Episodes

  • In this episode of the Habitual Excellence podcast, host Ken Segel interviews Dr. Paul DeChant, an expert on physician burnout, with a focus on how workplace dysfunction rather than personal resilience drives burnout among clinicians. Dr. DeChant explains that burnout arises when clinicians spend too much time on administrative tasks and not enough on meaningful patient care. He highlights cynicism as a key dimension of burnout, stemming from lack of control, recognition, and a breakdown of community and fairness. Leadership plays a crucial role in addressing these issues by empowering frontline workers and aligning them with organizational values and processes, such as using lean management systems to improve workflows. Dr. DeChant emphasizes the importance of leaders "going to the Gemba" to understand frontline challenges and build trust with clinicians. The episode also promotes the upcoming Enduring Excellence CEO Seminar, where leaders can learn more about these frameworks and their practical applications.

  • In this podcast episode, Katie Anderson and Gerald Harris discuss the concept of serious leadership in healthcare, emphasizing the importance of long-term thinking and a deep commitment to patient-centered care. Katie shares insights from her experiences, including lessons from Japanese leadership practices, highlighting how leaders can break the habit of simply telling their teams what to do and instead engage them in collaborative problem-solving. Gerald underscores the challenges healthcare leaders face, such as time constraints and regulatory pressures, and the need to manage these complexities to create conditions for success. The episode also promotes the upcoming 2024 Lean Solutions Summit, where both Katie and Gerald will be actively participating, offering healthcare leaders an opportunity to reflect, learn, and gain new perspectives to enhance their leadership practices.

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  • Tune in to our latest podcast episode as we delve into the critical topic of leadership and organizational culture in healthcare, featuring insights from Cooper Linton, Associate Vice President – Duke HomeCare and Hospice, a prominent voice in the home care and hospice sector. In this engaging conversation, Cooper and Ken Segel discuss the impact of fear in the workplace and how it's often disguised as "pressure" or "stress." They explore strategies for leaders to create a supportive and fearless work environment, fostering collaboration and trust among team members.

    Discover how embracing compassion and understanding can transform organizational culture and drive excellence in patient care. This episode offers valuable perspectives on overcoming fear, setting higher standards, and building a stronger, more unified healthcare community. Don't miss this opportunity to gain insights that can help elevate your leadership approach and improve your team's performance. Join the conversation and be part of the movement to revolutionize care in the healthcare industry!

  • Congratulations to former Value Capture client, WellSpan Health, for being honored with the American Hospital Association Quest for Quality Prize!

    Our guest is Roxanna Gapstur, PhD, RN, the President and Chief Executive Officer of WellSpan Health, in Pennsylvania. She has been in that role since January 2019.

    Dr. Gapstur has extensive experience in strategic planning, business development and operational leadership in both ambulatory and hospital settings. She has served in multiple executive roles including chief operating officer, chief nursing officer and as a senior executive accountable for population health.

    Dr. Gapstur obtained her bachelor’s degree from the College of St. Catherine in St. Paul, Minn., and her master’s degree and doctorate from the University of Minnesota.

    In today's episode, host Mark Graban asks her about these questions and topics:

    You’re leading the creation and adoption of a comprehensive lean management system — what does that mean and what do you aim to achieve? As part of that management system, what is Real Time Problem Solving and what are your keystone goals? How will you follow through on the promise of having 20,000 problem solvers? How do you engage with your leaders and teams? Tell us about the importance of you, as CEO, getting alignment, focusing on culture, and leading the transformation…
  • In this episode of "Habitual Excellence," Ken Segel, CEO of Value Capture, interviews Dr. Marc Gorelick, the CEO of Children's Minnesota. Dr. Gorelick shares his journey to becoming a leader in pediatric healthcare, highlighting his background as a pediatric emergency medicine physician and his motivation to impact more children's lives. Throughout his career, Dr. Gorelick has focused on improving clinical effectiveness and system-wide care, aiming to create better health outcomes for children.
    Under his leadership, Children's Minnesota has prioritized building core capabilities in diversity, equity, inclusion, and continuous improvement. These initiatives have been crucial in responding to the rapidly changing healthcare environment, especially during and after the COVID-19 pandemic. Dr. Gorelick shares insights into the organization's strategic planning process, focusing on creating a flexible and nimble system that can adapt to future challenges.
    The conversation highlights the importance of leadership in driving transformational change in healthcare and the ongoing efforts at Children's Minnesota to provide the best possible care for children.

