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Inside Steven Gabbe's billion-dollar plan for OSU Medical Center Featured

4:01pm EDT March 31, 2011

Dr. Steven G. Gabbe was aware that a lot of hours had been put in developing plans for a new cancer hospital on the campus of The Ohio State University. Gabbe was at OSU when the James Cancer Hospital first opened 20 years ago, and in 2008, he was back as CEO of The Ohio State University Medical Center.

He was excited that the project was moving forward but also aware that concern had been expressed about some of the plans that had been made.

“People wondered about the plan,” says Gabbe, who is also senior vice president for health sciences. “There was concern about the design of the hospital, which included two towers side by side with an atrium in the middle.”

This wasn’t the only concern and the uncertainty was great enough that university trustees wanted planners to take another look at the project.

“They challenged us to pause and go back and look carefully at those plans and then come back to the board of trustees and present to them our revised plans for the new hospital,” Gabbe says.

This opportunity excited Gabbe. He saw it as a great chance to go back to square one and get a clear understanding of the plan and its impact on the 16,000-employee OSU Medical Center.

“It was a billion-dollar project and most of the hospital was going to be paid for by our clinical revenues, as well as some philanthropy, but primarily by our clinical revenue,” Gabbe says.

It would have been completely natural for those who had put in a lot more time and effort on the project than Gabbe to be a little frustrated at the prospect of starting over.

“I’m sure some folks said, ‘Oh my gosh, now we have to go back and look at the plan again,’” Gabbe says. “But to everyone’s credit, no one was discouraged. No one looked at it as a burden. They all realized this was a chance to get to do this right.”

Get people excited

Gabbe began his effort to meet this important challenge by focusing on the opportunity he and his team were being given, rather than presenting it as a burden they would have to bear.

He focused on the fact that this new hospital would be built on a site that had previously been home to a tuberculosis hospital that was no longer needed.

“We now have effective means to prevent and cure tuberculosis,” Gabbe says. “And on this site, we hope to build a hospital that will provide care for cancer patients while at the same time, hoping there will be a day when this hospital won’t be needed anymore, because we’ll find cures for cancer.”

Gabbe focused on that opportunity, and then quickly moved into the challenges that were facing his team in making the opportunity a reality.

“Clearly describe the challenges you’re facing and why those challenges are important to everyone involved in the work group or in your company,” Gabbe says. “The project that you’re going to be working on impacts everybody’s position and the outcomes are going to impact everyone for years going forward.”

One of the keys to getting support on a big challenge is your ability to convey confidence and personal engagement. Your team needs to see that you’re not just passing all the work off of your plate.

“If you’re going to be leading an effort like this, you have to come in having done the work,” Gabbe says. “You have to have a vision for what you see that future will be. You have to understand the strategic priorities in the planning process. You have to be realistic about the challenges and about the difficulties. It’s going to be hard work. There are some understandings and some compromises we’re going to need to make.

“We’re going to make those together. You also have to make sure that people understand they need to be accountable for the decisions that are made and that those decisions need to be made together.”

Gabbe began by making sure that everything was put on the table at the beginning and nothing was left out. He began to ask questions, a lot of them, and had his team do the same.

“We kept asking the question, ‘Who else needs to be at the table?” Gabbe says. “What information do we need?’ One thing we did not want to do was create an elite planning group where people felt like it was being done behind closed doors, and they didn’t have a chance to influence the plan. This was too big and too important a project. Much to everyone’s credit, when we got done with the project, we did not have someone come up to us and say, ‘Well, you didn’t think about us.’ Or, ‘We weren’t involved.’ The group was very inclusive as we made the plans.”

Be thorough

There were more than 100 issues that were identified as requiring an answer with the cancer hospital project. Gabbe knew the team needed a method to track progress on resolving each of these items.

They came up with a color-coding system that used three colors everyone knows very well: red, yellow and green.

“We found the scorecard was very helpful in defining each of the tasks we had to complete for the project,” Gabbe says. “It was something we could look at and see red if we hadn’t solved the problem, yellow if we were getting there and green if it was fixed. It was a good reminder of where we were and what we had done and what we hadn’t done. Then we expected people to be ambassadors for the project and be willing to go out and talk to their constituencies and come back with objective feedback about what we were doing.”

Once again, reaching out to others is crucial in beginning to move toward solving your problems. The team asked the CFO to go back and confirm the medical center’s and OSU’s long-range financial plan to make sure financial projections were still accurate going forward.

“We had our architects go back and begin to look at design elements of the building and how they could be structured in a different way in a setting where there were smaller patient care units, space for education, space for research and space for families,” Gabbe says.

There was an analysis of parking and how far people would have to walk from their car to specific rooms. When concern was raised about the height of one of the hospital towers and how it might impact medical helicopters, the Federal Aviation Administration was contacted.

“We said we better make sure we talk to the FAA to make sure we’re not going to need to change where our helipad is,” Gabbe says.

