- Email: [email protected]
Tim Tracy, RN, MPA, CHE
Leader To Watch Tim Tracy, RN, MPA, CHE Interview by Linda Burnes Bolton, DrPH, RN, FAAN Photography by Mike Paulson © 2005
“The quest for knowing and acting” describes Tim Tracy, executive vice president and chief executive officer of John C. Lincoln Hospital–Deer Valley in Phoenix, Arizona. His quest for knowing has guided his leadership journey over the past 30 years. He is committed to using his leadership abilities to both promote enablers of patient care quality and to remove the barriers to excellence in health care delivery. Tim has received multiple honors throughout his outstanding career. He has distinguished himself as well as the organizations that have tapped him on the shoulder and asked, “Would you be willing to lead us?” He has served as board chairman of the Arizona Hospital and Healthcare Association and as secretary/treasurer of that board, as chair on the Taskforce on Healthcare Regulations, and as chair and member of the Council on Healthcare Professionals. He is a past president of the Arizona Organization of Nurse Executives and has served in a variety of leadership roles, including nursing director, house supervisor, vice president, and executive vice president. Meet Tim Tracy, an inspiring leader on the move! 14 Nurse Leader
Describe your leadership journey over the past 30 years. It started back when I was a staff nurse in an emergency department. I became a charge nurse after a year. I was a new grad, and a year later I was the most senior nurse, and then I was a charge nurse in a few months. I really enjoyed influencing what was going on and just working with people. It was the first time I had ever been in a management position. I really liked it, and I got a tap on the shoulder, so to speak, by an assistant director of nursing who said, “We’d like you to be a house supervisor.” So, here I was, three and a half years out of nursing school and I was house supervisor. I was 25 years old; most of the people in the position were 50 or older. It was a heck of a shock to have a young man in that position. It was very entrusting, and as the house supervisor you get to do absolutely everything; anything can happen. The part that I liked the best, though, was when people were creating 24-hour head nurse accountability and reorganizing around clinical services. When I first started as a supervisor, it was all centralized. But I had responsibility for the evening shift. There was a day supervisor and a night supervisor. There was a director
for each shift for the whole hospital, so it was very centralized, and I was able to participate and suggest and help groom 24-hour head nurses. It was a really interesting time. I was bitten by the leadership bug, and I never expected it! In fact, when I first told my father that I was going to nursing school, he said, “Good, you can be an administrator some day.” I said, “No, thanks. That’s the last thing I want to do.” Do you have a metaphor for your journey? I guess I’ve always tried to be there before I get there. I try to function in a greater capacity than the position I’m holding at a specific point in time. I’m not talking about competition; what I’m talking about is an outlook that goes beyond your boundaries; with your thinking, with your perspective, with your influence versus just direct responsibilities; spending a lot of time looking at the other perspectives, not just your own. I started functioning in the next-level position before I got it. What prepared you to do that? Was it this quest for wanting to be known or to do more? No, I think it wasn’t even clearly to get a different position. I guess I October 2005
just have this compulsion to look at things from the outside in and sort of have a broader outlook than my direct responsibility. I was in nursing, but my focus was patient care, not nursing as a discipline. To me, patient care is a broader focus than just nursing care. Is that what started you down the hospital administration pathway on your leadership journey? I think that expanding my boundaries is probably what got me into hospital administration. First of all, I had great, great mentors and bosses along the way. I’ve been given lots of freedom and a lot of support. When I was working at Good Samaritan Medical Center with Rhonda Anderson, my job was director for support and ambulatory services. My nickname was “TaskForce Tracy,” because in every area where there were problems, I was the one pulling the radiology department and nursing department together to talk about how we could operate differently. It’s
October 2005
