‘Our goal is to be the most innovative and safest hospi­tal in Amer­ica’

Modern Healthcare - - Q & A -

thinks lead­ers in the health­care in­dus­try should think big or go home. Dur­ing John Couris his first year as CEO of Tampa (Fla.) Gen­eral Hospi­tal, the re­gion’s largest safety-net facility, Couris has given his staff im­plicit in­struc­tions and a road map to be No. 1. The teach­ing hospi­tal is home to one of the lead­ing or­gan trans­plant cen­ters in the county, but it aims to be the best. Pe­riod. Mod­ern Health­care Ed­i­tor Aurora Aguilar re­cently talked with Couris about his am­bi­tious plan. The fol­low­ing is an edited tran­script.

MH: What brought you to Tampa Gen­eral?

Couris: I found an un­der­ap­pre­ci­ated as­set. It’s a won­der­ful in­sti­tu­tion with great peo­ple, but they needed strong lead­er­ship, a vi­sion and a strat­egy. We have about 10,000 em­ploy­ees ded­i­cated to this in­sti­tu­tion and this com­mu­nity and, re­ally, the state. A lot of what we do, from a ser­vice line per­spec­tive—be­cause we’re a ter­tiary, qua­ter­nary, teach­ing hospi­tal—has an im­pact across the state and across the South­east.

MH: How did you learn what you were dealing with?

Couris: I worked in ev­ery sin­gle op­er­at­ing area across the hospi­tal. As a mat­ter of fact, I’m sit­ting here right now in scrubs, be­cause I spent the en­tire morn­ing in our in­ten­sive-care unit work­ing along­side a nurse, tak­ing care of pa­tients.

I have worked week­days and week­ends and nights. I do it about two to four times a month. I’ll prob­a­bly end my day to­day around 11-12 o’clock tonight. Our board chair­man will be with me. I’ll go with one nurse, he’ll go with an­other, and four to five hours later, we’ll meet and com­pare notes and share ex­pe­ri­ences. So when we’re in the board­room, it comes alive be­cause he’s been there. He’s seen it.

MH: What’s in your strate­gic plan?

Couris: Ev­ery five years we’ll write a new chap­ter but our first goal is to be the most innovative and safest hospi­tal in Amer­ica. That is our po­si­tion state­ment. That’s our vi­sion.

When peo­ple say, “Wow, that’s bold, that’s im­pos­si­ble.” Well, there are hos­pi­tals out there that are con­sid­ered the most innovative and safest in­sti­tu­tions in the coun­try. We are go­ing to be that in­sti­tu­tion. I tell my team, we may never be the largest sys­tem in our re­gion but we will be the best sys­tem in the re­gion and, even­tu­ally, the coun­try. That’s the jour­ney we’re on.

MH: How will you get there?

Couris: There are six ac­tiv­i­ties. The first is a con­cept called “Zero harm to pa­tients, team mem­bers and physi­cians.” We will never, ever com­pro­mise qual­ity, safety, out­comes or ser­vice for vol­ume. We will com­pete on one thing—value. In the world of health­care now, value equals qual­ity and safety and clin­i­cal out­comes and ser­vice.

The se­cond piece is op­er­a­tional ex­cel­lence. It’s all about pulling waste out of the sys­tem. We’ve part­nered with GE Health­care to build a 9,000-square-foot care co­or­di­na­tion cen­ter that takes AI and pre­dic­tive an­a­lyt­ics and mar­ries that with hu­man in­tel­li­gence.

The third cat­e­gory is the de­vel­op­ment of a key mem­ber and lead­er­ship in­sti­tute so we can do tal­ent map­ping and suc­ces­sion plan­ning and re­ally train peo­ple to think and be­have dif­fer­ently as it re­lates to the de­liv­ery of health­care.

