Lillee S. Gelinas, RN, MSN, FAAN

Article Outline

• What early professional opportunities and experiences shaped your passion for making a difference in nursing's future?
• How long have you been at VHA Inc.?
• Sometimes when professionals are in an organization for a long period of time they become stagnate and loose passion. How have you overcome that problem?
• You are the consensus nominee for the nursing profession to AHIC. Can you explain?
• What does Lillee Gelinas want our field to know about the next 5 years?
• I understand you have some leadership pearls for us that are the 10 Laws of Healthcare Quality. What are those?
• Many people say we should look outside our traditional industry for situations and knowledge that is helpful and applicable to our industry leaders. Can you share with us one of those learnings?
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Lillee Gelinas, our featured guest, is a consummate nurse leader. She has contributed to the development of nurse leaders, to nursing performance measurement, healthcare delivery systems, and individual nurses in numerous ways. Her influence is direct and indirect depending on the national board, committee, or subcommittee on which she sits or that she chairs. Her contributions have been numerous. She has a passion for nursing, patient care, quality, and safety. She has prepared herself to be a leader through continuous learning, staying current with healthcare industry trends, and networking inside and outside the profession.

Lillee, thank you for spending time with me to share your thoughts with our colleagues.

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What early professional opportunities and experiences shaped your passion for making a difference in nursing's future? 

My first position in the US Navy Nurse Corps shaped my continued leadership journey. As a young nurse and a naval officer I had the opportunity to develop leadership skills that were fundamental to all my future roles and functions. The Naval Officer Training School was a tremendous experience. It taught me many lessons I certainly didn't get in a baccalaureate RN program. I learned many of the attributes of leadership: DISCIPLINE, delegation, motivation, listening, and standing behind your decision. It was not for the faint of heart, but the outcomes were sustainable for my lifetime. I took my responsibilities very seriously. I learned accountability was an expectation, and it was a privilege to accept and develop the foundational skills of leadership.

Later in my career I landed in the VHA Inc. organization just at the right time. When I began my career at VHA Inc., we were primarily a group purchasing organization. I helped develop a clinical focus and with the help of VHA Inc. senior leaders, created the VHA Inc. Nursing Initiative that today supports VHA Inc. CNOs and nursing leaders with a number of programs and services, both nationally and within the reach of VHA Inc. TV (one of the largest healthcare satellite networks in the United States) and locally with many improvement collaboratives. I had, and continue to have, an opportunity to work with nursing leaders and staff throughout the VHA Inc. member organizations. I enjoy meeting staff in all of the organizations and try to round on patient care units as much as I can, connecting with the front line to stay centered on current issues and barriers to excellence. I learn so much from the staff, but I also use their pragmatic reality when I am participating in national committees and helping to shape public policy.

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How long have you been at VHA Inc.? 

I have been at VHA Inc. since 1986. VHA Inc. is an organization that gave me a venue to succeed in supporting and coaching others to achieve clinical excellence in their organizations. Since clinical excellence is my passion, this has been a natural fit for me. The organization has encouraged my growth, development, and national contributions. I am always encouraged to stretch, flourish, and function at my optimum capabilities.

Nurses are how a great deal of health care gets implemented, so they can be crucial gatekeepers when it comes to driving efficiency, both in the clinical and operational arenas. That's why VHA Inc. has always focused on building relationships with nurses and nursing leaders. We see them as key advocates for our mission to help hospitals with clinical and operational improvement.

People who have worked in hospitals typically come to VHA Inc. because they see the opportunity to impact on a broader scale. People who are striving to make a difference are the people who fit best in this fast-paced environment.

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Sometimes when professionals are in an organization for a long period of time they become stagnate and loose passion. How have you overcome that problem? 

