Increasing pressure to reduce costs and improve quality can be overwhelming for hospital leaders. Elizabeth G. Nabel, MD, president of the Brigham and Women's/Faulkner Hospitals in Boston, says she approaches this challenge, like others she has faced, as an opportunity. Here, she describes how Brigham and Women's plans to continue to innovate and provide quality care while reducing costs.
Q: What are the biggest challenges you are currently facing as president of Brigham and Women's Hospital, and how are you working to overcome them?
Dr. Nabel: One of the biggest challenges that we are currently faced with is driving down the cost of healthcare while maintaining quality, safety and the patient experience. In 2010, we set a three-year goal to reduce our base expenses by $160 million. I am proud to say that we are $125 million toward our goal, and that we have developed plans for the final $35 million, which we will implement over 2012 and 2013. We will work to create efficiency while being ever mindful that quality outcomes, patient safety and the patient experience cannot be sacrificed. To do this, we are working together as a multidisciplinary team and asking those closest to the patients how to make changes to improve care while cutting costs.
In 2011, we also completed a strategic plan which articulates our strategic commitments. The plan is centered on the following "truths:" The care we deliver must be the best and must provide more value to patients and families, specifically through our efforts to push the boundaries of innovation, research and education. We have to continually prove our value to all those we serve — patients, families, referrers [and] payor and community and government partners. We must optimize the use of our assets and match patients' healthcare needs with the appropriate level of resources, both inside the walls of our academic medical center and with our partner institutions. Our work across our mission areas must be integrated and coordinated, and we must be able to adapt quickly as the environment in which we live and work changes.
Q: How do these challenges compare to those you have faced in the past?
EN: As a physician, scientist and leader, I have approached challenges throughout my career as opportunities to innovate, and in that way this challenge is quite similar. The Brigham has a history of transforming the future of healthcare — performing the first organ transplant, launching the world's first intraoperative MRI system, conducting the Nurses' Health Study, America's first study of women's health, and more recently performing the nation's first face transplant — and we intend to continue to do so as we shape how we will provide the highest quality patient- and family-centered care going forward. The challenge is to provide the right care at the right location with the right expertise, which will contain costs and improve the patient care experience.
That being said, many of the challenges in healthcare are different now than they were even five years ago. Delivering high-quality, affordable, safe care consistently requires diligence in setting priorities and taking advantage of efficiencies. Going forward, we will focus on coordinating care across the continuum, making appropriate and better use of our varied sites of care and further integrating and aligning our research, education, clinical and community mission areas.
Q: How do the challenges you deal with as a hospital leader shape your leadership style and your approach to healthcare?
EN: My leadership style as president of Brigham and Women's Hospital is focused on collaboration. I learned very early on in my career as a physician and a scientist that most often teamwork yields the best outcome. I encourage those on the front lines and staff across the organization at all levels to share their thoughts and ideas. I have established open forums to interact with our staff and encourage all employees to send me their ideas and concerns via an email forum that I've established for this purpose. I've found that this approach — encouraging participation — allows us to capture the creativity of our workforce and implement ideas that improve the quality, safety and efficiency of the care we provide.
Q: What are the most valuable lessons you have learned as president of Brigham and Women's Hospital, and how have you learned from them?
EN: In my time as president of Brigham and Women's Hospital, as well as during my career as a practicing physician and a scientist, I have learned the value of being flexible and adaptable. This is also something I learned from my father, a scientist for 3M, very early on. By anticipating changes in our environment and by committing to being nimble while staying true to our four-part mission of providing exceptional clinical care, innovating through research, training the next generation of caregivers and promoting health equity for our community, both locally and globally, we, as an institution, have been able to continue to be successful while planning for the future.
Q: What advice do you have for other hospital and health system leaders?
EN: My advice would be to stay focused on the people — the patients, their families, the caregivers, the scientists, your community. If you focus on doing right by the people, everything else will fall into place.
