'll help impact the hospital's approach to healthcare.
Maples: I think if you talk with any woman in the professional setting, all of us have probably had those experiences where you look around the room and you realize you're the only woman at the table. Or you're the only person who is talking about the obligations that you have outside of the workplace that weigh on how you prioritize your time. As a woman leader, and in this role, it's important and it's a passion for me to just talk about those experiences.
As women, we are exceptional problem solvers, firefighters, prioritizers, teammates, and collaborators. There are so many things that I find women are wonderful at that drive business forward. It's my job as a woman leader to continue to work on exemplifying that in my own work and elevating the work that's been done by other women in our organization. We talk as a society all the time about how representation matters, and it matters in a variety of ways. It's important that other women see that women can lead, that women can lead well, and that our gender doesn't dictate our capacity for success.
HL:How would you define your leadership style?
Maples: I love collaboration. I played softball, I played volleyball; I am a team sport-minded person and I view all of this as a team sport. I am someone who enjoys getting feedback from the other leaders around the table, the other teammates that work at the hospital. I frequently round, as we all do in healthcare, on units and talk with frontline staff, middle managers, anyone doing the work here at UH to get their perspectives and their feedback. I don't pretend to have a monopoly on good ideas and I think I've done my job well when I'm not the smartest person in the room, when the experts that are in the room feel safe and comfortable raising their voices and sharing their views.
HL:What advice do you have for other women leaders working in the healthcare sector?
Maples: Never underestimate the power of asking someone for a cup of coffee.
My reason for saying that is because I think women especially put so much pressure on themselves to know all the answers, to have all the right solutions in place. We need to continue to be comfortable raising our hand and asking questions and asking somebody to sit down for a cup of coffee and tell their story.
Editor's note: This story was updated on June 23, 2022.
Violetta Ostafin will assume her new role as executive vice president and chief strategy officer on July 11.
CVS Health recently announced that it has chosen a new executive vice president and chief strategy officer.
Violetta Ostafin will lead the organization's core business strategy development, as well as identify new market opportunities and product innovations, with a focus on accelerating growth to further the company's vision to provide greater quality, simplicity, and choice for consumers.
Ostafin will join CVS Health and assumer her role on July 11.
"Violetta’s deep health care experience has been focused on bold innovation and finding new sources of growth, two priorities for CVS Health," CVS Health resident and CEO, Karen S. Lynch, said in a statement. "Her accomplishments are driven by a passion for improving how consumers experience health care, which aligns with our goals and values."
In her previous role, Ostafin served as global chief operation officer, health solutions, for Aon, plc, a global professional services firm. Prior to that she served as CEO of Aon's Latin America Health Solutions business.
In the past she also worked as a managing director and partner at Boston Consulting Group, to advise companies, both in the U.S. and globally, on large-scale change, strategic growth, and expansion.
"CVS Health has the assets and strategy to meaningfully change how care is delivered," Ostafin said in a statement. "It’s such an exciting time to join a company that has redefined itself through a consumer-centric lens."
This announcement follows CVS Health's additional leadership appointments announced in May. The organization's previous SVP, cross-enterprise strategic innovation, Sheryl Burke, was named the company's SVP of corporate social responsibility.
Sree Chaguturu, MD, who previously served as chief medical officer for CVS Caremark, now serves as EVP and chief medical officer for CVS Health.
The FTC continues to crack down on anticompetitive M&A transactions in healthcare.
For the second time this week, the Federal Trade Commission (FTC) has thwarted another M&A transaction, this time between Utah health system competitors HCA Healthcare and Steward Health Care System.
The systems called off the transaction on Friday, only a few weeks after the FTC launched a lawsuit to block the proposed merger.
According to the agency, the deal would have eliminated competition in the Wasatch Front region in Utah, where approximately 80% of the state's residents live.
