Executive Conversations: Change Before You Have To

Over the past year, Sutter Health, the 24-hospital, 5,000-physician California health system, aggressively redesigned itself.

Sutter built patient-centricity into the organizational chart, installed physician leaders in key roles, and created leadership “dyads” linking key clinical and administrative functions. It also put a new focus on patient experience, creating functions to encourage cross-silo collaboration and innovation. In this Executive Conversation, Dr. Stephen Lockhart, Sutter’s chief medical officer, and Linda Khachadourian, who fills the newly created role of chief enterprise transformation officer, explain how they guided the process by keeping the focus on the patient.

Taking down the barriers: Linda Khachadourian on creating “one Sutter”

For a long time, we've been on this journey toward being “one Sutter”—one organization. Our latest round of change was a natural next step in that progression. What's different is that we've tried to remove some of the barriers, real or imagined, that might exist out in the field to allow more sharing of best practices. We've embedded people in the right places so the right partnerships can exist so we can share resources in a better way. We've tried to eliminate barriers or silos so there are more opportunities for sharing and more opportunities to design things from a system perspective and then deploy them as appropriate across the organization.

The other thing we've been trying to work on is our dissemination processes. We really have to have a much faster cadence once we've identified something that works, so we have the right tools and processes and people that can translate an idea to action as quickly as possible. And if it doesn't work, that’s OK. We can fail, fail fast, improve, and come back out with something even better.

Sam Glick Answers 3 Questions
  • 1Why is Sutter's restructuring worth paying attention to?

    They did many things right. They got started when they were under little financial pressure to do so. They involved a wide range of leaders. And they enhanced both their business efficiency and their focus on their mission at the same time. I think other health systems should pay particular attention to their "dyad" approach to organizational structure, and the steps they've taken to speed up innovation - especially the dissemination of innovative ideas throughout the system.

  • 2How does the dyad approach work?

    The dyad concept has been around for a number of years at a handful of top healthcare organizations. The idea is that physician and non-physician leaders are paired as dually-accountable leadership teams. The goal is for the institution to do a superior job of balancing its goals of clinical and operational excellence. Sutter has built the concept deep into its structure, and is already seeing favorable results.

  • 3You mentioned mission. How does Sutter view its mission?

    Fundamentally, Sutter strives for community impact and national leadership. This is an intensely patient-centered organization. Throughout the restructuring, the design team kept their focus on patients. They created an Office of Patient Experience with a mandate to set standards for how patients access care, how to make it personalized and high quality, how to make it seamless. They also designed an organization that supports a more continuous model of care, making the links between ambulatory and acute, and engaging clinicians across the continuum.

Executive Conversations: Change Before You Have To