Executive Spotlight—Trinity Health's Mike Slubowski on community wellness, workforce pipelines and what's prolonging COVID-19

As a fresh college graduate, Mike Slubowski didn’t expect that he would be spending his career in healthcare.

Rather, the future CEO of Trinity Health followed the path of countless other Detroit natives and took his first steps into the workforce with a local automobile manufacturer. After being laid off within six months due to a downturn in the auto industry, he heard from a surgeon in the family that the healthcare sector “needed people with some business acumen.”

Business administration degrees in hand, Slubowski joined nearby Henry Ford Health System’s finance department in 1977 before eventually switching over to operations. He took another job in the late 1980s with Samaritan Health Services (now Banner Health) in Phoenix and has been drawn to faith-based health systems like Trinity ever since.  

“Many organizations in healthcare have worthy mission statements,” Slubowski said. “I think in Catholic healthcare and faith-based healthcare, our commitment to serve those who are poor and underserved is driven directly by our mission, not a byproduct of our mission.”

Today, Trinity Health is among the largest nonprofit health systems in the country with 88 hospitals, 115,000 employees, an estimated $20 billion in annual revenue and roughly 1.4 million patients served per year.

Slubowski said Trinity’s vision statement—to “become the national leader in improving the health of our communities and each person we serve” and “be your most trusted health partner for life”—has fueled the organization’s recent push to link its clinical care to social services over the past several years.

Slubowski said these types of broad goals and mission statements can be strong motivators in healthcare. On a smaller scale, he also encouraged everyone to put together their own personal mission statements that can align with their work and daily life.

“It’s about the most important things in life,” he said. “[For me] there’s five elements: faith in God, love of family and friends, good health, happiness and service to others. Those are the five things that I try to live by—and I don’t always deliver on those—but that personal mission statement is sort of my witness mark, my litmus test that I can come back to periodically to see if I’ve fallen off track or not.”

But while high-level mission statements and strategies are a useful guiding star, Slubowski said complex organizations need to be able to translate their goals into frameworks and measures that can demonstrate whether significant progress is being made. This is particularly true in healthcare, where areas of improvement and ideas to do so often outstrip an organization’s capacity to execute.

“We’re constantly revisiting whether we’re focused on the critical few versus the worthwhile many,” Slubowski said. “Especially in healthcare, we have a lot of ideas that are clearly worthwhile, but they aren’t the critical few that will move us the furthest the fastest. That’s what we need to constantly reevaluate as we face the future.”

FierceHealthcare caught up with Slubowski to discuss how healthcare organizations can lead on community health, pandemic recovery and workforce development.

Fierce Healthcare: How does Trinity aim to serve its communities beyond the delivery of healthcare services?

Mike Slubowski: We do $1.2 billion a year in community health and well-being services, and that’s not just the IRS definition of community benefit. Trinity has had a huge commitment in community health and well-being, and that includes community investing; it includes things like our partnership as one of the members of the Healthcare Anchor Network. Besides doing community assessments focused on things like healthy food, we have community health workers in every one of our ministries across our 25 states that we serve that do outreach into the communities, and we actively partner with social service agencies, in particular in our communities, so that we meet the holistic needs of the people we serve, because we find that most patients, especially those who are poor and underserved, have social issues.

Defining ourselves as providing health and well-being services through a network of organizations and partnerships for our members also means you need to take stands on things that impact the environment and impact people’s well-being. So we’ve made a major commitment to diversity, equity, inclusion and anti-racism. We’ve trained 600 of our senior leaders and now are rolling it out to thousands of our supervisors and managers in anti-racism training and in cultural competency. We’ve set goals on diversity and hiring, diversity in spend around our supply chain. We’ve upgraded our HR policies to support diversity, equity and inclusion, and we’re also looking at all of the things that we do clinically as well as patient engagement and satisfaction, and stratifying that by race, gender, religious preference, whatever, to see if populations are being adversely or positively impacted by the care that we deliver. It’s really important to us.

FH: Does this holistic care mentality fuel Trinity’s adoption of alternative payment models?

MS: It’s really been five or six years now, and I credit my predecessor [Richard J. Gilfillan, M.D.] in getting our organizations more amped up around creating clinically integrated networks in each of our communities. We now have 17 very robust clinically integrated networks that are taking on responsibility for total cost of care and outcomes of our populations, whether through Medicare Advantage or Medicare risk programs established by the Innovation Center, or direct contracting.

The benefit of being involved in linking clinical care to social care also means you can be a positive performer in delivering care where you have responsibility for the outcomes and the cost of care. That’s where it really pays off.