I continue to challenge my leadership skills and personal development through a number of activities, such as the use of mentors as well as an executive coach. VHA Inc. made an enormous investment in me by getting me an executive coach. It was humbling and made me tremble at the thought! It was very hard work. I was really challenged by my coach. My thinking was expanded in breadth and depth, and I became very aware of my frailties and weaknesses. I also faced them as opportunities, worked on ways to overcome them, and ultimately become a better person and better leader for nursing and for VHA Inc. By understanding how to accomplish personal development in varied ways, I can continuously grow, develop and contribute to the VHA Inc. mission, even after 21 years! The most important thing though: you have to love what you do and respect the organization in which you work.

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You are the consensus nominee for the nursing profession to AHIC. Can you explain? 

A good example for influencing public policy is my role as a member of the American Health Information Community. AHIC, chaired by Department of Health and Human Secretary Michael Leavitt, is a federally charted body in place to realize President Bush's vision of electronic health records for all Americans by 2014. I have seen firsthand the benefit that electronic records can have on clinical quality, patient safety, and costs. We must replace the clipboard with the keyboard, if we're to make the monumental changes consumers and payers are demanding.

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What does Lillee Gelinas want our field to know about the next 5 years? 

Never forget that good nursing care and sound nursing leadership provide the basic framework for success no matter what changes take place nationally. There will continue to be many changes in our American healthcare delivery system. As all payers continue to pay closer attention to quality and safety, nursing can be a real asset to the organization's success. With the link now between clinical quality and reimbursement, changing practice at the bedside quickly and reducing practice variation is more important than ever.

The second thought I have for all leaders in our field is to be aware of and adapt to the trends. We must adapt to the trends but not disrupt the quality and safety of nursing care.

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An important trend that requires our attention is the impact of international medical tourism as well as the recruitment of US nurses to work in foreign hospitals. Medical tourism is the practice of leaving one's native country and traveling abroad to seek medical care. The origins are in cosmetic procedures where US citizens can hide and heal. But now, patients are going abroad seeking heart surgery, orthopedic surgery, gastric bypass, and other procedures that are the most profitable for American hospitals. Estimates are that 500,000 Americans were medical tourists in 2005, but that number is expected to increase by 30% annually. Thailand and India are forecasting a 30%+ growth for the foreseeable future, and India expects $2.2 billion in international patient business by 2012. Many American patients are looking at “Scalpel Safari's,” where you can go on a safari in South Africa and then have your procedure. South Africa is expecting 20,000 visiting patients next year and predicts this is a fraction of the potential long term.

I know of several scenarios where staff has gone abroad for more pay and better working conditions, and the hospitals are accredited by Joint Commission International—indicating patient safety and clinical quality are on par with US standards. This is a mobile society: The world economy is in place now—the threat for stealing our talent is real. Liability and malpractice costs seem non existent overseas, so healthcare costs are lower. Several large US employers are shifting operations overseas … and workers will follow. Harvard, Cleveland Clinic, Mayo, MD Anderson, and many more well-known names in American healthcare are building hospitals and joint ventures overseas.

Nursing leaders have to be well aware of this trend. The demand to create best places to work has never been greater as a result. Retention has been a challenge the last few years, and it's even more critical now. Therefore, I see the following implications and imperatives for leaders related this trend:

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I understand you have some leadership pearls for us that are the 10 Laws of Healthcare Quality. What are those? 

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Many people say we should look outside our traditional industry for situations and knowledge that is helpful and applicable to our industry leaders. Can you share with us one of those learnings? 

I'm from New Orleans, so for us who had numerous family members and friends suffer greatly, we learned a lot that should not be lost both personally and in the business world. Here are a few Hurricane Katrina lessons in my view that correlate to our nursing world:

There are no signs of relief … every day in healthcare feels like a Category 5 Hurricane … are we running toward it or away from it?

We could dialogue forever based on your passion, philosophy and current national policy work. As we complete this interview I want to thank you for mentoring many of us on a regular basis. Your professional generosity has helped many and sparked their flame of passion. Your description of how you want to be characterized says it all:

“I am passionate and tenacious about the nursing profession with all of the related issues, challenges and opportunities!”