Friday, August 6, 2010

Guest Commentary: Healthcare Quality Calls for Visionary Leadership

Laura Kimberly, MSW, MBE
Director of Special Projects
Jefferson School of Population Health

Do you ever wonder what it takes for a health system to win NQF’s prestigious annual National Quality Healthcare Award? On Friday morning, JSPH had the honor of hosting Michael Dowling, President and CEO of North Shore-Long Island Jewish Health System, this year’s winner of the NQF award. It became clear to everyone present that Mr. Dowling is a truly visionary leader, and his transformative approach to creating a culture of quality at NSLIJ is remarkable. Over the course of the morning, Mr. Dowling shared numerous pearls of wisdom, including his take on the essence of the quality movement – “quality is a value, it is the DNA of an organization, and every employee is a quality professional.”

During his tenure as CEO, Mr. Dowling has promoted a quality agenda through radical changes to the structure and organization of the primary hospitals, long term care facilities, community hospitals, and ambulatory sites that now make up the NSLIJ Health System. The health system owns each entity, and all primary administrative and clinical functions are centralized for maximum efficiency, communication, and integration. In addition, the health system has a single board of directors, enabling effective decision-making with a constant eye to the health system’s big picture.

Mr. Dowling faced enormous challenges to bring about the massive systems changes required to create NSLIJ. Nearly every entity within the health system was operating at a deficit at the time of purchase – the health system is now profitable, generating over $6 billion in revenue and employing 42,000 people.

As an example of Mr. Dowling’s paradigm-shifting approach to leadership, he attends NSLIJ’s Monday morning orientation sessions and personally meets every single new hire, on average 70-90 people each week. In another example of his commitment to integration, teamwork and transparency, he has established protected time on Fridays during which all administrative and clinical staff attend patient safety rounds.

Mr. Dowling identified 6 key areas that underlie NSLIJ Health System’s accomplishments:

1) Employee Development
2) Teamwork and Collaboration
3) Commitment to Transparency
4) Commitment to Innovation and Continuous Improvement
5) Focus on Accountability
6) The Big Picture – Manage for the Short Term, Lead for the Long Term

There is a great deal to be learned by studying NSLIJ’s approach to quality, and to organizational culture and leadership more broadly, particularly within the context of the current health care reform efforts.