Latest / Becker’s Healthcare Podcast / Leadership Lessons on People, Healthcare Transformation and the Power of Listening: Part 2

Transcript

Leadership Lessons on People, Healthcare Transformation and the Power of Listening: Part 2 · Becker’s Healthcare Podcast

• 0:00
  - Thank you for tuning in to the Becker's
• 0:01
  - Healthcare podcast.
• 0:02
  - This is part two of our leadership unscripted
• 0:05
  - conversation with Mark Clement, the recently retired president
• 0:08
  - and CEO of TriHealth in Cincinnati.
• 0:10
  - Here, he discusses the bets he has made
• 0:12
  - in health care that had paid off, what
• 0:14
  - it will take to restore trust in the
• 0:15
  - health care industry,
• 0:17
  - and what he considers to be the most
• 0:18
  - underrated leadership traits.
• 0:21
  - We hope you enjoy this episode as well
• 0:22
  - as part one and find more podcasts at
• 0:25
  - beckershospitalreview.com.
• 0:27
  - Mark, switching gears a little bit here. So
• 0:30
  - when you become president or CEO of health
• 0:33
  - system, no doubt you have to take risks
• 0:35
  - as well. Right? So what is one risk
• 0:38
  - that you took that has really paid off?
• 0:41
  - Well, you know, the one risk... I've I've
• 0:43
  - I've been a CEO since 1992
• 0:47
  - in 04/04 different organizations,
• 0:50
  - in starting at Holy Cross Hospital in in
• 0:53
  - Chicago on on the South Side Of Chicago
• 0:55
  - and then MetroWest
• 0:57
  - Medical Center, you know,
• 1:00
  - a a a a community hospital,
• 1:01
  - network... Multiple hospital network in the,
• 1:04
  - MetroWest area of Boston, the Western Suburbs, and
• 1:07
  - then Rochester Regional, before returning to Cincinnati and
• 1:10
  - then most recently TriHealth.
• 1:12
  - In every one of those organizations,
• 1:15
  - I bet on people. And the investments
• 1:18
  - that we made,
• 1:19
  - were in in in our people and,
• 1:23
  - in building
• 1:24
  - a great culture.
• 1:25
  - And those risks, you know,
• 1:28
  - if you wanna characterize it as a risk,
• 1:29
  - they have never let me down. They've always
• 1:31
  - paid off. You invest in people and you
• 1:34
  - do the right thing, and your people will
• 1:36
  - will engage and and do their part in,
• 1:39
  - you know, bringing the organization's
• 1:41
  - mission to life, elevating quality and safety, delivering
• 1:44
  - better care.
• 1:46
  - TriHealth,
• 1:47
  - you know, over the past eleven years is
• 1:49
  - also... You know, we started with with investing
• 1:52
  - in our our people, building a great culture.
• 1:55
  - Today,
• 1:56
  - team member engagement
• 1:57
  - is
• 1:58
  - at the ninety seventh or ninety eighth percent
• 2:00
  - when we percentile when we compare it with,
• 2:03
  - you know, the industry.
• 2:06
  - That our culture of safety,
• 2:08
  - survey, which we do on a on a
• 2:10
  - annual basis, our team members expressed that that
• 2:14
  - TriHealth is,
• 2:15
  - committed to delivering,
• 2:17
  - high reliability and safety put... Putting... You know,
• 2:20
  - when we compare
• 2:22
  - favorability with that that survey with the industry,
• 2:24
  - it's at the ninety ninth percentile. And it's
• 2:27
  - because we've bet on people. We've begun with
• 2:29
  - purpose.
• 2:30
  - We connect the dots. We engage our people.
• 2:33
  - And those... That that... Consistently throughout my career,
• 2:36
  - that's that's the bet that I've I've made
• 2:38
  - and the risk that I've taken.
• 2:40
  - And then, at at TriHealth and even before,
• 2:43
  - and and my work in Rochester,
• 2:45
  - we've recognized
• 2:47
  - that, you know, the traditional,
• 2:49
  - episodic
• 2:50
  - and fee for service, you know, models of
• 2:53
  - delivering care and financing that care are good,
• 2:56
  - but they're insufficient,
• 2:58
  - to to really deliver on the triple aim
• 3:00
  - of better care, better health, better value. So
• 3:03
  - the second major,
• 3:04
  - bet that we've made at TriHealth, which has
• 3:07
  - paid off,
• 3:08
  - is to,
• 3:10
  - recognize
• 3:11
  - that that we need to transform health care
• 3:13
  - for the better, become a more proactive...
