A Conversation with Dr. Ted James of Harvard Healthcare System

NHPCO had the opportunity to sit down with Dr. James and ask him a few questions about leading high-quality programs in the healthcare sector.

Ted James, MD, MHCM, FACS
Medical Director and Vice Chair, Beth Israel Deaconess Medical Center
Associate Professor of Surgery, Harvard Medical School

Dr. Ted James is a medical director and lecturer within the Harvard Healthcare System with extensive experience in efforts to advance healthcare. He leads international programs focused on digital health, clinician engagement, and patient experience, and collaborates with healthcare executives and industry experts from around the world.

He is an author who writes about the trends shaping the future of medicine and strategies for transforming the healthcare ecosystem. Dr. James has received numerous awards for his contributions to teaching, leadership, and quality. One of his greatest professional satisfactions comes from partnering with others to reimagine healthcare in ways that improve organizational performance and the wellbeing of patients, care teams, and communities.

NHPCO had the opportunity to sit down with Dr. James and ask him a few questions about leading high-quality programs in the healthcare sector, and his lessons learned over the years. NHPCO questions are italicized for clarity.

Why should hospice and palliative care teams enhance their focus on quality?

Focusing on quality improves patient outcomes and enhances the patient and family experience, which results in greater confidence in the care team. These have been shown to improve pain and symptom management. Essentially, the quality focus improves the patient's overall quality of life. Quality also leads to more efficient and less costly care, which is critical in the era of value-based care. Lastly, focusing on quality is a source of professional satisfaction

Where should hospice and palliative care teams begin in their quality improvement process? What does an organization focused on quality look like?

Start with a comprehensive assessment of current performance and then identify areas for improvement. This should be a leadership-supported, team-based approach with measurable goals and action plans to address identified gaps in care. Regular monitoring and measurement of outcomes with a constructive, not punitive, focus should be done to track progress and make necessary adjustments. The organization should be focused on continuous quality improvement, always seeking to elevate the next level.

What advice do you have for hospice and palliative care teams focusing on clinical innovation and leadership development?

Embrace change. Foster a culture where change is welcomed and seen as necessary to meet the future needs of patients. Leaders should promote psychological safety where people feel safe to ask questions, admit mistakes, challenge norms, and provide new ideas. Create venues for brainstorming and collaboration. Having opportunities for individual growth and professional development are also critical. Finally, realize that we can all be leaders and take ownership in making things better.

How can hospice and palliative care teams overcome resistance to new ideas?

People are not so much resistant to change as they are resistant to uncertainty. Conveying the "why" behind change, the purpose, can be a powerful way to motivate others. Involving people in the change process is also crucial to getting by in and overcoming resistance to new ideas.

What are some organizational best practices to encourage leadership at every level?

One of the best ways to foster leadership is simply to provide leadership opportunities. Make sure people have opportunities to initiate and lead projects. Seek out people who show potential and give them a chance to shine. Make certain to encourage autonomy and ownership; nothing will stifle leadership development like micromanagement. It also helps to recognize and reward good leadership.

How do you become a high-performing team? How do you know if you are a high-performing team?

High-performing teams need open communication, shared goals, structured processes, and, most importantly, mutual respect and mutual support. Great teams also have high expectations for the team and for individual members. They regularly evaluate their performance, deal with conflicts effectively, and celebrate wins collectively.

What advice can you share on how to enact transformation at different scales (i.e., system/organization-wide versus departmental)?

It requires tailoring the approach to the specific context. Organization-wide transformation needs centralized leadership, extensive strategic planning, and strong communication channels. Departmental transformation needs engaged champions who can spearhead targeted interventions. Well performed departmental initiatives that align to the goals of the organization will often scale to system wide. programs.

What are some steps hospice and palliative care leaders can take to develop leaders at all levels of an organization? What mistakes are healthcare leaders currently making when it comes to leadership development?

Mistakes in leadership development include neglecting to offer adequate resources and support, not recognizing and rewarding leadership behaviors, and not promoting a culture of inclusivity and diversity.

What are some tips that care team members can use to center their focus on the greatest priority of healthcare (and often, the reason for their connection to their work) – the patient?

Prioritize meeting the needs of our patients. We can understand their needs by actively listening to patients and families. Other key approaches are to communicate with empathy, strive to meet patient's physical, emotional, cultural and spiritual needs, convey respect, and empower patients through education and shared decision-making.

What’s the best piece of advice you’ve ever received?

That's a difficult one. I've received good advice from many mentors over the years. I think we should all view patient care as a calling. Also, we should remain curious and never stop learning. Healthcare is constantly evolving and being open to new ideas is essential for quality improvement.

What are some leaders doing that other leaders should be doing?

Leaders should think about how healthcare can innovate to improve the patient experience, including leveraging technology to improve care coordination and patient outcomes. We've seen great advances in other industries that are meeting user needs through technology and innovation. By embracing change and learning lessons from outside healthcare, leaders can drive positive changes.

Are there any other questions that we should have asked you that you’d like to ask and answer yourself?

Clinical teams are under a great deal of stress. Burnout is a serious threat. We should be asking how to use the power of teams and teamwork to support and revitalize the clinical workforce. Leaders and individual team members can take steps to promote mutual support, psychological safety, and a sense of inclusiveness and belonging that helps to address these challenges and allows teams to thrive.

 

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If you’re interested in hearing more from Dr. James, he was a keynote speaker at the NHPCO 2023 Virtual Interdisciplinary Conference. His session recording, Revitalizing Your Healthcare Teams Through Action-Based Leadership, is available in the conference portal until May 24. Attendees can watch and re-watch the presentation to glean takeaways for them and their teams.