"Had this transaction been allowed to proceed, it would have combined the second and fourth-largest healthcare systems in Salt Lake City and the Wasatch Front region of Utah, resulting in higher prices, less innovation, and lower quality care for patients," FTC Bureau of Competition director, Holly Vedova, said in a statement released today. "I am glad that patients and healthcare providers will not have to endure any more uncertainty while waiting for courts to rule on the FTC's legal challenges."
Nashville, Tennessee-based HCA Healthcare owns and operates more than 180 hospitals across 21 states and the United Kingdom. The for-profit organization's Mountain Division, called MountainStar Healthcare, currently operates eight hospitals in the region: Brigham City Community Hospital, Cache Valley Hospital, Lakeview Hospital, Lone Peak Hospital, Mountain View Hospital, Ogden Regional Medical Center, St. Mark's Hospital, and Timpanogos Regional Hospital.
In September 2021, HCA Healthcare and Dallas, Texas-based Steward signed a definitive agreement for HCA Healthcare to acquire the operations of all five Steward's hospitals in Utah. The transaction would have included the purchase of the private health system's Davis Hospital, Jordan Valley Medical Center, Jordan Valley Medical Center-West Valley Campus, Mountain Point Medical Center, and Salt Lake Regional Medical Center.
"This transaction, like the RWJBarnabas Health/Saint Peter's transaction that was abandoned two days ago, should never have been proposed in the first place," Vedova said. "This should be a lesson learned to hospital systems all over the country and their counsel: the FTC will not hesitate to take action in enforcing the antitrust laws to protect healthcare consumers who are faced with unlawful hospital consolidation,"
HealthLeaders reached out to HCA Healthcare and Steward with no response.
Michael Backus, who currently serves as the system COO, will succeed Michael Harlovic as CEO in 2023.
Oswego, New York-based Oswego Health recently announced that the nonprofit health system's president and CEO, Michael A. Harlovic, will retire at the end of the year.
Harlovic has a healthcare career that spans almost four decades and joined the system in July 2017 where he has since led the system's strategic, executive, and operation guidance and has championed healthcare accessibility.
Michael Backus, who currently serves as executive vice president and COO of the system, will become president and CEO on January 1, 2023, after having worked closely with Halrovic over the past two years as part of the organization's succession plan to prepare for the leadership transition.
In a statement shared with HealthLeaders, an Oswego Health spokesperson shared, "Together they have navigated the challenging healthcare environment throughout the pandemic, and both remain committed to the mission of the organization, which is to provide accessible, quality care and improve the health of residents in the local community."
In an email interview with HealthLeaders, Harlovic and Backus shared their thoughts on the upcoming leadership transition.
"Working in healthcare for nearly forty years, I can honestly say that this leadership team at Oswego Health has been one of the best to be a part of," Harlovic said. "Persevering throughout a global pandemic in such unchartered territory and collaborating at all levels were pivotal to our success. Mike [Backus] was right there with me throughout all of this, and I’m confident in his leadership that he will further strengthen and position the organization to meet the needs of our community."
Backus shared that he is honored to succeed Harlovic, who has served as his mentor for the past two years.
"This hospital and health system is a cornerstone of our community and incredibly important to everyone, and it is the honor of my professional life to succeed Michael Harlovic as president and CEO of Oswego Health, as he has been a mentor these past two years," he said. "I am blessed to have a tremendous leadership team already in place that we will continue to grow as we expand our services. I am tremendously thankful for not only our Board of Directors for placing their trust in me to lead the system, but also to our employees for their support over the last two years as I joined the system. Together, we’re all going to care for our community and ensure Oswego Health’s best days are ahead."
Backus has served on the Oswego Health board of directors since 2016 and joined the system as COO in September 2020. Prior to joining the organization, he served in elected office as clerk of Oswego County, where he led the legislative committee for the New York State Association of County Clerks. Previously, he served on the legislative staff of state and federal officials, including former U.S. Representative John McHugh.
Backus' background in government is valuable in his current and future roles, especially since the Oswego community is heavily reliant on Medicare and Medicaid as a payer source.
