When you put together the collective pressure of perpetually saving lives, maintaining quality of life for patients, ensuring financial sustainability, navigating significant policy reforms, and facing everyday heartbreak, it is natural to wonder how hospitals and medical teams do it. Jandel Allen-Davis is the CEO of Craig Hospital, a world-renowned specialty rehab for people facing spinal cord injury and brain injury. Craig Hospital finds lasting resiliency and meaningful sustainability by tapping into a deeper collective Purpose. In this leadership feature, Jandel explains that what organizations do doesn’t drive relevancy – it is all about how you do it, and why.
Moving From Doing Good to Making an Impact Requires Intention and a Long View
By Jandel Allen-Davis, President and CEO, Craig Hospital
Ray Baxter, who was the Senior Vice President for Community Benefit and Health Policy for Kaiser Foundation Health Plan and Hospitals (KFHP-H) when I was a Vice President in the Kaiser Permanente Colorado Region, laid a challenge at the feet of those of us who carried out the community benefit work in each region. He said the work ahead was to move from doing good things to making an impact. He went on to state that we also need to be mindful of the impacts of our impacts on the planet, vis-à-vis the environmental consequences of healthcare’s day to day activities. Since that time, which seems to stretch back at least a decade, many of us who focus not only on the delivery of health care but also on the promotion of health and wellbeing have struggled with ways to measure the impact of our efforts to promote health in ways that are sustained and meaningful in the eyes of those we serve – from the perspective of the broader community and through a lens that can sound cold and yet is important, namely “to lessen the burden of government.” This last aspirational goal means that our work has improved individual lives in such a manner that self-sufficiency along a number of dimensions is sustained and quite evident. And we have an obligation to always think mindfully about small and large impacts of our investments of time, talent and treasure.
So in answer to the question, “Do those of us in health care have an obligation to think about the social impact of what we do?” I would answer affirmatively.
We often speak of good health as an enabler to living one’s best life. As physicians and other health professionals, our primary tool, the delivery of health care, is our primary means of creating the best possibility of achieving that end. Ultimately, what we do contributes to the very social fabric of individuals, families, communities and indeed the world. It is why fully committing to serving those who come in need of our care and compassion is a sacred trust, one that can get lost in the complexity and pace of today’s world if we don’t remain mindful and attentive.
It can be easy to lose sight of honoring that trust in today’s technology-driven and complex world. It seems more important now than ever that we examine our work lives and contemplate how personally and professionally one might make impactful contributions that go beyond that which is reflected in our financial statements. In health care, thankfully few physicians, nurses and therapists, let alone those who perform all the functions that enable the healers to do their best work, wake up in the morning inspired simply by profit margins. While we understand that without a margin it is quite difficult to fulfill a mission, it is mission…the opportunity to make a difference in the lives of those we serve, those whose lives are made better because of our contributions…that serves as the driver for how we care for our patients and families.
In Colorado, we are graced with many world-class hospitals, and one such institution is the one I serve, Craig Hospital, a nationally and globally recognized inpatient and outpatient hospital that focuses on the neurorehabilitation of persons who have sustained catastrophic or acquired spinal cord and/or brain injury. We serve people who literally woke up with one reality and went to bed with a very different one. Our goal is to create the types of opportunities for renewal that enable social, cognitive, spiritual, financial, and occupational independence for those impacted by these life-altering injuries. We live in the space of constantly considering the impacts of our work, not only in the immediate sense, but also in terms of how skills taught and learned here will impact those we serve across a lifetime.
Craig’s longest serving CEO, Denny O’Malley, stated, “Craig is simply a dress rehearsal for real life challenges following a spinal cord or brain injury.” Every member of the Craig staff goes about their work through an Impact Lens, and we think about how our actions will make a difference at a societal level. The work done inside the walls and halls of the hospital is done in service to what is possible outside of the hospital, when patients and families resume their lives, however altered those lives may be. It is holistic whole-person and whole-family care at its best. And our work doesn’t end when patients discharge home. We remain available to our patients nationwide through our Nurse Advice Line. The focus on preventing illness or harm, serving as listening ears when patients and families may be struggling, and connecting them with needed care or service enables people to remain in their community and live their lives.