But it wasn’t just problems Gabbe and his team had to address. They also needed to look at ideas that might not be able to be implemented for some reason, whether it be funding or the lack of availability of resources.

“We developed what we called ‘circuit breakers,’” Gabbe says. “If our long-range plan is not as positive as we had hoped, we need to come up with a list of parts of the building that we can hold back on.”

It’s easier to come up with these things in the beginning and easier when you have to make adjustments if that possibility is already stated at the beginning of the project. So develop a list that you can refer to in the event something unexpected happens. If it doesn’t, you haven’t lost anything for the effort.

“We presented that to the board that if things are not as good as we had hoped, we will defer the construction of this part of the hospital until things are better,” Gabbe says.

The fact that all this work was supposed to be completed in 100 days was never far from Gabbe’s mind and he made sure it was never far from his team’s mind either.

“You need to create an understanding of the overall importance of the project to the company or the work group and the sense of urgency about the time that’s allowed,” Gabbe says. “Provide a sense of what the timeline is and when this work must be done.”

Keep asking questions

As much effort as you make to work with your team and include others in a project, you still need to make sure everybody else knows what you’ve been up to. Whether that’s the rest of your employees or, in Gabbe’s case, the employees, students and faculty at OSU, you need to share your story with the masses.

And you need to do it before you’ve carved it all in stone.

“You want to do it at a point in time when the plan remains open to change,” Gabbe says. “This is going to be the largest building we’ve ever built at Ohio State and it’s going to be something they are going to pass by or be in every day. They need to feel they had the opportunity to be part of the planning. That was a key question. We wanted to have enough information so they could react to the plan. We wanted to have enough time so we can respond to their constructive criticism.”

Don’t just rely on one meeting to present and wrap everything up. People need an opportunity to hear about what you’re doing, mull it over, and then come back and raise their concerns or ask questions.

“We presented to them the overall design, but we also presented to them a number of different options we had for the hospital plan,” Gabbe says. “‘Here’s how we could do it. Which of these options do you prefer? Here’s how we could do that. Which of those options do you prefer?’ They could come and they could hear the plan and they could participate in the audience response, they could participate in a question-and-answer session, and they could send us their comments to a website so we could review those, as well.”

You should also let people know how they will be affected and be thorough and thinking about the impact of your project on the business, aside from the project itself.

“For example, we know the construction on our campus has disrupted traffic and we know it has made parking more difficult,” Gabbe says. “We tried to do everything we could to get out in front of those plans and let people know why we were doing what we were doing.”

If people have concerns, go out of your way to address them and give the person everything you can to either allay their fears or show that you’re addressing the issue.

“It’s what people don’t know that can be the risk,” Gabbe says. “People then begin to imagine or project. It’s always best when people understand what the finances look like. It’s just very important. There were no secrets. If people said something was wrong or something wasn’t right, we worked together until we were convinced we had the right projections for the future.”

Gabbe and his team worked through the multitude of issues that needed to be addressed and met the challenge. Work on the new James Cancer Hospital and Solove Research Institute is expected to be completed by 2014.

By 2015, the entire expansion to the OSU Medical Center is expected to add more than 10,000 full-time jobs in Ohio, in addition to the 5,000 construction jobs that will have been needed. The center takes in about $1.8 billion in operating revenue each year, but the expansion project is expected to create an additional economic impact of $1.7 billion by 2015.

“It was a great privilege and opportunity to be part of planning something that would make a difference in people’s lives every day for years and years to come,” Gabbe says.

He credits the openness and transparency of his team’s efforts for the successful outcome.

“The communication plan when you’re doing something as big and impactful as this is almost as important and maybe just as important as the plan for the new building itself,” Gabbe says.

How to reach: The Ohio State University Medical Center, (800) 293-5123 or http://medicalcenter.osu.edu.

Steven Gabbe


Ohio State University Medical Center

Born: Newark, N.J.

Education: Bachelor of arts degree, Princeton University; medical degree, Weill Cornell Medical College

What was your very first job?

I was probably about 10 or 11 when I worked on a fishing boat off the New Jersey coast. I helped people bait their hooks and clean their fish, and I got a chance to do some fishing while I worked on the boat. I met a lot of people who got seasick.

Whom has been the biggest influence on who you are today?

Dr. Priscilla White. She was a pioneer at the Joslin [Diabetes Center] in Boston. I developed diabetes when I was a medical student. Dr. White took care of me when I was a resident in Boston. She was a pioneer in the field of diabetes in pregnancy. She began working with women not long after the discovery of insulin. I have dedicated most of my career to taking care of pregnant women with diabetes. She was a huge influence on my career.

What’s the best advice you’ve been given?

Do good, and don’t complain.

If you could sit down with anyone, past or present, whom would it be and why?

Hippocrates. I’d like to learn about the practice of healing as he thought of it in its very earliest stages. As physicians, we take the Hippocratic Oath. I would love to talk with him about how the Hippocratic Oath came to be formulated. It still influences our day-to-day practice of medicine.