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Dr. John Krueger. Courtesy photo
Dr. John Krueger, chief medicalofficerfortheChickasaw Nation Department of Health (CNDH), was recognized as one of the top 110 health system chief medical officerstoknowinthecountry for 2023 by the publication Becker’s Hospital Review. Dr. Krueger was nominated for the recognition by Dr. Charles Grim, Chickasaw Nation Secretary of Health.
The pair have been working together since 2019 to improve and support the Chickasaw Nation health system as needed, as well as navigate the whirlwind of the COVID-19 pandemic.
“I’m honored to be recognized, however this recognition is really about the Chickasaw Nation, our incredible leadership, the amazing and dedicated people that I have the privilege to work with every day, and serving the Chickasaw people,” Dr. Krueger said.
“No one does all the things that people recognize you for by yourself, and without the leadership, my team and colleagues, nothing I am associated with having accomplished would be possible. This is about our whole team here at the Chickasaw NationDepartmentofHealth and everyone across the Chickasaw Nation.” he said.
Dr. Krueger is the under secretary for medical staff and quality and the chief medical and quality officer for the Chickasaw Nation Medical Center (CNMC) and the CNDH.
His primary job at CNDH is to support the medical staff of the Chickasaw Nation Department of Health, including physicians and other members of the clinical staff. He works with the department chiefs, vice chiefs and chief(s) of staff to serve as an administrative liaison.
Dr. Krueger also oversees the quality care team that is responsible for the safety and overall quality performance of CNDH. In addition, his leadershipguidestheCNDH/ Oklahoma State University family medicine residency, a chief information officer and chief medical information offi cer(CIO/CMIO),theCNDH electronic medical record and ITdepartments,andclinician services and recruiting.
“I’m proud of our work to operationalize a Malcom Baldrige methodology and quality framework across our health system,” he said.
Dr. Krueger explained Malcolm Baldrige is a nationally recognized United States Department of Commerce sponsored quality performance system that evaluates many industries including health care.
Organizations participating in the Malcolm Baldrige process undergo a rigorous process of self-evaluation and improvement with a focus on the customer and assuring development of organizational processes and culture to assure high quality.
“The Malcolm Baldrige National Quality Award is the highest level of national recognition for performance excellence that a U.S. organization can receive. The end goal is to create the best healthsystempossibleforour patients and those we serve,” Dr. Kreuger said.
The CNDH received the Leadership in Excellence Awardin2021fromtheOklahoma Quality Foundation, the top level of recognition bestowed by the foundation. Dr. Krueger said earning this designation is a major accomplishment for a health care system at any time, especially one engaged in battling a pandemic. This award makes CNDH eligible to apply for the Malcolm Baldrige National Quality Award.
About Dr. Krueger
Dr. Krueger’s career started in northwest Arkansas in banking while working on his bachelor’s degree in economics.
“I soon discovered that banking was not the right fit for me,” he said. “I was doing some lobbying and political work in D.C. one year when I saw a booth set up by a resident from Johns Hopkins (hospital) who was collecting blood samples for the National Marrow Donor Program. I matched several months later with a patient who had leukemia.”
He soon developed a relationship with the patient and his family through the liaison at the American Red Cross.
“That’s when I really changed my mind about my career trajectory,” he said.
Dr. Krueger attended medical school at the University of Oklahoma College of Medicine in Oklahoma City and Tulsa before entering a residency program at John Peter Smith Family Practice Residency in Fort Worth, Texas. Later, he worked in private practice before having his first tribal health experience.
“Istartedworkingwiththe Muscogee Nation first, then worked for the Cherokee Nation, which is how I met Dr. Grim, my current boss,” he continued. “At the Cherokee Nation, I was involved in a large quality program working nationally with Centers for Medicare and Medicaid Services (CMS).”
In 2010, he was selected to move to Boston, Massachusetts, for a year as a George W. Merck Health Care Quality Improvement Fellow.
“That was a real honor and privilege for me to have that experience. I was able to travel around the world and learn about health system design, quality improvement in patient care, public and population health; learning how different countries and systems provide high quality care,” he said.