• 3:16
  - Build more proactive
• 3:18
  - delivery systems that are focused on,
• 3:20
  - you know, better management of chronic conditions,
• 3:23
  - early detection, delivering care in the most appropriate
• 3:26
  - setting
• 3:27
  - across the health care continuum, which is increasingly
• 3:30
  - in the ambulatory setting and the net effect
• 3:33
  - of of of, again, that risk.
• 3:36
  - And and it took some courage for our
• 3:37
  - board to get behind this, you know, twelve
• 3:40
  - years ago,
• 3:41
  - eleven years ago with our physician leaders as
• 3:43
  - well. But they did rather than, you know,
• 3:46
  - doubling down on a broken fee for service
• 3:48
  - system.
• 3:49
  - They... We embraced what we refer to as
• 3:52
  - a a journey to get health care right
• 3:53
  - and adopting innovative
• 3:55
  - care and financing models. So today,
• 3:58
  - peanut trial patients are objectively healthier if you
• 4:01
  - define health as better management of chronic condition,
• 4:04
  - better early detection,
• 4:06
  - delivering care in the most cost effective setting.
• 4:10
  - Patients are today at, you know, try health
• 4:13
  - objectively healthier and care is more affordable. So
• 4:16
  - those are those are two two big bets
• 4:18
  - that we've made, and they've always been grounded
• 4:19
  - in in the mission of the organization. How
• 4:21
  - do we ultimately improve the health of the
• 4:23
  - community that we serve?
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  - Thank you for sharing that, Mark. I mean,
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  - you love all the details in there, including
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  - the the measurements that you've, used... You and
• 4:32
  - the organization have used to say, hey. Here's
• 4:34
  - how we're getting better all the time. It
• 4:36
  - sounds like a a path we're following, definitely.
• 4:40
  - Mark,
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  - next thing I wanna talk about with you
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  - is you mentioned a number of the challenges
• 4:46
  - that health care is facing, and and they
• 4:49
  - are
• 4:50
  - numerous. Right?
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  - But I also wanna zero in on one
• 4:56
  - one aspect rather that deserves a brighter spotlight,
• 4:59
  - and who do you think should be shining
• 5:01
  - that spotlight?
• 5:03
  - Well, you know, we we... Thanks, Chris. So,
• 5:05
  - you know, we talked a little bit about
• 5:06
  - some of the the real time challenges that
• 5:08
  - that health health care organizations are facing, you
• 5:11
  - know, from Medicaid cuts to elimination of the,
• 5:15
  - exchange,
• 5:16
  - enhanced subsidies,
• 5:18
  - to, you know, to other other changes that
• 5:20
  - are being contemplated, all economic challenges. And those
• 5:22
  - are important challenges that, you know, our industry
• 5:25
  - will face and and over come. I... You
• 5:27
  - know, the the the one that I think
• 5:29
  - requires,
• 5:31
  - or that deserves more attention is what I
• 5:33
  - touched on a moment ago, and and that
• 5:35
  - is
• 5:37
  - that,
• 5:38
  - there there there are better ways to to
• 5:40
  - deliver health care today, you know, given advances
• 5:44
  - in, information
• 5:46
  - technology,
• 5:47
  - new new more proactive care models. You know,
• 5:51
  - thirty years ago in in the nineties, there
• 5:53
  - was a movement to to capitated payment.
• 5:57
  - Unfortunately,
• 5:59
  - in risk based contracting, unfortunately,
• 6:01
  - we didn't have the insight around the health
• 6:04
  - of of a population of patients to really
• 6:07
  - manage the the health of a population
• 6:09
  - successfully. And so we created gatekeepers
• 6:12
  - primary care physicians
• 6:14
  - whose job was was more about, you know,
• 6:16
  - preventing access to care in many cases than
• 6:19
  - it was
• 6:20
  - managing the care that a patient required.
• 6:23
  - Well, fast forward thirty years, you know, we've
• 6:25
  - got very robust,
• 6:27
  - information technology
• 6:29
  - capabilities.
