A com­mit­ment to pa­tient care

Modern Healthcare - - Special Feature - El­iz­a­beth Gard­ner

Kenneth Abrams likes to ask job candidates what ac­tiv­i­ties they en­joyed when they were kids. He lis­tens for those that in­volve group co­op­er­a­tion, whether it’s sports or de­bate or band. “I played soc­cer, and I find that those team-based ac­tiv­i­ties re­ally en­able peo­ple to do im­prove­ment work,” he says.

Im­prove­ment work is how he spends his days as se­nior vice pres­i­dent of clin­i­cal op­er­a­tions for 10-hospi­tal North Shore-Long Is­land Jewish Health Sys­tem, Great Neck, N.Y.: try­ing to cut the in­ci­dence of cen­tral-line in­fec­tions, stan­dard­iz­ing care in pre­na­tal units and de­vel­op­ing a pro­to­col for deal­ing with sep­sis. He’s not the only one, ei­ther: All of the sys­tem’s 38,000 em­ploy­ees, from the CEO to the jan­i­to­rial staff, are ex­pected to share the com­mit­ment of mak­ing pa­tient care bet­ter. They’re one gi­ant team; and iden­ti­fy­ing candidates who can con­trib­ute to that team cul­ture is a key part of hir­ing, he says.

All new hires get a ses­sion with Pres­i­dent and CEO Michael Dowl­ing on how to be a qual­ity ad­vo­cate—it’s a stand­ing ap­point­ment on his cal­en­dar ev­ery Mon­day morn­ing. They get an­other ori­en­ta­tion at their home fa­cil­ity, where they learn how the sys­tem’s phi­los­o­phy is ex­e­cuted at their site. “Some of them get it the first time around,” Dowl­ing says. “If they don’t get it even­tu­ally, we don’t keep them. You don’t just have a job here; you have a re­spon­si­bil­ity to pa­tients.”

It’s that sys­temwide ded­i­ca­tion to qual­ity that helped North Shore-LIJ earn the 17th an­nual Na­tional Qual­ity Health­care Award, pre­sented by the Na­tional Qual­ity Fo­rum in part­ner­ship with Mod­ern Health­care. The or­ga­ni­za­tion stood out from a group of 10 strong ap­pli­cants, NQF Pres­i­dent and CEO Janet Cor­ri­gan says. “They have a strong com­mit­ment to qual­ity and im­pres­sive re­sults,” she says. “It’s a re­mark­able or­ga­ni­za­tion.”

One of the more re­mark­able as­pects of North Shore-LIJ is that it’s an or­ga­ni­za­tion at all. Be­fore it was cre­ated in a 1997 merger, it was a dis­parate col­lec­tion of fa­cil­i­ties bound up into two groups: North Shore Health Sys­tem and Long Is­land Jewish Med­i­cal Cen­ter. Its ser­vices in­clude not only acute care, but long-term care, hospice and home care. Its ser­vice area en­com­passes ur­ban, sub­ur­ban and ru­ral ar­eas, and many of its com­po­nent fa­cil­i­ties were orig­i­nally com­peti­tors.

Dowl­ing ar­rived in 1995 as chief op­er­at­ing of­fi­cer at North Shore Health Sys­tem af­ter a var­ied ca­reer that in­cluded stints at Blue Cross and Blue Shield, the New York State Health and Hu­man Ser­vices Depart­ment, aca­demic posts at Ford­ham and Columbia uni­ver­si­ties, and jobs in construction and plumb­ing. He paid his way through col­lege as a dock­worker af­ter em­i­grat­ing from Ire­land. (“There is no such thing as a bad job,” he says. “Ev­ery­thing is a good ex­pe­ri­ence and a learn­ing ex­pe­ri­ence.”)

Dowl­ing spent much of his first decade in the or­ga­ni­za­tion han­dling is­sues con­nected to the merger. He took over as CEO in 2002. “We didn’t just want a col­lec­tion of en­ti­ties stand­ing side by side,” he says. “We wanted to have con­sis­tent ad­min­is­tra­tive over­sight and lead­er­ship, share best prac­tices and set the rules of the game so every­one ap­plies the same prin­ci­ples and stan­dard­ized met­rics across the whole sys­tem.”

The merged en­tity op­er­ates a cor­po­rate uni­ver­sity for its em­ploy­ees, the Cen­ter for Learn­ing and In­no­va­tion, to pro­vide con­tin­u­ing ed­uca-

Dowl­ing: “You don’t just have a job; you have a re­spon­si­bil­ity.”

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