By Aurora Aguilar
John Couris thinks leaders in the healthcare industry should think big or go home. During 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 under-appreciated 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?
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.