Chief Improvement Officer Skip Steward on Leading Change in Healthcare

Skip Steward, VP and Chief Improvement Officer at Baptist Memorial Health Care Corporation, sat down with Jamie Flinchbaugh on the People Solve Problems podcast to share what thirty-four years of cross-industry experience looks like when it's put to work inside one of the most complex systems in existence, American healthcare.

The conversation opened on the challenge of prioritization, a particular puzzle in healthcare where competing demands and shifting conditions are the norm. Skip traced his team's solution back to a strategic A3 deployment process he brought to Baptist Memorial nearly thirteen years ago, developed with the guidance of mentor and improvement expert Pascal Dennis, author of Getting the Right Things Done. At the highest level, this process organizes all work under four guiding themes: right care, right time, right place, and right cost. Skip noted that across Baptist's more than twenty-four thousand employees, almost anyone can finish that sentence from memory, a quiet but telling measure of how deeply the direction has taken root throughout the organization.

But strategy at the enterprise level is only part of the story. Skip described how, at the ground level, he returns again and again to one clarifying question: "What are we trying to accomplish?" He shared a recent visit to a clinic where an enthusiastic manager had a full list of ideas and concerns, and fell completely silent when Skip asked that single question. Her honest answer was that she wasn't sure. For Skip, that moment is not a failure. It's the essential starting point. Without knowing what you're anchoring to, he argued, everything else is just activity.

Much of the conversation centered on how Skip and his team build the human side of improvement. The Baptist Management System is built on eleven guiding principles organized around people, process, and purpose, and Skip pointed to two practices that do the most work in making collaboration real. The first is TWI Job Relations, a framework he described as the best way he knows to turn respect for people from a value on a wall into a daily operational skill, helping teams respond to problems objectively rather than emotionally. The second is humble inquiry, which Skip practices as the art of asking open-ended questions you genuinely don't know the answers to, to understand someone's situation before trying to improve it. Whether speaking with a senior physician or someone new to the front lines, Skip described meeting people with curiosity rather than credentials, sometimes literally taking his jacket off to reduce the distance between them.

The final stretch of the conversation turned to healthcare's broader challenges, and Skip was honest about the difficulty. He called healthcare the most complex open sociotechnical system he has encountered in his career, drawing on the thinking of organizational psychologist Edgar Schein. He pushed back firmly on the notion that any single solution, AI included, will fix the system's deep problems. What he believes in is a mindset: the patient, hypothesis-driven thinking that takes on one part of the process at a time. He pointed to a striking example from Baptist's own work, where a daily multidisciplinary patient review meeting that once lasted two hours has been reduced to a focused, information-rich fifteen minutes, the result not of top-down directives but of physicians and nurses experimenting their way forward. One doctor captured the shift with a line Skip clearly treasures: "I learned that it wasn't okay to wait." For Skip, stories like that are the reason for hope.

To learn more about Skip Steward's work, visit baptistonline.org or connect with him on LinkedIn at linkedin.com/in/skipsteward.