"Advocating for further investment in healthcare at the state and federal level is where we are right now as the challenges healthcare nationally face are directly tied to escalating costs and reduction in reimbursement rates. We as a country have to level set the cost of care, which has exploded during the pandemic, with payment mechanisms that are very flat and stagnant," Backus said. "Thankfully with good relationships at the state and national level, Oswego Health is positioned to provide care in rural, underserved areas — my job is to ensure we are not lost in the shuffle on Capitol Hill. Ensuring that voice is heard is a daily responsibility and one that I plan to expand upon as president and CEO of Oswego Health."
He added, "When I officially become president and CEO in January, I will already be directing the mission and vision of Oswego Health, and so building on that by expanding services in Fulton, Oswego, and other parts of our community will help bring that care even closer to our patients. I want to improve the overall health and well-being of our community and we’ll do that by recruiting the next generation of caregivers that will build upon our 141-year foundation of care in this community."
The transaction received opposition from the FTC, which sued to block the New Jersey health system merger earlier this month.
New Jersey health systems, RWJBarnabas Health and Saint Peter's Healthcare System, have called off their merger plans, the organizations announced Tuesday.
According to separate statements, the systems mutually agreed to end their transaction due to the Federal Trade Commission's (FTC) move to block the merger earlier in June due to alleged anticompetitive behavior.
Barry H. Ostrowsky, CEO of RWJBarnabas and Leslie D. Hirsch, FACHE, president and CEO of Saint Peter's shared their disappointment in calling off the transaction, both of which said was a difficult decision to make.
"We are disappointed in the termination of the proposed transaction, which we believe would have transformed quality, increased access and decreased the overall cost of care for the people of this State through the creation of a premier academic medical center," Ostrowsky said. "Despite the loss of this opportunity, RWJBarnabas Health remains resolute in its commitment to serve the people of New Jersey – especially those who reside in our most vulnerable, chronically underserved communities – and shall continue to do so."
"We are very disappointed with this outcome. However, we are grateful for the strong partnership we've had with the RWJBarnabas leadership," Hirsch said. "We were truly excited about the potential of this opportunity with RWJBarnabas to create a premier academic medical center of national distinction that would have improved quality and increased access especially to the most vulnerable in the communities we serve. We are now assessing the best way to move forward as we consider potential options to ensure Saint Peter’s longstanding Catholic healthcare mission."
According to the complaint filed by the FTC at the beginning of June, the transaction would have harmed the competition for inpatient general acute care services in Middlesex County, New Jersey, and would give the combined health system a market share of approximately 50% for general acute care services in Middlesex County. According to eh FTC, this would result in antitrust violations by eliminating competition between the two health systems, increasing concentration, and leaving insurers with fewer and less attractive alternatives.
"I am glad that rival hospital systems RWJ and Saint Peter's have terminated an anticompetitive merger that would have harmed patients in Middlesex County, New Jersey … the transaction was presumptively unlawful and would have resulted in higher prices and lower quality of care for New Jersey residents," FTC Bureau of Competition director, Holly Vedova, said in a statement.
"I am proud to say that this is the third time the Commission has filed a complaint to block an anticompetitive hospital merger so far in 2022," Vedova said. "This enforcement action is a reminder that the FTC remains vigilant in enforcing the antitrust laws and will continue to protect healthcare consumers who are faced with unlawful hospital consolidation."
Hoag chief digital officer, Kathy Azeez-Narain, shares how the health system developed an app to strengthen the relationship with its consumers and keep them connected to their health.
Today's healthcare consumer is more tech-savvy and connected than ever before. They want to be involved in how their care is delivered. They want more than a simple transactional relationship with their primary care physician. They want options and they want to be in the know.
To keep up with their patients, health systems are developing new strategies that focus on the connected consumer. This includes developing patient portals and digital health apps that connects patient to provider at any time and place.