Healthcare CEOs of the Round Table: Organizational Strategies for 2012
7 Ways CEOs Can Curb Healthcare Costs
Q: What are the biggest challenges you are currently facing as president of Brigham and Women's Hospital, and how are you working to overcome them? Dr. Nabel: One of the biggest challenges that we are currently faced with is driving down the cost of healthcare while maintaining quality, safety and the patient experience. In 2010, we set a three-year goal to reduce our base expenses by $160 million. I am proud to say that we are $125 million toward our goal, and that we have developed plans for the final $35 million, which we will implement over 2012 and 2013. We will work to create efficiency while being ever mindful that quality outcomes, patient safety and the patient experience cannot be sacrificed. To do this, we are working together as a multidisciplinary team and asking those closest to the patients how to make changes to improve care while cutting costs.
In 2011, we also completed a strategic plan which articulates our strategic commitments. The plan is centered on the following "truths:" The care we deliver must be the best and must provide more value to patients and families, specifically through our efforts to push the boundaries of innovation, research and education. We have to continually prove our value to all those we serve — patients, families, referrers [and] payor and community and government partners. We must optimize the use of our assets and match patients' healthcare needs with the appropriate level of resources, both inside the walls of our academic medical center and with our partner institutions. Our work across our mission areas must be integrated and coordinated, and we must be able to adapt quickly as the environment in which we live and work changes.
Q: How do these challenges compare to those you have faced in the past?
EN: As a physician, scientist and leader, I have approached challenges throughout my career as opportunities to innovate, and in that way this challenge is quite similar. The Brigham has a history of transforming the future of healthcare — performing the first organ transplant, launching the world's first intraoperative MRI system, conducting the Nurses' Health Study, America's first study of women's health, and more recently performing the nation's first face transplant — and we intend to continue to do so as we shape how we will provide the highest quality patient- and family-centered care going forward. The challenge is to provide the right care at the right location with the right expertise, which will contain costs and improve the patient care experience.
That being said, many of the challenges in healthcare are different now than they were even five years ago. Delivering high-quality, affordable, safe care consistently requires diligence in setting priorities and taking advantage of efficiencies. Going forward, we will focus on coordinating care across the continuum, making appropriate and better use of our varied sites of care and further integrating and aligning our research, education, clinical and community mission areas.
Q: How do the challenges you deal with as a hospital leader shape your leadership style and your approach to healthcare?
EN: My leadership style as president of Brigham and Women's Hospital is focused on collaboration. I learned very early on in my career as a physician and a scientist that most often teamwork yields the best outcome. I encourage those on the front lines and staff across the organization at all levels to share their thoughts and ideas. I have established open forums to interact with our staff and encourage all employees to send me their ideas and concerns via an email forum that I've established for this purpose. I've found that this approach — encouraging participation — allows us to capture the creativity of our workforce and implement ideas that improve the quality, safety and efficiency of the care we provide.
Q: What are the most valuable lessons you have learned as president of Brigham and Women's Hospital, and how have you learned from them?
EN: In my time as president of Brigham and Women's Hospital, as well as during my career as a practicing physician and a scientist, I have learned the value of being flexible and adaptable. This is also something I learned from my father, a scientist for 3M, very early on. By anticipating changes in our environment and by committing to being nimble while staying true to our four-part mission of providing exceptional clinical care, innovating through research, training the next generation of caregivers and promoting health equity for our community, both locally and globally, we, as an institution, have been able to continue to be successful while planning for the future.
Q: What advice do you have for other hospital and health system leaders?
EN: My advice would be to stay focused on the people — the patients, their families, the caregivers, the scientists, your community. If you focus on doing right by the people, everything else will fall into place.
Related Articles on Hospital Leadership:
Surgically Remodeling a Hospital: Q&A With Dr. Jeffrey Steinberg, CEO of Vanguard's Weiss Memorial HospitalHealthcare CEOs of the Round Table: Organizational Strategies for 2012
7 Ways CEOs Can Curb Healthcare Costs