I was struck by my early impression of Wright’s leadership capabilities and his accomplishments. Even though Wright would not necessarily have been on our radar, because he ran a smaller organization, I thought, “Wow, this is a person who could really do the job.”
I told Kathy about Wright, and she began the due diligence process. After she came back with a very positive response, I spent time talking with him and subsequently went out to visit him in Oakland. We had an excellent dinner and I spent the better part of the following day meeting with Wright and his senior team to learn about what he’s done and the important issues he faced. With a public hospital board and a very challenging set of business circumstances, he didn’t have an easy job. Despite the fact that the Alameda Health System was much smaller than HFHS, Wright was dealing with significant complexity. We began what turned out to be nearly a year of discussions. Sandy Pierce, chair of the board, went out to meet with him after I did, and she agreed that he seemed like a talented leader who was ready for this type of opportunity.
The courtship process is always interesting and delicate. Although Wright and his wife, Cathy were not sure they did not want to move to Detroit and brave the brutal winters, we continued to encourage them to visit. If my experience at Henry Ford taught me anything about attracting leaders, it is this: the key to increasing interest is getting individuals to visit. The people and the culture here are extremely special, and if the fit is right, a visit generally seals the deal.
In September 2014, Wright and Cathy came out and spent three days with us. We had the best weather in months that week, despite a horrible winter and a rainy summer. They had dinner one night with Sandy and her husband and Pam and me, and over the next two days Wright met key board members and some of the executive team. As we hoped, Wright became enamored with the organization and the opportunity to lead it. Most importantly, Cathy became comfortable enough with the community that she said to Wright, “This is what you’re supposed to do next. I can see it. I can see it in your eyes, I can see it with how you’re interacting with the folks here. I’m not sure I’m going to love Michigan, but this is where you’re supposed to be and I’ll support you.”
According to Wright, there were three things that made Henry Ford a place he wanted to be. First, there was our vision of an organization that would operate at the top of the game in health care but still maintain humble roots in the community it serves. That was a very big part of the equation for him. Next, he found the plethora of strategic conundrums facing Henry Ford, as well as the numerous opportunities, to be intellectually appealing. The last thing he found appealing, he said, was the opportunity to help lead a major economic force in a community that was experiencing a renaissance. The chance to participate in restoring Detroit was a significant attraction for him. In short, Wright said that it was “wildly appealing to be able to lead an organization that would play a significant role in reestablishing one of America’s greatest cities to the successful point.”
I think that says it all.
An Unconventional Succession
Succession is a process like any other, and people need to proceed through the stages of change in order to reach acceptance. Bringing Wright on board in the way we did—going outside the usual search process and building in a two-year overlap for Wright and myself—was designed to ease the transition for the organization and for Wright. Did it work that way? I think it did, but let me explain the rationale.
By circumventing the traditional executive search process, we believed we could find the right candidate faster and create a clear pathway for him. Sometimes an organization needs a turnaround effort to get things back on track. That entails a departure from the type of leadership the organization had previously been accustomed to. Yet at other times, a radical shift is not what’s needed. At Henry Ford, I got the clear sense from our board and our leadership that we needed to sustain the progress we had made and continue to grow. Given that mandate, I was concerned—and I think our board shared my concern—that the traditional search process would be risky. When you are going out and simply casting the net, the odds of finding the right fish are not great.
Because the stakes were so high, we opted to trust our instincts and maintain a greater degree of control. After all, a large part of success in leadership transitions is achieving the right fit culturally. You can have the smartest leader in the world, but if he is not a good match for the organization, he may fail and the organization may falter. My deep understanding of our culture and the specifics of our environment enabled me to identify Wright as a prime candidate within an hour of hearing him speak. He was running a much smaller organization at the time, so chances are good that he would have slipped through a search firm’s net. Yet, after thirteen years of running HFHS, I have a clear sense of the type of person who will thrive here. By bringing on Wright, I could vouch for him, in a sense, and be the one to introduce him and enter his phenomenal past performance into the record. In addition, identifying Wright while I was still part of the organization made people more comfortable with the change because we were able to maintain some sense of familiarity.
