Forensic Science: Bodies of Evidence
Studying Disease Effects in Underserved Youths
Quality Management in Health-Care Settings
Changing the Cancer Treatment Paradigm
Unwrapping Secrets of the Ancient World
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Quality Management in Health-Care Settings
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Christine St. Andre '72 |
Christine St. Andre '72 began her undergraduate studies at Bryn Mawr College as a mathematics major and later added a major in economics. "As mathematics got more theoretical," she says, "I wanted to balance it with something more practical."
St. Andre had had little exposure to hospitals and would never have considered a medical career, she notes. But a Haverford College microeconomics course focusing on health care sparked her interest. "The intricacies of the economics of the health-care industry really fascinated me," she recalls.
St. Andre completed her Bryn Mawr studies in three years and then worked in information technology at Philadelphia's Thomas Jefferson University Hospital. She earned a master's degree in health-services administration from George Washington University in Washington, D.C.
St. Andre then embarked on a career in managing complex health-care organizations. From 1979 to 1989, she held successively responsible positions at the George Washington University Medical Center, ultimately rising to chief executive officer, a position she held from 1989 to 1994. From 1994 through 1999, she was CEO of the University of Utah Hospitals and Clinics in Salt Lake City.
Managing the Complexities
"Hospitals are their own little cities," St. Andre says. "One of the biggest challenges is to try to align everyone involved in the organization around common goals. In a hospital, you have a very wide range of employees, from physicians and nurses to a large food service and hospitality staff." Teaching hospitals are even more complex, St. Andre notes, because they also have research and educational missions.
With so many details to manage, "You have to focus on being efficient at everything you do," St. Andre says. "You have to look at priorities and not forget things that might otherwise get dropped off the radar screen."
Fund-raising and public interaction are also important, she notes. "When I was in Salt Lake City, there were very few women leaders in the community at the time," St. Andre says. "I was very conscious of my position as a role model."
Life-and-Death Situations
St. Andre was working at George Washington's medical center when President Reagan arrived there after having been shot; as CEO, she dealt with Secret Service teams accompanying presidents visiting patients. She also led the Salt Lake City hospital's advance preparations for the 2002 Olympics.
She also faced tragedy—a helicopter accident in which the patient and crew were killed; a boiler accident resulting in a worker's death; a baby kidnapping. "When I think about these things in retrospect," St. Andre says, "they seem so unreal."
Among the most difficult decisions a hospital must confront, St. Andre says, arise when uninsured patients need costly lifesaving procedures. "Often, something can be worked out, and you end up with a win-win situation," she says.
It's no surprise, she notes, that hospital executives have historically been prone to burnout and high turnover. "But the bottom line is that the work is rewarding despite the challenges," she says, "and that's why people do it."
Consulting to Providers
St. Andre left Salt Lake City in 2000 not because of burnout but because of a family relocation. She entered the for-profit sector, she says, out of a desire to move "outside my comfort zone." She became president and COO of Patient Infosystems, a publicly traded health management company, and led the firm through restructuring. When Patient Infosystems merged with CareGuide in 2006, St. Andre became COO of InnovaCare Solutions, an innovation and improvement division of CareGuide.
Today, St. Andre is COO and Principal of Bethesda, Md.-based CSI Solutions LLC, which consults to primary-care organizations serving primarily underserved populations with federal or Medicaid funding.
St. Andre says there was some adjustment involved in moving from a large medical center to a small firm. "There's a lot of juggling when you're working on multiple projects for multiple clients," she notes. "But the skills of listening, systems thinking, and financial analysis serve you well regardless of where you're working."
Hospital staff members interact with patients on a temporary basis, whereas primary-care providers have longer-term relationships with those they serve, St. Andre notes. "They have more of an impact on patients' lives on an ongoing basis." Her work today, she says, is "an extension of the work I did in a hospital setting, but on a completely different scale, and very, very focused."
Since she left the hospital environment, St. Andre says, "expectations of the health-care system continue to grow. People expect world-class health care and world-class service. In our society, setting limits is not the norm." The solution, she predicts, will lie in finding a way to work smarter. "How do you work differently so you can do what's right for the patient without burning yourself out?" Hospitals began early on to address such questions, she says, "because they had to."
St. Andre credits her Bryn Mawr education with providing a solid background on which to build her career. "I think Bryn Mawr prepared me well," she says. "It promoted individuality, independence, and respect for one's abilities.
"I have been very blessed," St. Andre says. "It's been a phenomenal ride."
Barbara Spector writes on science and technology as well as business topics. She is the editor-in-chief of Family Business magazine and former editor of The Scientist.