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After a young Todd Allen broke his arm jumping off a hill, the drive to the orthopedics’ office seemed endless. But, when he got there, he was fascinated by how well staff could “calm patients down mentally and fix them physically.”
“It was such an amazing combination of skills and an amazing thing to do for work,” says Allen, who went on to earn his MD from the University of Utah School of Medicine.
That fascination planted a seed for him to one day become a fresh leading force for the Queen’s Medical Center and the Queen’s Health Systems, based in Honolulu, where he serves as senior vice president and chief quality officer. There, he’s responsible for regulatory reporting and certifications, quality, safety, infection prevention and control, system analytics, performance improvement, and engineering.
He’s also playing a part in solidifying the system’s pledge to put patients first, a commitment he says will mean a redesign of everything in the system.
“The system of healthcare in America was designed around the provider,” he says. “So, this pledge is to think about how you engage patients, their families, and the community in an entirely different way. It means the delivery model is different, it means the engagement model is different, and the outcomes we measure are different—they must be outcomes important for the patient. It’s a journey all healthcare in America is still on, and we’re still early on that journey at Queens.”
The overhaul is vital to improve the life expectancy of Native Hawaiians, which lags other groups in the state. Native Hawaiians and other Pacific Islanders are also disproportionately affected by chronic conditions like coronary heart disease, diabetes, and certain cancers. A 2019 study highlighted by the Associated Press noted that these ailments are impacted by several factors including socioeconomic status, individual behaviors, and access to healthcare services.
Allen says the life expectancy disparity traces back to 1859.
“Queen Emma and King Kamehameha IV, who founded the system, had witnessed over the course of just a few decades the population of Native Hawaiians going from about six-hundred thousand in the islands to about thirty thousand to fifty thousand. They were decimated by diseases people brought into Hawaii,” he says. “But, still in 2023, Native Hawaiians still live about eight years less than other ethnic groups.”
That’s why the system holds as its aspirational goals to decrease that gap in half over the next decade and to become a lifetime partner in health for the people of Hawaii.
Allen is working to obtain those goals with a focus on high reliability, pushing the system to a state with failure-free operations over time. That involves educating everyone in the system on what high reliability is, how to reach it, and what the science says about it. Additionally, he and his team are rolling out a culture of safety survey and instituting a daily standard operating model. Allen’s work on the system’s Clinical Program structure goes hand in hand with those efforts.
“Our mission used to be waiting until people were broken, then we’d fix them, not getting too involved in primary care or pediatric care,” he says. “Overall, we want to get out of the hospital-centric model and become present at all points in a person’s life.”
His perspective is informed by his previous work at Intermountain Healthcare based in Salt Lake City, where he spent nearly twenty years focused on research, teaching, improvement science, and leadership. He directed efforts in process improvement in clinical medicine, systems research, and teaching in Intermountain’s Advanced Training Program. He was also the medical director of the Emergency Department Development Team, which supervised the work of the twenty-one emergency departments across the breadth of Intermountain Healthcare’s hospitals.
Allen credits much of his development to being in rooms with Intermountain’s senior leadership and decision-makers, who were passionate about delivering health that was both quality and affordable. Armed with a strong mission, he and his colleagues made great strides in redesigning data structures, engaging patients, and zoning in on social determinants of health.
He brought his expertise to Queens during the pandemic in October 2020. His first six months were the most difficult in his whole career.
“My family and I were all adjusting to a new place in Hawaii versus Utah,” he recalls. “It was a new system, a new culture, and new people in the context of COVID, so it was a challenge.”
He got through that time by getting to know his new home and his colleagues—and being transparent with them. “I let people know that I didn’t think I was there to upend their world,” he says. “Queen’s history is filled with really remarkable work, and my job was to bring a pair of fresh eyes, different experience, and to improve upon that history while honoring it intently.”
As a leader, he focuses on the frontline workers to bring out their best and constantly communicating his strategy with them. When asked what’s special about his team, he says simply: “They care.”
“Medicine is cool because it brings in smart and curious people,” he adds, “and then if you can add empathy to that, you have a magical combination.”
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