Advancing Professionalism and Clinical Excellence at Vanderbilt with Dr. Bill Cooper

Summary

Episode Overview

Podcast: Becker’s Healthcare Podcast
Episode: Advancing Professionalism and Clinical Excellence at Vanderbilt with Dr. Bill Cooper
Date: March 6, 2026
Host: Mariah Muhammad
Guest: Dr. Bill Cooper, Senior Vice President for Professionalism and Clinical Excellence, Vanderbilt University Medical Center

This episode centers on how Vanderbilt University Medical Center fosters professionalism, self-regulation, and clinical excellence among its staff. Dr. Bill Cooper describes the institution's philosophy, practical systems, and real-life impacts of professionalism initiatives—particularly peer feedback mechanisms—to enhance team culture, retention, and patient care.

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Key Discussion Points and Insights

1. Background and System Overview

• Vanderbilt's Scale and Mission
  • Vanderbilt is a large academic health system with a central Nashville campus and affiliate hospitals, serving Tennessee and surrounding states.
    • [01:00] Dr. Cooper: “We are a large academic health system...We serve a pretty large catchment area, both in Tennessee as well as many states surrounding us.”

2. Defining and Supporting Professionalism

• CREDO Behaviors as the North Star
  • The health system’s “CREDO” behaviors—like ownership, collegiality, professionalism, and clear communication—form the foundation for expected conduct.
  • These behaviors are embedded in orientation programs for all employees and are recognized through awards and regular acknowledgment.
  • Evaluation of staff, including leaders, is partially based (25%) on modeling these CREDO behaviors.
    • [01:56] Dr. Cooper: “We really ascribe to the notion here at Vanderbilt that if we can understand and model our CREDO behaviors...those things which are basic tenets of what it means to be a good member of a healthcare team, really serve as our North Star.”
    • [02:40] “25% of my evaluation as a leader at Vanderbilt is dependent on do I consistently model the CREDO behaviors…every single employee in our health system gets evaluated in the same way.”

3. Feedback and Peer-to-Peer Accountability

• Cup of Coffee Conversations

  • Vanderbilt encourages immediate, respectful feedback through brief, informal “cup of coffee” conversations after lapses in professionalism.
  • All employees are trained to address concerns directly with colleagues instead of talking about them behind their backs.
  • The emphasis is on curiosity and care, not blame.
    • [03:24] “We talk with each other and not about each other. And so what we've trained thousands of our employees to do is to have as much as possible in the moment, a conversation that we call a cup of coffee conversation.”
    • Example dialogue: “Hey colleague…when you asked me, you know, if I was lazy or just hate my job, that just kind of didn’t seem like what we’re trying to accomplish in terms of our credo values.” [03:45]

• Event Reporting and Peer Messengers

  • If direct conversation isn't possible, incidents are entered into an electronic event reporting system.
  • Within days, trained peer messengers (from the individual’s own profession) deliver feedback, again using the cup of coffee approach.
    • [04:40] “Within a couple of days, someone within that person’s profession, and hopefully within their sort of area of work, will just pull them aside and have the same cup of coffee.”

• Impact of Timely Peer Intervention

  • This feedback approach is highly effective: “97% of the time, if we'll have that cup of coffee as soon as possible after the event, it does not happen again.” [05:32]

4. Tiered Interventions for Persistent Behaviors

• Escalation Protocol

  • If an individual doesn’t respond to initial feedback, interventions escalate in seriousness and consequence.
  • The focus remains on addressing the root issue and supporting professional development.

• Case Example: Real-world Impact

  • A physician known for dismissive responses to nurses received cumulative peer feedback and benchmarking data.
  • Confronted with data showing deviation from peers, the physician reached out to a nurse manager to improve communication.
  • The nurse manager candidly explained how dismissive comments hindered the unit's functioning and discouraged calls for clarification, especially among newer nurses.
  • The physician’s subsequent behavioral change led to improved teamwork, reduced nurse absenteeism, better retention, and a “light switch” shift in the unit culture.
    • [07:10] “The nurse manager said, it was almost like a light switch was flipped that that individual took that to heart and figured out that what they were doing…was actually getting in the way of really good patient care.”
    • [08:00] “There was a couple of nurses who told me that if that person was working a shift in the unit, they would call out sick because they just were so bothered by being around them. And after the physician improved their performance, nurses didn’t have to call out sick anymore.”

