Wes Wright, CIO, Seattle Children’s Hospital, Chapter 1

One of the core philosophies of military leadership is to train the person who will eventually replace you to help ensure a smooth transition. That’s precisely what happened at Seattle Children’s Hospital this past summer. When Drex DeFord resigned as CIO, Wes Wright was ready to fill the role. Recently, healthsystemCIO.com spoke with Wright about what it was like to move from CTO to CIO, what he learned from working with Drex, and how the organization incorporates Continuous Process Improvement into its overall strategy. He also discusses the clinical application environment, managing multiple vendors, why leaders must be willing to take risks, and how his organization is working to foster innovation.

Chapter 1

• About Seattle Children’s
• Keeping clinicians in mind with building design
• From CTO to CIO — “Things don’t happen as quickly”
• Learning from Drex
• “Panic doesn’t do you any good whatsoever”
• Cerner EMR, Epic revenue cycle
• 5-year strategic plan — “We’re still marching along”

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Bold Statements

When you start at a place, you get a couple of years to fix things up and get your stability straightened out, and so I was kind of heads-down, getting that day-to-day operational stuff done for the first couple of years. And then the next couple of years I got to, for lack of a better term, encroach upon Drex’s purview in the strategy role.

Drex made sure he was mentoring me in that role. We’re both prior military and that’s considered part of our job description — you have to train the person that’s going to replace you. And that’s what he did.

When you focus on day-to-day operations, you can make things happen very quickly, because that’s your job. When you move up a level into the strategic and long-term tactical plans, things don’t happen quickly, so you have to be patient.

I learned during one part of my military career that panic doesn’t do you any good whatsoever, and if you maintain a calm, reassuring attitude, then those around you will be calm and reassured.

There’s going to be no big zig where we thought we were going to zag. We’re still marching along on the same five-year strategic plan.

Gamble:  Hi Wes, thanks so much for taking the time to join us today.

Wright:  My pleasure.

Gamble:  First off, I wanted to congratulate you on being named CIO at Seattle Children’s. That was back in the summer?

Wright:  Yeah, August actually.

Gamble:  Okay, so it’s only been a short time.

Wright:  It’s been a short time.

Gamble:  Can you just give us a brief overview of the organization?

Wright:  Sure. We’re a currently 250-bed, tertiary, specialty care children’s hospital in the Pacific Northwest. Our service area is Washington, Alaska, Montana, and Idaho, and there’s some talk about adding Hawaii and Oregon in there. We are in the process of building a new wing that’s going to initially give us 68 more beds. That will come up in spring or early summer of 2013. We’re looking forward to it because we’re pretty full; we have a pretty high census pretty much all the time.

Gamble:  As far as the new wing that is being added to the Children’s Hospital, how involved are you with the planning and design of it?

Wright:  As much as you’d expect. We have a Lean organization; we call it CPI (Continuous Performance Improvement), and part of that is something called Integrated Facility Design that we picked up and used in our Bellevue Surgery Center that we stood up two or three years ago. So we used that same process for the new wing and had many meetings and many simulations with the actual users in that facility — our partners that will be in there. Our new ED will be over there. We’re moving Seattle Cancer Care Alliance in there and some of our inpatient psych units are going to move over there. So all those folks met in the warehouse and kind of mocked up what everything is going to look like using cardboard walls and that kind of thing. So we all had a great big hand in the design of that facility. It was pretty cool.

Gamble:  I asked because one of the things that we sometimes like to talk to CIOs about is how much they are involved. It can be interesting. Obviously you’re going to be dealing with the IT component of it, so you want to make sure that there’s a solid infrastructure in there.

Wright:  Yeah, of course we were deeply involved in the cabling. We need fiber here, we need this there and that there and the other thing there. But over and above that, we were also really deeply involved in those integrated facility designs so we could see how our partners are going to use the technology that we’re providing. Maybe over here we need a laptop rather than a virtual desktop unit or something like that, so that was pretty cool.