Our impacts also include contributing to the field of neurorehabilitation through research. We are active participants in the worlds of spinal cord and brain injury research. One of the unique experiences at Craig is our opportunity to focus on outcomes as participants in the National Institute of Disability, Independent Living and Rehabilitation Research competitive Model Systems grants that are awarded every 5 years. In addition to other extramurally funded grants, we are especially honored to participate in multiple research collaborations alongside a small number of other neurorehabilitation hospitals nationwide through these competitive grants for brain injury and spinal cord injury. This work allows us to ask, “Are we making a difference? Is the impact well-articulated through patient and family voice?” While the grants focus on numerous areas of neurorehabilitation, patients and families who receive care in the participating institutions are followed longitudinally and assessed for life quality attributes such as satisfaction with life, hours of daily care attendance and return to work and school, to name a few. These outcome or impact data indicate that Craig is fulfilling its mission to ensure that what happens inside our walls is having a measurable and significant impact outside our walls on behalf of the communities we serve!
Another overlooked contribution to meaningful impact is philanthropy. Many of the services we provide that are not covered by insurance would not be possible without the generosity of donors to the Craig Hospital Foundation. Programs such as the Assistive Technology Lab, Therapeutic Recreation and Rehabilitation Engineering are but a few of the donor-supported services that enable our patients to live as independently as possible.
Looking ahead, I believe that some of the most important next steps to understanding the impacts of our good work involve applying an equity lens to our programs, especially as this pertains to the resumption of a fully integrated social and economic life for persons living with these injuries, let alone other disabilities. There is something that happens in the minds of those of us who are “able-bodied” when in the presence of someone who is differently abled: they are too often seen as “less than,” as “unable.” The implications of this subtle form of marginalization are significant: high unemployment rates, lower educational attainment, high levels of social isolation, increased health care costs and lower self-assessed quality of life. Add any of the typical dimensions of diversity (i.e., race/ethnicity, age, gender, socioeconomic status) and the intersectionality with disability magnifies the issues for those impacted individuals. In addition to working with our patients’ employers and teachers, we are active participants in the advocacy community, as this marginalization reinforces many of the forms of discrimination that many of us have been fighting for years. At Craig we speak of equity, diversity, inclusion and accessibility. The Americans with Disabilities Act has provided for many improvements for those living with disabilities…and there is still much work to do. We are using our voice to assure that the policy makers and others understand the strength and potential of those living with disabilities to make meaningful and important contributions to society at all levels.
You might think that Craig Hospital would be a place filled with unhappiness, both for the patients and families we serve but also for our teammates. Although it would be disingenuous to say that every moment of every day is joyful, I can state emphatically that most days are pretty good. Craig is a place of joy, a place where hope is restored. Craig is an example of what happens when highly skilled, committed professionals who live from a place of purpose come to work. We understand how our work aligns to the mission, whether we serve patients and families directly or not. We call ourselves family and consider those we serve part of this big and enduring family. I get to hear and see gratitude from this big old family because of what we do. In a real sense, I witness short and long term impact. It is a privilege to serve all who walk through our doors.
I certainly appreciate how special Craig is and that this mission and purpose-driven culture is one that has been honed over the generations. I also believe that other health care settings strive to have the same impacts and that the work, our work, is to view our small and large contributions to health through the lens of deep, sustained impacts. It is our job to identify what those impacts might and should be, and to assess our progress by talking to our teams and our patients. In our case, and perhaps in the case of the entire field, improving community health, educational opportunity, economic opportunity and how we use the tremendous assets of benefactors should be just the beginning of our impact-driven journey.