much more integration-focused than silos. And the more I thought integration—and I don’t mean everyone reports to one person but that we all have the same focus— the more I thought it meant focusing on the patient, which cuts through a lot of colloquialism and territorialism. But that experience of working through territories and making those bridges, I think, was enough of an outlook that when upper positions became available, I was progressing. So over the course of the past 3 decades, you have had progressive leadership responsibilities for which, in your own words, you were already there before you assumed those responsibilities. I tried to be. Again, I’ve been very blessed with bosses who gave more and more accountability and responsibility. They allowed me to grow. The statement that you have been “allowed to grow” resonates with me, because we say leaders are supposed to allow
their staff to grow. And I’m sure you’re doing it for others. I hope so. I believe I am. It is really so important for me to work for people who have a broader perspective and positive outlook. I just need, personally, to have a very broad perspective. They’ve allowed me to go beyond my traditional roles and they’ve gotten me involved with other things. It has broadened my horizons and made me a more valuable leader. What about your life experiences? What did you learn from personal experiences that prepared you for leadership? I was the oldest child, and for 12 years the only child. I learned the importance of giving and negotiating in family life. What about your Waterbury Nursing School experience? Great! I was absolutely, totally focused and totally committed. I just couldn’t get enough information. I couldn’t spend enough time on my studies or practice. I knew I wanted to be a nurse, and I also knew I
Nurse Leader 15
Name: Tim Tracy
Hometown: Hartford, Connecticut
Current job: CEO and Executive Vice President
Education: Master’s of Public Administration in Health Service Management, Golden Gate University, San Francisco, California, 1986 Bachelor of Science in Health Administration University of Phoenix, Arizona, 1984 Diploma in Nursing, Waterbury Hospital School of Nursing, Connecticut, 1972
First job in nursing: Staff nurse in emergency department
Being in a leadership position gives me the opportunity to: Have a positive impact on all aspects of health care (management, nursing, physicians, staff, patient care, etc.)
Most people don’t know that I: Own a Harley-Davidson motorcycle
My best advice to aspiring leaders: Look beyond own areas of responsibility and embrace a system view of health care
One thing I want to learn: How to achieve Baldrige status
One word to summarize me: Integrator
16 Nurse Leader
wanted to be an excellent nurse and a very smart nurse. My need to care for people was very high. To me it was more like a calling or a mission than it was a career. It sounds like that has threaded its way through your professional career. I’m astounded by the leadership positions you have held over the past 30 years. They were always progressive, each one having a little twist. Is that what excites you about hospital administration? Yes. The higher up you go, the more vicarious things get. And I’m still patient-focused, even though I’m not taking care of patients. It comes across with what I enforce, what I remind people of, questions that I ask, and what I pay attention to—patient satisfaction and day-to-day problem-solving. I’m blessed to have good relationships with physicians, but it’s because it generally gets down to, “OK, let’s look at this from a patient perspective or a patient care perspective.” And that is enough to get them to the table? It’s something that stops them. It stops them because we all get caught up in our own perspectives, and if we have a common goal we can at least agree to disagree on some things. There are some things that we are definitely here for. It’s our root, our main purpose. How do you achieve balance in life? Family has been very important. I have three adult children; my daughter, the oldest, is a clinical manager, she’s an RN in pediatrics. I also have two sons. My daughter has two daughters, so I’m a grandfather of a 10-year-old and a 2-year-old. How did you get to Arizona from Connecticut? My wife and I went to school with a couple, and they moved out here. They told us about it. Winters were rough back there, and I wanted a change. I wanted to grow. Back East, people worked in places for 35 or 40 years in order to progress. You had to wait for someone to retire or die. There just weren’t opportunities. So I decided to “go West, young man.” It was a very, very good move. What are the primary forces shaping health care delivery? What roles should nurse leaders assume in addressing these forces? It’s my bias that the people who will be the most successful can look beyond their noses and beyond what they control. Nurse leaders should look at what they can influence. I also believe that we all exist in a greater system than just the nursing system. In order for nursing leaders to be looked on as true leaders of the system, they really need to have a more “system” outlook. They need to see things in relationship to the whole. I worry sometimes that we pigeonhole ourselves. I have heard many times over the years from other administrators, “Yes, this person might be a senior vice president, but that’s in nursing.” They have a high regard for nursing, but it’s a boundary, and nursing shouldn’t be a boundary. I think it’s really important that we get out of October 2005
