Erik Mikaitis, MD (Host): Hi, everyone. Welcome back to this month's episode of Pulse Check, Cook County Health's internal podcast. First, I want to recognize March as Women's History Month. We have a majority female staff from the frontline to our leadership team. This is a time to celebrate the incredible contributions of the women at Cook County Health, who play vital roles from delivering compassionate care and services to shaping policy and strategy to driving our mission forward. Thank you for all that you do.

And I'm very excited to share that today we're joined by Andrea Gibson, our Chief Strategy Officer. Welcome, Andrea.

Andrea Gibson: Thank you very much. Thanks for having me on.

Host: Thanks for being here. So before we dive into the conversation, I also want to acknowledge two really exciting anniversaries that we celebrate in March. The first is March 16th, which marks the 88th anniversary of the Cook County Hospital Blood Bank, which was founded in 1937 by Dr. Bernard Fantas. It was the first blood bank in the United States. The ability to store and transfuse blood made modern day surgery and resuscitation in Critical Care, Trauma and Obstetrics possible. The cost to open the blood bank was $1,500 and it facilitated more than 1,300 blood transfusions in its first year.

Today, the blood bank at Stroger Hospital supports 15,000 transfusions a year, including over 100 massive transfusions for patients with traumatic injuries or hemorrhagic shock. Andrea, do you want to tell us about the second anniversary?

Andrea Gibson: Sure. The other anniversary we are celebrating this month is the 59th anniversary of our Trauma Unit, which was the first comprehensive trauma center in the nation, providing intervention and pre-hospital services, critical care and surgery, rehabilitation and extensive follow-up care. We are so proud to celebrate Cook County's tradition of medical advancements with both of these anniversaries.

Host: Absolutely. So as we jump into the conversation, we're going to talk about how we're looking to the future and how we're continuing our institution's legacy for innovation and equity, and developing our next three-year strategic plan. So, Andrea is here with us to tell us a little bit about how we're delivering on our current strategic plan, so looking backwards; and then, all the efforts we're putting into our plan for 2026, '27, and '28.

Andrea Gibson: Great. I'd be happy to talk about our current strategic plan. We are really proud of the fact that our strategic plan doesn't just sit on a shelf. And we have already implemented a lot. We are in two of the three years of our strategic plan, and we've already made a lot of significant accomplishments across the organization. Thinking about quality for both patients and members, we've advanced quality across the board on our quality metrics. We've achieved a Leapfrog B for Stroger. We've received a Leapfrog award for Providence. We've achieved Joint Commission reaccreditation. Our correctional health team was accredited. And our County Care Health Plan received a four-star rating from NCQA. So, we're really proud of those accomplishments.

In other areas, like under Equity, we have done a lot of work to build programs to support food and housing insecurity. At Public Health, within our Equity Department and also in County Care, we've done a lot of work to invest in behavioral health access across the county, and we also have done a lot to distribute Narcan and help address the opioid crisis. We've done a lot of public health campaigns over the past two years: vaccination campaigns, STI campaigns, et cetera. Under workforce, we have done a lot of work to establish pipeline programs. For example, the Providence Scholarship Fund. We are proud that we've improved our employee engagement scores and we've launched hiring process improvement work.

Under the fiscal strategies, we've improved our yearend net position over the past few years and our revenue cycle turnaround project is progressing. And that started a few years ago and still has a few years to go. We also are proud that we have implemented new systems to manage policies, contracts, inventory management. We've increased our capital equipment expenditure to keep our equipment more up-to-date. Finally, under the growth pillar of the strategic plan, we've increased the County Care market share, and we've established a new referral platform and additional referral partnerships.

Host: Wow, that's an impressive list, right? Really a lot of great achievements. And I think you covered a lot there and I think that that really highlights the fact that the entire team really has something to be proud of. And I hope everyone listening can take just a minute to kind of reflect back on their role and all of the things that Andrea just talked about over the last three years and how each of you has contributed to those successes.

I know in the day to day, it can be a little bit tough, right? To take a step back and look at that big picture and really see how far we've come. But I do think it's important to take a minute to really, you know, appreciate how all the hard work is paying off. So, that was looking back, Andrea. Let's talk a little bit about how we're going to look forward now with the new strategic plan that's coming out.

Andrea Gibson: Yeah. And I think that's great to highlight the contributions of everyone to the strategic accomplishments so far. And the same is true going forward, we're going to need to have everyone involved in implementing the next strategic plan. So, you and I, Dr. Mikaitis, have a great 10,000-foot view of everything happening across the system. But we don't have the perspective of an individual who might work at a health center or an inpatient unit or in Materials Management, EVS or supports County Care members or works in public health. So, part of the strategic planning process is to get information from everyone through a survey and through various meetings.

So, we are pleased to share that we got an increase in the number of people responding to our survey and who provided a lot of interesting feedback that'll help us build the strategic plan. It'll help us set our priorities and help us think about how we best serve our patients, our members and communities. We've held various meetings some town halls with our community advisory councils and partners. And right now, we're compiling all of that information that will report out to the board of directors as we think about developing the rest of the next three-year strategic plan.