We hired Wright as president of the system in December 2014, two years prior to my departure, as a way to buy us time. Extending the transition allowed the board and the rest of the leadership team to learn to work effectively with Wright while I was still on hand to support him. To borrow a metaphor from Dr. Kimberlydawn Wisdom, transitioning from me to Wright is like passing the baton during a footrace. In order to avoid dropping the baton, you run alongside the next runner for many yards before he actually grabs the baton and takes off with it. You don’t just throw it to your teammate and expect him to catch it on the fly. In this case, the extended transition created a smoother handoff.
So far, the handoff is smooth indeed, and if our strong performance is any indication, it will almost certainly continue. As I look toward my retirement in December 2016, the sting of stepping away is greatly lessened because I know that I am leaving the organization in such capable hands.
My Hopes for the Future
As I look toward the next chapter of my life, I feel like I’m leaving Henry Ford at the right time—the organization has strong momentum and a special leader will be in place as chief executive. We’ve become a $5 billion organization with 23,000 employees and more than 89,000 patients admitted to HFHS hospitals annually. We are the fifth-largest employer in metro Detroit and the sixth-largest health system in Michigan. I hope that our considerable success is ongoing—and I believe that it will be, in large part because of the excellent people we have in place and their commitment to HFHS’s mission, vision, and values.
My hope for Detroit is that it continues along its path to renewal and that the health-care sector, and Henry Ford in particular, continues to play a role in restoring the city to greatness. Judging by the number of new tech companies, investments in the arts and sports, the significant increases in venture capital and federal research grants, and the soaring pride of longtime residents of Midtown and Downtown Detroit, the city is, once again, full of possibility and poised for future growth and momentum.
In health care, I hope that we can understand our patients better and engage them at a much deeper level. The cultural complexity of our world means that everyone’s needs are different, and I hope that we can create a customized approach to health care that takes diversity into account. There’s also significant work ahead to determine how to pay for high-quality, reliable care in this country. I hope that we can continue to innovate and devise new and better models for delivery and financing.
I also hope that women and minorities fill more top positions in health systems and large organizations in every sector. I have no doubt that business will become a better place with greater diversity in leadership that fully reflects the global world we live and work in. This will require systemic changes, as well as a personal commitment from individual leaders to focus intentionally on equity and diversity.
/> Turning to my future, I also have a number of hopes for myself. One, which is very personal, is to take better care of myself: to exercise, have fun, and build into my life the hobbies I enjoy. I think that will help me stay in better shape and hopefully live a little bit longer.
The second thing I hope is that I can remain intellectually engaged through board service, teaching, community service, and other special projects. I want to serve on a number of different types of boards, for instance, and move beyond health care. As a lifelong learner, I have enjoyed getting to know organizations such as Walgreens and the Kresge Foundation as I’ve served on their boards. The next part of intellectual engagement, for me, is through teaching. I hope to continue to teach—probably at the University of Michigan and Cornell—on at least a part-time basis. Finally, I hope and expect to be involved in helping children within the community of Detroit and elsewhere.
My hope for Michigan is that it becomes more hospitable for its LGBT citizens. Pam and I hope to stay in Michigan for both personal and professional reasons, yet we need to live in a place where we feel comfortable. We are, frankly, disappointed in Michigan’s current lack of support for the LGBT community. There are too many examples of the state making poor decisions, in my view, including our governor’s recent signing of a law that essentially allows discrimination against LGBT people. It’s a disappointing development, but I realize we can either stay and try to make a difference or retreat. We’d like to stay. We have a wonderful circle of friends and family here, including both our dads. In addition, we’ve felt tremendously supported at Henry Ford and elsewhere—there are a lot of enlightened people in Michigan, and certainly in Detroit.