Kathy Azeez-Narain, who serves as vice president and chief digital officer for Hoag, a regional health system in Orange County, California, helped develop Hoag Compass as part of their consumer-centric strategy. The application and services provided help connect their patients to their health and strengthen the relationship between patients and physicians.
Azeez-Narain recently spoke with HealthLeaders about the app's success so far, and offered her thoughts on consumer-focused technology being integrated in healthcare.
This transcript has been edited for clarity and brevity.
HealthLeaders: What are your thoughts on healthcare organizations using technology to be more consumer-focused?
Kathy Azeez-Narain: It's obviously a necessary thing right now. As you think about where healthcare is, the demand from the consumer market and patients' expectations on what the experience needs to be like for them within healthcare is high on the list.
Healthcare has been on that journey for a little bit now. COVID probably accelerated that as well, where the consumer market is now in a more of a demanding state: I want things that are more accessible and convenient. I want to be able to reach doctors in different mediums, not just in the traditional office setting. Technology has a critical role in enabling a consumer-centric strategy; it's necessary as we think about what's ahead. But beyond that, it's become almost table stakes for us to be able to compete in today's market.
HL:What trends are you seeing in the digital space for consumers?
Azeez-Narain: AI is playing a critical role these days in how we use our data, and how personalized we can be in our outreach and in our products that consumers are going to interact with.
Virtual primary care models and virtual pharmacy models, those are high on the list, and there's demand from consumers. A big one that's come up recently is in the behavioral health space and mental health, and supporting that entire community getting virtualized. COVID shed a light on tools like Talkspace, Headspace, etc, that people can tap into, and now more and more you're hearing about companies that are heading in that direction.
So, quite a few trends from the AI world to the different care models, and [we are] virtualizing them to net new niches that are leveraging digital technology to reach patients about episodic and or pre-episodic care that they might be looking for.
HL:Why did Hoag create Compass and what pain points do you hope to address with it?
Azeez-Narain: I joined Hoag in 2020 right in the heat of the pandemic, and this was a newly created role in the organization that I came in and took on. The intent of it was to address what problems are there for our customer base where digital solutions could be built to help solve.
Overarching, the strategy has been around what are the true problems we see in the Orange County market from patients that exist today and/or new community members and customers. What do they want? How does digital help support that?
Step A was doing a body of research to listen and understand what are the needs out there. What are people asking for? What problems are they still dealing with within healthcare? Through that body of research, we came up with findings that people still want us to focus on and/or solve for them.
A couple that I can think of off the top of my head [are centered around how the patient/doctor relationship has changed:
Patients don't want to just see their doctor once a year in one facility; they want to be able to communicate and have a dialogue with and reach them in between visits.
Patients want the opportunity to book an appointment or to see their medical record.
Patients don't want a transactional relationship with their physician.
Compass was born out of those ideas and feedback that we got from the community in the consumer market space. What we drill down into is there's this need from the market for Hoag to step into a relationship with patients pre-anything going wrong.
Compass embodies three pillars:
The first pillar embodies the accessibility area, which I would say is your logistical tasks that you might want to do, including meeting the doctor virtually, setting up appointments, looking at health records, and filling prescriptions.
The second pillar is the relationship with that physician and being able to build a relationship beyond just the moments of the visit, including messaging between visits.
The third pillar is continued access right into our world class care model and a larger care team. With Compass Plus, you get a care coordinator who gets to know you one-on-one and helps you at all the logistical things you're trying to take care of as it relates to your healthcare. You also get access to three health coaches and a registered dietician, exercise, and mindfulness coach.
We have patients on the app already that are coming to the Newport Beach Hoag On-Demand Care and Innovation Center that opened as part of the Compass offering. We have people already signed up on Plus that are talking to the coaches. Their feedback has been positive, and we've heard they feel connected to this larger care team and the accessibility of getting all of those things through the device, as well as feedback around experience.
