Paul O’Neill, an Important Person in My Life

Paul O’Neill Sr. passed April 18^th, 2020. There are a few people in a lifetime that help you define what is important for you. For me that has been my family and a few others. The people I consider the critical few. Paul was one of the critical few.

In 2008, after I had stepped down as CEO of an integrated delivery system in Wisconsin, I emailed him. I explained I was starting a non-for-profit education institute that was focused on patient safety. I planned to incorporate the emerging knowledge of operational excellence in healthcare in teachings, writings, and policy strategy of the new institute. The goal being to transform the industry to a culture of safety and reliability. His secretary responded to my email within an hour, “Mr. O’Neill would be happy to meet with you”. I was stunned. Paul O’Neill was my hero. His thinking was center to my belief that front-line workers were the key to unleashing the possibilities of the human spirit. Management’s job was to create an environment where this untapped creativity could blossom. He had made it clear at his time at Alcoa that worker safety was paramount to creating such an environment and he staked his career at Alcoa on that, eventually making Alcoa the safest place in the world to work.

A one hour scheduled meeting in Pittsburgh turned into a three-hour heart to heart with both Paul Sr. and Paul Jr, his son. We drew pictures on flip charts, discussed many aspects of what was fundamentally flawed about the healthcare industry. And of course, agreed employee and patient safety must become front and center if we were to improve healthcare. At the end of the three hours, we agreed we would work together to improve the healthcare industry by introducing the ideas Paul had implemented at Alcoa and I had experimented with as CEO in healthcare.

Paul was one of a handful of people that shared a common vision of making healthcare dramatically better by applying operational excellence techniques to worker and patient safety. He agreed to become one of the first board members at what is now Catalysis Inc. With Paul on board it was easier to attract world class leaders. Our board became, and still is, the Who’s Who of manufacturing and healthcare leaders dedicated to operational excellence.

I have many stories related to the impact Paul had on me/us. He visited our health system shortly after joining the board. He didn’t’ mince words. As he entered our offices at one of the hospitals, he noticed a glass case full of crystal trophies touting our quality awards. He examined these awards and then turned to me with a wry smile and said “John, you know those awards just mean you are cream of the crap”. Of course, he was referring to the poor quality of healthcare performance. With 250000 people dying each year unnecessarily from medical error and hospital acquired conditions, being the best in a sick industry wasn’t much good.  His pointed comment helped shift my thinking from comparative performance measurement to absolute numbers. No one should ever die in our hospital of medical error or iatrogenic infection, or falls, no one!

Paul’s constant mantra of employee safety first has certainly been highlighted in the Covid19 crisis. Management’s job is to create an environment that can unleash the creativity of workers. Building that environment starts with worker safety. If Paul were leading the healthcare delivery system, he would have first made sure all the personal protective equipment required was available for his healthcare workers. He would not have left his office until that was done, and none of his managers would have either. He would have given out his phone number for any front-line worker to call if they didn’t feel safe. Just as he had done at Alcoa when he was CEO. He would have held his managers accountable if there were unsafe conditions reported by staff at the front line.

In his last days during conversations with Paul Jr. he was as steadfast as ever. He told his son “you and our colleagues must carry on the work. There is still much to be done to build excellence into every health system”. He specifically called out the work of Value Capture, the organization he founded that educates leaders in operational excellence. Also mentioning our work at Catalysis and specific leaders like Rick Shannon M.D. former CEO of U. Va. Health system. There are many others leading the journey to excellence work in North America represented by the Catalysis Healthcare Value Network https://createvalue.org/networks/healthcare-value-network/

All of us are now standing on the shoulders of one of the real giants. I am proud and humbled to have called Paul O’Neill my friend and mentor. I promise to carry out your vision, thanks for everything.

John Toussaint, Executive Chairman
Catalysis