Airplanes, nuclear subs inspired this 'incredibly effective' change for Northwest Permanente physicians

In this special Speaker Series, Becker's Healthcare caught up with Tim Borne, chief of staff at Northwest Permanente in Portland, Ore.  

Mr. Borne will speak at Becker's Hospital Review 7th Annual CEO + CFO Roundtable in a session titled, "Instant Team Effectiveness: How to Quickly Create Surgical Safety Success," at 12:45 p.m. on Tuesday, Nov. 13. Learn more about the event and register to attend in Chicago.

Question: What keeps you excited and motivated to come to work each day?  

Tim Borne: The people. I was brought up and trained to be of service and support to the people around me. On the administrative side, our role is to support our physicians, so they can do their best work in exam rooms, operating rooms and hospitals. A wise mentor of mine used the metaphor of a garden to explain good leadership. You don't just plant a seed and call it good. To really grow something, you're constantly supporting the possibility of growth. It's our job to create the right conditions for things to grow. That's the key to good leadership. That creating — and serving — is what keeps me motivated to come to work each day.

Q: What initially piqued your interest in healthcare?

TB: Many people in my family have worked in healthcare, and so it was a natural direction for me to go. My mother was an administrator in operations; she ran an ambulatory medical facility and later went into finance. And my brother was a physician's assistant who eventually worked in the OR — and there are others as well. You could say that healthcare is the family business.

Q: What is one of the most interesting healthcare industry changes you've
observed in recent years?

TB: To me, the most interesting changes are advances in safety practices in the OR and
hospitals — specifically, the advances of checklists and the improved safety timeout. At
Northwest Permanente, for example, we looked at how we could enhance the safety timeout, to make it a team timeout, to put the surgeon and patient at the center and really
make it as good as it could be. To get there, we looked at safety practices in other
settings, like airplanes or nuclear subs, and then tailored and customized those for the
healthcare setting. That's a new approach for us and one that's been incredibly effective.

Q: What is one piece of professional advice you would give to your younger self?  

TB: Don't doubt yourself — trust that you're going down the right path. I pursued a liberal arts degree in my undergraduate years, and I remember thinking, is this really a wise thing to do? But what I discovered in graduate school and then throughout my career is that a liberal arts education helps you in every field. It rounds you out. Much of what we do in leadership, in medicine, in healthcare, is art and science. And what I've seen in my time in leadership, which is quite a long time now, is that the soft stuff oftentimes is the hard stuff.

A liberal arts background, which is a mile wide and an inch deep sometimes, not only
gives you an excellent foundation from which to specialize but also deepens your
understanding of people.

Q: What's one conviction in healthcare that needs to be challenged?

TB: We need to expand our notion of what we mean by "dignified endings," which is a tenet of healthcare under the Kaiser Permanente model — and elsewhere. There is a paradigm in healthcare that we have to fight and combat death as the enemy, as a sign of failure or defeat. We forget that it is a part of the natural life cycle. We need to challenge the notion of what it means to have quality of life, as opposed to quantity of life.


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