Retiring UI Hospitals & Clinics CEO oversaw expansion of clinical enterprise, leaves legacy of service to patients and families
Often throughout his tenure as CEO of University of Iowa Hospitals & Clinics—during hospital management staff meetings or at forums open to all UI Health Care employees, for example—Ken Kates would share a letter from patients or family members.
These letters would express heartfelt thanks to hospital staff—for a successful surgery or procedure, for providing comfort to a loved one, or for simply helping a visitor find their way across the expansive hospital complex.
For Kates, letters like these were as important as financial reports and performance data, for they served as real-world reminders of the UI Health Care mission of changing medicine and changing lives.
“I have always believed that the most powerful words come from our patients and family members,” says Kates, who also serves as associate vice president for UI Health Care. “Their firsthand feedback drives home the importance of what our team relentlessly focuses on each and every day.”
Emphasizing the patient experience has been a top priority for Kates since he assumed leadership of UI Hospitals & Clinics in September 2008.
As he looks to retire after a 40-year career in health care administration, Kates’ influence over the past 10 years with UI Health Care is reflected in the growth of patient care volumes, new facilities and technologies, and persistent focus on patient care quality and safety, and operational efficiencies.
Kates recognized patient and family satisfaction as a key performance metric. He spearheaded the establishment of “The Iowa Experience: Excellence Every Time,” an initiative to identify and implement best practices and behaviors that help create a culture of service across UI Health Care. The organization initially partnered with the Disney Institute to engage a broad cross-section of the clinical enterprise in understanding, committing to, and practicing service excellence. Since 2011, when “Excellence Every Time” was first introduced, practically every UI Health Care staff member—over 15,500—has participated in this training, which continues today.
But for Kates, putting patients first was not about boosting the bottom line. It was simply the right thing to do.
Empathy, understanding, and seeing others’ perspectives are reflections of Kates’ leadership style and day-to-day approach, notes Brooks Jackson, MD, vice president for medical affairs and dean of the Carver College of Medicine.
“Since I came to Iowa last November, Ken has been a tremendous source of institutional knowledge, collaboration, and expertise,” Jackson says. “And I’ve come to recognize that this is just how Ken is. In meetings and in interactions with others, Ken is always well-prepared, respectful, and inclusive. He’s a ‘people’ person—a good listener and someone who is genuinely glad to share the credit for our growth and success.”
During Kates’ term as CEO, these successes include:
- Growth in patient care activity—an 18 percent increase in inpatients, 30 percent increase in outpatients, and a 38 percent increase in surgeries from fiscal years 2009 to 2018. In FY17, UI Hospitals & Clinics reported more than 1 million clinic visits—a first for the organization. Over this period, total revenues increased by almost 80 percent.
- New/expanded patient care facilities and services—including UI Stead Family Children’s Hospital, UI Health Care location at Iowa River Landing, new operating rooms, patient care unit upgrades, new technologies, and expanded primary and specialty care locations in many Iowa communities
- Implementation of Epic, an enhanced electronic health record and order-entry system in 2009
- National recognition in rankings by U.S. News & World Report and Forbes magazine, re-designation of Magnet status for nursing excellence, re-designation by the National Cancer Institute for Holden Comprehensive Cancer Center, and national awards for using information technology to substantially improve patient outcomes and value
Kates is quick to note that these accomplishments are not his alone.
“Our success is because of ‘we,’ not ‘me,’” he says.
In a recent interview in his office, Kates reflected on coming to Iowa and looked ahead to life as a ‘former’ CEO.
Were you familiar with the University of Iowa and Iowa City before joining UI Health Care?
I’d spent 20 years in various leadership roles at the University of Chicago Hospitals and Health System. We regularly benchmarked against other academic medical centers, and one of those was University of Iowa Hospitals & Clinics because it was widely regarded as a high-performing center. Also, my daughter had chosen to attend the UI—so even before I was aware of the CEO position opportunity, I’d been to Iowa City numerous times and completely loved it. We were so impressed with the friendly and welcoming nature of so many folks we had the opportunity to meet. So, I was absolutely delighted when the offer did come to join the team here.
When you began in 2008, UI Health Care was in the early stages of becoming an integrated health system, in terms of the Carver College of Medicine, UI Hospitals & Clinics, and the faculty practice group, now known as UI Physicians.