  • In this special episode of the "Habitual Excellence" podcast, Ken Segel, CEO of Value Capture, discusses the leadership principles of the late Paul O'Neill Sr., former CEO of Alcoa and U.S. Treasury Secretary. Joined by Bill O'Rourke, Kevin McKnight, and Paul O'Neill Jr., they share personal stories highlighting O'Neill's unwavering respect for everyone, his emphasis on safety, integrity, and his down-to-earth nature. The episode commemorates the fourth anniversary of O'Neill's passing, underscoring the relevance of his leadership lessons in today's challenging times, particularly for healthcare leaders.

  • In this insightful episode, host Ken Segel engages Ronnie Daves, a seasoned leader in healthcare, to explore the innovative approach of the Pancake Syrup model in delivering high-quality care. Ronnie shares how this model focuses on routine tasks being performed exceptionally well, thereby freeing up valuable time for healthcare providers to focus on specialized patient care. By streamlining operations and fostering a culture of accountability and engagement among frontline staff, the Pancake Syrup model has demonstrated remarkable success in elevating healthcare standards and driving better patient outcomes. Join the conversation as Ronnie and Ken delve into the principles and impact of this transformative approach in healthcare delivery.

  • In this podcast episode, Ken Segel, the CEO of Value Capture, meets with Mayor Ed Gainey, City of Pittsburgh, to discuss the city's journey toward habitual excellence and Mayor Gainey's leadership learnings.

    We will explore the principles of habitual excellence as exemplified by Mayor Ed Gainey of Pittsburgh. The episode delves into Gainey's leadership style, focusing on his commitment to continuous improvement and excellence in public service. It highlights Gainey's background and how his experiences have shaped his approach to leadership. Additionally, the post discusses specific initiatives and strategies implemented by Gainey to foster positive change and improvement within the Pittsburgh community. Through anecdotes and insights, the episode provides valuable lessons and inspiration for individuals and organizations striving for excellence in their respective fields.

  • In this podcast episode, Ken Segel, the CEO of Value Capture, engages in a conversation with Lou Shapiro on developing and deploying a strategy that breaks through and makes the kind of difference we need in healthcare right now, and it's very challenging circumstances, and trying to use this as a moment to change deeply for the better.

    They will discuss lessons learned, but also, as we go forward to think about how to achieve that breakthrough as a sector and as individual institutions.


  • In this podcast episode, Ken Segel, the CEO of Value Capture, engages in a conversation with Dr. David Zaas, a pulmonary and critical care physician with extensive leadership experience in major health systems. The episode revolves around the theme of strategy deployment and its importance in healthcare. Dr. Zaas, who currently serves as the president at Wake Forest Baptist, shares insights into his leadership philosophy and how it has been shaped by his background as a physician-scientist.

    The discussion delves into the challenges facing healthcare, such as cost pressures, consolidation, and job losses, and the need for authentic, optimistic leadership to navigate these issues. Dr. Zaas emphasizes the privilege of working in healthcare and the opportunity to make a significant impact on the lives of patients, communities, and caregivers.

    Dr. Zaas breaks down his approach to strategy into three key components. First, he underscores the importance of a people strategy, where creating an environment of respect, value, diversity, and continuous improvement is crucial. Second, he emphasizes the need to build robust management systems and processes to support the organization's growth and adaptability. Finally, the discussion addresses setting bold goals and achieving excellence, focusing on eliminating harm, striving for top-tier performance, and fostering academic discovery.

    The episode highlights the significance of creating a strong foundation in culture and processes before setting ambitious goals, and it explores how these principles can differentiate healthcare organizations and drive them towards excellence.

