Sam Shields, Director, Operational Excellence, Dartmouth-Hitchcock

Today’s guest is Sam Shields, the Director of Operational Excellence at Dartmouth-Hitchcock Health System. In his role as Director, Sam provides leadership and strategic planning for the Value Institute. He has oversight of Performance Improvement, the Project Management Office, and the The Value Institute Learning Center.  He is responsible for developing programs and partnerships to improve patient outcomes and drive the organizational culture of the largest system in New Hampshire, with a reach of over 2 million people, toward operational excellence.

In this podcast we talk about Sam’s career, which began as a chemical engineer working in specialty chemicals. Through experiences in a variety of manufacturing and production roles, Sam became an expert in supply chain management and quality and performance improvement. Like many of my guests, Sam’s road to serving in health care was circuitous. When he joined the Dartmouth-Hitchcock team in 2009 and returned again in 2013, he brought his extensive and diverse experience to bear on improving the functioning of the organization.

Soundcloud: 

Extended version: https://soundcloud.com/healthleaderforge/sam-shields-director-operational-excellence-dartmouth-hitchcock

Abridged version: https://soundcloud.com/healthleaderforge/sam-shields-director-operational-excellence-dartmouth-hitchcock-1

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

YouTube:  https://youtu.be/XWjXeg5PSa8

Podcast Outline (this timeline refers to the extended version)

Time       Topic 

0:01:58		University of Massachusetts/Amherst, Chemical Engineering
0:03:11		learning process improvement at Cabot Corporation in Pampa, TX as a production engineer
0:08:10		root cause analysis
0:09:31		the basic tenets of quality management
0:10:41		transition to supervision
0:12:29		MBA - choosing management over technical career
0:13:29		Global Supply Chain Manager for Cabot
0:16:39		Timkin Aerospace Corporation - Supply Chain/Materials Manager
0:17:55		comparing quality management between Cabot and Timkin
0:18:50		comparing organizational culture
0:20:18		Lean Six Sigma at Timkin
0:21:55		flow vs. job shop
0:23:12		kanban
0:23:46		value stream
0:24:58		first time as manager of multiple departments
0:26:44		Momenta - VP of Operations, lessons learned
0:29:46		Dartmouth-Hitchcock Health System
0:31:36		supply chain management for Dartmouth-Hitchcock
0:33:46		transition to healthcare - importance of relationships and credibility
0:38:14		quality management at D-H
0:39:36		applying prior experience to healthcare
0:40:42		Labsphere - back to manufacturing
0:43:44		returning to Dartmouth-Hitchcock and The Value Institute
0:45:42		the LSS belt structure and certification
0:51:15		getting blackbelt certification
0:51:57		transition to quality vs. supply chain
0:52:53		D-H Sepsis Project and clinical process improvement
1:00:34		advising clinicians as a non-clinician
1:02:39		what allows an effective project to happen
1:04:04		Operational Excellence
1:07:19		journey mapping - voice of the customer
1:09:03		departments under Pperational Excellence
1:10:37		Six Sigma vs. Lean
1:12:24		the influence of previous roles on today
1:14:16		concerns as the Director
1:15:16		leadership philosophy
1:17:09		influences on his leadership philosophy
1:18:37		what does he look for when hiring a leader?
1:20:22		reflecting on lessons learned "the hard way"
1:22:28		where junior leaders go wrong
1:23:43		the importance of professional organizations
1:25:32		book recommendations
1:26:41		advice for early careerists

Links to Topics Discussed

Dartmouth-Hitchcock Health System

The Value Institute

Labsphere, Inc.

Timken

Cabot Corporation

American Society for Quality

National Association for Healthcare Quality

University of Massachusetts, Amherst, Department of Chemical Engineering

Book recommendation:
Execution - the Discipline of Getting Things Done

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Nirav Shah, MD, MPH, Senior VP and COO for Clinical Operations, Kaiser Permanente Southern California

Today's guest is Dr. Nirav Shah, the Senior Vice President and Chief Operating Officer for Clinical Operations for Southern California in the Kaiser Foundation Health Plan and Hospitals, in Pasadena, California. Nirav oversees the health plan and hospital quality, service, accreditation, regulatory compliance, and licensure, as well as nursing, the continuum of care, and the effective use of technology, data, and analytics to produce better patient health outcomes for $24B region serving 4.2M members.

Prior to coming to Kaiser, Nirav served as the Commissioner of Health for the State of New York, administering a $60B budget and was responsible for public health insurance programs covering 5 million New Yorkers as well as regulating the state's hospitals and nursing homes among other responsibilities.

Nirav completed an internal medicine residency at Yale, followed by a fellowship in epidemiology at Stanford. Before moving into leadership roles, he worked as a physician researcher at Bellevue Hospital in New York City and at the Geisinger Clinic in Pennsylvania.

I really enjoyed listening to Nirav's journey from physician researcher to large organization leader. Perhaps more than any other guest, Nirav talks about the importance mentors have played in his career, and how he seeks out support and guidance to help him solve his problems, while at the same time reaching out to return the favor.

Links to the Podcast:

Anchor: https://anchor.fm/healthleaderforge/episodes/Nirav-Shah--MD--MPH--Senior-VP-and-COO--Kaiser-Permanente-Southern-California-egra6j 

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://podcasts.apple.com/us/podcast/nirav-shah-md-mph-senior-vp-coo-kaiser-permanente-southern/id981989377?i=1000372542503

Transcript: A transcript of the podcast is available here.



