Blazing the trail: Creating quality and value for a loyal customer following

An avid walker, John D. Couris often traverses Bayshore and South Tampa — listening to and finding inspiration from one of his favorite bands, the Grateful Dead.

With Tampa General Hospital (TGH) in the foreground, it’s a time he uses to reflect — not just about how far he and his team have come in the seven years since he assumed the role of president and CEO of Florida Health Sciences Center but where they’re headed.

Couris, a published management and social science researcher, has bold ideas about pushing healthcare forward, and he believes the guiding principle in caring for patients begins with improving the community in a holistic way. It’s foundational to his commitment of creating a people-first workplace culture that he says is based on “authenticity, transparency, kindness and vulnerability.”

“We focus first on our team of staff, advanced practice providers and physicians,” he said. “Because if you give them your very best, they in turn will give their very best to our patients.”

And like the Grateful Dead, who Couris argues were true pioneers of consumerism by providing their fanbase with the highest level of access to their music (think capped ticket prices, rejection of corporate sponsorships and distributing music on multiple channels), he says the healthcare industry must also rethink how to engage with patients in a more efficient, consistent, impactful and convenient way.

“The Dead’s product was not their music or the band — it was their audience. They were about building a loyal community,” he said. “As healthcare leaders, our ability to succeed will be a result of our willingness to embrace change and innovation — to not just adjust but capitalize on the new realities of our business and build a loyal following of consumers.”

Here, Couris — a national expert in healthcare, organizational leadership, and workplace culture transformation and management — shares the importance of teamwork, operational excellence, strategic partnership and embracing technology to evolve how providers care for patients.

When did you know you wanted to work in healthcare?

I’ve been doing this work since I was 21. After being exposed to healthcare case studies in my classes at Boston University, I immediately became curious and interested in the mission of the industry — dedicated to helping people with chronic illness, debilitating diseases and teaching health and wellness.

During my last semester, I was recruited by Massachusetts General Hospital in Boston for a human resources position. Soon after, I realized I wanted to be a president/CEO of a health system. I later moved to Florida and worked for BayCare Health System in Clearwater before being named president and CEO of Jupiter Medical Center in 2010 and then president and CEO of Tampa General Hospital in 2017. The fact that I'm president and CEO of an academic and research health system that encompasses both Tampa General Hospital and USF Health is a great privilege, and the fulfillment of what I set out to achieve.

There’s real meaning behind the work we do. We’re here for the health and wellness of the community, and our residents, fellows and medical students who are defining how care is delivered in our country in an academic environment.

I’ve devoted my life to healthcare and to learning every day from people in the industry, from my team, my trustees and the people around me. That’s what gets me up in the morning.

What differentiates your organization’s culture and how does your leadership approach guide it?

We have a distinct culture and a very specific way we lead that was born out of my doctoral program in business administration (with a focus on management and social science) at the University of South Florida, Muma College of Business. My dissertation, “Driving Health Care Results with Authenticity, Kindness and Vulnerability: A New Model of Authentic Leadership,” was focused on culture and leadership.

There's a lot of quantitative and qualitative data that shows if you lead and build a culture that's predicated on authenticity, kindness, transparency and vulnerability, you will drive improvements in team member engagement, trust and psychological safety. And by doing so, you will produce better results for your organization in a more highly reliable and sustainable way from an operating, clinical and strategic perspective.

It absolutely works and has helped drive our journey at TGH.

Our team member engagement year over year operates within the top quartile of the U.S. It’s a result of creating an environment where people feel psychologically safe to challenge and disrupt the status quo. It’s okay to fail. But fail fast. Celebrate your failures. Pick yourself up, dust yourself off and push yourself forward. That’s how real innovation and creativity blossom.

What are some examples of how this culture has helped move TGH forward?

We’ve experienced tremendous growth and success. Tampa General’s footprint has expanded to include six hospitals and more than 150 care locations across Florida and employs nearly 15,000 team members and physicians.

That doesn't happen by accident. It happens because of a vibrant culture with world-class people who lead in a consistent way, predicated around authenticity, love, kindness, empathy and grace while being completely transparent about the decisions we make.

Twice a year, I meet with 100% of my nearly 15,000-member team, including 600 leaders. We make it mandatory, because it’s important they understand where we're going and understand the “why” behind it.

Fostering an environment of continuous learning is key. In 2021, we started a shared initiative between TGH and USF’s Muma College of Business — the TGH-USF People Development Institute (PDI). It’s rooted in my deep-seated belief in the importance of lifelong learning. PDI fosters professional growth of clinical and non-clinical team members through a broad range of courses like business skills, values-based care, personal and professional development, management and leadership and communication. It also underscores our commitment to creating a positive workplace culture. It works because it's always about the people we serve, not about brick and mortar.

You’ve talked about transforming healthcare. What are some of the innovations TGH has put into action?

We are very aggressive when it comes to building novel approaches to delivering care and asking ourselves the tough questions as to why care is delivered a certain way. If we don't get comfortable with disrupting, innovating and changing, especially as the industry craves it, somebody else will — and likely someone outside of healthcare.

For example, in 2019, through a partnership with GE Healthcare, we launched CareComm, a command center for patient care that gathers data points to provide insights into patient care, identify trends and drive decision-making. It doesn’t just look at efficiency and effectiveness — it’s our central nervous system from a quality and safety perspective. It shines a big, bright light in the dark corners of our healthcare system. You must be willing to look at all the issues in an unbiased and unemotional way.