  • View video and more here

    ay 16, 2023, from 1 to 2:30 pm ET

    A panel discussion with a team of leaders from Value Capture, LLC, clinicians, Continuous Improvement professionals, and DEIA practitioners (scroll down for bios):

    Deondra Wardelle Mark Graban Debbie Sears Barnard Alan Wikler, Psy.D. Gerald Harris Ken Segel

    About the Session

    Discover what getting to zero harm means and explore how getting to zero harm for patients and staff can be achieved by emphasizing the most fundamental aspect of Lean, actively showing respect for others.

    Recognize how combining Continuous Improvement, Diversity, Equity, Inclusion and Accessibility (DEIA) and the four stages of Psychological Safety can promote health equity and improve patient and staff safety.

    Discuss intentional approaches to create and develop equitable, psychologically and physically safe spaces for diverse healthcare staff and patients of underrepresented groups that benefit staff engagement and the overall patient experience.

  • Deondra Wardelle and Mark Graban discuss the ongoing blog series and upcoming panel discussion webinar on the theme of "Getting to Zero Harm for Patients with DEIA and Psychological Safety.They share what sparked the #RootCauseRacism® collaboration with Value Capture, LLC.They also discuss the power of connecting Diversity, Equity, Inclusion, and Accessibility (DEIA) to Psychological Safety as a way to promote health equity and offer countermeasures that improve patient and staff safety.Blog series: https://www.valuecapturellc.com/blog/tag/rootcauseracismWebinar registration (for the live event or recording): https://www.valuecapturellc.com/webinar-panel-zero-harm-patients-staff-deia-psychological-safety

  • Psychiatrist, expert on "moral injury" in healthcare, author

    Welcome to Episode #77 of Habitual Excellence, presented by Value Capture.

    Episode page with transcript, video, links, and more

    Our guest today is Wendy Dean, MD, a psychiatrist. She is the President and co-founder of “Moral Injury of Healthcare,” a nonprofit organization focused on alleviating workforce distress.

    A seminal article she co-authored with Simon Talbot, MD for STATNews in July of 2018 began the conversation about moral injury in healthcare.

    She’s the co-author of the upcoming book If I Betray These Words: Moral Injury in Medicine and Why It's So Hard for Clinicians to Put Patients First. It will be available April 4th and you can pre-order it now through the publisher.

    In today's episode, Dr. Dean talks with host Mark Graban, about topics and questions, including:

    What is “moral injury”?

    Definition 1: “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.”

    Definition 2: “a deep soul wound that pierces a person’s identity, sense of morality, and relationship to society.”

    Why is moral injury different (and worse) than “burnout”? What’s the effect of moral injury? Can anything be done to reverse moral injury and its effects? Or just need to stop injuring others? What are some of the primary causes of moral injury in healthcare? How is the healthcare system broken? Recommendations related to EMR/EHR? Getting rid of "the stupid stuff" The role of psychological safety in creating an enabling environment… Why did you stop practicing as a psychiatrist? What’s the Level of moral injury in countries like Canada or England that have very different healthcare systems? What reforms do you recommend? With urgency... A "Clinician Protection Act"?

    Click to visit the main Habitual Excellence podcast page.

  • See video and more via this page

    The recording of the webinar panel that was presented on January 25, 2023.

    A panel discussion with:

    Karen Wolk Feinstein, PhD, President and CEO of the Pittsburgh Regional Health Initiative Ken Segel, CEO of Value Capture Moderated by Mark Graban, Value Capture

    1

  • Register here

    January 25, 2023, 1 to 2 pm ET

    A panel discussion with:

    Karen Wolk Feinstein, PhD, President and CEO of the Pittsburgh Regional Health Initiative Ken Segel, CEO of Value Capture Moderated by Mark Graban, Value Capture

    The Institute of Medicine’s groundbreaking report, To Err is Human, was published 20 years ago and spurred a vigorous effort to improve patient safety, but preventable medical errors still cause an estimated 250,000 deaths a year in the United States, making this problem the third-leading cause of death. Additionally, the COVID-19 pandemic has put the healthcare workforce in crisis, and safety is suffering.

    Well-intentioned efforts to improve processes and change behavior in the healthcare industry have been decentralized and resulted in minimal improvements, says Karen Wolk Feinstein, Ph.D. The failure can be traced, in part, to the lack of a single federal agency that investigates healthcare errors and identifies ways to prevent them, she says.