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Notable Quotes & Memorable Moments

• On organization-wide role modeling:

  • “Every single employee in our health system gets evaluated in the same way around. How are we modeling those themes, things that are the best part of who we are?” — Dr. Cooper, [02:50]

• The ‘Cup of Coffee’ culture:

  • “What we've trained thousands of our employees to do is to have…a conversation that we call a cup of coffee conversation...” — Dr. Cooper, [03:27]
  • “I'm just hoping that next time you and I talk about a potential admission, it might go differently. It's a 60 second conversation where we're just asking that person to consider how they might be a better version of themselves.” — Dr. Cooper, [03:55]

• Effectiveness of peer feedback:

  • “97% of the time, if we’ll have that cup of coffee as soon as possible after the event, it does not happen again.” — Dr. Cooper, [05:32]

• Organizational transformation via feedback:

  • “Not only did that person improve their performance, that physician, it actually improved the culture of the entire unit.” — Dr. Cooper, [07:50]

• Host Reaction:

  • “That is definitely an amazing example. And I think that…the example beforehand in this example is definitely a stark contrast between, you know, just the coffee and what obviously helped him kind of get his emotions and actions in order.” — Mariah Muhammad, [08:32]

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Timestamps for Important Segments

• [01:00] – Dr. Cooper introduces Vanderbilt and his role
• [01:56] – Explanation of CREDO behaviors and integration into evaluation
• [03:24] – Peer feedback and the ‘cup of coffee’ model
• [04:40] – Description of event reporting and peer messenger follow-ups
• [05:32] – Effectiveness statistic: 97% resolution rate post-feedback
• [06:06] – Example of tiered intervention and real-life improvement story
• [07:50] – Impact on culture, retention, and teamwork following intervention

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Conclusion

This episode presents a comprehensive look at how deliberate professional standards and structured peer feedback at Vanderbilt tangibly elevate clinical culture and patient care. Dr. Cooper’s insights reveal that systemic professionalism initiatives—grounded in clear organizational values and respectful, data-informed feedback—yield transformative, sustainable improvements in both staff behavior and healthcare outcomes.

Transcript

[A]

This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.

[B]

Welcome everyone to the Becker's Healthcare Podcast series. I'm Mariah Muhammad, writer and moderator with Becker's Healthcare, and I'm thrilled to have with me today Dr. Bill Cooper, Senior Vice President for professionalism and Clinical Excellence at Vanderbilt University Medical center and professor of Pediatrics and health policy. Dr. Cooper, welcome to the podcast. Welcome back to the podcast. We're very excited to have you join us again today to get us started. Would you mind please introducing yourself a little bit more and telling us about your system?

[C]

Absolutely. Thanks. Thanks, Maria. So I'm a pediatrician. I practice in our children's hospital in Monroe, Carroll junior Children's Hospital of Vanderbilt and also lead our health systems professionalism efforts. So we are a large academic health system. We have a downtown campus in Nashville and then we have several affiliate hospitals in our local region. And we serve a pretty large catchment area, both in Tennessee as well as many states surrounding us.

[B]

Wonderful. Thank you so much for giving us that background. So today I know we want to talk a little bit about professionalism and obviously this is well within your area of expertise. So I guess for a good baseline to start our conversation, how does your hospital or health system support clinicians in developing self regulation skills? Do you have any specific programs or initiatives put in place right now?

[C]

We really ascribe to the notion here at Vanderbilt that if we can understand and model our CREDO behaviors, and those were sort of a set of behaviors that our employees identified several years ago, I take ownership, I'm committed to my colleagues, I behave professionally, I communicate clearly those things which are basic tenets of what it means to be a good member of a healthcare team, really serve as our North Star for how we behave. We include our CREDO in all of our employee orientation, our new clinician orientation. We talk about it regular. We recognize those who have excellence in CREDO behaviors with CREDO awards that we really publicize widely throughout the medical Center. We also 25% of my evaluation as a leader at Vanderbilt is dependent on do I consistently model the CREDO behaviors. But it's also actually Every single employee in our health system gets evaluated in the same way around. How are we modeling those themes, things that are the best part of who we are as a part of being a build.

[B]

Oh, wow, that is definitely very good to hear. And I, I don't think I've talked to executive who's kind of had this system put in place or I've had a conversation with them about it. What role does feedback play in maintaining professionalism within your organization? I know you was talking about evaluation and how is feedback typically delivered and received among clinicians?

