Care in Every Corner

Janet Miller leads a legal department recognized as one of the most innovative in the country to help University Hospitals serve its community

When University Hospitals began its search for a new general counsel in 2001, it called an attorney who had already become a valued legal partner during her years as outside counsel. At first, Janet Miller turned down the offer because she was concerned the job wouldn’t allow her to continue her work in the community. However, when the CEO assured her that her commitment to that work was an asset, Miller agreed to explore the option.

“During the interview process, the hospital personnel kept emphasizing their organizational culture,” Miller recalls. The hospital has always been vocal about its commitment to serving the community and being culturally centered around quality, compassionate, state-of-the-art care. “I thought it all sounded nice, but when I got here and saw firsthand how they live it every day, I was convinced,” she says. That was more than fifteen years ago, and Miller has never found a job more satisfying.

University Hospitals is one of the oldest organizations in Cleveland. It was started by a group of civic-minded women with the intent of providing care for those who couldn’t afford it—particularly soldiers wounded during the Civil War and workers who were injured during the Industrial Revolution. During Word War I, the original Lakeside Unit of doctors and nurses cared for soldiers in France. The next generation of the unit was stationed in Austria and cared for soldiers in World War II in the Pacific regions. The children’s hospital of University Hospital is 125 years old, and its MacDonald Women’s Hospital is the only hospital in Ohio dedicated to women’s health.

“We were started and supported by people who wanted to care for their community,” Miller says. “All these years later, our strategies remain focused on that same goal.”

To support these strategies, Miller has structured her law department around practice groups that focus on the primary business areas of the organization. Attorneys work closely with executive leadership, physicians, operations, finance, human resources, and other areas to build collaborative expertise and new solutions. Lawyers learn the business, and business leaders learn applicable legal principles, empowering each to interact and work more effectively. “As a lawyer, seeing the big picture is incredibly helpful but typically only happens if you’re working in-house,” Miller says. “Recognizing that has made me a better general counsel with my outside counsel, and I am careful to keep them informed. Early on, we even invited outside counsel to sit in on our department to learn our business better.”

Putting University Hospital’s values of teamwork, excellence, innovation, and compassion into action every day is one reason why InsideCounsel named the law department one of the top ten most innovative in the United States in 2013. It received the award for developing a computerized system used by personnel to report any incident at any hospital or physician office as soon as it happens. “Knowing when an incident happens allows us to address the issue immediately rather than wait months or years if and when a claim arises,” she says. “We want to address quality, safety, and care issues immediately.” The introduction of the program initially resulted in an increase in incidents at the hospital because everything was being reported, but the immediacy of the information decreased the number of claims and lawsuits and has saved the hospital more than $200 million to date in litigation costs and increased the quality of care and patient safety.

Transparency was vital for the success of this and other programs, allowing personnel in each area to analyze how the process could be improved. “Every incident—even if there was no harm—went back to its respective department to be addressed in order to improve the quality of care,” she says. It is called the Lessons Learned program and hinges on the expectation that teams would not point fingers, but rather work together to solve problems. It built trust among teammates, which allowed them the freedom to focus on providing excellent quality care and finding creative solutions. “It has also bettered the legal team because people aren’t afraid to bring issues directly to us,” she explains.

Another factor that makes Miller’s legal team and the entire organization better is University Hospital’s prioritization of diversity. “We serve an incredibly diverse community,” she says. “We have a hospital in an Amish community and have a member of the Amish community on that hospital board of directors.” This location also has a parking lot with a buggy rail, and its maternity ward has many midwives to accommodate traditional Amish birthing needs. “Those are the kinds of things that we take into account when we say we’re committed to serving our communities,” Miller says.

University Hospitals also prioritizes diversity of staff, vendors, and service providers as one of its five core values. Miller is proud of the diversity of her legal team, but acknowledges that it can be a challenge to find qualified candidates in healthcare law who are ethnically and racially diverse. True to her nature, Miller has used this particular challenge as another opportunity to innovate. “Our interns here in Cleveland tend to be very diverse, and after they work with us, we have the ability to follow them in their careers,” she explains. To capitalize on this homegrown pool of potential future hires, all interns complete an intensive, two-day in-house training course (for which they often receive course credit) to prepare them for both their internship and their career. “We’re building our own talent and setting our interns up to get great jobs when they leave us,” she says.

Miller is committed to helping others find creative solutions to complex problems and for investing in others—from her interns to her team to business partners, patients, and the community. Her goal is to set up her talented staff with the ability to reach their hopes and dreams, and if they are recruited away from University Hospitals, it’s Miller’s hope that they duplicate and advance those values elsewhere. She is a champion of values like innovation, excellence, compassion, and teamwork, and believes that diversity brings unity, creativity, and a better ability to solve new issues. “If I do my best to fight for values like these in my corner of the world, maybe others will, too,” she says. “And maybe soon, every corner of the world will be better together.”

Fortunately, Miller has found the perfect corner of the world to start, and thanks to her colleagues at University Hospitals, it’s getting bigger all the time.