    Dr. Feinstein is spearheading the creation of a proposed federal independent agency, the National Patient Safety Board (NPSB), modeled in part after the National Transportation Safety Board (NTSB) and the Commercial Aviation Safety Team, that would identify and anticipate significant harm in healthcare; provide expertise to study the context and causes of harm and solutions; and create solutions to prevent patient safety events from occurring.

    This idea is fully supported by Ken Segel, as he has discussed in this blog post. He will join Dr. Feinstein for the discussion.

    In December, legislation was introduced into the U.S. House of Representatives: H.R.9377 – the National Patient Safety Board Act.

    Learning Objectives

    This session will cover topics including:

    The inspiration provided by the late Paul O'Neill, Sr. What progress have we seen on patient safety in the past 20 years? Why haven't we seen more? How can we spread proven approaches for preventing harm? Why create another new agency, the NPSB? What models were used to formulate the NPSB? What coalition have you formed to support the NPSB, and how can attendees help?

    You'll be able to ask our expert panelists live questions about this legislation, the NPSB, and patient safety in general.

  • President and CEO of Washington Health System

    Episode page with links, transcript and more: https://valuecapturellc.com/he74

    Welcome to Episode #74 of Habitual Excellence, presented by Value Capture.

    Joining us today as our guest is Brook Ward, the President and CEO of Washington Health System (WHS) in Washington County, Pennsylvania, in that role since July 2019. From 2010 to June 2019, he served as Executive Vice President and Chief Operating Officer.

    In his role, Brook provides leadership, direction, and administration across the entire Washington Health System, which includes a large community hospital, a small rural hospital, a 70-provider physician group, a community wellness center, residency and fellowship programs, a school of nursing program and onsite medical simulation center and joint ventures in the areas of hospice, senior living, home health, cancer center and others.

    Brook is a graduate of Grand Valley State University, Grand Rapids MI, with a master’s degree in Public Administration (MPA). He also has a Bachelor of Science in Health Care System Administration from Ferris State University, Big Rapids MI and received an Associates of Allied Science in Radiology from Ferris State University.

    Today we’re going to be talking about how the WHS has never (I repeat, never) used a traveler nurse in their system. Acknowledging the travel nurses are skilled and they're good people, Brook makes a compelling case that quality and safety is better with full time staff members who are not "strangers" to the organization and how they do things. Brook also discusses the program that they created (and continue to iterate) that's win/win/win for the system, staff, and patients.

    In today's episode, Brook talks with host Mark Graban, about topics and questions, including:

    How bad are the staffing challenges in your area? Biggest concern - not just economics, but safety for patients and staff Great people, but there’s a risk… safety, morale, not knowing our systems It's their "fourth or fifth iteration" -- what's the latest iteration and change? Staff get almost the same comp by picking up extra shifts, without needing to travel Telling peers about it — can’t get people too interested?? Why? Expense gets talked about more… is there research about the impact? Future retrospective studies?? Iteration — Impact of extra shifts over time?? Meeting with nurses to learn what’s working and not working Risk of burnout and fatigue — constant dialogue PILOT — Inpatient innovation unit to pilot and test things around team-based nursing So speaking of safety, you created a safety index — tell us about that? "Washington Hospital Patient Safety Score" Tell us about the Washington Performance System — respect, their version of Lean/TPS — your key influences?? "Permission to try things and fail” — how to create that culture?

    Click to visit the main Habitual Excellence podcast page.

  • View the slides, video, and more

    Presented by two leaders from Duke HomeCare & Hospice:  

    Cooper Linton, Associate Vice President, Duke HomeCare & Hospice 

    Janet Burgess, Director Patient Care Services 

    Mike Radtke, from Value Capture, will also be part of the Q&A

    Duke Home Health (DHH) faced a crisis of nursing turnover, even before COVID hit. Staffing retention is a major issue across all of healthcare -- please join us for this impactful and practical webinar regardless of where you work within the broader healthcare system — home health or otherwise!

