This article first appeared in the St. Louis Beacon, Nov. 15, 2011 - Sister Mary Jean Ryan took a meandering path that eventually led to becoming the leader of SSM Health Care for 25 years. She stepped down as CEO of one of the largest Catholic health-care systems in the nation at the end of July and assumed the role of board chair.
Looking at the organization she helmed for so long, many attribute its size, scope, but most of all the quality to Sister Mary Jean's leadership. Her quiet, reserved bearing belies boldness strong enough to transform a conglomerate.
"She has a strong personal compass," said William P. Thompson, president and chief executive officer of SSM Health Care. "She had courage and faith in people around her."
She also made big decisions, Thompson said, like keeping Cardinal Glennon Children's Medical Center in its current location on South Grand at a time when other hospitals were looking to move to more affluent areas.
Then there's the Malcolm Baldrige National Quality Award, which, Thompson said, Sister Mary Jean insisted upon pursuing when others thought the effort futile.
"In 2002, we submitted our fourth Malcolm Baldrige application in as many years, and on a cold November morning right before Thanksgiving, I received a call from the U.S. secretary of Commerce telling me we had become the very first health-care organization to receive the Baldrige," Sister Mary Jean said.
The Baldrige is recognized as the nation's foremost award for performance, excellence and quality achievement that a U.S. organization can receive. Established by Congress in 1987, it was named for Malcolm Baldrige, U.S. secretary of Commerce from 1981 until his death in a rodeo accident in July 1987. Baldrige was a proponent of quality management as a key to U.S prosperity and long-term strength.
The first awards were given in 1988. Since then, 91 out of 1,471 applicants have received the coveted award, which is presented to winners by the president.
Physician, Heal Thyself
Sister Mary Jean credits the Baldrige win in part to SSM finally finding its "magic elixir" in its new mission: Through our exceptional health-care services, we reveal the healing presence of God.
"It leaves me in awe," Sister Mary Jean said.
In 1990, SSM had rolled out "continuous quality improvement, a management philosophy that contends that most things can be improved. CQI was implemented throughout the system and proved effective. About a decade later, SSM began pursuing the Baldrige and added the award's criteria to its CQI efforts.
Sister Mary Jean chronicled SSM's progress in two books: "On Becoming Exceptional: SSM Health Care's Journey to Baldrige and Beyond" and "CQI and the Renovation of an American Health Care System: A Culture Under Construction," which she co-authored.
Then SSM added yet another wrinkle: systems thinking.
Systems thinking says that "you can't do one thing in isolation without knowing that it's going to impact all other things," Sister Mary Jean said.
The multiple quests for excellence resulted in SSM being one of two hospital systems profiled in the 2006 book, "The Nun and the Bureaucrat."
With constant improvement methods implemented, SSM successfully addressed the symptoms of "sick" hospitals, such as dissatisfied patients, medication errors, overcrowded emergency rooms and deaths due to errors. Some SSM hospitals saw readmission declines of nearly 5 percent and an 85 percent reduction in hospital-acquired infections.
Some employees balked at the constant assessments, but Sister Mary Jean stood firm.
When asked at a conference what she would say if one of her hospitals did not want to implement the new safety measures, without hesitation and completely off-script she replied, "I'd tell them to suck it up."
Farren and Platt said it took several minutes for the laughter to die down.
"I told you she's funny and feisty," Platt said. "People have a mental image of a nun -- my image was the nun from 'The Sound of Music' -- but that's not Sister."
One change she never considered was turning away the poor, lovingly referred to in early hospital ledgers as "Our Dear Lord's" to retain the dignity of the patients who could not pay for services.
Unlike many health-care entities, SSM offers discounts to people without health insurance. And as Sister Mary Jean helped the organization to grow, she remained cognizant of the compassion of those who joined the group.
When it had an opportunity to do so, SSM declined to acquire a profitable physicians' practice that would not accept Medicare and Medicaid patients.
Under Sister Mary Jean's leadership, SSM's caring practices extend far beyond patients to encompass the environment, diversity and equality.
Styrofoam and plastic water bottles became verboten, a Preservation of the Earth committee was established at every SSM entity, and the organization became the first large health-care system to ban tobacco use on its property.
Language became gender-neutral and nonviolent: There are no "bullet points" at SSM and photos are enlarged, never "blown up."