We're trying to also ensure that as we add features, and as we think about what we're hearing and learning, that the user experience remains best-in-class and we continue to focus on that as a pillar.
HL: How do the different versions of the app work?
Azeez-Narain: There are two parts.
1. "Base model"
You can form a relationship with one of our primary care physicians here and you can download the app to be able to do all the accessibility pillar things that we talked about. [You can] book your appointment, you'll see your visit summary, [ and] you'll be able to see what kind of next steps you need to take.
You can come to the physical location, you can still see your doctor, and still have that relationship with your doctor. Your access is still there and you still have a deep relation that you can build with your physician.
2. Plus membership
When you move over to Plus membership, we're really going beyond a physician relationship. When you go into Plus, that is where you're going to get access to the health coaches and your care coordinator, who's helping all the logistical parts, and they're guiding you along the way as well to ensure you're getting the care you expect and the quality of care that you were expecting. You get your access to the three health coaches, you also get specialists connection from a Hoag-accredited specialist if you do have to go down that path. And you get your care plan, which is that additive component to get you going on a deeper level of insight about steps we are recommending you to take as you're trying to attain those goals. Part of the Plus model is you get access to the Premier Lounge, which is basically a space that you can come in and meet with the coaches.
I would think of Plus as we're really activating this additional suite of things on the whole care concept of health, whereas your base model is still there to support you through your relationship with a physician and trying to get normal level of care completed and done.
HL: What metrics will you use to track patient satisfaction and outcomes?
Azeez-Narain: From a metrics perspective, there are app downloads, usage, how often you're logging in, etc. But, there's a bigger angle that we're looking at. We want to help patients get to the goals they've set for themselves, the health outcomes they've set for themselves, and we want to make sure that what we're building here and what we're providing to the community is actually bringing value to them.
What will take us some time, because we need people in the model for a little bit more before we can pull some of that out, is going to be, did we see the population using these features getting more health benefits out of it? Are they achieving the goals that they were trying to achieve because of this model? It comes down to: did we bring a new model of care into the market that is helping the lives within our community?
Genemarie McGee, RN, BSN, MS, shares how she's helping to address nursing burnout and inspire resiliency at Sentara Healthcare and offers advice for future leaders.
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.
Sentara Healthcare is a nonprofit health system with more than 3,700 beds across 12 hospitals in Virginia and North Carolina. The organization employs more than 8,000 nurses among its hospitals, clinics, home health and hospice services, assisted living facilities, as well as the system's health plan, Optima Health, which has more than 850,000 members.
Genemarie McGee, RN, BSN, MS, a registered nurse who serves as corporate vice president and chief nursing officer, oversees those nurses, along with the coordination of nursing care across the health system.
McGee was "bitten by the leadership bug" early in her career, and has held numerous leadership positions for Sentara, including vice president and nurse executive for Sentara Leigh Hospital, and director of Sentara Norfolk General's emergency department and Level I trauma center, Nightingale Regional Air Ambulance, and the ambulatory care clinics.
During the most recent HealthLeaders Podcast episode, McGee shared insights into her leadership background, discussed how she's helping address nursing burnout and inspire resiliency at Sentara, and offered advice for future leaders.
This transcript has been edited for clarity and brevity.
HealthLeaders: In your role as system chief nursing officer, how are you addressing burnout at the health system?
Genemarie McGee: We have been focusing on making sure that we are staffing as well as we can, which has been difficult over the past two years. We've tried to make sure our employees have the mental health resources they need online so that they can access them when they need them.
Here at Sentara, for about the past 12 years, we have had a strong nursing shared governance structure, and that shared governance structure serves to lift the voice of the bedside nurse. It also helps us to pay attention to what's important to our nursing staff. For me, that's part of ensuring that we're trying to stay in touch as much as possible and understand what they're doing. We're also encouraging our managers to be flexible on scheduling and getting people time off when they can.