    Powered by a system-wide quest for zero harm throughout Duke Health, DHH leaders used this philosophy and accompanying principles to identify root causes, then build rapid-cycle learning into improvement and management systems. Investigation revealed poor staff engagement and excessive work-process burdens, leading to significant negative patient impact, referring-customer dissatisfaction, and financial harms.

    To resolve these problems, DHH’s rapid-cycle learning system, rooted in the principle of respect, involved:

    Understanding of current condition Leadership behavior changes to quickly respond to staff needs, remove barriers, and coach problem-solving Tiered-huddle management system to elicit and escalate problems, especially safety problems, and vitally, ensure psychological safety so frontline staff and managers raise issues The willingness to shed traditional leadership methods, to experiment, iterate and be perpetual learners

    So far, RN turnover has been reduced from 75% to 18% (annualized rates).

    These lessons are transferrable to many different settings, so please attend if you work outside of home care.

    Learning Objectives

    This session will provide practical tips on how to design systems that produce:

    Responsive, supportive, effective leaders Empowered, engaged safe employees Better patient and financial outcomes
  • Webinar preview -- Register here to watch live or get the recording

    Nursing turnover is very likely costing your organization millions of dollars. But you don't have to just accept that… you can fix it.

    I'm happy to be moderating a webinar that is being hosted by Value Capture, presented by two leaders from Duke Health who have reduced nursing attrition from 75% to 18% (annualized rates) in just over a year.

    Using a Rapid-Cycle Learning System to Tackle Turnover & Attrition

    It comes down to leadership.

    Duke HomeCare & Hospice reduced nursing turnover from 75% to 18% in one year's time.

    The same principles and systems they used can work in ANY type of healthcare setting!

    Join us for a free webinar on December 6th, presented by Cooper Linton and Janet Burgess, two leaders from that organization.

    How did they reduce nursing attrition? How did their teams do this?

    They worked hard to understand the current condition, instead of jumping to solutions Leaders changed their behaviors to quickly respond to staff needs, remove barriers, and coach them on problem-solving (instead of having all the solutions themselves) Their tiered huddle management system, with a focus on psychological safety making it safe for them to raise issues so safety problems and other issues could be solved Leaders were willing to shed traditional leadership methods, to experiment, iterate and be perpetual learners.

    Now you can learn from them – their process and their results.

    Join us Tuesday December 6th from 1 to 2 pm eastern – it's free… join us live or we'll send you the recording.

  • Episode page with video, transcript, and more

    Joining us today as our guest is Louis (Lou) A. Shapiro. He is the President and Chief Executive Officer of the Hospital for Special Surgery HSS. He has served in this role since October 2006.

    Under Lou’s leadership, HSS has experienced significant growth, expansion of facilities and recognition as the world leader in its specialty areas of orthopedics, rheumatology and their related disciplines.

    Lou has more than 30 years of healthcare experience, including as Executive Vice President and Chief Operating Officer of Geisinger Health System in Pennsylvania, and as a leader in the healthcare practice at McKinsey & Company. He began his career at Allegheny General Hospital in Pittsburgh, where he served in a number of capacities.

    Today we’re going to be talking about how the culture at HSS contributes to their habitual excellence, including 13 years being ranked #1 at what they do as a specialty hospital for musculoskeletal care. What's the role of hiring the best of the best and how does a culture help them thrive and stay? What can be learned from the HSS approach that delivers such great value, including incredibly low infection rates.

    In today's episode, Lou talks with with host Mark Graban, about topics and questions including:

    Patients being willing to travel to HSS for better care and service (Net Promoter Score of 94) HSS will be celebrating its 160th year anniversary Do other organizations who are losing patients to HSS look to them for how to improve and compete? Why Lou doesn't compare HSS to anybody else Sharing data transparently Culture as strategy Would the HSS management model and culture translate to a general hospital or system? Commitment to culture on top of hiring the very best (and keeping them) Breaking down tradeoffs: better flow, faster care can also be more caring care, higher quality care, safer care Comparing costs - not just per episode, but across the continuum including conservative care The importance of not becoming a commodity Being visible and accessible as a leader "Excellence" as one of the values of the organization and realizing you're not perfect Aiming for and wanting ZERO injuries, infections, complications and ZERO dissatisfied patients