Creating a healthcare system built to withstand a crisis

At deadline, it was announced that Tom Jackiewicz, CEO of Keck Medicine of USC, was leaving the organization to become president of the University of Chicago Medical Center and chief operating officer its parent health system. Prior to that transition, which will happen in late August, Jackiewicz said his boldest move helped put USC in a position to better engage patients.

What was your riskiest decision? After 20 years of working at academic medical centers across the country, I left my position as CEO of UC San Diego Health to become CEO of Keck Medicine of USC, an academic health system startup. In 2009, Keck Medicine was created when USC regained control of its hospitals and wanted to become a leader in academic medicine. This was a once-in-a lifetime opportunity to build a health system that would have a lasting impact on how healthcare is delivered in the second-largest city in the country.

Why was that move risky? The odds of building a successful academic health system from scratch were not always in our favor. The legacy of for-profit ownership meant that our culture was very individualistic. Everyone was used to fending for themselves instead of working together. Quality and patient-satisfaction scores were lagging, and staff morale was low. The list of what needed to be accomplished was huge.

What was the outcome? Last summer we made the U.S. News & World Report list of top 20 hospitals in the country for the first time. We accomplished that with the highest case-mix index in the country and in the L.A. healthcare market, which is one of the most competitive in the U.S. What went on behind the scenes during the last 10 years to accomplish that needs to be acknowledged. We doubled the total number of USC doctors, and quadrupled the number of employees to over 7,000. Inpatient visits have tripled, and we now provide outpatient care at more than 40 clinics throughout Southern California. We also achieved Magnet recognition, and patient experience is ranked above the 90th percentile.

Response from those involved: We’ve been able to attract and retain people who are all-in on becoming the best academic health system in the country. You will hear them talk about wanting to be a part of building something special, and taking advantage of opportunities to be entrepreneurs and pathbreakers. The COVID-19 crisis has demonstrated how all that we’ve built is working as it should. Our clinical teams are focusing relentlessly on patients and taking caring of each other. I’m enormously proud of them.

Advice to executives in similar positions: Executives need to ensure their strengths match what the organization needs. My work at Keck Medicine has been an opportunity to take everything I’ve learned in my career about leadership, implementing change, and engaging with physicians and put it into action. But leading transformational change is not for everyone. There were days when I sat at my desk and wondered if we had the stamina to keep moving ahead.

Describe your leadership style: I’m painfully optimistic. I’m also very goal-oriented, so I see my role as constantly driving momentum toward achieving our goals. I’m a student of leadership and history. One key lesson I’ve learned is to never fight battles of attrition. If people are recalcitrant about change, I tell my team to leave them be and work with the willing. We can move mountains without having everybody on board. Once people start to see positive changes, the resistance usually melts away. I also believe you should never start with just one initiative because people will pick sides. If you have two or three initiatives, people tend to focus on the positives of all of the initiatives rather than the potential for disruptive change.

How would others describe your style? My team will tell you that I like them to think big, be creative, move swiftly and never be satisfied. When that is set in a trusting environment, great things will happen.