The other piece is we have intentionally, each year, done what we call our staff engagement survey. Even during COVID, we went ahead and did that to get feedback from our staff. In November 2021, we had about 5,000 of our nurses across our system lean in and take that engagement survey.
There were some things going on with burnout across the U.S. before COVID, so a lot of our focus has also been on helping the staff to build resiliency. Resiliency seems to be kind of an overworked term, but I think that's important that they take what they've learned about themselves, about their profession, about our organization, throughout this pandemic, and learn from it. How do you take the good parts of what you learned? How do you make sure any habits that you may have been doing or participating in before that wasn't helpful and not carry that on?
[Recently I spoke] at a virtual research symposium, and encouraged the staff that were attending to look at resiliency professionally, but also personally. Do you have compassion for yourself? Are you kind to yourself? Are there some things you might need to adjust in your personal life? We've been through a rough two years, we've got a fatigued workforce, so it's giving them a message of hope, and moving forward, but also recognizing we've been through a tough time, and ensuring that people have the resources whenever and whatever they need.
HL: As you mentioned, burnout has been an ongoing issue. What other ways did you address burnout prior to the pandemic?
McGee: Before the pandemic, we had certain populations of nursing that it was a bit more difficult to hire for. As a system we started to focus in and figure out what could we do to ensure that we had appropriate staffing in those areas. It's also the reason we started, about seven or eight years ago, our own internal pool so that we had staff that were available, and actually knew what Sentara was expecting in quality, safety, and professionalism. If we had someone who was going to be out long-term, we could pull one of our "swap nurses" to assist at that facility.
The other piece is we have managing for daily improvement boards. Those are boards on every nursing unit that share some of our patient-sensitive measures and some other quality safety metrics. We also document if we have more staff members starting. That is how we keep that two-way communication going.
We also encourage and require that all of our leaders round throughout our facilities; our nurse leaders are rounding on their units, our administrators are rounding, engaging the staff, and checking up on the staff. That's part of our being a highly reliable organization. We found that that structure through COVID helped us to manage what we were seeing and what was happening.
A couple of things we look to make sure we are communicating: That the communication is two -way and that employees feel comfortable giving us feedback. That helps quite a bit around resiliency and engagement, which are the opposite of what we would call burnout.
HL: What other initiatives have you been leading for the health system?
McGee: I am the executive sponsor for customer experience across our health system, and that's something that's near and dear to my heart. It's important that we try and ensure that our patients and our families have a good experience. I always say that we are taking care of people at some of the most vulnerable times of their life; they may have been given some bad news, or they may have had an acute event occur. I even point out that having a baby, which is a very joyous event, is also a very stressful and vulnerable time for our patients in our family.
I work with our clinical effectiveness team to ensure we take the time to focus in on our quality results, but more importantly, on making sure that we are safe, that we follow our safety habits, and that we're highly reliable.
I also have responsibility for hospital case management. So, I am looking at transitioning patients and assisting their families as they're bringing them home or maybe placing them in another form of care.
I still sit on the COVID-19 team steering committee. We are still meeting two years later and will continue to meet.
I sit on the board for our local EMS system. We also have a degree-granting BSN college within our health system and I sit on that board, and then I also sit on the board for the Virginia Organization of Nurse Executives and Leaders. Some initiatives are internal and external, but all weave together.
HL: How would you describe your leadership style and how does your background as a nurse impact it?
McGee: I would hope that I have a transformational, coaching leadership style. I believe strongly that you can be an excellent leader and be compassionate and kind at the same time, but still hold people accountable for results. I do try and be as authentic as possible; what you see is what you get. I try not to be a person that surprises anyone.
And I like to empower nursing, but also recognize and encourage nursing to be a great partner to our health system. We are part of the health system and we need to partner with our health system and their strategic plan. I encourage us to be collaborative players in our system.
HL: What advice do you have for nurses in the workforce who may want to make the jump into leadership positions or into the C suite?
