HealthCare Business News spoke with MemorialCare’s chief transformation officer Helen Macfie about her background, the newer version of what the CTO title can mean and about what that role delivers. Macfie also talked about the ongoing work her organization is doing to improve a number of patient-centered metrics.

HealthCare Business News: How long have you been with MemorialCare?
Helen Macfie: Since 2005. I actually did an administrative residency in the early ‘80s and returned home to my current position in 2005.

HCB News: What attracted you to pursuing a career in healthcare?
HM: I was originally an education major. Kind of a side story — my parents moved and said “you have to get a job to stay out in California,” which I badly wanted to do, so I got a job in a regular outpatient pharmacy. I remember one day thinking, “I can do what that guy’s doing,” so I applied and got into a very good clinical program with clinical pharmacy, which was at the forefront back then. It was a great program, and I learned a lot about inpatient hospitalized care. I worked in that, providing all kinds of services in all kinds of nooks and crannies of the hospital. Eventually, I got into system designs to work on safer medication systems and medication protocols, working with doctors who put those together. From there, I ended up getting into management of the pharmacy as director. One day, someone said I’d be really good at working at big system quality, not just for pharmacy. So I looked into that and ultimately moved over to overseeing that particular hospital’s quality programs and I guess the rest is history.

HCB News: What is the role of a Chief Transformation Officer?
HM: Sometimes, the T stands for technology, so this is different from that. It’s a newer role in healthcare. Originally my title here was senior vice president of performance improvement. The way I describe my role now is really in three parts. One is improving the performance of “fill-in-the-blank” opportunities. Certainly quality and safety, it could be Lean experience and operational design — so ways to improve the care that we provide. The next component is overseeing our strategic planning for the health system, so really working with our governance and our executives to move MemorialCare forward and take on our next set of challenges. The third, I think because of my clinical background and all the work I was able to do and all the learning, there is a set of what I call “the gnarly projects.” Those are the projects we want to roll out across the health system that have a clinical focus. An example of that might be four years ago when we wanted to create a clinically integrated network with our doctors co-leading on projects. So we got that together and I’m the executive administrator for that work. Or a more current one, since February of 2020 I’ve been serving as our incident commander for the COVID command center of our pandemic response.

HCB News: With the CTO title, in this case with the T for “transformation,” are there training courses or other formal education tied to the role?
HM: No, there’s no degree program to be a chief transformation officer. Usually the folks I know who do this kind of work have evolved. Most of them are clinical. I have a clinical background — pharmacy, nursing, medical, etc. We somehow have that identified skill which is that we’ve worked in the healthcare system, we have a lot of experience in what it takes to do it well. Many of us have a very good facilitative ability to be able to take people and the challenges in front of them and be able to take them from here to there to figure out what will work to redesign the system. I think the last skill is the ability to inspire people to get them to think we can change. A lot of health care was built maybe since World War II — so roughly 80 years — ago and so many aspects of healthcare have evolved over that time, yet in some cases we’re still working in the some of those same buildings from back then. Really, there’s a lot of processes and technologies and tools and complexity that have happened in just 80 years. Transformation is about taking that and taking it from wherever you are now to a better “where,” so we can make It more reliable and simpler for folks to work in a system, provide that great quality and safety and basically plan for the future to make health care amazing.

HCB News: Prior to the pandemic, what were the biggest challenges facing MemorialCare?
HM: We’ve really grown as a system. When I first joined, we were more hospital-focused. Since 2010, we have a whole array of focus on providing care where people work and live. We now have a medical group, a physician organization out there in our communities, ambulatory care — surgery, imaging, dialysis, physical therapy, along with our hospitals. It’s really been about growing MemorialCare into this amazing jewel in our area. Because of that, we’re being tapped on the shoulder by many health plans and employers to provide care for their members or beneficiaries. It’s really about creating that whole system safety not just for hospitals, but across the whole ambulatory network. That was one of the challenges.

Another great example is working on something called ease and access. We’re about transforming and revolutionizing care. Part of that is making it easy and accessible for people to reach us. I think some of that has to do with safety as well. For example, we’ve put together key things so people can find us online, digitally or human interactions. We have a navigation system we’ve put up where people can call for help to connect their care. We have advice nurses available 24/7 that can help people with their questions. We have online scheduling for appointments. It’s just about making it very easy for people to get in for their care and helping them to navigate their care. While it may not sound like a traditional safety project if you will, helping people navigate their care and get connected is probably one of the best things we can do so that they get great advice and get timely care even during the time of pandemic.

HCB News: In regard to safety, when was MemorialCare’s pledge to join the Patient Safety Movement Foundation made?
HM: We actually started our efforts in 2005 — we made an internal pledge to get to zero incidents at MemorialCare then. Because of that commitment and our work there, I got invited to be on a panel at one of the Patient Safety Movement Foundation’s annual meetings. At the time, Joe Kiani, CEO of Masimo was leading the movement and I got to meet him. I was impressed by the meeting and the conversations and the panelists, so later that year in December 2019, when they were taking in the commitments, our team filled out the lengthy and comprehensive application. We were very happy to get to the five-star level not only in terms of our commitment, but our outcomes. Joe came to our meeting we had with our executives to present us with the award in February right before March and the major start to the pandemic. Of course life changed after that with added focus on safety in regard to the pandemic.

HCB News: It sounds like with the work you did previously, you were really well-positioned to meet the requirements of that pledge?
HM: We were. When I first started, really working with another organization I also like — called the Institute for Healthcare Improvement or IHI – it was about reducing preventable harm, reducing preventable mortality and improving the patient experience. Those three focus areas have really driven our internal goals for quality of care for our hospitals and ambulatory settings. Again, we’ve had 16 years’ experience really doing that and that is partly how we’ve gotten to our 85% reduction in harm. But it’s a series of goals that dovetail very nicely with the Patient Safety Movement Foundation’s. They’re things like reducing patient infections, reducing pressure injuries, reducing falls with injuries, reducing maternal complications … we’ve had those goals for a while. What I’ve found with the Patient Safety Movement Foundation’s approach to that is really the rich research they have done into the area and the production of tool kits so me, as a provider and a lifelong learner, would be able look at the toolkits and say, “we’ve done that, we’ve done that. Oh, here’s another good idea!” It’s allowing us to mine for those other best practices and then bring them back to our teams. We have a series of teams. We have what we call “best practice teams” with clinicians, physicians, pharmacists, nurses, dieticians, socials workers — the folks that work at the bedside or the visit side that come together to create what will work at MemorialCare. We’re always looking at externally facing toolkits to see what else we can learn to augment the work we’ve already been doing to sustain our improvements as well as to make further improvements.