• 6:30
  - Most health systems
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  - have EHRs,
• 6:33
  - and we we now have with the right
• 6:35
  - investments
• 6:36
  - in the technologies
• 6:37
  - that that can aggregate claims and clinical data
• 6:41
  - and provide insights around gaps in care, around
• 6:44
  - the the level of of of management of
• 6:46
  - of chronic conditions
• 6:49
  - around,
• 6:50
  - early detection. We now have the insights and
• 6:52
  - the tools
• 6:53
  - to to shift from reactive health care delivery
• 6:56
  - to more proactive health care delivery. And and
• 6:58
  - I think,
• 7:00
  - actually, I gave a talk, a couple of
• 7:01
  - the talks on, at,
• 7:03
  - ACHE, American College of Health Care executives over
• 7:06
  - the past couple of years on this topic.
• 7:09
  - I'm I'm I'm authoring a book with my
• 7:12
  - friend, Quinn Studer, on
• 7:15
  - the, the moral imperative,
• 7:17
  - around,
• 7:19
  - you know, find... Finding a better way to
• 7:21
  - to fulfill our respective missions of improving the
• 7:24
  - health of our community.
• 7:25
  - You know, our missions are about improving health,
• 7:28
  - but our focus is is, as an industry
• 7:30
  - has been largely on reacting to illness.
• 7:33
  - And and, you know, reacting to illness is
• 7:35
  - important, but it's it's insufficient in improving health.
• 7:39
  - So I would say population health, value based
• 7:41
  - care, and and really evolving
• 7:44
  - operating models
• 7:46
  - and culture to put the sent... The patient
• 7:48
  - at the center
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  - of how we deliver care. We continue to
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  - be as an industry to provider
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  - centric, and it's one of the reasons why
• 7:57
  - today, based upon, you know, a JAMA article
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  - published
• 8:01
  - recently,
• 8:03
  - University of Michigan,
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  - consumer sentiment
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  - surveys, trust and confidence in in health care
• 8:09
  - institutions
• 8:10
  - is at a fifty year low. And
• 8:12
  - we need to be talking more about that
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  - and and doing more about turning that around.
• 8:18
  - Mark, thank you for shining that particular spotlight
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  - on population health and value based care and
• 8:24
  - the other issues that that you mentioned. And
• 8:26
  - no doubt it's gonna be...
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  - There's a lot to be discussed in the
• 8:30
  - near and and far the futures.
• 8:32
  - And, Marcus, it also seems like you... Even
• 8:34
  - though you've just recently retired from TriHealth, you
• 8:37
  - are... Have no shortage of things to do
• 8:39
  - between the book and and speeches and marathons
• 8:42
  - and,
• 8:43
  - you know, I I imagine you wouldn't have
• 8:45
  - it any other way, though. Right?
• 8:48
  - Well, you know, that was, that that was
• 8:50
  - kind of the plan. Yeah. So so,
• 8:53
  - yep, you know, I've I've had the opportunity,
• 8:55
  - to, you know, to speak nationally.
• 8:57
  - I spoke at the, American Hospital Association Leadership
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  - Summit in July.
• 9:03
  - I'm actually speaking at, at your upcoming Becker's
• 9:06
  - conference in Chicago. I think it's in I
• 9:09
  - think it's in November.
• 9:10
  - And we'll continue to do that to, you
• 9:12
  - know, to share, you know, some of the
• 9:14
  - important work that's been done at trial as
• 9:15
  - a... As an example of what can be
• 9:17
  - done. And,
• 9:19
  - you know, I'll brag a little bit about,
• 9:21
  - you know, the trial team. You know, Monagle
• 9:24
  - is a national brand,
• 9:26
  - consultancy.
• 9:28
  - They evaluate... Independently evaluate,
• 9:32
  - health care brand strength in 40 markets around
• 9:35
  - the country,
• 9:36
  - including Cincinnati, and they and they
• 9:39
  - interview roughly 30,000
• 9:41
  - health care consumers and then correlate that information
• 9:44
  - with HCAHPS,
• 9:45
  - patient experience data, which is publicly available because
• 9:48
  - we all, as as participants in the Medicare
• 9:50
  - program, have to report that to CMS,
• 9:53
  - and it's publicly available. And then... And and
• 9:55
  - Monagle then rates and ranks
• 9:58
  - rates and ranks,
• 10:01
  - health care organizations in those 40 markets,
• 10:04
  - around preference, around
• 10:07
  - trust and competence,
• 10:08
  - around experience access,
• 10:11
  - and outcomes. And, you know, TriHealth has emerged
• 10:14
  - as as the the most trusted health care
• 10:16
  - brand in in Cincinnati,
• 10:18
  - the the the most trusted health care brand
• 10:20
  - in Ohio,
• 10:22
  - and, among the top 10 most trusted health
• 10:25
  - care brands in the nation. So,
• 10:28
  - you know, we've we've, we've got a lot
• 10:30
  - to share, and and so we're out there,
• 10:32
  - you know, kind of trying to to share
• 10:34
  - and help other organizations to get better.