McGee: I would encourage anyone that has the drive and wants to be a nurse leader to sit down and talk to their current nurse leader. Talk to them about their role, what they like, what they don't like. I would also encourage anyone to shadow another nurse leader, something I offer to my own nurses. It's important that you see what a day in the life is, because there's many perceptions of what you may see about your nurse leader, but there are many things that they may do that you don't see.
I also encourage them to be a lifelong learner and to go back to school if you need to, to get your BSN or your master's. I also encourage that if you're going to go that doctoral route that you really think through and figure out why you might want to do that, and what you need to do.
I would also encourage people to interview other leaders to figure out what is your passion and what is your niche, and where do you want to be two years or five years from where you are currently.
The acquisition would give the combined health system a market share of approximately 50% for general acute care services in Middlesex County, according to the FTC.
Continuing a major crackdown on anticompetitive transactions in the healthcare sector, the Federal Trade Commission (FTC) has taken preliminary steps to block the merger between nonprofit health systems RWJBarnabas Health and Saint Peter's Healthcare System.
According to the complaint, the transaction will "harm competition for inpatient general acute care services" in Middlesex County, New Jersey. The acquisition, according to the FTC, would give the combined health system a market share of approximately 50% for general acute care services in Middlesex County, resulting in antitrust violations, by eliminating competition between the two health systems, increasing concentration, and leaving insurers with fewer and less attractive alternatives.
"Saint Peter's University Hospital is less than one mile away from RWJ in New Brunswick, and they are the only two hospitals in that city," FTC Bureau of Competition Director, Holly Vedova, said in a statement. "There is overwhelming evidence that this acquisition would be bad for patients, because the parties would no longer have to compete to provide the lowest prices and the best quality and service."
Barry H. Ostrowsky, CEO of RWJBarnabas Health, and Leslie D. Hirsch, president and CEO of Saint Peter's released a joint statement Friday morning sharing their disappointment in the FTC's decision to block the systems' vision to create "New Jersey's first premier academic medical center."
"Today, we were notified that the Federal Trade Commission ("FTC") is going to file an administrative complaint and has authorized a suit in federal court to block our proposed transaction that would have enabled us to build the first premier academic medical center in New Jersey to increase services and provide better access to such care for New Jersey residents," the statement said.
"We are incredibly disappointed by these FTC actions against our proposed transaction, which has received full approval from New Jersey’s Attorney General and is supported by grassroots community groups, employer groups, unions, managed care organizations and elected officials at all levels within the State of New Jersey. We are most disappointed, however, for the people of New Jersey – especially those who reside in our most vulnerable, chronically underserved communities – who will be denied access to the complex care only provided by premier academic medical centers.
"We shall be reviewing the FTC’s complaint, which the State of New Jersey did not join, over the coming days and determine how to best move forward."
Last month, the health systems' shared that their merger plan was approved by the State of New Jersey, a "tremendous milestone in a years-long journey towards fulfilling our shared vision to bring transformative care to New Jersey," Ostrowsky said.
According to a press release, On April 26, in authorizing the transaction under New Jersey's Community Healthcare Assets Protection Act ("CHAPA"), Superior Court Judge Lisa Vignuolo said, "the applicant has met the requirements necessary…[and the transaction between RWJBH and Saint Peter's] will serve in the public interest and the public good resulting in the creation, the hopeful creation and anticipated creation, of the premier New Jersey academic medical center which would benefit the citizens of this state."
The merger has received ongoing support from state officials and payers, including: U.S. Rep. Frank Pallone, Jr. (NJ-06), New Jersey Senate President Nicholas Scutari, New Jersey Assembly Speaker Craig Coughlin, Middlesex County Commission Chair Ronald Rios, New Brunswick Mayor James Cahill, the New Jersey Legislative Latino Caucus, New Jersey Legislative Black Caucus, African American Chamber of Commerce of New Jersey, New Jersey Business & Industry Association, Horizon Blue Cross Blue Shield, and Aetna Better Health.