Then, the health care organization began canvassing its workforce for interested participants. All 40,000 employees received an e-mail inquiry about the new training program. They expected some takers, but company officials were surprised when more than 300 people expressed interest.
"It was like asking, ‘Who wants free concert tickets?’ " says Kathleen Gallo, the senior vice president and chief learning officer for the 15-hospital health system, which is based in Lake Success, New York.
All candidates were required to write an essay detailing their reasons for wanting to join the program, pass multiple interviews with an admission-selection team and commit to working full-time while attending training classes twice a week through the health system’s corporate university. Of the initial group of 22 applicants, 17 completed the certification program and advanced into EEG jobs at the health system’s medical facilities.
"The point of the story is that we were able to advance the careers of 17 people and solve our own business problems," without hiring outside consultants, Gallo says.
Even while the presidential candidates spar over how to fix the U.S. health care system, the EEG certification program illustrates how North Shore-Long Island Jewish Health System may be ahead of the curve in changing how medical services are delivered. Formed by the 1997 merger of longtime rivals North Shore University Hospital and Long Island Jewish Medical Center, its success hinges on having knowledgeable, committed employees, says CEO Michael Dowling.
"It’s like I always tell staff: We can create our own future. There are an amazing number of things we can do better in health care. To me, the transformation will occur within systems like ours," and not because of government mandates, Dowling says.
From competing to collaborating
Before the merger, North Shore and LIJ Medical competed fiercely for 50 years for both patients and staff. Bringing the two together was "the Mobil-Exxon merger in health care," giving the merged organization a combined market share of 33 percent in the New York metropolitan area, Gallo says.
Even so, the two health systems operated autonomously until 2001. As the combined enterprise evolved, it realized it lacked a uniform way for the different facilities to share practices and exchange ideas.
James Champy, the chairman of consulting with Dallas-based Perot Systems Corp., says health care mergers are enormously complicated and fraught with risk. As they focus on integrating the various facilities, health systems seldom make employee learning a top priority.
But Champy, who serves on the advisory board for the system’s Center for Learning and Innovation, says North Shore-Long Island Jewish Health System is focusing on learning as the key to a successful integration. He credits Gallo and Dowling with giving employees the tools to develop their skills and their careers.
"Kathy and her team have spent a lot of time focused on improving the processes, from administrative to clinical, to improve both quality of care and the patient experience. To change the behavior in a large organization takes a lot of work," especially in an industry as fragmented as health care, Champy says.
One of Dowling’s first moves as CEO was appointing Gallo, a veteran nurse with advanced practice degrees, including a doctorate, as the company’s first chief learning officer. Gallo also was given sole responsibility for human resources, including developing of professional growth and development curricula to nurture in-house talent.
"We had bright people throughout the organization, but unless we could get them to work fluidly together, we were not going to reap the benefits of these two powerhouses coming together," Gallo says.
Anchoring the effort is the Center for Learning and Innovation, described by Gallo as "our little business school." Modeled after the General Electric Leadership Institute in Crotonville, New York, the center is housed in a stand-alone complex near North Shore University Hospital’s campus in Lake Success. The idea is that employees will better focus on learning away from the distractions of their work environment, which has been one of the cornerstones of GE’s leadership training.
Built for about $1.2 million, including construction and first-year operating costs, it houses a 5,000-square-foot business development center and an 8,000-square-foot Patient Safety Institute.
The business-development function features a spectrum of "enrichment classes" open to employees at all levels, including courses in business fundamentals, coaching, communication, finance, motivation, performance management and a host of other subjects.
The purpose is to make professional development an option for everyone. Employee participation has been surging since the center’s inception in 2002, when 3,000 people took courses. Thus far in 2008, nearly 16,000 employees have pursued some form of learning.
"We have waiting lists to get into these classes," Gallo says.
Developing esprit de corps is a top priority. The staff of the Center for Learning and Innovation customizes workshops at the request of individual work teams, usually consisting of frontline clinical staff and those in support functions. Employees join forces to tackle specific projects relevant to their daily duties.
"We’ve had classes where a midnight housekeeper is sitting next to a physician" on the same project team, Gallo says.
At the Patient Safety Institute, clinical staff "train in teams those who work in teams," Gallo says.
Using a concept borrowed from aviation, clinical teams composed of different medical disciplines receive technical training that enables them to rehearse the lifesaving medical scenarios they are likely to encounter. The simulation center enables clinicians to practice on digitally enhanced mannequins, with each session recorded on video for training purposes.
Another, broader aim of the Center for Learning and Innovation is to communicate standard business processes across the system’s 15 facilities, which include hospitals and clinics. Dowling says employees at all levels are encouraged to volunteer suggestions.
"We want a standard way of doing things, but we don’t want to stifle innovation and entrepreneurship. Our message is: All ideas are accepted for how to improve things," Dowling says.
On the lookout for leaders
The dual forces of retirement and stiffer competition for capable replacements played a crucial role in the establishment of the learning center. The intent is to "change the notion of hiring into selection" by differentiating between "burning needs from developmental needs," Gallo says. In other words, North Shore-Long Island Jewish needed way to plug immediate skills gaps, while also looking long term at its future talent needs.
Gallo expects to lose 20 percent of her workforce to retirement in coming years, including nearly one-third of the company’s leaders. To complement the business training, a separate track of core management courses at the center targets up-and-coming managers.
That has enabled the health provider to promote people at a rapid pace. Dowling estimates 95 percent of the organization’s leaders advanced to their current job within the past five years.
The list includes Jonathan Sobel, a supervising physician assistant at 827-bed Long Island Jewish Medical Center in New Hyde Park, New York. Sobel says he was encouraged by a superior to pursue foundational leadership training in preparation for moving into his current supervisory role.
"Not only do I have a deeper insight into how I’m handling my responsibilities, but I am thinking now about how others perceive me," Sobel says. "It’s made me aware of how I function and how I can do a better job of leading others through all the changes that are coming down from management."
The health system’s executives often pull double duty as faculty members. That level of personal involvement has won converts among those who manage the various teams of medical professionals.
"The fact that management [serves as] the teachers means that the training we receive is distilled for the hospital environment, rather than being theoretical, like a university course," says Karl Bocchieri, the director of perfusion services in North Shore-Long Island Jewish Health System’s cardiovascular and thoracic surgery department.
To build a cadre of competent future leaders, the health care system decided to replace standardized evaluation forms that had been used for decades with 360-degree assessments. That has enabled decision makers to identify about 160 people as part of a long-range leadership succession plan.
Additionally, "hundreds and hundreds" of employees are pursuing master’s and bachelor’s degrees, Dowling says. Notably, in an effort to combat an industrywide shortage of nurses, the health system is investing money to increase the odds of retaining its nurses. Fifty-five nurses are working toward their doctorates.