There’s a real opportunity for greater physician-nurse collaboration. It could be a very powerful strategy to address the health care delivery system issues now and in the future. our own paradigm and take a look at things from the other perspective, at us and what we do, what nurses do. Significant change in the system is going to be driven by those who know how to look at the whole. Consumerism is a growing and important force shaping care delivery. I think more and more responsibility is going to be placed on people using our services. I think that, down the road, we’re going to see more and more physician integration. I think our economic situation is going to continue to be very challenging, including demands on outcomes. And all that calls for a broader perspective, working together, truly understanding team and lean thinking. I think it’s also going to be a challenge for nurses as well as physicians to get more involved on the administrative teams. Typically, the only clinical person is the chief nursing officer. It might be a little different if there’s a physician in there. I think that might be a challenge. I think it’s an opportunity because doctors and nurses are critical components; in fact, when you hear most people talk, they rarely say one without the other. There’s a real opportunity for greater physician-nurse collaboration. It could be a very powerful strategy to address the health care delivery system issues now and in the future. What advice do you have for your colleagues? Be open to change and don’t settle for the status quo. Focus on why we exist—to make a difference. Focus on quality, patient outcomes, and safety. The other huge part of my life has been the fact that I know that what I do has a huge impact on the people who work in the organization. I pay as much attention to internal culture as I possibly can. It’s a people business. It’s certainly technology, skill, and knowledge, but it’s a very human field. If you don’t have good, happy people, an environment for patient satisfaction cannot be created. So I believe focusing on internal culture, being visible and accessible, is very important. Be visible, be open, be supportive, and make sure that you’re investing in the people who are really getting the job done? Absolutely. People want to do well. I don’t think anyone comes to work thinking, “Oh boy, I can’t wait to go in and screw up.” I don’t think people are basically bad; I think sometimes people are in the wrong place. I believe it’s our job as leaders to make sure people are in the best October 2005
position to contribute and to feel appreciated for what they do. It’s important to let staff know they are appreciated for their contributions. What hobbies do you have? I don’t really have any hobbies. I do ride a motorcycle—I have a Harley-Davidson and I love to ride for fun. Do you have a favorite quote? I have two of them: “If it's going to be, it's up to me,” I think is my number one. The other is “What you do speaks so loudly, I can't hear what you're saying.” What would you like readers to take away from our interview? I really hope that we all stay optimistic. Sometimes our health care seems so challenging. If you’re going to be a good leader in health care, you’ve got to maintain optimism. We need to find ways to make people feel good about what they do and also find ways to be better at what we do. You have been serving us in leadership roles within professional associations, such as chairman of the hospital association board of directors. You’ve moved from being “Task-Force Tracy” to “Association Tracy.” What role do you think that associations play in fulfilling our community stewardship obligations to society? Most associations—and I don’t mean this in a negative way—are put together to serve their members. I mean, it’s a bit self-serving for advocacy, for position. Sometimes I wish I could mix up associations, mix up people and have people from cross areas get together, do more problem-solving and looking at the bigger picture. I think that, in my time with the Arizona Hospital Healthcare Association, there really has been much more of that, much more involvement with the medical association. I think associations are very helpful. I know from my own perspective, the networking and learning have been great. I appreciate the learning experience I received by participating in associations. Leadership is about doing and serving others in health care settings and within the communities in which we live. Linda Burnes Bolton, DrPH, RN, FAAN, is vice president and chief nursing officer of Cedars Sinai Medical Center in Los Angeles, California. She can be reached at [email protected]. 1541-4612/$ See front matter Copyright 2005 Mosby, Inc. All rights reserved. doi:10.1016/j.mnl.2005.07.005