Finally, I also hope to contribute in a public service capacity. In the spring of 2015, I received a call from Sloan Gibson, the deputy secretary of Veterans Affairs, to say that President Obama was interested in appointing me to the Commission on Care, established by Congress to examine ways to best deliver health care to military veterans. He asked me questions about my background, and I said that what I really like to do is make organizations better. I was a chief operating officer for twenty years, and I’m very operationally focused. I think he liked what he heard, because he called back in a week or so and asked if I would be willing to chair the commission. It’s not an honor I expected, but the timing is ideal, with Wright on board, and the opportunity dovetails perfectly with my interests. I also believe it reflects well on HFHS to have me serve in this capacity.
I am proud of what I have accomplished in my career, although I believe that health-care leaders have to put a foot on the gas pedal and be willing to be unconventional if health care is to improve. I got into health-care to make it better—it’s always been a labor of love for me. And if I hadn’t gotten into health care, I always thought I’d be an orchestra conductor. As a young violinist, I loved watching conductors. I found it amazing that they always knew what everybody was doing. They managed every part of the orchestra—every musician and every instrument that needed to chime in to create beautiful music. I’ve talked about this for years, and people look at me and say, “Nancy, you are leading the orchestra!”
It has been a different sort of orchestra, but one that nonetheless brought together many different sights and sounds. When I think of the people I have met over the years in leadership and the situations we’ve weathered together, I see how the arc of my career comes together in a sort of musical score, and I hope that I have been the sort of conductor who helped people perform at their best.
NOTES
Introduction
1. This quote always makes me think about Maya Angelou. It is frequently attributed to her in books and other publications. For example, USA Today listed the source as an “interview for Beautifully Said Magazine (2012)” here: http://www.usatoday.com/story/news/nation-now/2014/05/28/maya-angelou-quotes/9663257/. However, the original source, if it exists, is unknown to me.
2. Sara Ellison and Wallace P. Mullin, “Diversity, Social Goods Provision, and Performance in the Firm,” Journal of Economics and Management Strategy 23, no. 2 (Summer 2014): 465–481; and “Connecting Corporate Performance, and Gender Diversity,” Catalyst, 2004, accessed August, 3, 2015, http://www.catalyst.org/system/files/The_Bottom_Line_Connecting_Corporate_Performance_and_Gender_Diversity.pdf.
Chapter 1
1. “Women CEOs of the S&P 500,” Catalyst, April 3, 2015, accessed August 3, 2015, http://www.catalyst.org/knowledge/women-ceos-sp-500.
Chapter 2
1. In 2013, we fell slightly short of profitability due to the installation of a new $350-million electronic medical record system.
Chapter 3
1. Ralph Waldo Trine and Henry Ford, The Power That Wins: Henry Ford and Ralph Waldo Trine in an Intimate Talk on Life—the Inner Thing—the Things of the Mind and Spirit—and the Inner Powers and Forces That Make for Achievement (Indianapolis, IN: Bobbs-Merrill Company, 1929), 147.
2. Jeffrey L. Rodengen, Henry Ford Health System: A 100 Year Legacy, (Ft. Lauderdale, FL, 2014), 223.
3. Rodengen, Henry Ford Health System, 224–225.
4. Rodengen, Henry Ford Health System, 220.
5. Henry Ford and Samule Crowther, My Life and Work (Garden City, New York: Garden City Publishing Company, Inc., 1922), 83.
6. “Depression Care Program Eliminates Suicide,” Henry Ford Health System, accessed August 3, 2015, http://www.henryford.com/body.cfm?id=46335&action=detail&ref=1104.
7. Sabrina Rodak, “6 Steps to Encourage Patient Safety Innovation at Hospitals,” Becker’s Hospital Review, October 1, 2012, accessed August 3, 2015, http://www.beckershospitalreview.com/hospital-physician-relationships/6-steps-to-encourage-patient-safety-innovation-at-hospitals.html.
8. This is something that William Conway, Henry Ford Medical Group CEO and Chief Quality Officer HFHS, has talked about quite a bit.