The idea of one integrated health system was envisioned by then UI President Gary Fethke a year or so before I arrived, and Jean Robillard played a major role in developing, and then leading, the new enterprise. I was fortunate to be the first CEO to serve under this new structure. Operating with one integrated vision and strategy, unified leadership team, and integrated planning allowed us to work efficiently and effectively as one enterprise. This ensured an enterprise-wide focus on our missions of providing exceptional patient care, advancing innovation and discovery, and training the next generation of leaders in science and health care. This new structure was critically important when established back in 2007 and remains so today.
What were the challenges?
A major challenge when I arrived was the fact that the recession was hitting. We had to deal with the economic realities of reduced reimbursement, volume changes, and higher expenses. We needed to put in place a number of action steps to respond, including a detailed expense moderation plan. The team did an exceptional job managing through these challenges. Each time we’ve faced similar types of financial or operational challenges, we’ve developed a plan and successfully executed the plan. That’s what we did in 2008, and the team has continued to perform remarkably well since.
I am most proud of the team here at UI Health Care. I’m proud of the fact that our successes are team successes. So often have I been in awe of the great things our teams have done. It takes a lot of dedicated, hard-working, and amazing people to make an organization like ours function at a high level. I am also quite proud of our improvements in quality, safety, the patient/family experience, and organizational culture.
How did a commitment to service and the patient experience become a priority?
Health care is very metric-driven industry, and we’re a metric-driven organization. When we benchmarked against other academic medical centers, we found that we did a very good job in many areas, but we always have strived to be among the best of the best—in the 90th percentile or better.
When we looked at how we were doing in the area of patient and family satisfaction and other key service and operational areas, we saw opportunities to do better. We convened a group of key stakeholders—patients, family members, faculty physicians, residents, nurses, pharmacists, social workers, environmental service workers, facilities staff, and many others—and asked ourselves what we needed to do to get better. We decided to partner with the Disney Institute based on their experience in this area. We implemented a variety of best practice initiatives, we communicated them to the staff, and we worked hard at it with great discipline and rigor. It took the input and buy-in from people across the organization—and they’ve responded tremendously.
I’ve had 40 incredible years in health care, working with some wonderful organizations and truly great people—the culmination being here at Iowa. I don’t take for granted how fortunate I’ve been. I very much look forward to being a full-time grandfather. I have incredible children and grandchildren, so I am quite excited to be able to move closer to them. I look forward to having more time for family and friends and to whatever many new adventures lie ahead.
Anything else you would like to add?
Again, I would emphasize that every person in our organization makes a difference. One of the greatest privileges I have had is getting to talk to people who choose us for care. When you hear their stories, you understand immediately the trust they are placing in us. A former patient once told me that a patient’s “special” day at UI Hospitals & Clinics is our “every” day. Remembering this and treating patients and their family members with respect and understanding for what they’re going through is an enormous responsibility. Patients and families are literally—and I mean literally—trusting us with their lives and the lives of their loved ones. We must never forget that.
Ken Kates’ UI Health Care colleagues share their thoughts:
Mike Brownlee, associate director and chief pharmacy officer, UI Hospitals & Clinics
Ken always had a way of making sure that our patients and families felt welcomed and well cared for at UI Hospitals & Clinics. He would greet patients in the hallway, visit them on the patient care units, and make sure we responded to their letters of praise or complaint. These qualities helped make it a better environment for our patients and families.
Lee Carmen, associate vice president for information technology, UI Health Care
Ken has always understood the potential for IT to advance the goals of the organization. He has always tried to include IT in planning and problem-solving discussions to make sure IT aligned with institutional priorities and timelines. And he’s always been a data-driven leader. He understands how important it is to define performance and operational metrics for initiatives and then to transparently share that data with impacted parties.
Also, Ken has always understood that all staff contribute to our mission. He routinely interacts with clinical and non-clinical operational support staff throughout the organization, thanking them for their hard work and recognizing their successes and the role they play in providing great care to our patients.
Joe Clamon, associate vice president for legal affairs, UI Health Care
All you have to do is walk down the halls of the hospital with Ken. You’ll see how many people he knows on a first-name basis and how dedicated he is to making sure that everyone is working toward making the patient care experience as meaningful and positive as it can be. He cares deeply about this place and the value and importance it holds in the community—not just for the people who work here, but for anyone who visits or comes here for care.