Nurse Leader 17
“The quest for knowing and acting” describes Tim Tracy, executive vice president and chief executive officer of John C. Lincoln Hospital–Deer Valley in Phoenix, Arizona. His quest for knowing has guided his leadership journey over the past 30 years. He is committed to using his leadership abilities to both promote enablers of patient care quality and to remove the barriers to excellence in health care delivery. Tim has received multiple honors throughout his outstanding career. He has distinguished himself as well as the organizations that have tapped him on the shoulder and asked, “Would you be willing to lead us?” He has served as board chairman of the Arizona Hospital and Healthcare Association and as secretary/treasurer of that board, as chair on the Taskforce on Healthcare Regulations, and as chair and member of the Council on Healthcare Professionals. He is a past president of the Arizona Organization of Nurse Executives and has served in a variety of leadership roles, including nursing director, house supervisor, vice president, and executive vice president. Meet Tim Tracy, an inspiring leader on the move! 14 Nurse Leader
Describe your leadership journey over the past 30 years. It started back when I was a staff nurse in an emergency department. I became a charge nurse after a year. I was a new grad, and a year later I was the most senior nurse, and then I was a charge nurse in a few months. I really enjoyed influencing what was going on and just working with people. It was the first time I had ever been in a management position. I really liked it, and I got a tap on the shoulder, so to speak, by an assistant director of nursing who said, “We’d like you to be a house supervisor.” So, here I was, three and a half years out of nursing school and I was house supervisor. I was 25 years old; most of the people in the position were 50 or older. It was a heck of a shock to have a young man in that position. It was very entrusting, and as the house supervisor you get to do absolutely everything; anything can happen. The part that I liked the best, though, was when people were creating 24-hour head nurse accountability and reorganizing around clinical services. When I first started as a supervisor, it was all centralized. But I had responsibility for the evening shift. There was a day supervisor and a night supervisor. There was a director
for each shift for the whole hospital, so it was very centralized, and I was able to participate and suggest and help groom 24-hour head nurses. It was a really interesting time. I was bitten by the leadership bug, and I never expected it! In fact, when I first told my father that I was going to nursing school, he said, “Good, you can be an administrator some day.” I said, “No, thanks. That’s the last thing I want to do.” Do you have a metaphor for your journey? I guess I’ve always tried to be there before I get there. I try to function in a greater capacity than the position I’m holding at a specific point in time. I’m not talking about competition; what I’m talking about is an outlook that goes beyond your boundaries; with your thinking, with your perspective, with your influence versus just direct responsibilities; spending a lot of time looking at the other perspectives, not just your own. I started functioning in the next-level position before I got it. What prepared you to do that? Was it this quest for wanting to be known or to do more? No, I think it wasn’t even clearly to get a different position. I guess I October 2005
just have this compulsion to look at things from the outside in and sort of have a broader outlook than my direct responsibility. I was in nursing, but my focus was patient care, not nursing as a discipline. To me, patient care is a broader focus than just nursing care. Is that what started you down the hospital administration pathway on your leadership journey? I think that expanding my boundaries is probably what got me into hospital administration. First of all, I had great, great mentors and bosses along the way. I’ve been given lots of freedom and a lot of support. When I was working at Good Samaritan Medical Center with Rhonda Anderson, my job was director for support and ambulatory services. My nickname was “TaskForce Tracy,” because in every area where there were problems, I was the one pulling the radiology department and nursing department together to talk about how we could operate differently. It’s
October 2005