9. Tara Parker-Pope, “Making Hospitals Pay for Their Mistakes,” New York Times, December 19, 2007, accessed August 3, 2015, http://well.blogs.nytimes.com/2007/12/19/making-hospitals-pay-for-their-mistakes/?_r=1.
Chapter 4
1. Henry Ford, The Great To-Day and Greater Future (New York: Cosimo, 2006), 66.
2. Henry Ford, The Great To-Day and Greater Future, 66.
3. Bill Taylor, “One Hospital’s Radical Prescription for Change,” Harvard Business Review, June 2, 2010, accessed August 3, 2015, https://hbr.org/2010/06/going-radical-one-hospitals-p/.
4. The 3-D printing efforts in cardiology are led by William O’Neill, MD, and the Structural Heart Team at HFHS.
5. StatChat was created by two HFHS doctors: Dr. Ogochukwu Azuh and Dr. Peter Adams.
Chapter 5
1. Ford published an anti-smoking book in 1914: The Case Against the Little White Slaver (Detroit: Henry Ford, 1914, revised 1916).
Chapter 6
1. The latest breakdown by ethnicity and nationality dates back to the 2010 census: http://quickfacts.census.gov/qfd/states/26/2622000.html.
2. Christopher P. Scheitle and Roger Finke, Places of Faith: A Road Trip Across America’s Religious Landscape (New York: Oxford University Press, 2012), 174.
Chapter 7
1. Jeff Green and Mark Clothier, “U.S. Automakers Thrive as Detroit Goes Bankrupt,” Bloomberg News, July 19, 2013, http://www.bloomberg.com/news/articles/2013-07-19/u-s-automakers-thrive-as-detroit-goes-bankrupt, accessed August 3, 2015.
2. John Wisely and Todd Spangler, “Motor City Population Declines 25%,” USA Today, March 24, 2011, accessed August 3, 2015, http://usatoday30.usatoday.com/news/nation/census/2011-03-22-michigan-census_N.htm.
3. “TechTown of Detroit, History,” accessed August 3, 2015, http://techtowndetroit.org/about-us/history/.
4. Natalie Broda, “Detroit Launches Innovation District to Spur Job Growth,” Detroit News, June 12, 2014, accessed August 3, 2015, http://www.crainsdetroit.com/article/20140612/NEWS/140619939/detroit-launches-innovation-district-to-spur-job-growth.
5. Steven Ross Joh
nson, “Mothers’ Helpers: Providers, Insurers Use Home Visits to Reduce Infant Mortality,” Modern Healthcare, March 14, 2015, http://www.modernhealthcare.com/article/20150314/MAGAZINE/303149941.
Chapter 8
1. Moses Harris, “Henry Ford-Beaumont Merger May Have Been Doomed by Good Financial Health,” Detroit Free Press, May 27, 2013, accessed August 3, 2015, http://www.freep.com/article/20130527/BUSINESS06/305280010/Henry-Ford-Beaumont-failed-hospital-merger.
INDEX
A
accessibility, 91
accountability, 47-48
Affordable Care Act, 19-20, 37, 58, 63, 127, 133
African American Initiative for Male Health Improvement, 122
AIDET + 1 standard, 82
Akron City Hospital, 1-2, 4-5, 132
Sation during turnaround at, 28-29
disruptions facing, 20
innovation at, 67
recognition program, 92
Alameda Health System, 133-134
American Diabetes Association, 89
American Heart Association, 89
American Hospital Association, 77
art, 90
assembly lines, 42, 46
avatar technology, 66
B
Babcock & Wilcox Company, 16, 29
Balanced Budget Act of 1997, 20, 21
Baldrige award. See Malcolm Baldrige National Quality Award
Beaumont Health System, 126-130
best practices, 45, 47-48
blame, 31-32
boldness, 1-17
Buerki, Robin, 59
bureaucracy, 79
buy-in, 85-87
C
Cardinal Health Distribution Center, 117-118
careers
author’s path, 3-5
doing difficult things in, 9-17
Unconventional Leadership Page 16