To head a system, communicate, delegate and anticipate, say system chiefs

July 1, 2015


WASHINGTON, D.C. — The skill set a leader needs to run a Catholic health system has shifted from what it was even about a decade ago, and yet the basic character traits one must have to succeed in this role have remained constant. That was a theme that emerged during a June 7 Innovation Forum session at the Catholic Health Assembly. "Stepping Into a System Leadership Role" featured a panel of four system chief executives — one of them the moderator — sharing their insights.

Sharing their perspectives during the chief executives panel were, from left, Kevin Lofton, chief executive of Englewood, Colo.-based Catholic Health Initiatives; Sandra Bruce, president and chief executive of Chicago's Presence Health; William P. Thompson, president and chief executive of St. Louis' SSM Health; and Deborah Proctor, president and chief executive of Irvine, Calif.-based St. Joseph Health.
Photo credit: Evelyn Hockstein/© CHA

Now that health system composition is transitioning for many providers, with new kinds of partnerships the norm, system chief executives need to be able to lead by influencing, not just controlling. This is particularly true when they have no direct authority over partner organizations, said panelist Kevin Lofton, chief executive of Englewood, Colo.-based Catholic Health Initiatives.

Top system executives also must continually educate themselves on the transformation happening in health care, including the shift from sick-care delivered in a hospital setting to population health approaches carried out in the community, said panelist Sandra Bruce, who is to retire as president and chief executive of Chicago's Presence Health by the end of the year. She said she's spent more than a year and a half trying to discern exactly what the implications of health care reform will be for Presence. Part of the education is trying to learn the particulars of shifting from a fee-for-service model to a model based on providers sharing risk and on capitated payments.

Despite all the changes, basic requirements remain for system heads, said the panelists: they must excel in communicating with many different stakeholder groups, be able to delegate to the right people and have a strategic mind for the future.

Panelist William P. Thompson, president and chief executive of St. Louis' SSM Health, said, as has always been the case for Catholic health leaders, ministry system heads also must have "a true concern for the people we serve — the poor and the marginalized."

The group discussed some of the greatest challenges they face as system chief executives, especially compared with those they encountered when heading individual hospitals in past roles. Thompson noted the difficulty of keeping up with the magnitude of information that barrages the head of a system — and the need to focus on what's most important. Bruce described feelings of isolation from the mission that can come with being located at a system office, away from patients, clinicians and hospital staff. Lofton spoke of the complexity of trying to standardize best practices and approaches across an extremely diverse system. Accommodating differing populations, market characteristics, local norms and other dynamics can be very difficult, Lofton said.

The panelists shared advice for aspiring system chief executives. Bruce said they should learn the value of listening hard to the people in their organizations and of responding to what they say. Lofton said to be prepared to have a thick skin, since there is no way to please everyone, and system chief executives must take sometimes difficult positions that generate volumes of what Lofton calls "nastygrams," or complaint letters and emails.

Thompson advised prospective top leaders that it is important to have courage. "Be prepared to disrupt yourself and not be protective of doing things the way they've always been done."

Deborah Proctor, who is retiring Dec. 31 as president and chief executive of Irvine, Calif.-based St. Joseph Health, moderated the panel. She advised potential system chief executives to realize "it's God's ministry, not mine. I constantly rely on that, and it causes me to be more prayerful throughout my day and work."


Copyright © 2015 by the Catholic Health Association of the United States
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