much more integration-focused than silos. And the more I thought integration—and I don’t mean everyone reports to one person but that we all have the same focus— the more I thought it meant focusing on the patient, which cuts through a lot of colloquialism and territorialism. But that experience of working through territories and making those bridges, I think, was enough of an outlook that when upper positions became available, I was progressing. So over the course of the past 3 decades, you have had progressive leadership responsibilities for which, in your own words, you were already there before you assumed those responsibilities. I tried to be. Again, I’ve been very blessed with bosses who gave more and more accountability and responsibility. They allowed me to grow. The statement that you have been “allowed to grow” resonates with me, because we say leaders are supposed to allow
their staff to grow. And I’m sure you’re doing it for others. I hope so. I believe I am. It is really so important for me to work for people who have a broader perspective and positive outlook. I just need, personally, to have a very broad perspective. They’ve allowed me to go beyond my traditional roles and they’ve gotten me involved with other things. It has broadened my horizons and made me a more valuable leader. What about your life experiences? What did you learn from personal experiences that prepared you for leadership? I was the oldest child, and for 12 years the only child. I learned the importance of giving and negotiating in family life. What about your Waterbury Nursing School experience? Great! I was absolutely, totally focused and totally committed. I just couldn’t get enough information. I couldn’t spend enough time on my studies or practice. I knew I wanted to be a nurse, and I also knew I
Nurse Leader 15
Name: Tim Tracy
Hometown: Hartford, Connecticut
Current job: CEO and Executive Vice President
Education: Master’s of Public Administration in Health Service Management, Golden Gate University, San Francisco, California, 1986 Bachelor of Science in Health Administration University of Phoenix, Arizona, 1984 Diploma in Nursing, Waterbury Hospital School of Nursing, Connecticut, 1972
First job in nursing: Staff nurse in emergency department
Being in a leadership position gives me the opportunity to: Have a positive impact on all aspects of health care (management, nursing, physicians, staff, patient care, etc.)
Most people don’t know that I: Own a Harley-Davidson motorcycle
My best advice to aspiring leaders: Look beyond own areas of responsibility and embrace a system view of health care
One thing I want to learn: How to achieve Baldrige status
One word to summarize me: Integrator
16 Nurse Leader
wanted to be an excellent nurse and a very smart nurse. My need to care for people was very high. To me it was more like a calling or a mission than it was a career. It sounds like that has threaded its way through your professional career. I’m astounded by the leadership positions you have held over the past 30 years. They were always progressive, each one having a little twist. Is that what excites you about hospital administration? Yes. The higher up you go, the more vicarious things get. And I’m still patient-focused, even though I’m not taking care of patients. It comes across with what I enforce, what I remind people of, questions that I ask, and what I pay attention to—patient satisfaction and day-to-day problem-solving. I’m blessed to have good relationships with physicians, but it’s because it generally gets down to, “OK, let’s look at this from a patient perspective or a patient care perspective.” And that is enough to get them to the table? It’s something that stops them. It stops them because we all get caught up in our own perspectives, and if we have a common goal we can at least agree to disagree on some things. There are some things that we are definitely here for. It’s our root, our main purpose. How do you achieve balance in life? Family has been very important. I have three adult children; my daughter, the oldest, is a clinical manager, she’s an RN in pediatrics. I also have two sons. My daughter has two daughters, so I’m a grandfather of a 10-year-old and a 2-year-old. How did you get to Arizona from Connecticut? My wife and I went to school with a couple, and they moved out here. They told us about it. Winters were rough back there, and I wanted a change. I wanted to grow. Back East, people worked in places for 35 or 40 years in order to progress. You had to wait for someone to retire or die. There just weren’t opportunities. So I decided to “go West, young man.” It was a very, very good move. What are the primary forces shaping health care delivery? What roles should nurse leaders assume in addressing these forces? It’s my bias that the people who will be the most successful can look beyond their noses and beyond what they control. Nurse leaders should look at what they can influence. I also believe that we all exist in a greater system than just the nursing system. In order for nursing leaders to be looked on as true leaders of the system, they really need to have a more “system” outlook. They need to see things in relationship to the whole. I worry sometimes that we pigeonhole ourselves. I have heard many times over the years from other administrators, “Yes, this person might be a senior vice president, but that’s in nursing.” They have a high regard for nursing, but it’s a boundary, and nursing shouldn’t be a boundary. I think it’s really important that we get out of October 2005