Cindy Dawson, chief nurse executive and associate director, UI Hospitals & Clinics
Throughout the past 10 years, Ken has been a tireless advocate for, and on behalf of, the Department of Nursing Services and Patient Care. His advocacy efforts have gone far beyond additional resources in the form of increased numbers of staff members to meet the ever-increasing census and growth experienced throughout the organization.
During his time at UI Health Care, Ken has continually recognized, supported, and acknowledged the work accomplished by the department to both internal and external audiences. He has always listened to concerns and actively collaborated with key stakeholders to determine solutions that best meet the needs of the situation and always appropriately prioritized what is in the best interest of the patients and others served by the organization.
Kathy Dean, associate vice president for marketing and communications, UI Health Care
Ken is a strategic and compassionate leader who keeps a focus on what’s most important: the patient. Every person he works with has heard him say it: “Nothing trumps quality and safety!”
Michael Edmond, associate chief medical officer and chief quality officer, UI Hospitals & Clinics
What I really like about working with Ken is that he encourages the expression of opposing viewpoints, is a great listener, and is always respectful.
Amy O’Deen, senior assistant director, UI Hospitals & Clinics, and interim executive director, UI Stead Family Children’s Hospital
Ken’s unwavering commitment to the highest quality of care and patient and staff safety was widely recognized and evident in the “Excellence Every Time” initiative he launched and spearheaded. These patient-centric values and Ken’s dedication and collaborative style underpinned his successful leadership tenure during a time of unprecedented clinical growth as well as systemic health care reform and financial challenges.
In my role as interim executive director of UI Stead Family Children’s Hospital, I now have a heightened appreciation for Ken’s remarkable humanism and compassion for our pediatric patients and their families. He gives of his time, energy, and resources to attend events; champions their needs; and connects on a very personal level. His leadership and advocacy will be greatly missed.
Jean Robillard, former UI vice president for medical affairs and dean of the Carver College of Medicine
There are no words to express my appreciation and my gratitude for Ken’s hard work and exemplary leadership over the last 10 years. His dedication and passion for service excellence changed our culture and transformed our institution. Service excellence is now part of our fabric, and it’s helped make our organization a great place to work—where everyone respects and helps each other and where patients can feel that they are safe and that their health is our only focus.
Sabi Singh, chief operating officer, UI Hospitals & Clinics
Ken possesses a number of intrinsic qualities that contributed to his success as an institutional leader. He has warm human relation skills, is a consensus builder, and was always thoughtful, honest, and fair in his interactions. Further, he truly embraced our mission and values, with an unwavering commitment to patient-centered care and meeting the holistic needs of our patient population. He regularly performed rounding on inpatient units and listened to patients and frontline staff on ways to continue to improve care delivery and patient experience.
One of my favorite recollections was observing Ken with our pediatric patients when they paraded through the hospital every Halloween. He truly enjoyed making personal connections with the children and their families and ensuring that they were receiving the very best care possible. This just provides further evidence of the kindness of his character and his strength as a health care leader.
Doug Van Daele, vice dean for clinical affairs, UI Carver College of Medicine, and executive director, UI Physicians
Ken has always been the consummate professional. He recognizes the importance of all team members working at the top of their game, and he constantly recognized the hard-working attitude of Iowans. His extensive experience in academic centers allowed him to provide focus on quality, safety, and the patient experience for all three missions. His collaborative style and approachable demeanor allowed him to be successful.
Jana Wessels, associate vice president for human resources, UI Health Care
I have known Ken since the day he arrived, and I remember his interview. He is positive, upbeat, hardworking, and kind. He cares so much about his work—the employees, the patients, and their families. Ken has done so much for patients here behind the scenes—playing Santa during the holidays, pop-in visits to patients, sponsoring families. I have slept better at night knowing Ken is the CEO and whatever crisis comes our way, we will get through it together. I have learned so much from Ken; I will be ever grateful. We are lucky to have had him for a decade. He will be greatly missed.
Pat Winokur, executive dean and senior associate dean for clinical and translational science, UI Carver College of Medicine
Ken is calm, open to suggestions, and truly cares about the patients and staff. He often greets the employees by name and has a very warm approach. He asks patients what he can do to help them find their way. He provides a very personal touch.
Also, very few hospital CEOs would support using hospital funds to help escalate the research mission in the college. Ken was not only supportive; he was excited by the ability to support something that might have a longer term, but still very positive, impact. He was thoughtful in the discussions as we tried to develop the best plans for use of funds to support research. When we started to see the impact of the investment, he was truly happy to see the progress.