James G. Springfield, president and CEO of Valley Baptist Health System in Harlingen, Texas (USA), shares his thoughts on the concerns of healthcare administrators today and his vision of healthcare’s future. His views offer a profile in Six Sigma leadership.

James G. Springfield
President and CEO
Valley Baptist Health System
Harlingen, Texas

Those who know James G. Springfield were not surprised by the announcement that he had been named Young Healthcare Executive of the Year for 2004 by the American College of Healthcare Executives (ACHE). Nominations for the Robert S. Hudgens Memorial Award (the official name of the honor) come from peers and professional colleagues. And the annual winner is chosen on the basis of demonstrated leadership, administrative ability, motivation, attitude, innovation and creativity. Springfield brings all of these attributes – plus abundant energy and a commitment to Six Sigma – to his position as president and CEO of Valley Baptist Health System in Harlingen, Texas.

During a recent interview, Springfield shared his thoughts on the top concerns facing healthcare administrators today and his vision of the future of the healthcare industry.

“I hear a lot of gloom and doom out there. People say nobody’s paying us enough money, regulatory people are after us and doctors are trying to invest and take away our business and this kind of thing. My position is that it’s simply a changing environment and we’ve got to learn to deal with it.”

While there are challenges, he sees the positive side as well. “There are great things going on and I think the next 20 years will be the most exciting time to be in the industry. The genome project is really going to come to fruition, and I think in this generation we’ll see the promise of information technology and the impact it can have. We’re on the cusp of major new drugs and preventive techniques as well as interventional medicine. If you look at the number of people receiving organ transplants today, for example, it’s staggering compared to where it was five years ago.”

To prepare for this new world, healthcare organizations must become more focused on improving quality and management systems, Springfield said. “We need to develop defect-free environments and let the public know what’s “behind the curtain” in healthcare so there’s no mystery to it. Through that openness, perhaps we can learn ways to improve and do things better.”
One improvement initiative he introduced at Valley Baptist involves Six Sigma and change management. Since implementing this approach in 2002, the organization has seen a revitalized culture empowered to effectively lead change. More than 100 Six Sigma projects and Work-Out sessions have been completed or are under way in areas such as admissions, laboratory, emergency department and operating room, providing measurable results in terms of cost, quality, efficiency and satisfaction. Also, many employees are now trained in the Six Sigma methodology, including 14 green belts, 1 black belt, 3 master black belts and 66 change agents.

“I have been in health care for 15 years with total quality management programs…and had never seen a solid commitment to making it the operating system of the company,” Springfield said. “Instead of converging, previous systems seemed to run parallel tracks with routine management and consequently I don’t think we ever saw the full value. Six Sigma shares similar tenets and statistical tools with other quality improvement efforts, but it’s the level of robust implementation that really makes the difference.”
Springfield also noted the importance of addressing the acceptance side of the equation, adding techniques such as Work-out and Change Acceleration Process (CAP) to augment the statistical rigor of Six Sigma. “It doesn’t matter how good a solution may be,” he said. “If it’s not culturally accepted, the results will be diminished.”

Springfield stressed the importance of taking on projects that are highly visible and touch a lot of people within the organization. “This is about cultural change, and not so much about what our return has been in six months or twelve months.” he said. “I think the initiatives propel the notion of constantly driving change through the organization and making those sustained improvements for our patients.

“We have seen major improvements in operating room turnaround, order entry, pharmacy turnaround, our discharge process, emergency room turnaround time and laboratory results reporting. Lots of things that represent core processes of the hospital in that they touch everything and everybody, and as we move forward, we have become increasingly specific and more people are offering ideas for improvement,” Springfield said. “But we thought it was important, initially, for us to be rather controlled and thoughtful about the processes we intended to focus on first.”

Frequent communication is part of Springfield’s management style. He has monthly breakfasts with 30 employees randomly selected from a staff of 2,200, holds management retreats, and schedules around-the-clock quarterly meetings with all the employees.

