June 15, 2014

John Bluford’s leadership brought better medical care for the poor in Kansas City

The city can be proud to have a hospital that provides excellent care to a population once relegated to second-tier service. Bluford’s legacy is better health care for poor and underserved people, which is always a work in progress.

John Bluford’s legacy in Kansas City and in health care circles is well established.

Fifteen years ago, he took the top job at Truman Medical Centers, a hospital with financial problems, legal issues and low morale. “Our culture was bad,” Bluford said. Truman’s reputation was that of a hospital for the poor, the uninsured and people with nowhere else to go.

Today Truman is lifted up as proof that those patients need not expect second-rate medical care. The institution, and Bluford himself, have received multiple honors, including as a top five teaching hospital and a leader in using information technology.

Bluford, 65, has little left to prove. But even as his July 18 retirement date approaches, he is working on his legacy.

Fourteen college students have spent the last two weeks getting an inside look at the hospital’s operations and meeting with heavy hitters in the industry. They are the second class of the Bluford Healthcare Leadership Institute, which introduces high-achieving minority undergraduates to health care administration.

Only 14 percent of hospital leadership positions and a similar share of board of director seats nationwide are held by minorities.

“You want your governance and your staff to reflect your patient base,” Bluford said. “So much of health care outcomes has to do with cultural issues.”

Along those lines, he’s involved in a project to build a full-service grocery store at 27th Street and Troost Avenue. It’s an extension of the mobile produce market that Bluford initiated to make fruits and vegetables more accessible to patients, visitors and staff. So many of the health problems he sees stem from poor nutrition and health habits. Hospitals, he says, are compelled to “think outside of the bed.”

During a recent chat with Kansas City Public Library director R. Crosby Kemper, Bluford shared some of the principles he used to change the culture at Truman Medical Centers.

It starts with high expectations, he said. Environment matters, too.

“We spent $250,000 that we didn’t have to take the folding chairs out of the lobby and make it presentable.” Bluford said. He knew that move had paid off when a housekeeper told him, “I don’t mind cleaning this place now.”

Later, Bluford hired a scholar and created the Truman Corporate Academy to help employees advance their education levels. He thought it would mostly serve younger people, but one student who gained a high school equivalency diploma was a 50-year-old man who had worked at the hospital 30 years.

Bluford credited the hospital’s board for giving him latitude and for boldly investing more than half a billion dollars in capital improvements and technology, “despite having low margins and sometimes no margins.”

“They recognized that you can’t reduce yourself to prosperity,” Bluford said.

The board’s confidence has been rewarded with net revenues that more than doubled over the last 15 years and a significant increase in commercial insurance revenue.

Thanks in large part to Bluford’s leadership, Kansas City can be proud to have a hospital that provides excellent care to a population once relegated to second-tier service. His successor will be Charlie Shields, a former Missouri Senate president who currently is chief operating officer at Truman’s Lakewood campus. That appears to be a good choice by the board.

Retirement will give Bluford more time to be involved with the leadership academy and the grocery store, and probably a few other projects. His legacy is better health care for poor and under-served people, which is always a work in progress.

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