Culture, costs, quality

Modern Healthcare recently held its fifth Top 25 Women in Healthcare gala. At the event, we had the rare opportunity to interview a number of the honorees, getting some of the industry's most important voices to weigh in on some of the most crucial healthcare issues of the day. What follows are excerpts from some of those interviews. View all of the honoree interviews.

Modern Healthcare: How is the Mayo Clinic working to push the envelope on the quality front?

Weis: Quality has to be the first and foremost part of our attention for every healthcare organization. For Mayo, we're like everyone else in terms of always trying to be better. We are at the top by most standards but continuing to always do better. We have put in place a Quality Academy, and so over three-quarters of our employees now have been through the Quality Academy, which helps us to learn how to make process improvements, understanding how to communicate better because we understand that most mistakes in healthcare are related to communications. So taking away those barriers between hand-offs, making sure that we are very much open to bringing forward issues is part of the success that we have really enjoyed. Anytime there's any mistake, anytime there's anyone who's harmed, then we feel that we have not been successful. And I think a goal for all of us is really approaching zero, getting to the point where there's no safety issues and that everyone has the best care possible.

MH: You represent some of the biggest corporations in America and their ongoing concerns about the high cost of healthcare. How has your focus on cost shifted in recent years and why?

Darling: Well, I'm not sure it's shifted much. In fact, it has been a major concern, at least since I joined the organization in 2001, which was right after 9/11. The economy was actually really in the worst possible shape. We've kind of forgotten that. There was a time when everything was in real trouble. So cost started out at that point as being No. 1. We weren't sure when we'd recover from the financial problems then, so our members were deeply concerned because they had no customers coming through the door; they didn't have patients, in some instances, if they were hospitals. So it was a really tough time. But, as the economy recovered and then basically went into the great recession with the financial meltdown, we have seen companies again feel that it's an unsustainable situation, that the percentage of the economy and the amount of money they have to spend compared to their increased revenues on healthcare has become worse and worse. So, it's more a question of proportionality, not a change in focus.

MH: You have one of the most difficult challenges in healthcare today—rolling out the exchanges that are going to open Oct. 1 for open enrollment. What are the biggest challenges you face right now on that front?

Tavenner: I would say right now the challenges are two-fold. We are on a tight implementation schedule, but it's going well, so we have to complete the implementation schedule to turn on the switch, if you will, on Oct. 1. The second challenge, and it will be an ongoing challenge, is educating the public about who the exchanges actually apply to and the importance of health insurance and the assistance that's available to them through the exchanges or through Medicaid expansion. So we have a lot of education ahead.

MH: As you look across the healthcare leadership of the United States today, evaluate the role of women in top positions. Where are they now? Is that where it ought to be, or is there still room for improvement?

Bowen: Well, you probably know, only about 26% of hospitals have female CEOs, so certainly we have much work to do. We're actually soon releasing our gender study, which we did the last year, and I think women are obviously making good strides, but I think women have more work to do in terms of rising in the ranks and being recognized for their leadership capabilities. I think women seem to have more of a transformational sort of leadership style, really following on collaboration skills, having followers, empowering followers, the people that they lead, and I think that style resonates well with where we are in healthcare today. So certainly there's more work to do, but nearly half of our members now are women. That certainly wasn't the case 20 years ago.

MH: In your current job, you're knitting together two systems and there must be a lot of egos involved. How are you addressing that?

Persichilli: Well, that's a cultural challenge. I think that one of the things we have to realize is that bringing groups together is a huge transformation, a change management process, and at the end of the day culture matters. The strategy may be spot on, but if you can't merge the cultures, if you don't really study what's important to each group, you will fail. And egos will get in the way, so we have to keep reminding ourselves, why did we do this? To build a stronger foundation, to be able to continue our ministries into the future is why we did it; to sustain what we do now and broaden it and enhance it is why we're doing this. And as leaders, you need to keep reminding yourselves of that and things will fall in place. But culture matters, and this consolidation could fail on the lack of attention to culture.

MH: Does being a woman leader in healthcare today bring any special strengths to this kind of transformation that the healthcare sector is trying to negotiate right now?

DeVore: I think all diversity is an asset, and if it's a different way of thinking, a different way of looking, a different way of solving a problem. The more you can bring all of that together and you can agree and disagree and try things, I think all that works. And so, maybe women are more open to all that collaboration and the messiness of trying to figure things out in a collaborative partnering way. But I actually value the differences and opinions everywhere I go, and to me it doesn't matter where they come from or who they come from.

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