In March of 2021, Gene Kim visited the mass vaccination site at the Oregon Convention Center in Portland, which has been described by the press as a logistical masterpiece where over 465,000 Oregonians have been vaccinated as of May 2021.

After a three-hour tour of the site, Gene Kim sat down with Trent Green, Senior Vice President and Chief Operating Officer (COO) at Legacy Health and one of the organizers of the mass vaccination operation. Kim and Green discuss firsthand what it looks like to vaccinate 8,000 people a day and the strategic level of planning it took to produce and operate the mass vaccination clinic.

Green reveals what those first few days of operation were like and how the site was able to increase distribution from 2,000 vaccines per day to 8,000 per day. Lastly, he discusses the lessons he learned during the rollout process and how those lessons can inform how to improve the overall health care system.

Also joining the conversation is Dr. Steve Spear, who has helped the Pittsburgh Regional Healthcare Initiative create its “Perfecting Patient Care System” and has worked on a few pilot programs with Beth Israel Deaconess Medical Center in Boston.

ABOUT THE GUESTS

Trent Green, COO of Legacy Health, focusing on innovation in Legacy Health’s hospital operations and service lines, and responsible for Legacy Laboratory Services, Legacy Imaging Services and Unity Center. Green oversees the OHSU Knight-Legacy Health Cancer Collaborative, the LifeFlight partnership, as well as other ventures that directly impact hospital operations. Prior to his most recent role, Green served as Legacy Health’s senior vice president, chief strategy officer, and president of Legacy Medical Group. He brings more than 20 years of experience in leading health care organizations, with specific strengths and accomplishments in clinic and hospital operations, strategic planning, business development, marketing, mergers and acquisitions, and finance. 

Green’s notable achievements include advancing a re-imagined Master Facility Plan for the Legacy Emanuel and Randall Children’s Hospital campus; navigating a complex regulatory situation at Unity Center by providing decisive leadership and a unified approach to problem-solving, resulting in the successful restoration of status, cultural alignment, best in system performance on medication administration practices, and accelerated incident review and mitigation implementation practices. He also led and developed several of Legacy’s most transformational initiatives, including the PacificSource joint venture, Silverton Health affiliation, Legacy-GoHealth urgent care joint venture, and the OHSU Knight–Legacy Health Cancer Collaborative, among others.

Dr. Steve Spear (DBA MS MS) is principal for HVE LLC, the award-winning author of The High-Velocity Edge, and patent holder for the See to Solve Real Time Alert System. A Senior Lecturer at MIT’s Sloan School and a Senior Fellow at the Institute, Dr. Spear’s work focuses on accelerating learning dynamics within organizations so that they know better and faster what to do and how to do it. This has been informed and tested in practice in multiple industries including heavy industry, high tech design, biopharm R&D, healthcare delivery and other social services, US Army rapid equipping, and US Navy readiness.  

Visit Steve Spear's Website

YOU’LL LEARN ABOUT

• Green’s role as the Chief Operating Officer, how it compares to the Chief Medical Officer, and what are the other key leadership roles in a healthcare organization
• The strategic level of planning, human creativity, and problem-solving it took to produce and operate the mass vaccination clinic as efficient as possible
• Green’s role and the various leadership roles at the vaccination clinic
• What the first days of operations at the vaccination site were like
• The major milestones Green saw as distribution increased from 2,000 vaccines per day to 8,000 vaccines per day
• Fast versus slow integrated problem-solving styles and theory building versus theory testing
• The lessons Green has learned during the COVID vaccination rollout process and how these lessons could inform how to improve the overall health care system

RESOURCES

• Trent Green’s bio at Legacy Health
• Legacy Health
• Videos from DevOps Enterprise Summit Virtual - Europe
• NPR: Half Of All U.S. Adults Are Now Fully Vaccinated Against COVID-19
• Willamette Week: Oregon’s Largest Vaccination Site is a Logistical Masterpiece. We Take You Inside.
• Tweet describing the vaccination site with “apocalypse vibe”
• The Unicorn Project: A Novel about Developers, Digital Disruption, and Thriving in the Age of Data by Gene Kim
• FEMA Region 10’s video featuring Starbucks and Trent Green
• The Indicator from Planet Money: Why Hospitals Are Laying People Off
• The Indicator from Planet Money: Healthcare: The Pandemic's Financial Fallout
• Operation Warp Speed
• Eroom's law
• Fast and Slow Integrated Problem Solving Structures with Gene Kim and Dr. Steve Spear
• Team of Teams: New Rules of Engagement for a Complex World by General Stanley A. McChrystal with Chris Fussell, David Silverman, Tantum Collins
• Mastering Outages with Incident Command for DevOps: Learning from the Fire Department
• Decoding the DNA of the Toyota Production System by Dr. Steven Spear and H. Kent Bowen
• Thinking, Fast and Slow by Daniel Kahneman
• The DevOps Enterprise Journal: White Papers from the 2020 DevOps Enterprise Summits
• The High-Velocity Edge: How Market Leaders Leverage Operational Excellence to Beat the Competition by Steven J. Spear
• The DevOps Enterprise Journal: White Papers from the 2020 DevOps Enterprise Summits
• The PDSA Cycle (Plan-Do-Study-Act)
• Leadership Lessons Learned From Improving Flow In Hospital Settings using Theory of Constraints by Dr. Chris Strear
• Smash the Bottleneck: Fixing Patient Flow for Better Care (and a Better Bottom Line) by Dr. Chris Strear and Danilo Sirias
• Bleacher Report: A Detailed List of an NFL Coach's Responsibility
• Walter A Shewhart, 1924, and the Hawthorne factory by M Best and D Neuhauser

TIMESTAMPS

[00:20] Intro

[04:39] Meet Trent Green

[06:19] Key leadership positions in a healthcare organizations

[07:52] Meet Steve Spear and his work in the healthcare industry

[11:13] The early days of the operations

[14:02] The major milestones from increasing distribution

[20:42] Steve’s thoughts on an organization’s ability to adapt

[24:42] The DevOps Enterprise Summit videos and journal

[25:35] Continuation of Steve’s thoughts

[26:56] The path of good ideas and barriers

[32:04] Trent’s role at the vaccination site

[36:15] The strategic level of planning

[39:19] Two interviews with Dr. Patrick Cawley and Eroom's law

[47:31] Gene’s firsthand observations at the vaccination site

[54:40] Fast vs. slow integrated problem-solving styles

[1:01:58] Lesson learned in the vaccination process

[1:09:50] Uncovering constraints

[1:22:25] Cost of change goes down, frequency of change goes up

[1:25:46] Becoming an effective coach

[1:30:19] Gene adds additional context

[1:36:57] Contacting Trent Green

[1:38:05] Outro