LORI GUSTAVE, 39

Chief administrative officer, musculoskeletal and rheumatology University of Pennsylvania Health System

When Lori Gustave took over as head of musculoskeletal and

rheumatology, a leading service line at the University of Pennsylvania Health System, she found a department in disarray.

Orthopedic surgery, the largest group, was operating at an annual loss of more than $500,000 with no reserves. The department struggled to recruit physicians in the competitive Philadelphia market.

But four years later, patient revenue has increased 90%. Patient visits are up 20% and surgical cases, 35%. There are 32 operative surgeons, a 50% increase.

As chief administrative officer for the service line, Gustave and her team mapped out what happens when patients come in for care.

What she found was a lack of coordination. Patients with hip fractures, for instance, were being admitted to three different service lines, not only orthopedics, but geriatrics and internal medicine. That created delays. Now the goal is to have hip replacements performed within 24 hours.

“Every patient has a plan; we’re not just figuring it out on the fly,” Gustave said. “Every patient is risk-stratified to determine where they should go.”

She also implemented same-day scheduling and online self-scheduling. The service line expansion is evident in the department’s newly built, state-of-theart outpatient center.

“She has this very compelling, results-driven approach,” said Phil Okala, senior vice president of business development at Penn Medicine. “It’s been a miraculous trajectory. People are energized; people are very upbeat around our vision.”

“Every patient has a plan; we’re not just figuring it out on the fly.”