Navigating Uncertainty in Health Care - Keynote Presentation at 2018 Washington State of Reform Health Policy Conference


The executive keynote at the 2018 Washington State of Reform Health Policy Conference featured a panel of respected leaders across the State of Washington sharing their vision for charting a path forward in 2018 during a time of significant market and policy transition. The panelists addressed the challenges facing providers today, trends in the market, changing policies and topics that are impacting the national healthcare climate. The panel included a cross-section of executive leaders in Washington healthcare:

  • Leanne Berge: Chief Executive Officer, Community Health Plan of Washington
  • Gary Kaplan, MD: Chief Executive Officer, Virginia Mason
  • Sally Watkins, PhD., MS, RN: Executive Director, Washington State Nurses Association

Challenges and Opportunities

There is no doubt that providers today are expressing sentiments of burnout. Yet, the panelists all agreed there is an opportunity right now to create positive change in the industry. The question of whether or not providers are being asked to accomplish too much in a short period of time is a good one. It’s important to consider how we can maximize their time, increase efficiencies, reduce the challenges they are facing to do their jobs most effectively, but also provide them with the resources they need.


There is such an incredible, innovative spirit of collaboration in healthcare today where we are expanding what it means to provide good healthcare and broaden our communities. For example, panelists proposed moving the following key initiatives forward throughout Washington and nationwide can tremendously improve healthcare for our communities:

  • Providing a full scope of practice for nurse practitioners
  • Establishing innovative approaches to care delivery such as telehealth, etc.
  • Continuing to advance the Children’s Health Insurance Program
  • Partner with schools to ensure there are effective partnerships in place to benefit patients/communities
  • Remain innovative and not afraid of change
  • Bringing nurses to the table and engage them in major healthcare decisions and conversations


Communication is so important throughout every aspect of the healthcare setting from the executive leadership team to the staff to the patients. We need to be able to clearly communicate objectives and goals and to get our teams on board to ensure consistency and effectiveness. It’s also important to stay in touch with the workforce and ensure they are able to carry out their work and meet growing and fluctuating demands.

Equally as important is ensuring patients and providers are able to communicate effectively. With an increasing number of limited English proficient, Deaf and hard of hearing patients in the United States, it’s critical health systems consider their language access programs as a means to improve care for these patients by improving communication with their caregivers.

Moving Forward in 2018

With so much to accomplish and many challenges ahead, it’s easy to question where to focus our energy, but the panel provided a hopeful vision for the future and a balanced perspective on where we go from here.

It’s important to maintain relationships, stay true to each other and strategize on how we are going to move forward into the future in a different world together. When we think about how to focus our energy, think about the patient first and how to provide the best possible care. If we focus on the patient, we can’t go wrong. By following the broader principle: “how would I want to receive care if I were the patient?” it can immediately access our priorities. Start with the patient first and everything else follows.

Involving providers of direct care in decisions is vital. Leaders need to pull in the people who are delivering care and tap into their knowledge. Nurses and care providers have an intimate understanding of what isn’t working, inefficient policies and what’s getting in the way of delivering the right care to the right people at the right time. We have to take the time to listen to these individuals, engage them in important leadership decisions to ensure they are on board with instrumental changes and are a part of the solution.

The good news is, we are on the right track. If we stay the course, we will see very positive change, improved costs and improved quality. We are on a trajectory that we should and could be proud of, and we need to accelerate this work. The impact we have on our society in the healthcare sector in terms of the cost of care and the toll of ineffective care has on patients and their families, is direct and immediate. We need to continue our work to find new and even better ways to improve healthcare to ensure every patient has access to high quality care.

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