Host: Yeah, I think that's really important, right? Getting that broad sampling of diverse perspectives inside and outside the organization, right? It's going to help us really create a plan that's aligned with our internal capabilities and our goals, but then is also responsive to external needs. So, I'm really excited to see what all this feedback is going to be. And so, to that end, what are the next steps in terms of the strategic plan?

Andrea Gibson: Sure. We kicked off the strategic planning process in January, and we have been reporting out different pieces of information to the board every month. Most recently, as I mentioned, we did both a community survey and an employee survey. But even if you miss the window to take the staff survey, you can email me at amgibson@cookcountyhhs.org. It's not too late to provide your perspective on what you think we should focus on as the most critical issues in the next three years.

Over the next two months, we'll be drafting the strategic plan. And this summer, the board will review it, tweak it, and vote on the strategic plan. And then, it will go to the board of commissioners actually this fall. And after that, assuming it's approved, we would start working on implementation.

Host: Wonderful. So, I assume most everyone in the organization's pretty aware of kind of the goings on in the healthcare space. A lot of activity at the federal level, at the state level, that could have some pretty direct impact on our health system. And we're looking at those changes around healthcare laws and funding allocations, insurance mandates that could really impact delivery of care, particularly for some of the populations that we care for who are already at risk for being marginalized. With cuts to Medicaid and federal grants and other funding, you know, the significant effect on patients in the communities that we serve, and how we're looking at how our health system operates, how does all of that come into play and kind of inform the strategic plan over the next three years?

Andrea Gibson: Yeah, I mean it's a very, tricky time to develop a strategic plan. There's so many things that are dynamic right now at the federal and a little bit at the state level. And even at the local level, that everything is kind of shifting a little bit and it's hard to come up with a plan to address everything, to anticipate everything. So, our focus will be to design it with flexibility, treat it as a blueprint that we can alter if circumstances change, I think, we'll still be focused on providing access to care, providing care regardless of the ability to pay, and it will have to challenge us to continue to optimize and do process improvement and do things that'll make us more competitive in a difficult environment, in a resource-constrained environment.

So, the plan will be to incorporate regular assessments of the federal and state landscape and make updates as we need to. But we're watching everything at the federal level very carefully and try making plans to address those.

Host: Yeah, definitely, right? Kind of that constant reassessment, ensure that we're pivoting, that we're being responsive, and taking a good look at the landscape. Absolutely. And I know that can probably sound a little bit scary, but I want to assure our team, especially those listening that we're really doing extensive contingency planning for a variety of scenarios. We're also advocating strongly for the programs that support our patients as well as public health. And should cuts come down the road, we anticipate being prepared so that we can respond in a way that minimizes the impact on our services as best as we can.

And as you were alluding, Andrea, how they're being proactive and adaptable is going to be key to our sustainability as things evolve. And sometimes strategic plan can feel really high level and kind of amorphous. What do you want to tell our colleagues? What do you want them to know really about the strategic plan?

Andrea Gibson: Well, I want everyone to know how important their contribution is to executing the strategic plan. And I think, you know, I want to make an effort to make sure everyone understands how their role contributes to the strategic plan. Everyone plays somewhat of a role on safety, quality optimization, growth. And it's all essential to keep us moving forward. We're working with the same values and with the same mission in mind. And as we finalize the strategic plan we will be having town halls with staff to talk through kind of how do we translate a high level strategic plan to what everyone works on every day. So, I'm looking forward to those engagements, and looking forward to really advancing our strategies throughout the organization.

Host: Definitely, I think it's something we've been kind of trying to do already with the current strategic plan is helping trying to be more intentional about ensuring that our team across the board can see themselves in there and understand their role in the strategic plan. I think that's incredibly important. And I think you said earlier, right? The strategic plan isn't a document that's just going to sit on a shelf and gather dust, and we dust it off every three years, do the exercise again, and then put it back on the shelf. Really, we're trying to use it as a roadmap, right? A guide about where we're trying to go as an organization, right? And to that end, it needs to empower staff and create more opportunities for collaboration and advancement. This is the plan that's going to help us build a more inclusive, effective, and sustainable organization.

And I think one is, as you're already saying, right? That that's going to help us weather the ups and downs, you know, from policy and funding changes and supports us delivering on the health of Cook County residents. So Andrea, I think we're kind of at the end of the discussion. I just want to say thank you again for your time and for your insight. Thank you to all of our colleagues who shared their thoughts on the upcoming plan. Thank you for your involvement, your engagement, Andrea. One more time, if someone hasn't given the feedback, how can they get ahold of you?

Andrea Gibson: They can email me, A, M-- as in Maria-- gibson@cookcountyhhs.org. I have one of the older emails, so I look forward to hearing from you if you haven't already responded to the survey.

Host: Perfect. Well, thank you again, Andrea. And thanks to everybody for listening or watching. We look forward to sharing more updates with you next month. Thanks again.