By TIM O'NEIL
In her final speech to SSM Health's annual leadership conference before Sr. Mary Jean Ryan, FSM, retired as the system's chief executive in 2011, she opened with the allegory at the heart of The Man Who Planted Trees by Jean Giono.
Sr. Mary Jean Ryan, FSM
Photo by Chris Ryan/© CHA
The hero of the story is a conscientious shepherd who, pained by the environmentally degraded landscape he traverses with his flock, takes it upon himself to improve it. Every day for 30 years, he plants 100 trees, ultimately transforming the land into lush meadows and forested hills. He creates an environment where people can flourish. Sr. Ryan used the story to make her point that every one of SSM Health's then 20,000-plus employees — from the maintenance team members to surgeons — have the opportunity to sow seeds of kindness with every patient encounter.
The story of the tenacious shepherd also is an apt metaphor for Sr. Ryan's 25-year career as chief executive of SSM Health, her five years as board chair and her 60 years in health care. Just like the shepherd, Sr. Ryan made a lifelong commitment to continuous quality improvement. For that work and other contributions to the Catholic health ministry, Sr. Ryan is a 2018 recipient of CHA's Lifetime Achievement Award.
Factorylike precision
At SSM Health, Sr. Ryan promoted adherence to clinical processes that prioritized patient safety above all else. Colleagues say she shaped a culture that valued employees and challenged them.
"Sister was always very clear and specific about what she wanted, and that was quality care for the patient," said Paula J. Friedman, now SSM Health's chief strategy officer. Friedman frequently accompanied Sr. Ryan on her annual visits to the system's 24 hospitals. Sr. Ryan was generous with praise as she engaged with professional and support staff — she wanted every employee to know their contribution was essential to SSM Health — but she was forthright in discussing errors, procedural failures and accountability. Said Friedman: "She had a unique ability to tap into the spirit in each of us that compelled us to serve and be better."
Although her focus was the four-state health system, Sr. Ryan's systematic approach to reducing medical errors and delivering exceptional care with factorylike precision and replicability has inspired and influenced health care safety improvement work the world over. She's given lectures on quality improvement and patient safety in 17 countries on five continents.
Continuous quality improvement
Under her leadership, in 2002, SSM Health became the first health care organization in the nation to win the Malcolm Baldrige National Quality Award, which is sponsored by the U.S. Department of Commerce. Sr. Ryan had begun SSM Health's continuous quality improvement initiative in earnest a dozen years earlier, becoming one of the first health care leaders in the U.S. to adopt this disciplined approach with the goal of achieving measurable improvements in patient care outcomes and driving value by removing waste from the system.
In accepting the award at the Catholic Health Assembly, Sr. Ryan told the audience: “As a ministry of healing we must be present to … the immigrant, the mentally ill, the other.”
Photo by Chris Ryan/© CHA
The Baldrige protocol required that SSM Health take an unblinkered look at the way things were done at every level of the organization, identifying successes and failures. Sr. Ryan has said that early in the process, SSM Health leaders were flummoxed when Baldrige examiners asked about the system's mission statement: "Through our exceptional health care services, we reveal the healing presence of God." What exactly did SSM Health mean by exceptional?
To define exceptionalism, managers developed metrics to gauge whether SSM Health facilities and services met the expectations of patients, physicians and employees and achieved clinical and financial goals. "In the four years we went through the application process, we made progress that might have otherwise taken us 10 years," Sr. Ryan said of the system's pursuit of the prestigious Baldrige recognition.
She said a central goal was to improve processes and build in redundant safety checks to reduce the potential for errors that could injure patients. SSM Health improved procedures from janitorial, to pharmacy, to surgery as it built consistency and accountability across the system.
Good to great
Suzy Farren, a retired SSM Health vice president of communications, said Sr. Ryan was committed to creating the conditions where people at every level of the organization could thrive. "She knew that is how you make an organization great," Farren said. "When a housekeeper goes into a patient room, the housekeeper needs to know that they are doing important work. She wanted every employee to know that what they do is essential to the whole health care enterprise," Farren said.
Chris Howard, SSM Health's chief operations officer, said employees respected Sr. Ryan as a "devoted champion of quality who constantly strives for improvement from herself and others."
Laura Jelle, former president of SSM Health St. Clare Hospital in Baraboo, Wis., said Sr. Ryan "always tied our mission to that of the sisters who founded our hospitals. She told us the legacy is in our hands and that we must always work to be better. She never let up."
Always caring
The oldest of four children, Mary Jean Udelhofen grew up in Cuba City, Wis., a town of about 2,000 people east of Dubuque, Iowa. She considers the time she spent as a student at the nursing school run by the Sisters of Mary at St. Mary's Hospital School of Nursing in Madison, Wis., as the most important three years of her life.
"I learned to be a good nurse. I held the hand of a woman as her heart stopped. I saw the resilience of the children in pediatrics, and the gratitude of the families we could help." In a farewell speech at SSM Health before she retired in 2017 as board chair, she said the sisters taught her about "healing in its truest sense: Curing whenever possible, but always, always caring."
In 1960, one year after graduating from nursing school, she entered the Sisters of St. Mary, now the Franciscan Sisters of Mary. She earned a bachelor's degree in nursing from Saint Louis University and, in 1967, was promoted to operating room supervisor at St. Mary's Hospital in St. Louis — the job that she says first awakened her drive to systematize patient safety practices.
Her order sent her to Xavier University in Cincinnati, where she earned a master's degree in health and hospital administration in 1974. She served in administration at five of the order's hospitals before joining the headquarters in St. Louis in 1980. She was vice president of the five-member governing board of the Sisters of St. Mary Health Care System. When it reorganized as SSM Health Care in 1986, she became the system's first president and chief executive.
A quiet force
Sr. Susan Scholl, president of the Franciscan Sisters of Mary, said Sr. Ryan was the obvious choice to lead the more centralized health system. "She has a vision for quality health care and was always pushing to make improvements. She is quiet and unassuming. She chooses her words carefully. But she is very articulate and committed to the goal of making health care better for people. And when she spoke, she made you believe it, too."
Sr. Scholl added that Sr. Ryan was unafraid "to hire people who, she liked to say, were a lot smarter than her."
Colleagues said Sr. Ryan mentored many physicians, administrators and employees at all levels of the organization. She groomed women for administrative leadership positions, and prioritized racial diversity and the recruitment of minority talent.
Laura S. Kaiser, president and chief executive of SSM Health since May 2017, said Sr. Ryan's legacy is a "vision for quality that is hardwired into the culture."
Kaiser noted that Sr. Ryan was an early champion of environmental sustainability — she initiated the system's ban on water in plastic bottles and Styrofoam products containing chlorofluorocarbons, or CFCs. And, in 2004, Sr. Ryan directed that SSM prohibit tobacco use everywhere on all its campuses.
More than a decade before commentators sounded the general alarm that American culture was becoming desensitized to violence, Sr. Ryan banned the use of words that gratuitously connote violence. SSM PowerPoint presentations don't have bullet points, they have dot points. SSM does not capture markets, it secures them. Communicators don't blow up photos, they enlarge them.
Words have power; Sr. Ryan wanted SSM employees to wield words to further a culture of healing body and spirit.