• 10:37
  - I was gonna say, I think it's wonderful
• 10:38
  - that that you... Now you're sharing it, but
• 10:40
  - you have some other people to help you
• 10:41
  - share that message because it can't be easy
• 10:43
  - to share it all by yourself.
• 10:46
  - Exactly. And I'll put a little plug in.
• 10:48
  - So Quinn Studer, my friend,
• 10:51
  - and, lifelong,
• 10:52
  - you know, colleague,
• 10:54
  - we worked together back in the nineties. He
• 10:56
  - and I are penning a book on on
• 10:58
  - on just that consumerism and value based care
• 11:00
  - and and how, how... And the moral imperative
• 11:03
  - that that we as health care,
• 11:05
  - leaders have to find a better way. So,
• 11:08
  - hope hope to have that out next year.
• 11:11
  - Good to know. Keep an eye out for
• 11:12
  - it. Mark, last question I wanna run by
• 11:15
  - you today is simply,
• 11:17
  - you mentioned how important it is to round,
• 11:20
  - with the the front lines and at all
• 11:21
  - your hospitals. Right? So what would you say
• 11:24
  - is an underrated leadership trait, and whom have
• 11:27
  - you seen embody it? And that could be
• 11:28
  - one person in particular. It could be a
• 11:30
  - group of people,
• 11:31
  - however you see fit to answer that question.
• 11:35
  - Yeah.
• 11:37
  - Well, it it it won't come as a
• 11:38
  - surprise to you because I've touched on this
• 11:41
  - throughout this conversation a couple of times. I
• 11:43
  - think one of the... Yeah. A couple of
• 11:44
  - the most, I I I I I pinpoint
• 11:47
  - to,
• 11:48
  - an... Underrated leadership traits or at least leadership
• 11:51
  - traits that are not talked a lot about.
• 11:53
  - The first is listening. If health care leaders
• 11:55
  - were expected to have all the answers,
• 11:58
  - what what what what I've learned in my
• 12:00
  - career is that, if you listen,
• 12:03
  - to those you lead,
• 12:05
  - they will teach you. They will teach you,
• 12:07
  - and they will help you to find the
• 12:09
  - answer. So so active listening,
• 12:13
  - and rounding with with purpose,
• 12:15
  - are...
• 12:16
  - Represent, I think,
• 12:18
  - really critically important,
• 12:20
  - leadership behaviors and and leadership traits.
• 12:23
  - The second is, and I'll tell you a
• 12:25
  - quick story about about active listening and and
• 12:27
  - rounding with purpose in just a moment. But
• 12:30
  - the the second is
• 12:32
  - communicating. I think communicating
• 12:34
  - is an essential leadership competency that every effective
• 12:38
  - leader,
• 12:39
  - needs to master.
• 12:41
  - And too often,
• 12:42
  - I think leaders,
• 12:44
  - see that as something that the marketing and
• 12:47
  - comps department does, and it's delegated.
• 12:50
  - I think, you know, particularly a CEO, the
• 12:53
  - senior most leaders,
• 12:55
  - the the people in the organization, they wanna
• 12:57
  - hear directly,
• 12:58
  - from
• 12:59
  - their their leaders. They wanna know what keeps
• 13:02
  - them up at night. They wanna know what
• 13:03
  - what what they worry about. They wanna know,
• 13:05
  - what what they're most proud of within their
• 13:08
  - organization, what the challenges are moving forward.
• 13:11
  - And and where where where the organization may
• 13:13
  - have made made missteps. And so I think,
• 13:16
  - you know, authentic communication
• 13:18
  - is
• 13:19
  - is a really important leadership trait that isn't,
• 13:22
  - you know, spoken a lot about. I will
• 13:23
  - tell you that that I think, you know,
• 13:25
  - one of the ways that we've been able,
• 13:27
  - to
• 13:28
  - achieve such a high level of engagement on
• 13:30
  - the part of our physicians
• 13:32
  - and
• 13:33
  - our team members in the trials, the second
• 13:36
  - largest employer, roughly 15,000
• 13:39
  - team members and physicians, second largest,
• 13:41
  - employer in Greater Cincinnati,
• 13:44
  - is through communication.