FH: As the head of a health delivery system, how do you view the latest surge of COVID-19 and its impact on the healthcare industry? Is the organization making any preparations as much of the country is shifting toward "endemic COVID-19"?

MS: We’re not naive to the fact that we’re not done with omicron. There’s always uncertainty—these past two years, none of the predictions have held up on anything. So really being open and ready to pivot has been key to this whole drama that we’re experiencing.

I would say this last set of surges [delta and omicron] have been the hardest on health delivery systems. We’ve faced the "Great Resignation" just like the rest of the economy, in some cases more so because of the burnout caregivers have had. So one of the major focuses at this point in time has been how do we rebuild our staff, and how do we engage with them and help them with resilience through the next phase of where we’re headed?

I think that the thing that’s prolonging this is the refusal to get vaccinated. That is the one common denominator that will clearly move us from pandemic to endemic. You can debate masks and you can debate social distancing all that other stuff, but it’s very clear that vaccination prevents serious illness, hospitalization and death. It doesn’t prevent transmission, as we’ve learned, but neither do flu shots, and the reality is that would have a major impact in moving to endemic mode and helping manage the smaller number of people that would be sick enough to use hospital resources.

FH: How has Trinity worked to address vaccination across the workforce and community?

MS: This fiscal year alone, from July to now, we’ve run like 1,200 pop-up clinics in our communities to provide vaccinations to people where they live or where they shop or where they worship. It’s a pretty broad commitment that we’ve made, and we think that it provides dividends to us in many ways.

We were also one of the early national health systems to require vaccination. We made that call back in July of last year and set deadlines for our colleagues. I’m happy to say that ninety-nine-point-whatever percent of our colleagues are vaccinated. And, we’ve done so much work among our own colleagues, friends and family seminars and things in the community to share the facts about the pandemic and the effectiveness of vaccination and things we’re learning about therapies and everything else. Our colleagues have really been a model for our communities meeting the requirement of vaccination—and that doesn’t just include front-line colleagues; all the people who work in administrator services and so forth are vaccinated. That’s been, really, an important push for us to demonstrate our leadership.

FH: Recent years have put a spotlight on the need for more healthcare workers. What does the industry need to do to bolster the healthcare workforce?

MS: It's interesting. This pandemic, on the one hand, inspired more people to consider healthcare careers, but I think we have to do a lot of work to improve the pipeline capabilities for us to actually train people and also create new roles for caregivers.

I think the traditional models of healthcare delivery that are very nurse-centric instead of having broader care teams and people in different roles both in home, ambulatory and hospital, are incredibly important. Creating opportunities for people who maybe are in service jobs or whatever to actually be trained and grown into robust caregiving roles is a very important way for us to create a pipeline for the future. I think if we just rely on our old models and traditional educational channels that have led people to healthcare roles, we’re not going to be able to fill that pipeline adequately. That’s a huge task for us.

The other thing is creating capabilities to provide care using other support systems like, for example, in our health system we’ve created two hubs using technology from an organization called AvaSure to be able to remotely monitor patient beds across the country, to prevent falls and assist caregivers in the institution. These hubs are trained nurses and staff that are monitoring patients across the country.

Using technologies like that to change the care delivery model is really important if we’re to have a trained workforce that can be expanded.

FH: Does the public sector or others outside of healthcare have a role in ensuring these workforce pipelines and care models come to fruition?

MS: We’re doing a lot of work on the advocacy front to get support from federal, state and local governments to support the increase in the pipeline and the roles and the opportunities for people, but I think really the healthcare delivery system itself needs to demonstrate through pilots, for example, that we can come up with new roles and new models for people in caregiving.

We’ve created what we call “emergence teams.” We have eight of them, and we’ve partnered our leadership of our regional health ministries with people here at system services and populated them with people across the ministry to work quickly and clearly on the major challenges and opportunities that we’ve had. By way of example, back at the beginning of the pandemic when we came out of the first surge, we created an emergency team, one focused on how we create safe outpatient environments to serve people while we’re still in a COVID environment.

We have one team focused on how we recruit, retain and create the workforce of the future. Subteams of that emergency team are focused on new care models and are piloting new care models focused on staff and things they’ve learned from other organizations, creating our own capability to test and roll those initiatives out across the organization with different types of caregivers.

Demonstrate the possibilities to attract both educational institutions and the government to help us fund these initiatives. There’s so many ways here. Just putting your hands out and asking for more funds falls on deaf ears these days. You need to be able to show what’s possible.