This is part of an ongoing series of audio profiles of front-line improvers.
Chairman of the Board
Maine Medical Center
I’m Meg Baxter and I am the chairman of the board of Maine Medical Center. It is a tertiary care hospital of about 600 beds. We have a three-part mission: patient care, education, and research. We are very, very proud of our commitment to quality in all areas of our mission. And my day job is president of the United Way of Greater Portland.
As odd as it sounds I really enjoy health care despite its complexity, and I like to tell the story that growing up in Boston as a very sickly child I was cared for at Mass [Massachusetts] General Hospital. When you grow up thinking that that’s the standard of care that everybody gets it was a great honor to be asked to be on the Maine Medical Center board, and then when I was asked to get into the leadership queue it really was another great honor. I think it has always had a lot of responsibility but when you add in the layers of regulation, finances, physician employment — all of the pieces, the moving parts of a hospital — if a trustee doesn’t come to the table doing his or her work, he or she should not be there.
We’ve been involved in quality and safety for quite a while. About nine years ago we took all of our initiatives and resources that were aimed at safety and quality and put them into what we call our Performance Improvement Center. On top of that we have a Board Performance Improvement Committee. We’ve done a lot of change recently around that committee in terms of developing a monthly education curriculum — they’ve actually added harms stories to every meeting — and we’re in the process of adding two new members with process improvement skills, and that’s kind of interesting because we’re looking at folks who might have those skills perhaps from the manufacturing or the for-profit world. That’s really different than the kinds of folks that we’ve traditionally brought on to the board.
We really want to learn. Some of that learning can happen from our physicians, from our management experts, from the team that leads us from a staff perspective, but it’s great when trustees can get a broader perspective from national experts, from other hospital trustees — that sharing of information, the idea that there probably isn’t a lot of newness out there but we can learn from one another.
Finances has been the issue that boards focus on, that we feel more comfortable with and now we need to rebalance that emphasis and say we need to have as much time and energy and focus and understanding on quality as we do on finances and one of the big issues for us is, as we learn, quality literacy. How do we get everybody speaking the same language? Understanding the same language? Because if we don’t have the language down we’ll never get to the metrics and the metrics are what will absolutely show us how we are doing and how we can improve what we are doing.
I would be worried if we didn’t have a long history of partnership with the provider community. Every class of trustees on our board by our bylaws is required to have a physician. Our physician colleagues and our lay colleagues work well together respecting each other’s skills and differences and I think that that kind of partnership over many, many years is what makes our refocus on quality perhaps a little less unsettling. That being said, the health care world is on shifting sands and I think when we talk about change we always do it in a way that involves all the stakeholders. It’s never unilateral, it’s never passed down from the board to anybody else. It involves discussion and negotiation and work among the stakeholders before we would ever do anything that could ultimately harm how people view what the board’s role is and how we’re going to affect the outcomes for our patients.
There’s a lot of change. Whether it’s reimbursement rates, whether it is the changing social contract between physicians and hospitals, whether it is legislative scrutiny. We can look around at some of our sister states in New England as well as our own state and people are thinking that some of the issues of health care can be addressed through laws or through policy shifts, and so I think it is a very different environment than many people saw even 10 years ago. And I think our responsibility as trustees is to understand those changes and be educated about those changes, and then decide how to work within those changes to really live with our mission.
Yes, we have to pay attention to finances; yes, we have to pay attention to facilities; yes, we have to pay attention to that infrastructure that drives our work and that ultimately delivers patient care. We have to take care of employees, we have to take care of our stakeholder relationships, but in the end I think people want to come to the board to talk about things that excite them which is, “How do we care for people? How do we deal with that first leg of our mission: patient care?” And so I would hope that we can turn this into an even more exciting opportunity for trustees to be engaged.