There’s a real opportunity for greater physician-nurse collaboration. It could be a very powerful strategy to address the health care delivery system issues now and in the future. our own paradigm and take a look at things from the other perspective, at us and what we do, what nurses do. Significant change in the system is going to be driven by those who know how to look at the whole. Consumerism is a growing and important force shaping care delivery. I think more and more responsibility is going to be placed on people using our services. I think that, down the road, we’re going to see more and more physician integration. I think our economic situation is going to continue to be very challenging, including demands on outcomes. And all that calls for a broader perspective, working together, truly understanding team and lean thinking. I think it’s also going to be a challenge for nurses as well as physicians to get more involved on the administrative teams. Typically, the only clinical person is the chief nursing officer. It might be a little different if there’s a physician in there. I think that might be a challenge. I think it’s an opportunity because doctors and nurses are critical components; in fact, when you hear most people talk, they rarely say one without the other. There’s a real opportunity for greater physician-nurse collaboration. It could be a very powerful strategy to address the health care delivery system issues now and in the future. What advice do you have for your colleagues? Be open to change and don’t settle for the status quo. Focus on why we exist—to make a difference. Focus on quality, patient outcomes, and safety. The other huge part of my life has been the fact that I know that what I do has a huge impact on the people who work in the organization. I pay as much attention to internal culture as I possibly can. It’s a people business. It’s certainly technology, skill, and knowledge, but it’s a very human field. If you don’t have good, happy people, an environment for patient satisfaction cannot be created. So I believe focusing on internal culture, being visible and accessible, is very important. Be visible, be open, be supportive, and make sure that you’re investing in the people who are really getting the job done? Absolutely. People want to do well. I don’t think anyone comes to work thinking, “Oh boy, I can’t wait to go in and screw up.” I don’t think people are basically bad; I think sometimes people are in the wrong place. I believe it’s our job as leaders to make sure people are in the best October 2005
position to contribute and to feel appreciated for what they do. It’s important to let staff know they are appreciated for their contributions. What hobbies do you have? I don’t really have any hobbies. I do ride a motorcycle—I have a Harley-Davidson and I love to ride for fun. Do you have a favorite quote? I have two of them: “If it's going to be, it's up to me,” I think is my number one. The other is “What you do speaks so loudly, I can't hear what you're saying.” What would you like readers to take away from our interview? I really hope that we all stay optimistic. Sometimes our health care seems so challenging. If you’re going to be a good leader in health care, you’ve got to maintain optimism. We need to find ways to make people feel good about what they do and also find ways to be better at what we do. You have been serving us in leadership roles within professional associations, such as chairman of the hospital association board of directors. You’ve moved from being “Task-Force Tracy” to “Association Tracy.” What role do you think that associations play in fulfilling our community stewardship obligations to society? Most associations—and I don’t mean this in a negative way—are put together to serve their members. I mean, it’s a bit self-serving for advocacy, for position. Sometimes I wish I could mix up associations, mix up people and have people from cross areas get together, do more problem-solving and looking at the bigger picture. I think that, in my time with the Arizona Hospital Healthcare Association, there really has been much more of that, much more involvement with the medical association. I think associations are very helpful. I know from my own perspective, the networking and learning have been great. I appreciate the learning experience I received by participating in associations. Leadership is about doing and serving others in health care settings and within the communities in which we live. Linda Burnes Bolton, DrPH, RN, FAAN, is vice president and chief nursing officer of Cedars Sinai Medical Center in Los Angeles, California. She can be reached at [email protected]. 1541-4612/$ See front matter Copyright 2005 Mosby, Inc. All rights reserved. doi:10.1016/j.mnl.2005.07.005
Nurse Leader 17