Gamble:  It’s interesting and I’m sure it’s good to be able to try to establish that before actually opening it.

Wright:  Yes.

Gamble:  Okay. So you started back in August as CIO but you’ve been with the organization for a couple of years. Can you tell us a little bit about the process of being hired as CIO? Were there a few candidates? What do you think made you stand out?

Wright:  Well, at that time, I’d already been here a little over four years. Drex [DeFord] and I both got here in March of 2008. During that time, initially when you start at a place, you get a couple of years to fix things up and get your stability straightened out, and so I was kind of heads-down, getting that day-to-day operational stuff done for the first couple of years. And then the next couple of years I got to, for lack of a better term, encroach upon Drex’s purview in the strategy role. I was kind of in and out of that area before he left, and so they were getting used to seeing me in that area. We have succession planning here, and of course I was part of those plans. So when Drex announced that he was leaving, of course it was a big deal, but it wasn’t a big deal from a panic perspective, because they said, ‘Okay, your succession is Wes.’ That’s the natural thing, unless there’s a ‘do not pass go’ out there from somewhere, then that was just naturally the way we’d go.

Gamble:  So then you had some experience, obviously, dealing with the high-level, strategic aspects as opposed to some CTOs, who might really have more experience with day-to-day operations. So you were able to get a head start on that.

Wright:  Absolutely, yeah. And Drex made sure he was mentoring me in that role. We’re both prior military and that’s considered part of our job description — you have to train the person that’s going to replace you. And that’s what he did.

Gamble:  What do you think you learned the most from working with him?

Wright:  Patience and collaboration. When you focus on day-to-day operations, you can make things happen very quickly, because that’s your job. When you move up a level into the strategic and long-term tactical plans, things don’t happen quickly, so you have to be patient. And as you’re being patient, you need to broaden your field of collaboration and really that’s mostly what he taught me here at Seattle Children’s — to be patient. Even if you don’t think that person x has anything to do with what you’re doing, go ahead and collaborate with him. Let him know what’s going on, because they might have a unique view on the problem you’re trying to solve and can contribute to the solving of that problem.

Gamble:  Interesting. From what I know from speaking to him and meeting him in person, he seems to have a very laid-back personality. Do you have a similar personality? I would think that that would be helpful in having a CIO role.

Wright:  Yeah, I have a pretty laid-back personality. I learned during one part of my military career when I was the Air Force Surgeon General’s executive officer and traveled everywhere with him that panic doesn’t do you any good whatsoever, and if you maintain a calm, reassuring attitude, then those around you will be calm and reassured. And so I try to maintain a pretty even keel with a lot of humor thrown in.

Gamble:  That’s interesting that you both have military experience. I spoke with a CIO a couple of months ago who said that one of the things that he learned was what you were alluding to about panic, and that if you can handle situations in the military and not get too rattled, then it kind of prepares you for other manager- type roles.

Wright:  Absolutely. I agree 100 percent with that.

Gamble:  I guess you learn what true stress is, right?

Wright:  Yeah.

Gamble:  Alright. So I want to talk a little bit about the clinical application environment at Seattle Children’s. You’re using Cerner’s EMR, correct?

Wright:  Correct. That’s our primary clinical application. And to complicate things a little bit, on our revenue cycle we use Epic.

Gamble:  Okay. Now as far as the strategic plan, I know that in the past, Drex had talked about a five-year plan. Can you tell us kind of where you stand with that and what your plans are?

Wright:  Yeah, sure. It’s the same five-year plan. Again, Drex and I worked super close when he was out here, so I was intimately aware and involved in that five-year strategic plan. So there’s going to be no big zig where we thought we were going to zag. We’re still marching along on the same five-year strategic plan. The next module to come up, I believe, is ED physician notes in December. We’re on the exact same path we were on; it’s not going quite as quickly as we thought it would, but with a brand new building wing coming up, I can understand some of the delays.

Gamble:  Right.

Chapter 2