The fourth cat­e­gory is geo­graphic ex­pan­sion. We aren’t spend­ing a lot of money on big, ex­pen­sive, am­bu­la­tory build­ings. What we are build­ing is a col­lec­tion of con­sumer-cen­tered ser­vices that are low cost, high qual­ity. For ex­am­ple, we are build­ing what’s go­ing to be called the Tampa Gen­eral Hospi­tal Di­ag­nos­tic Cen­ter. Some­body in the com­mu­nity says, “Some­thing’s wrong with me.” That per­son goes to the cen­ter and ei­ther vis­its the imag­ing de­part­ment, the ur­gent-care cen­ter, the lab, or pri­mary care and they’ll fig­ure out what’s wrong. Then a care co­or­di­na­tor in­side that facility will man­age that care through our sys­tem.

We’re also tak­ing it a step fur­ther. We’re say­ing that if you live far from the main hospi­tal or we can’t pro­vide you the ser­vice, we will co­or­di­nate and nav­i­gate the ap­point­ment even if it’s with a com­peti­tor, be­cause we want to be seen as the trusted re­source for your health and well­ness

and we have to tran­scend com­pe­ti­tion.

The fifth cat­e­gory fo­cuses on con­sumerism and lev­er­ag­ing tech­nol­ogy.

The fi­nal bucket is a deeper col­lab­o­ra­tion with USF Health, which is the group prac­tice, in build­ing a new clin­i­cal plat­form and col­lab­o­ra­tive for physi­cians to not only work to­gether on a day-to-day ba­sis, but re­ally em­brace new tech­nolo­gies and new in­no­va­tions.

MH: How are you mea­sur­ing your progress?

Couris: We’re mea­sur­ing our­selves against the Vizient top 100 aca­demic med­i­cal cen­ters in the coun­try and their six do­main cat­e­gories and then some over­ar­ch­ing cat­e­gories around safety, qual­ity and out­comes.

We’re an aca­demic med­i­cal cen­ter. We have about 330 res­i­dents and fel­lows; we could have 600 to 800 trainees work­ing and travers­ing the hall­ways of 2 mil­lion square feet of clin­i­cal space on our main cam­pus. So we want to see this scale.

One of the things that we’re im­ple­ment­ing next year is a chief res­i­dent for qual­ity, teach­ing res­i­dents about clin­i­cal path­way de­vel­op­ment, about the ap­pro­pri­ate uti­liza­tion of tests and pro­ce­dures. We can’t equip them on one side of the equa­tion clin­i­cally but not equip them on the re­al­i­ties they’re go­ing to face in pri­vate prac­tice and com­mu­nity hos­pi­tals.

MH: So how are you keep­ing track of your com­pe­ti­tion?

Couris: We know where their out­pa­tient cen­ters are, their doctors, all of that. Be­cause let’s face it, most peo­ple aren’t com­ing to get a knee scoped at a ma­jor teach­ing hospi­tal. We’d love to have you, but it might not be con­ve­nient or cheap. So shouldn’t we do the right thing and help fa­cil­i­tate a con­nec­tion for you in your com­mu­nity?

“We can’t equip (res­i­dents) on one side of the equa­tion clin­i­cally but not equip them on the re­al­i­ties they’re go­ing to face in pri­vate prac­tice and com­mu­nity hos­pi­tals.”

MH: Would you ex­pect any kind of re­im­burse­ment?

Couris: Not at all. We’re just help­ing you. Look, health­care isn’t like sell­ing other things. We can learn a lot from pri­vate in­dus­try but we’re dif­fer­ent. You’re talk­ing about some­body’s life and well-be­ing. Why wouldn’t we want to try and tran­scend com­pe­ti­tion and cre­ate real value? The cynic in the room would say, “It’s not com­pletely al­tru­is­tic.” I’d say, “You’re right, it’s not.” What we’re cre­at­ing is brand loy­alty.

MH: But you’ll have to cover the cost of that staffer.

Couris: Yes, it’s a nav­i­ga­tor. We have to think and be­have dif­fer­ently in health­care. We can­not con­tinue to do the same things over and over again. We can­not even do vari­a­tions of the same thing over and over again. To truly in­no­vate will mean that we will have to dis­rupt, in a good way. ●

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