We have the functionality to track and monitor transfers from hospitals throughout Florida using real-time analytics that automatically pulls new information to update a patient’s progress and flags barriers that may occur such as completion of orders or transportation. We’re also working on automated algorithm workflow alerts to identify bottlenecks in real time to allow clinical teams to forecast and predict patient outcomes as well as future bed demands in advance.

And through implementation of ambient listening technology in our clinics, doctors and nurses don’t have to type in the EMR as they talk to patients. It saves them a lot of time, both in the clinic and at home when they’re catching up on their notes.

Finally, we’ve developed a robust relationship with Palantir, a leading builder of operation systems, to employ artificial intelligence and predictive analytics capabilities to augment critical decision-making on the front lines. It’s changing the DNA of our health system — how we think, perform and the speed at which we're making these decisions.

For example, using predictive analytics/AI, we’re able to model and track sepsis patients through 20 clinical indicators that are monitored 24 hours a day. It allows us in real time to dispatch diagnostic and therapeutic teams to treat these patients. We’ve saved over four hundred lives since we started this program and reduced mortality by 20%. These are mothers, fathers, husbands, wives, aunts, uncles and grandparents who can go back to their families and live their lives.

Can this care model work beyond large academic systems like TGH such as smaller community hospitals? Are there fundamental elements that are key to success?

Most definitely. It’s scalable across all sizes of hospitals — whether a critical access hospital or a community hospital.

To do it well, you need to understand that we are not in the health and wellness business. We're in the care coordination business and a component of what we do is health and wellness. Our job is to eliminate silos, reduce fragmentation, smooth out friction in the system and build a consumer-facing platform and operating system that coordinates care. We are collaborating with all sorts of partners and solutions to create one large operating system for our patients and team.

As a member of the Florida Health Care Innovation Council, what is your biggest hope in helping to advance innovation in healthcare as part of the Senate's Live Healthy initiative?

It’s an incredible honor and privilege to serve on the Council as we focus on dynamic and strategic solutions that increase access, cut costs and improve patient outcomes. I hope that through the work of the Council, Florida can serve as a national model in delivering high-quality healthcare. With support from Senate President Kathleen Passidomo and other leaders on the state level, we can make strategic investments in innovation that have the potential to revolutionize the way we deliver care in the Sunshine State.

At TGH, I have seen this type of work in action. We continuously leverage innovation to transform how we deliver care — care that provides better outcomes, increases access and is more cost effective for the consumer, the payer and the provider. For example, TGH at Home, a program we launched that is now becoming a national model, provides access to best-in-class hospital care from healthcare providers in the comfort of a patient’s home. Since the program’s launch, TGH at Home has demonstrably reduced the risk of readmission for participating patients.

What are some other examples of your most impactful community partnerships and what drives those collaborations?

We’re building out an ecosystem of like-minded partners and collaborators and innovators to build out a system of care that is both patient-centered and team member-centered.

For example, we partnered to open two specialty behavioral health hospitals — TGH Rehabilitation Hospital, an acute care rehab hospital and TGH Behavioral Health Hospital (opening in 2025), a psychiatric facility — with Lifepoint Behavioral Health. It's a wonderful collaboration that adds real value not just to our organizations but also to the communities we serve.

We also partner with Philips for technologies such as bedside patient and vital sign monitors, key imaging equipment in the catheterization laboratories and interventional radiology rooms. And recently, we expanded our reach to the growing Babcock Ranch — America’s first solar-powered town of 8,000 people — to provide urgent care and community health, eliminating the need to drive 20 miles to the nearest healthcare services.

Additionally, TGH Ventures, which is our own venture capital group, directly invests in early-stage companies that share our passion for streamlining access to comprehensive healthcare, lowering costs, optimizing care delivery methods and enhancing the overall patient experience.

What advice would you give other CEOs who are trying to move the needle on sustainable growth?

First, you need strategic tactics that are easily understandable. You must be able to communicate them to your entire organization on a consistent basis and engage them in a dialogue around what works and what doesn't work, solicit their feedback and incorporate it into your strategic plan. Your plan must be a blueprint, not a static document that sits on a shelf, but a living, breathing one that is constantly curated and adjusted based on the environment in which you operate.

Second, you have to get comfortable practicing what I call ‘strategic improvisation,’ the ability to adjust the sails when the wind starts to change. As leadership expert John C. Maxwell said, “The pessimist complains about the wind. The optimist expects it to change. The leader adjusts the sails.”

For example, I am very bullish with service line work in supporting our growing ambulatory market. Over the past five years, we have doubled down on our clinical service line structure, and we're about to roll out what we call Service Line 2.0, where we're lining up authority with responsibility and accountability.

Our service line leaders will have complete authority over their service lines, making decisions in a dyad model with the physician and in some cases, a triad model with a physician and a nurse. This work is transformative and allows them to execute on those strategies and tactics quickly to improve both quality and financial ROI.

How can the healthcare industry at large evolve?

As a nation, we have many challenges in our healthcare delivery from a quality, safety and customer service perspective. If you look at our collective customer service Net Promoter Scores, compared to other industries, healthcare is in the bottom quartile.

You would think that if putting the patient first was the right thing to do, we'd have better scores, we'd be performing better, we'd be seen in a better light by consumers. But we’re not. I think team member satisfaction — staff and clinicians — is No. 1. If you give your team your very best, they can give their very best to the patients. The patients are ultimately the beneficiary and the ultimate stakeholder in all of this.

Also, bigger isn't better. Better is better. You must build strategically and really add value to the communities you serve.

Lastly, be disruptive. Thoughtfully innovate. We need to change the DNA of the systems we run so they will thrive and serve their communities in the best possible way.