Efforts in this area and his commitment to improving healthcare delivery have garnered respect from his staff, colleagues say. Seeking regular input and sharing results also is a key strategy in dealing with physicians at Valley Baptist. Springfield’s philosophy is that if you demonstrate your commitment – starting with senior management – your initiatives will stand a better chance of getting traction across the organization.

“Isaac Newton was right,” he said. “Bodies in motion tend to stay in motion until acted upon by an outside influence. Likewise, at rest, they all stay at rest unless something moves them. Organizations are much the same, particularly in health care. We have been a rather steady, stable industry with respect to change. How many times do we say, ‘we fixed that problem,’ or ‘that will never happen again,’ and two weeks later the same thing happens because those loops are not closed and change has not been driven into the company. Standard operating procedures have not been rewritten in many cases and retraining hasn’t been done. CAP has been helping in this regard, gaining that cultural acceptance for setting the stage for why change is important.”

Springfield offered some advice to peers who may be considering Six Sigma for their own organizations: “I would say do not do it unless you are willing to commit to making it the operating system of your company. I understand a lot of people will say, ‘come in here and help us clean up this department or that department.’ We do not believe lasting improvement can be made short of total commitment. In healthcare, we need to work on improving quality, reducing errors, continuing to push that bar up and up. There are amazing things going on in our industry and that’s great, but I would like to see more of a wholesale commitment to developing an operating system built on driving defects out and being able to deliver on the expectations of various customers we have…. And it’s got to start at the top. If the president’s not interested, then it’s not going to happen.

“From my perspective, we’ve been very open and set some pretty high standards and frankly, some fairly aggressive time targets. We’re way ahead of where our expectations were when we started this. It’s a testament to hard work and the commitment people have made. I’m a young CEO and didn’t know exactly what to expect, but the people have been just terrific. I think if you set high standards, and make sure people understand this is what we’re going to do, they’ll do it.”

The leadership Jim Springfield is providing at Valley Baptist and the ongoing improvement initiatives across the system are having a positive impact on employee morale and satisfaction. Irma Pye, senior vice president and chief human resource officer, noted the value of providing a strong framework. “It’s important for organizations to know it’s possible to change the way you’ve always done things, and that employees will adapt to a new approach.” She pointed to a project to improve nursing levels and control costs that generated $460,000 in annual savings. “If you can overcome the stress surrounding change you can realize increased effectiveness. This is a positive way to control staffing without employing slash-and-burn techniques.”

With a strong vision of Valley Baptist’s future, Springfield noted, “Getting the right infrastructure is important. Instead of having someone ‘feed us a fish’ forever, we’re trying to learn how to fish so that we can be self-sustaining, moving forward with increasing expectations, rising standards and, we think, improved results.”

A Brief Biography of James G. Springfield

Jim Springfield was named president and chief executive officer of Valley Baptist Health System in 2003, after joining the organization as executive vice president and COO in 2001. The not-for-profit community health network includes a 611-bed regional academic referral hospital. Springfield holds leadership positions with the Texas Hospital Association, the Texas Institute for Health Policy and Research, the Texas Association of Voluntary and Nonprofit Hospitals and VHA Southwest. He received a Texas gubernatorial appointment to the Interim Committee on Bi-National Health Plans in 2002.

Prior to joining Valley Baptist, Springfield was vice chairman and president and chief executive officer of the healthcare information company e-DOCS.MD, Inc., in Houston. He began his career in 1988 as a financial analyst at the Houston-based Memorial Hermann Healthcare System. During his 12 years there, he had a variety of positions, including chief operating officer.
Board certified in healthcare management and an ACHE Diplomate, Springfield received his master’s degree in healthcare administration from the University of Houston -Clear Lake and his bachelor’s degree in business administration from Baylor University in Waco, Texas.

This is one of a periodic series of articles on people who play significant roles in leading their institutions in the deployment and development of Six Sigma.