Reflection from Leibig
The J&J/UCLA Health Care Executive Program was, hands down, the best management program I have attended in my 28-year career in health care management. As a result of the education I received, my Board, executive team and I have revolutionized Clinica Campesina. When I went to LA, we were bleeding over $50,000 a month in cash due to Colorado's reductions in Medicaid rates and benefits as a result state budget shortfalls and a loss of a $250,000 per year private donation. As of the last 4 months of 2003,this monthly loss has been eliminated. This recovery was based on a plan I, and my Board chair developed as a CHIP (Community Healthcare Improvement Project) while attending UCLA. Our CHIP instructor, Dr. Osborne, chastised us to set "big hairy audacious objectives" and we did.
The plan involved a number of factors. One of the lessons learned at UCLA was that performance depends on a number of factors, which are all interrelated: Strategy, Structure, Processes, Rewards and People. Following the J&J program, Clinica Campesina adopted a new strategic plan, reorganized our staffing structure, implemented a staff reward program, continued our emphasis on reducing staff turnover and continued implementing the process change principles of the disease collaboratives and practice redesign. These changes allowed us to significantly increase clinician productivity. We also analyzed our existing cost and staffing structure and realized that we had the facilities and support staff to add clinician FTE without adding other staff or facilities. At UCLA, I learned to "work on the margin." By adding relatively small marginal costs (provider time and variable visit costs) we could reap a fair amount of profit to fill the void in our budget. These changes saved the day for Clinica Campesina.
Two aspects of the Program stand out in my mind: the faculty and the students. The range of topics covered in the two-week program is mind-boggling. In fact, we were warned on day one that the class had been described as drinking from a fire hose and that we should have a strategy for absorbing as much as we could. The prediction about the volume of material was accurate, but I managed to accumulate plenty of valuable "take homes" by keeping a notebook of great ideas to implement when I got home. The faculty were so amazing that I had to buy a second notebook while at UCLA to record all of the great ideas. It was also very helpful to be in class with other seasoned executives serving the underserved. The after class discussions (with a glass on wine or two) and in-class exercises with classmates were extremely valuable. The information we learned in class became more useable as I discussed with my fellow executives how they intended to apply it.
In my 28-year career in health care planning and management, 17 of which as the CEO of a Community Health Center, I have attended over a dozen intensive multi-day trainings on how to do my job. Many of these have improved my skills and I have made many changes in how I do my job over the years based on this learning. But, again, none have had as great an impact on me or my organization as the UCLA/J&J Health Care Executive Program. I cannot think of a better investment an individual Health Center could make in improving both the access to care for the underserved, or the quality of care delivered than taking the time to attend this amazing program.
Pete Leibig, President and CEO (Class of 2003)