• 13:46
  - And and it was something that, that we
• 13:48
  - were very intentional and deliberate about during my
• 13:51
  - time there, and I know my successor,
• 13:53
  - Terry Hamlin Bremmer, is equally intentional and delivered
• 13:56
  - about, today.
• 13:58
  - And and that has really created a... An
• 14:01
  - organization that is really strongly aligned and highly
• 14:04
  - engaged.
• 14:06
  - I I... The the risk is sounding a
• 14:07
  - little immodest.
• 14:08
  - You know, I I, learned a couple of
• 14:10
  - days ago that the Academy of Medicine for
• 14:13
  - Cincinnati
• 14:13
  - is,
• 14:14
  - their annual gala is is in a... Late...
• 14:17
  - Later in September,
• 14:19
  - and they they are, creating a new award.
• 14:22
  - It's the inaugural
• 14:23
  - visionary leadership award, and they wanna give it
• 14:26
  - to me. Can you can you imagine doctors
• 14:28
  - getting... Meaning... Can you can you imagine doctors
• 14:30
  - wanting to give an administrator award?
• 14:34
  - But, anyway, I
• 14:35
  - I I I I... It... The, you know,
• 14:37
  - the the level of,
• 14:38
  - involvement that we've created for physicians that, you
• 14:41
  - know, lead the organization and the engagement that
• 14:44
  - we've that we've seen with our physician community,
• 14:46
  - which has helped us to achieve all of
• 14:48
  - the results that I've talked about, you know,
• 14:50
  - throughout this conversation.
• 14:51
  - Much of that turns on, you know, active
• 14:54
  - listening,
• 14:55
  - and
• 14:56
  - very deliberate intentional communication and engaging, you know,
• 15:00
  - physicians and team members in decision making... Shared
• 15:03
  - decision making. So,
• 15:05
  - but the story I was gonna tell you
• 15:07
  - is, you know, when I when I started
• 15:08
  - at TriHealth eleven years ago,
• 15:11
  - I devoted my first three months to just
• 15:14
  - active listening, and I I rounded through every
• 15:16
  - one of our hospitals and ambulatory facilities
• 15:19
  - and interacted with physicians and physician leaders and
• 15:22
  - team members and leaders. I I looked at
• 15:23
  - all of our performance data,
• 15:25
  - and and I and I and I did
• 15:27
  - that because I knew the organization would teach
• 15:29
  - me the work that I needed to do
• 15:31
  - moving forward. And I I, completed a SWOT
• 15:33
  - analysis,
• 15:34
  - what our strengths, weaknesses, opportunities, and threats were,
• 15:38
  - and then and then from that SWOT analysis,
• 15:40
  - what the imperatives moving forward would be.
• 15:43
  - I committed that to writing. I presented it
• 15:45
  - to the board, and then I took it
• 15:47
  - on the road and shared it with our
• 15:48
  - organization.
• 15:50
  - But, as as I was getting ready to
• 15:52
  - to make my announcement,
• 15:53
  - I pulled that document, and that document really
• 15:56
  - has served as the road map for trials
• 15:58
  - transformation over the past eleven years. If you
• 16:01
  - listen to your people, your stakeholders, your physicians,
• 16:04
  - your patients, they will teach you the work
• 16:06
  - that needs to be done.
• 16:08
  - Mark, that sounds like a perfect place to
• 16:10
  - put a cap on this conversation.
• 16:12
  - I know I've learned a lot.
• 16:15
  - I have no doubt that everyone who listens
• 16:16
  - to this will as well.
• 16:18
  - Mark, and thank you for the, unsolicited, by
• 16:20
  - the way, plug for our conference coming up
• 16:23
  - in November.
• 16:24
  - We can't wait to have you there, and,
• 16:26
  - we look forward to everyone being able to
• 16:28
  - hear you speak there. Mark, thank you. You've
• 16:30
  - been so gracious with your time and your
• 16:32
  - experience with us today. Well well, thank you,
• 16:34
  - Chris. It's been a lot of fun.