UW News

June 21, 2007

A conversation with Johnese Spisso

Johnese Spisso has been a guiding force in the operations of Harborview Medical Center for the past seven years. Here she talks about her career and what it takes to lead a complex and comprehensive health care organization.

Q: What were your earliest aspirations?

A: My first career aspiration was to be a critical care nurse. I was fascinated by all the pathophysiology of medicine, and I love a fast-paced environment. Nursing as a profession seemed very rewarding to me because you get to help not only patients, but also their families. I was thrilled to have the opportunity to begin my career as an ICU nurse at the University of Pittsburgh’s Presbyterian Medical Center in 1982. Innovation in medicine was evident throughout the hospital. We were the hospital doing the first liver transplants and heart transplants along with so much research and innovation in critical care. During my second year as an ICU nurse my highlight was being the nurse selected to take care of the first heart-lung transplant that the University did. I admitted the patient post-op to the ICU and he was really critical and required constant interpretation of hemodynamics and rapid decision-making. As a relatively new nurse, it was great to have the team of surgeons and pulmonary specialists confident in my abilities to do this!

Q: Why critical care nursing?

A: I enjoyed very much being there providing direct care to critically ill patients and also supporting their families during times of enormous stress — working in a very intense, stressful environment where patients were very fragile, and using a lot of critical thinking skills so that the patient survived. It required the ability to use knowledge and make the right decisions in a rapid way. I also enjoyed the tremendous opportunity to learn from the best and brightest in the medical field. Every day you would learn more from being on the teaching rounds the teams made on patients.

Q: Those skills also seem to apply to your role as chief operating officer of Harborview, and now as clinical operations officer for all of UW Medicine. What doesit take to lead such a complex health care organization?

A: I’ve had the opportunity to work at every level —- from the bedside up. From a staff nurse, I progressed to charge nurse, then manager of a hospital department, then an assistant administrator for many departments, then chief nursing officer and associate administrator for all patient care areas, and then a COO of the hospital. In this senior executive position, I have a very good understanding of what the business of hospitals is, and that is patient care, and how in an academic setting we need to support not only safe and high-quality care but also complete our missions of teaching and research. I also understand what staff and physicians at every level of the hospital do, what the drivers of satisfaction are, what the challenges are and what makes the staff feel valued and supported. Having a clinical background helps me to understand physicians’ needs and work with them effectively. My leadership and management experience also provide me with a solid understanding of the business side of health care. I think you need to know both to be an effective visionary and strategic leader.

Q: Who were your mentors?

A: First, my parents. I had working parents my entire childhood. My father was in management for a motor company. My mother was a teacher. During my early childhood, she got her master’s degree and a doctorate. She was teaching, going to school, and taking care of three children. As a career woman, my mother seemed to be able to work and successfully manage a family. So, I always had the confidence I could do that, too. Early in my career, I had the privilege of working with some of the best surgeons and physicians in the world, not only at the University of Pittsburgh Medical Center, but the University of California, and currently here at UW- Harborview. I learned how to fulfill the missions of teaching, research and clinical care in an academic environment. I also learned a lot about clinical care management from leaders in the nursing profession and those that I worked with in finance and strategic planning. I certainly benefited from working my way up under great mentors.

Q: What does it take to be a good leader?

A: First of all, it takes a clear vision of where the organization is going strategically and how the vision connects to the mission. It takes the ability to effectively and efficiently implement and deliver on the goals. You also need the ability to effectively bring people together and make decisions that are for the greater good of the whole organization. Leadership in a large system needs to help foster and create a culture that inspires the staff to stay connected to the goals of the system and the unique mission of their workplace. I like to help inspire people to stay connected to and take pride in the unique identity of all components that bring strength to the organization as a system.

A good leader needs a strong team — a team that is diverse and willing to provide you with different and differing opinions. One of the things that I like about our culture here is when we have meetings, everybody wants to be a part of the discussion and share their views on how to make things work better. I think this is because everybody is so passionate about their work. Having that kind of open and engaged feedback helps you make better decisions.

Q: What’s been your greatest reward as chief operating officer of Harborview?

A: The greatest rewards come from seeing the outcomes of meeting our mission and doing work that really makes a difference — being able to save people from devastating injuries and illnesses and making families feel safe and secure when their loved ones are in our hands. Also caring for patients from all walks of life. I think it’s a real privilege to work in a place where the hospital board, the physicians and staff commit to supporting that, each and every day.

Q: What about the challenges?

A: The fast pace and high level of intensity of our work can be challenging for us. We are always looking for new ways to keep the staff energized and supported. Our teams are at the front lines of this in every way to assure patient safety, quality care, financial viability and all the initiatives that are required for ongoing success for the organization. At times the stress in a hospital environment can take its toll, so staff have to be able to also get the support they need. We are very good at doing critical incident discussions, root-cause analysis reviews and other forums that allow staff to work through challenges. We also make efforts to do ongoing staff appreciation and recognition events.

Q: What’s next in your career?

A: As I move into the new position as VPMA/COO for UW Medicine, I look forward to the opportunity to work with the leadership teams on achieving the goals for Harborview, UW Medical Center, and UWPN as we continue to strive for excellence as a health care system.

Q: How do you find balance in your life?

A: The most enjoyable thing for me is spending time with my family — my husband, Ross, and my 10-year-old daughter, Veronica. My husband is a physician, so he is also quite busy and understands my hectic schedule. We love to do activities together. Every Sunday in the winter months, you’ll find us snow skiing, and in the summer months we love to go boating. My husband and I love watching our daughter participate in all of her various activities — she’s in the Pacific Northwest Ballet School, and plays soccer and basketball. We look forward to weekend activities — that’s really our time together as a family. 

Q: What makes you so passionate about working at UW Medicine?

A: The fact that we do make a difference! Every day I see the impact we make in serving patients who need our highly specialized expertise and care. It’s exciting to work in a system where the unique missions  of each entity (Harborview, UW Medical Center and UW Physicians Network) drive a strong organizational culture where staff stay connected to those specific missions at each site. This is what allows us to deliver the overall strategic goals of UW Medicine. This is evident in our patient service and leading-edge clinical care, teaching and innovation in research. Working in a system that offers world-class medical care to patients from all walks of life throughout the region, while also changing and improving outcomes for the nation through research, is incredible. It’s a real privilege for me to work here and be part of it.