“I saw all different kinds of healthcare models including systems like Mayo, Kaiser Permanente, Virginia Mason, Harvard affiliated hospitals and health systems, the VA, NHS, Sweden, and other health systems around the world and learned how they operate and take care of their patients and populations.”
He returned in 2014 to receive a master’s degree in public health from the Harvard School of Public Health in Boston. Through his travels, his education and experience with other tribal health systems, he learned about emergency management, and disaster preparation and response.
“We did quite a few exercises with the Department of Homeland Security and the FederalEmergencyManagement Agency(FEMA)whenI was at the Cherokee Nation. IhelpedtheCherokeeNation with the H1N1 Influenza Pandemic. It was certainly nothing like we experienced during COVID, but having that training and experience was really helpful for building an effective strategy to respond to the COVID-19 pandemic,” he said.
He also had access to resources at the Harvard School of Public Health during the COVID-19 pandemic and was able to gain a global perspective on it and see how it was being handled everywhere else. “We are the unconquered and unconquerable Chickasaw Nation,” he continued. “That was never truer than during my experience with the pandemic. We took on our response to the pandemic with a zeal I had never experienced withanyotherhealth care system. I had never seen anyone work harder together like we did.”
Dr. Krueger said he was inspired to see people solving problems and immediately moving on to the next.
“I am extremely proud of all the people that I worked with, and I am extremely proud of the Chickasaws Nation.”
“I got a call asking if I knew Dr. Krueger and if I would want to work with him again,” Dr. Grim said. “I said ‘Absolutely.’ The Chickasaw Nation was looking for a chief quality officer. We have been working together for nearing five years now, and he has helped us improve our quality of care, the effectiveness of our care, and the research hedoesaswellhastaughtour staff so much.”
Dr. Grim also said Dr. Krueger’s educational background in economics and business gave him an entrepreneurial spirit he never lost—something he brings to his work when helping with revenue generation.
“All the money goes right into our health care system to make it better,” he said.
Dr.GrimsaidDr.Krueger’s safety training background prepared him for the pandemic. The pandemic hit only a few months into his new job with the Chickasaw Nation. The health department staff had to create policies and procedures from scratch. Many of their plans for the system were put on hold to deal with the new issues caused by the pandemic, which was becoming an increased threat.
Chickasaw Nation Governor Bill Anoatubby declared a public health emergency for the Chickasaw Nation near the beginning of the pandemic. The reason for this was to care for not only Chickasaw Nation patients, but employees, families and people in the community around them.
During the pandemic, the doors of Chickasaw health service were opened to everyone. Anyone was able to get COVID-19 tests and vaccines. Many who came for testing and vaccinations were public school teachers, a top priority for vaccination near the beginning of the pandemic.
The Chickasaw Nation has given more than 82,000 vaccines and approximately 250,000 COVID-19 tests. An online dashboard was updated daily for people to keep track of these numbers.
“Dr. Krueger helped design this information, and we ensured the cabinet had the data it needed to make decisions throughout the pandemic,” Dr. Grim said. “With input from his team, Dr. Krueger helped design the mass drive-thrus for vaccines and testing.
“We used LEAN principles, a skill Dr. Krueger learned through prior training and experiences to make these services both customer friendly and extremely efficient. Thanks to these drivethru designs, the Chickasaw Nation won an award for logistics of operation during the (Operation) Warp Speed effort, which was the United States’ effort to get a vaccine developed and in the hands of medical centers as fast as possible,” Dr. Grim said.
Dr. Grim described Dr. Krueger’s action plans as cautious and thorough.
“He and his team would research treatment solutions and scan the horizon as vaccines and therapeutics were under development. This was accomplished by paying attention to social media, to journalistic publications, and news or scientific accounts of successes around the world with new treatments or therapies.
“When something showed sufficient promise, we would provide these new options to a team of senior medical executive staff from different specialties and backgrounds to discuss, explore and approve the solution before it was implemented,” Dr. Grim explained.
It was a step many health care systems did not implemented duringthepandemic, he said “There has been a lot going on these past few years, and it did delay some of the things we were getting started on as a team,” Dr. Grim said. “But the way Dr. Krueger carried himself and the Chickasaw Nation Health Care System during the pandemic certainly qualifies him for being in the top 110 chief medical officers across the country.”