How to Run an Academic Medical Center: Q&A With Johnese Spisso, Chief Health System Officer of UW Medicine


Academic healthcare organizations face some challenges that are unique to academic facilities, such as educating and monitoring students and balancing this education with delivering quality care to patients and conducting cutting-edge research. Johnese Spisso, RN, MPA, chief health system officer of Seattle-based UW Medicine and vice president of medical affairs at the University of Washington, describes challenges of running academic health systems and offers strategies to succeed.

Q: What are the challenges of running UW Medicine Health System?

Johnese Spisso: UW Medicine includes seven entities — Harborview Medical Center, UW Medical Center, Northwest Hospital & Medical Center, UW Neighborhood Clinics, UW Physicians, UW School of Medicine and Airlift Northwest. Healthcare today is a very challenging business. UW Medicine experiences the same challenges as many other large academic health systems.

Today, some of the biggest issues in academic centers is how we continue to stay financially viable while delivering the unique mission of improving health for patients through our expert clinical care, teaching the next generation of healthcare professionals and conducting clinical and basic science research that allows us to transform healthcare discoveries into improved outcomes for patients. UW Medicine also serves as the only academic health system and medical school in a five-state area — Wyoming, Washington, Alaska, Montana and Idaho — operates the only Level I Trauma and Burn Center in this region, is the sole provider of the most complex quaternary care and provides the lion's share of uncompensated care (safety-net care for the entire state of Washington), so we have a huge responsibility to serve our region.

Q: How do you overcome these challenges?

JS: We overcome these challenges through our strategic efforts in integrating our care across health system sites, partnering with our region, implementing rigorous patient safety and quality programs and hardwiring service excellence throughout our system.  We have system-wide pillar goals that focus on putting the needs of our patients first and measuring performance against goals on patient satisfaction, quality and safety, employer of choice and fiscal responsibility. We have a leadership team that is very aligned in embracing these goals and the accountability for them.

Q: How do you maintain UW Medicine's success as healthcare reform legislation makes significant changes to the healthcare industry?

JS: Our success is due to our efforts at effective and proactive strategic planning that is an ongoing part of our work every day. We stay focused on our mission and have continued to integrate across the seven entities. We are focusing on further system integration to prepare UW Medicine to serve as an accountable care organization and are working diligently to improve the quality and safety of care while reducing the overall cost and improving value for patients.

Q: What are your short-term and long-term goals for UW Medicine?


JS: Our short-term goals relate to the successful implementation of our annual operating and capital budget plans for the system, completing the investments in some of our new building projects and completing the deployment of IT systems. Our long-term goals relate to continuing to successfully implement our long-term financial and strategic plans that will allow us to continue to succeed in our mission of improving the health of the public and serving patients from all walks of life thorough our clinical, teaching and research discoveries. This will allow us to continue to succeed as a world class academic health system that is really changing the world through these efforts, both locally and globally.

Q: What strategies will you use to reach these goals?

JS: Our strategies are based on our strategic plan and pillar goals. These include expanding and strengthening our centers of excellence and core clinical programs, delivering consistent excellent access and services for every patient every time, expanding our strategic partnerships in the region, expanding our network of primary and secondary care, creating more capacity for tertiary and quaternary care, and continuing to strengthen our teaching and research programs.

Q: What is the most important lesson you've learned through your work at UW Medicine?

JS: I have learned that our success is due to having alignment of the team, commitment to the core mission of improving health through clinical care, teaching and research and collectively supporting this work as an integrated health system. You also have to empower the team and have the right leaders in the right roles at the right time.

Q: What advice can you give to other healthcare leaders?

JS: Stay focused on your mission, keep strategic planning as a dynamic process so that you can respond to windows of opportunity, be transparent in your communication and be sure everyone knows the key messages at key times and stays engaged in the process.

Related Articles on Hospital Leadership:

4 Strategies to Optimize Leadership in Integrated Care

5 Ways to Put Meaning Behind Your Hospital's 'Mission, Vision and Values'

Physician Integration: Hospital Medical Leaders Share Challenges, Strategies



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