Podcast Outline

Time Topic
0:02:22 Upbringing in India
0:03:41 College experiences, deciding to go into medicine
0:05:06 Completing a dual M.D./M.P.H. program in chronic disease
0:06:15 Being in a Pass/Fail environment at Yale Medical School
0:07:47 Residency in Internal Medicine
0:08:30 Fellowship in Epidemiology
0:10:20 The “Physician Identity”
0:11:31 Early career at NYU Medical Center/Geisinger Health System
0:14:34 Balancing the demands of a clinical vs. research career
0:15:24 Early career mentors, privilege, and grit
0:19:00 Early interests in administrative and leadership work
0:21:13 Work as the Commissioner of the NY Department of Health (DOH)
0:25:00 The importance of having a political appointee as a Commissioner
0:27:27 The importance of building networks for future leaders
0:29:12 Role of the Commissioner of the NY DOH
0:31:30 Reforms to Medicaid at the NY DOH
0:33:30 Dealing with conflicts as the Commissioner
0:35:25 Difficulties of implementing reform
0:37:48 Relationship with Kaiser Permanente prior to and as Commissioner
0:39:25 Leadership lessons learned as the Commissioner of the NY DOH
0:40:33 Shift to working at Kaiser Permanente
0:42:55 Advantages of the Payer/Provider alignment at Kaiser
0:48:38 Size and scope of Kaiser Permanente and KP Southern California (KPSC)
0:50:22 Day-to-day life and responsibilities
0:51:36 Use of data and analytics to improve patient outcomes
0:54:43 Benefits of KPSC and hospital association
0:56:03 Relationship between corporate and regional KP organizations
0:58:15 Regional leadership team organization
0:59:15 What keeps you up at night?
1:00:40 How did prior experiences prepare you for Kaiser?
1:02:48 Common misconceptions of Kaiser
1:04:11 Are you currently practicing medicine?
1:05:23 Questions regarding leadership, personal mentors, and leadership experiences, hiring and evaluating leaders
1:10:25 Working with “inexperienced” leaders, evaluating performance
1:13:20 Importance of organizational culture
1:15:30 Advice for students in developing good mentor relationships
1:19:54 Importance of professional associations in career development

1:20:54 Advice for clinicians/students going into healthcare 

Links Discussed

Kaiser Permanente Southern California
NY Department of Health

Geisinger Health System

Bellevue Hospital

Don Berwick

Robert Wood Johnson Foundation Clinical Scholars at UCLA

Yale Medical School

Thanks to Sameer Panesar for production support.

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Dr. Kenneth P. Anderson, D.O., M.S., CPE, Chief Operating Officer for the Health Research & Educational Trust

Today’s guest is Dr. Kenneth Anderson, DO, the Chief Operating Officer for the Health Research and Educational Trust, a subsidiary of the American Hospital Association in Chicago, Illinois. In this podcast, we trace Ken’s career in medicine, from his training in both family practice and internal medicine, then as nephrologist and kidney transplant specialist, followed by his movement into the physician executive ranks, specializing in quality and data management as the Chief Medical Quality Officer for the NorthShore University HealthSystem before his current position as COO of HRET. As the COO of HRET he helps to influence health policy at the national level through research and educational programs.

I really enjoyed speaking with Ken about his career – his passion for medicine and improving the quality of care for patients at the individual and system level is evident in everything he has done.

ADDENDUM: Since the recording of this podcast, Dr. Anderson has been promoted to Acting President of HRET and Acting Senior Executive for Health Improvement for the AHA (American Hospital Association). 

Links to the Podcast:

Soundcloud: https://soundcloud.com/healthleaderforge/anderson-interview

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

Podcast Outline

Time	Topic
0:01:47	Educational background, choosing to enter the medical profession
0:04:00	Going to medical school, osteopathic vs. allopathic medicine
0:06:47	Residencies in family practice and internal medicine, falling in love with nephrology
0:09:50	Fellowship in nephrology
0:10:55	The “Physician Identity”
0:12:40	First jobs after residency & fellowship training at Iowa Lutheran (IL)
0:14:17	First experiences in a leadership role at IL
0:15:25	Early clinical career experiences
0:16:58	Furthering education through an executive program in health management, a master’s degree in administrative medicine, and the college of physician executives
0:18:55	Initial involvement in Quality Improvement (QI)
0:20:53	Work as Chief Medical Quality Officer at the NorthShore University HealthSystem
0:22:05	Transitioning away from clinical practice
0:24:16	Work as Co-Director of the Center for Clinical Research & Informatics at NorthShore
0:26:58	Developing a mobile application to distribute health informatics, passion for health informatics
0:28:04	Information on the Health Research & Educational Trust (HRET)
0:29:07	Interaction between HRET and the American Hospital Association
0:30:51	Governance structure of HRET
0:32:09	Interaction between the President and COO of HRET, Ken’s role as COO of HRET
0:33:39	Staffing and organizational structure of HRET
0:34:37	Obtaining revenue at HRET
0:35:14	Business lines at HRET
0:36:10	Areas of research at HRET, sharing research results with other hospitals and health systems
0:38:25	Being a researcher vs. running a healthcare delivery system
0:39:58	Day in the life of Ken Anderson as COO of HRET
0:41:45	Importance of the physician perspective in healthcare delivery research
0:43:45	The “Physician-Executive Identity”
0:45:03	Personal leadership philosophy
0:45:52	What makes a good leader?
0:48:23	Learning a difficult leadership lesson
0:51:24	How to evaluate the performance of leaders
0:52:09	The importance of organizational culture, influencing organizational culture as a leader
0:54:08	The importance of mentorship, mentoring other leaders
0:57:50	Involvement with and importance of professional organizations
0:58:46	Advice for clinicians, others interested in healthcare management

Links to Topics Discussed:

Health Research and Educational Trust

American Hospital Association

NorthShore University HealthSystem

Iowa Lutheran Hospital




Thanks to Sameer Panesar for production support!

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