SSM actively seeks ethnic and gender diversity for its executive positions, and it patronizes minority-owned businesses and local businesses whenever possible.
"We worked to foster a sense of inclusiveness, where everyone -- no matter what their background or their religious belief -- feels welcome," Sister Mary Jean said.
A Doll's House
The executive is as humble at home as she is in the workplace.
Sister Mary Jean's apartment is welcoming, unassuming, orderly and homey. She had always wanted a mantle to decorate for Christmas, so she built a fireplace.
She pretty much builds whatever she likes.
"Years and years ago, I saw a pattern in a book for a barn and thought it was so darn cute. I said, 'Gee, I'd like to build that'," she said.
The model barn made of plywood turned out so well she tried her hand at building a dollhouse. She enlisted a friend's help. Sister Susan Scholl, another Franciscan Sister of Mary, was more than happy to comply.
"It really was a partnership; we made the houses together," said Scholl, former president of SSM St. Mary's Health Center.
Sister Mary Jean made all of the furniture while Scholl painted and made the accessories: tiny curtains, bedspreads, food, decorations.
"She was creative, persistent and a perfectionist," Scholl said. "When I watched her hands I saw the same fine movement you have to have working as a scrub nurse in the operating room, which she once did."
It took approximately three years to build a house with electricity, gardens, trees, swimming pools, sandboxes -- everything any fine home would have.
They began building dollhouses together around 1977. They had agreed from the outset that if the hobby ever became work, they would quit. Several years ago, they gave up their hobby after having built about a dozen houses, always for friends.
One building contract came from Carolyn Losos.
"I asked how to get on the 'friends list'," laughed Losos, former executive director of the Leadership Center of Greater St. Louis and a former SSM board member.
"She and Sister Susan made me this extraordinary doll house," Losos marveled. "I gave a dollhouse warming."
Losos' dollhouse yard mirrored her real home and yard, complete with Jewish symbols and hippos.
But Losos admires more than Sister Mary Jean's craftsmanship.
"Mary Jean is the essence of leadership," Losos said. "She is probably the most effective, caring and spiritual person I know.
"She really cares that people have access to good medical care, no matter who you are and what you do. Through Mary Jean, I learned to understand people."
March Of Time
Sister Mary Jean has seen her order dwindle from a peak of more than 500 to 100; more than 90 percent of all nuns are now at least 60 years old. Most have moved out of their convent and into a retirement or nursing home. Nuns are no longer being recruited.
She theorizes that more options for women have depleted their ranks. This self-avowed feminist accepts the change.
"Young women have benefited from the feminist movement," she said, admiringly ticking off on her fingers some of those who paved the way: Gloria Steinem, Marlo Thomas, Betty Friedan, Bella Abzug.
"I don't look on it fatalistically," Sister Mary Jean said. "We can find ways to serve that are much different than we did years ago."
The future of SSM Health Care also does not cause her any concern.
"I think we have embedded quality and a set of values in SSM that will keep us in good stead for I don't know how long," she said.
A Great Treasure
Brick by brick, Sister Mary Jean built a life of service. Her efforts have been duly recognized.
Her numerous honors include last year's distinguished service award, the highest honor given by the Missouri Hospital Association, the brotherhood/sisterhood award from the National Conference of Community and Justice, and she was named one of the most powerful people in health care by Modern Healthcare magazine eight years running.
She received honorary degrees from Webster University, the University of Missouri-St. Louis and Lindenwood University.
She was elected as an academician to the International Academy for Quality in 2008 and has served on numerous boards, including the International Academy for Quality, the Excellence in Missouri Foundation, the former National Commission for Quality Long-Term Care, the Institute for Healthcare Improvement and the District Industry Council (Health Care) - Federal Reserve Bank of St. Louis.
"Twenty-five years ago was my beginning as CEO," Sister Mary Jean reminisced. "I had no idea where we were going, where we would go. I only knew that my congregation had entrusted me with a great treasure, and I prayed that I would meet the challenges.
"It has always been about delivering health care breathtakingly better than it's ever been done before."
Since relinquishing her title as CEO, Sister Mary Jean has been on quality and leadership teaching missions across the world, including Hong Kong, Singapore and Sweden, with China possibly looming on the horizon.
"If this is retirement, I'm going back to work," she said.
Gloria Ross is the head of Okara Communications and the storywriter for AfterWords, an obituary-writing and production service.