[C]

One of the key things is we have to recognize that nobody's perfect. And some of us may have a bad day, we may go crosswise with a patient, we may have a challenging interaction with another clinician. So what we have in place is a system where we talk with each other and not about each other. And so what we've trained thousands of our employees to do is to have as much as possible in the moment, a conversation that we call a cup of coffee conversation. And it might just be, hey colleague, I was talking with you about this new admission to your unit and it sounds like that when you asked me, you know, if I was lazy or just hate my job, that, that just kind of didn't seem like what we're trying to accomplish in terms of our credo values. And I'm just hoping that next time you and I talk about a potential admission, it might go differently. It's a 60 second conversation where we're just asking that person to consider how they might be a better version of themselves. We also have, however, system level programs for, for those times where it may not be possible to talk in the moment, either because there's hierarchy or it's a threat to patient safety, or the person speaks to the individual but they go ahead and fail to follow one of our safety procedures or protocols. In that case, if they enter an electronic report into our event reporting system, 90 plus percent of the time we have peer messengers trained for nurses and surgical techs and medical assistants and physicians, advanced practice professionals as a part of the co worker observation reporting system. And within a couple of days, someone within that person's profession, and hopefully within their sort of area of work, will just pull them aside and have the same cup of coffee. But the reason for the cup of coffee is to say, gosh, tell me how your night went the other night. Sounds like it was kind of stressful. Any interactions that didn't go all that well? We got this report about this interaction and I get it sounds like that there was a lot of things that may have contributed to the tension there. I'm just curious, colleague, could that go differently next time? What's really amazing, Mariah, is that 97% of the time, if we'll have that cup of coffee as soon as possible after the event, it does not happen again.

[B]

That's definitely amazing to hear. And it does sound like very calm conversations, very respectable conversations. And it seems like these overall go really well. And are you able to kind of share an example of a successful peer to peer intervention that's helped address professional behavior in a clinical setting and I think, more importantly, what made it effective for you?

[C]

Yeah, really, really great example. So one of the things that we do, also knowing that most will respond to that initial cup of coffee, we have a tiered intervention that if you are one of those 2% individuals who don't respond to the cups of coffee, we up the stakes a little bit and keep moving up with higher and higher consequences to, you know, where we're going to do that. So one of the times I can think of here at Vanderbilt where this worked really well was an individual who had had repeated interactions that weren't all that professional with nursing colleagues. And the peer physician sat and talked with them and said, gosh, looks like that compared to your colleagues here at Vanderbilt, as well as in a national benchmarking that we run, that Vanderbilt runs as a part of the center I lead. For some reason, your practice is different than others, both locally and nationally within your specialty. And I just thought you'd want to know and here's the types of behaviors that we're seeing. Well, after that, the physician on their own went and approached the manager for the unit where they do most of their work and said, gosh, I'm on the list. Can you help me understand why I'm on it and what I need to do to get off it? And I heard actually from the nurse leader who said, you know what? I didn't know what the list was at the time, but I did know he needed to be on it because every time my nurse is called with questions, he would say things like, you know, don't call me with stupid questions. It's in the orders. Can't you read the chart? And so when he asked me this, the nurse manager said, I just said, hey, look, when we call with questions, it makes it difficult for us to complete our tasks. And also some of my younger nurses are afraid to call you back with subsequent questions. The nurse manager said it was almost like a light switch was flipped that that individual took that to heart and figured out that what they were doing, which they were frustrated sometimes when they would get phone calls, was actually getting in the way of really good patient care. And the nurse manager said, not only did that person improve their performance, that physician, it actually improved the culture of the entire unit. Manager said, there was a couple of nurses who told me that if that person was working a shift in the unit, they would call out sick because they just were so bothered by being around them. And after the physician improved their performance, nurses didn't have to call out sick anymore. So it actually helped the engagement, the retention, and the overall culture of the unit so positively.

[B]

Wow, that is definitely an amazing example. And I think that the example beforehand in this example is definitely a stark contrast between, you know, just the coffee and what obviously helped him kind of get his emotions and actions in order. But overall, I want to thank you so much for those final thoughts. It's definitely been a very informative discussion. So, again, I want to thank you so much for coming back on Becker's healthcare podcast, and I look forward to connecting with you again soon.

[C]

Thanks for having me. Great conversation.