Tapping into the leadership DNA to transform patient care

Anna McFagden, Chief Executive of St Vincent’s Health Network Sydney, was in her early twenties when she knew she was destined for healthcare leadership.

Having studied a degree in economics, newly graduated McFagden had been toying with the idea of a bank internship.

But when she saw an advert for a graduate program in healthcare management, she had a light bulb moment.

“I felt called to pursue it. It just made sense,” she said.

Years later, McFagden is flourishing in the sector’s highest ranking position.

Overseeing 4800 employees at one of Sydney’s best-known hospitals, the high-profile CEO is leading the health network into a new era, and adding weight to its reputation as a national innovation leader.

“Innovation is in our DNA at St Vincent’s Sydney. We have delivered the nation’s first heart transplant, the first Intensive Care Unit, the first Homeless Health Unit and the first long-COVID clinic. It’s exciting to be part of the next generation of innovation and clinical breakthroughs.”

Tackling wicked problems

Leading this charge in an ever-challenging healthcare climate — beset with “wicked problems” — is a credit to McFagden’s leadership.

“Like the rest of the sector, we are dealing with an aging population and patients with increasingly complex comorbidities, so we need to continually innovate — and in a really creative way,” she said.

With this in mind, St Vincent’s Health Australia recently overhauled its strategy, with a major focus on connecting care.

“The current healthcare system is still fairly disjointed and, while we’ve made some inroads over the last few decades, we still have a way to go.

“For example, we need to sync up hospital-based care with aged- and home-based care; as well as primary with tertiary. This will really help us improve a patient’s journey across the system,” she said.

In a testament to her character, McFagden’s strategy is also focused on community impact.

“We have a duty, if you will, to the public, to our community, and to our funders, to be strong stewards, financially.

“Also, from a governance perspective, to make sure we are doing the best we can for our communities with scarce resources, and really driving efficiencies through innovation.”

To this end, McFagden is rolling out popular care models, like virtual health, to keep abreast with patient needs.

“People want to be treated in their homes. It’s convenient, much more pleasant, and often safer, depending on your clinical condition.

“That’s why we are partnering with our St Vincent’s Virtual and Home Healthcare Division and looking at what services we can provide — either in the home or closer to it — through remote monitoring, and other digital strategies.”

In a similar vein, McFagden is committed to improving the interface between public hospitals and aged care.

“Because most older Australians have multiple medical comorbidities, they often end up in hospitals, when they actually need to be in residential aged care settings.

“This isn’t great in terms of patient experience. So we’re working with our aged care division and exploring different models — for example, geriatric flying squads, where doctors are sent out to aged care facilities.”

A positive outlook

Despite the challenges she is dealing with, McFagden is optimistic about the future of St Vincent’s, and says its broad portfolio is more of a “strategic advantage” than a challenge.

“Because we’re across public and private hospitals, aged care, home and virtual health, we’re sort of like a microcosm of the overall healthcare system. This gives us a unique perspective.

“It helps us see all the challenges and opportunities, how they intersect across subsectors, and how we can work together as a system to achieve healthcare excellence,” she said.

McFagden also draws confidence from her earlier experience with the Victorian Department of Health, where she helped design ‘diversion and substitution models’, like virtual emergency wards.

“This taught me that, if the conditions are right, and if all parties are willing to take some risk, you can get innovation done very quickly.”

This experience also helped inspire a ‘fail fast’ philosophy at St Vincent’s, where it is accepted that not all innovations will become long-term fixtures.

“We have a culture at St Vincent’s where we really encourage innovation and calculated risk-taking, in a supportive and controlled environment.

“It is really beneficial for us, and I believe it’s necessary in the current environment, where we — like everyone else — are dealing with workforce and funding constraints. We need to be creative in terms of how we use our workforce.”

The approach might also be an echo from McFagden’s past, where, as a fresh graduate decades ago, she took a chance on health leadership.

“I took a risk and it gave me the most rewarding career — one I continue to enjoy rain or shine.”