How it all began—early inspiration and direction
The roots of my journey from practicing nurse to senior healthcare executive run deep, reaching back to early childhood. My grandmother was a nurse. I remember seeing her in the traditional nurse uniform as she left for the hospital to care for her patients. She was a powerful role model and mentor in terms of professionalism, compassion, and commitment—values that would shape my life and career.
Educational and professional track—from LPN to MBA
After graduating from high school, I became a licensed practical nurse (LPN) and quickly developed a passion for nursing, professionalism, caring for others, and seeing positive outcomes. Having worked my way through nursing school, I gained experience in neonatal intensive care, labor, and delivery. At that time, nurses who were the most clinically competent, skilled, and passionate were tapped as the most capable of becoming leaders who could achieve positive outcomes. I worked hard to demonstrate competency, honing my skills to the highest level.
As I moved into director roles, service line leadership roles, and assistant VP roles, it became clear that those positions needed professionals with both clinical experience and business acumen to make sound judgment calls. Back then, it was not uncommon for folks with nursing diplomas to rise to levels of leadership and responsibility well beyond their capabilities. With new insights and direction, I earned an undergraduate degree in general studies and then entered an executive MBA program. With no option to step back from my career, I attended school Friday nights, Saturdays, and sometimes Sundays to finish the program within 24 months.
With MBA in hand, I landed a job as director of surgery for a multi-facility hospital system that generated approximately $25 million in gross revenue. It astounded me that the business ran itself versus operating from a strategic planning perspective. An initial assessment indicated the need for sophisticated processes—standardization of OR scheduling and workflows along with implementation of enabling technology. Harnessing the power of technology made a significant impact on efficiency, quality, safety, and overall outcomes. Moreover, we saw an increase in patient satisfaction, staff satisfaction, and eventually our surgeons’ satisfaction. By applying fundamental business processes, the organization built a $60 million operating room within the first four years I was there.
Finding my voice as a businesswoman—combining clinical care, business, and IT knowledge
Women sometimes ask if I’ve faced challenges having my voice heard as a businesswoman in a man’s world. Have I had to work harder to present my views and be heard? Yes, of course.
As COO of a 400-bed hospital in Omaha, I found myself in a man’s world. The CEO, who was a friend of mine, said he knew I could run the hospital but preferred to bring in a “thoroughbred.” There I was, working day and night to keep the wheels turning at a major tertiary hospital that drove revenue for the entire organization. When the thoroughbred arrived, I was assigned to a corporate-level position as executive director of the quality department. The organization had created a new program called “quality accelerator” to eliminate inefficiency through standardized processes, practices, and technology. In fact, a firm had identified a $350 million opportunity.
My role was to lead the initiative, hire my own team, and engage stakeholders across 10 hospitals—a great next step in my career. I hired industrial engineers rather than clinicians to work within organizations to quickly map the current state and workflow, and then provide science, guidance, and direction. We achieved our goals, including refined robotic automation in the OR. Thoroughbreds have their place, but never underestimate a team of powerful workhorses!
In retrospect, guiding industrial engineers and project managers while communicating across the organization—with physicians, medical executives, the leadership team—provided a deep understanding of opportunities to drive efficiency, improve patient outcomes, and ensure quality and safety. The initiative took place on the heels of CMS starting to publish quality ratings—and ours were abysmal at the outset. As a result of achieving excellence in clinical quality, we were recognized as the best health system in clinical quality and patient experience in 2008 by the Network for Regional Healthcare Improvement.
Guidance from my father
My success as a businesswoman evolved from a rare experience. As the oldest daughter of six children, my father thought the sun and moon shone over me. He was a successful, articulate businessman who mentored and groomed me to become a strong, articulate woman. I admired his ability to stand up and speak in front of a group—family events, business meetings, funerals, and more. He had a lovely command of his presence and expressed himself eloquently.
Early on, I began to emulate him. I continued to groom myself and take different approaches in my work. I’ll never forget my father’s words: “If you can tame that tiger—the surgeon—and get those folks to follow your lead, you can master the hospital.” Ultimately, I had 200 surgeons who would walk on water or walk through fire for me to help us get what we needed for the OR and for the community. In many ways, I’ve learned by trial and by fire, but I had a great mentor in my dad. His influence and the memory of my grandmother empowered me to pursue my passion with patience and confidence.
