A question that kept David Zonies, MD, MPH, MBA ’20, up at night was how to improve critical care services across the newly formed OHSU Health. He decided to propose a Capstone project to explore this further. Together with three classmates, the team developed a model for a system-wide critical care service line. However, the COVID-19 pandemic caused the team to pivot mid-project. Healthcare systems needed new and immediate ideas to address the needs of patients locally and regionally. Keeping the end in mind, the team developed a long-term plan along with alternatives to address the acute. The adaptability, creativity, and quality of work throughout this project helped to propel Dr. Zonies into an Associate Chief Medical Officer role.

The beginnings of an idea

Planning this project started months before Capstone began. After attending a guest lecture about critical care models, Dr. Zonies spoke with his leadership about this being a potential capstone project and noted that securing a sponsor for the project was pivotal. Together Dr. Zonies and their sponsor explored how to align the project with the organization’s strategic initiatives as well as succession planning.

The path to change

The capstone project provided a solid report and actionable recommendations. He spoke about the strength of his capstone teammates and how their strengths complemented each other from finance, to billing and coding, and clinical expertise. Changing systems takes multiple perspectives, skills, and teamwork.

And the work has not stopped. In his understated way, Dr. Zonies said, “It hasn’t all been roses.” Yet, he knows that this is the right way to move to improve care for the region. With the adage of never letting a good crisis go to waste, he has been able to move elements of the project forward out of necessity. He currently is tracking data to improve upon the model and prove its efficacy.

Advice for students

It is not surprising that Dr. Zonies recalled his careful consideration of course assignments. His strategic approach grew his knowledge and skills and demonstrated his commitment to improving healthcare delivery and advancing the organization’s goals. He kept in mind what he was building and then used everything he could to work toward that vision.

In considering the advice he would offer students embarking on capstone, Dr. Zonies offered these three thoughts:

  1. It may seem long, but it goes quickly. You must work at it each week and pivot when necessary.

  1. Craft an excellent deliverable. This honors the work you have done and reflects on you as a professional.

  1. Give your sponsor a focused report with actionable recommendations.

Dr. Zonies is currently the Associate Chief Medical Officer of OHSU Health and Professor of Surgery at OHSU.

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