I’ve always been driven to do the right thing and do it well. No shortcuts. Innovation is part of my DNA. Voicing that passion is important to me. When we look at data in the healthcare industry, that data reflects real people and real lives. We must keep this in mind as we ensure safeguards to protect patients who transfer across organizations from hospitals to post-acute care providers. Behind the data are mothers and fathers, daughters and sons, sisters and brothers…and our decisions affect their lives.
Bringing a unique perspective to the table
Having risen through the ranks in a leadership role with a nursing background and formal business education, I bring an ability to listen, understand, and guide people in the right direction. My experience in clinical leadership and the business world of IT brings credibility that encourages others to embrace enabling technology. Even so, some providers are hesitant to take the leap, despite frustration around accessing and delivering care in a constantly changing landscape.
With mentoring, they gain confidence and the ability to express themselves on both sides—clinical and business. I provide folks with a deck that fully explains what we do, why we do it, what the outcomes are, and what the return on investment will be. At various facilities, I enjoy moving up and down and across the organization, engaging leadership teams, C-suite executives, directors of case management, and end users to determine specific needs. It is satisfying to see people light up when they learn about tools designed to make their jobs easier and promote their success.
Today, my best experiences occur in the hospital—observing, interacting, and contributing from the perspective of a subject matter expert. I’ve always had my sight focused on working in a consultative capacity as I wrap up my career. I feel that I’m there now, making a difference for people who need assistance applying technology to improve outcomes.
As a healthcare IT executive, I offer a unique combination of skills and experience. My heart is in nursing. My head is in business. As I sit at the table with leaders, board members, and colleagues, I can contribute from a business and clinical perspective.
Advice for nurses considering advanced careers in healthcare
I try to offer encouragement and mentor others in terms of the vast opportunities available in the industry. On the clinical side, become a physician. Go to med school if you have a passion for the art and science of it all. You’d be surprised how many nurses become physicians. Nurses make great doctors. They fully understand the value of the nurse, always there to help. On the technology side, an emerging track for nurses is informatics, the perfect combination of clinical expertise, technology, and innovation.
Above all, find a mentor. Textbooks and professors are great, but you need someone day in and day out for support and guidance. Choose someone on your team, a manager, an educator, or the CNO. There’s a wide range of opportunities. Consider an accelerated track that evolves into a leadership position. If you look at industry statistics, healthcare is known for being predominately female, about 60 percent. However, that percentage shrinks within the leadership category. Fortunately, the healthcare industry allows women to take a break to have children, work part time, and still pursue an advanced career path. Now, more than ever, the industry needs women in leadership roles.
Finding and following your passion, your curiosity, your creativity
I’m one of the lucky people who love what they do. For me, it’s making a difference in people’s lives through quality healthcare. I’m a passionate healthcare executive who strives to improve the delivery of healthcare and improve outcomes through innovation.
However, healthcare is not my only passion. It surprises some folks to learn that I also love entertaining and gourmet cooking. Though preparing an elaborate meal can be challenging, the finished product gives me a sense of satisfaction. Therein lies a strong correlation between my desire to cook and my DNA. As the oldest daughter of six, I had to cook for everybody!
I especially enjoy cooking complicated dishes. It piques my curiosity, engages my creativity, and presents an opportunity to solve the problem. That experience of accomplishment goes back to my days as a clinician and businesswoman. I like to find solutions. I like to feed people, care for others. Making sure everyone enjoys the experience is one of my greatest pleasures.
About the Contributor
Mary Kay Thalken, RN, MBA, Chief Clinical Officer, Ensocare, provides executive, operational and clinical expertise to help hospitals better manage patient care transitions and achieve financial savings through reduced length of stay and preventable readmissions. She has held significant leadership roles for health systems in Georgia and Nebraska over the last 25 years, including roles as Chief Nursing Executive, Chief Operating Officer and Corporate Quality & Innovation Executive for CHI Alegent Health System in Omaha, Nebraska.
She earned her master of business administration degree from the University of Nebraska Omaha and an undergraduate degree from the College of Saint Mary. She is a member of the American College of Healthcare Executives (ACHE), the American Organization of Nurse Executives (AONE) and the American Case Management Association (ACMA).