BARRY WILLIAMS/Special

Alice Vautier, retiring associate administrator for patient services and chief nursing officer at Emory Healthcare, holds a photograph of a 6-foot sailfish she caught off the coast of Key Largo, Fla.

Alice Vautier, RN, Ed.D., is retiring this year from her job as associate administrator for patient services and chief nursing officer at Emory Healthcare in Atlanta. Among the many mementos dotting Vautier's office is a photo of her holding
a 6-foot-plus sailfish.

"That was the only sailfish caught that day," she said proudly. "I love the water, and I've been fishing all my life. I get
some of my best ideas out on the boat."

Vautier has landed plenty of good ideas in her 45-year nursing career, including some from unlikely places. She holds degrees from the University of Pennsylvania, Villanova University and Columbia University and a certificate from the Wharton Fellows Program in Management for Nurses, but it was choosing unorthodox elective courses that shaped her creative management style.

While earning her master's degree in nursing administration at Villanova, Vautier took a business course on organizational
design.

"It all made so much sense," she said. "If you design something one way, you get this outcome. If you design it another,
you get a different outcome. If things aren't working, you go back to the design to see what went wrong."

Vautier used that strategy in 1995 at Emory Healthcare to successfully merge three nursing and pharmacy departments at acute care hospitals. She standardized patient care, policies and procedures in order to make the new department function as one system.

In 2003, she used a manufacturing model to look at the average length of patient's hospital stays.

"If you want to decrease length of stay, you have to make the right changes in patient care," Vautier said. "Longer stays result in higher costs and complications. If patients are here longer simply because we're not efficient, then let's fix it."

Vautier helped fix it with an efficiency effort that saved 30,000 patient days thefirst year and 50,000 days the next.

When Vautier took over the job in 1995, her predecessor told her, "If you get the staffing right, you can do anything."

"It was a great piece of advice," Vautier said. "If you don't have the staff, you can't take care of your patients, and you're in crisis. If you do, then you can begin to think about being a magnet hospital [Emory's next initiative]."

To keep the staffing levels where they needed to be, Vautier negotiated for a flexible budget that gave nursing management the authority to add or decrease staff as needed.

"Negotiation is a major issue for a lot of nursing leaders. They know what's right, but they don't know how to get there," she said.

Vautier learned her negotiation skills by taking a conflict resolution course from a U.N. trainer at Teacher's College, Columbia University.

"For one summer I argued pro or con on different subjects three days a week. It taught me a lot about negotiation, " she said.

Vautier learned many of her skills on the job as she moved into levels of increasing leadership and adapted to changes in health care.

"Changes excite me, and there have been so many advances in medicine in my career," she said. "We've seen a lot of volution in technology and drug therapy. Patients do well today who would never have survived when I started."

Vautier decided to become a nurse as a preteen, after watching nurses care for her mother following a stroke. She earned her diploma in 1961 and worked to become a pediatric instructor at St. Christopher's Hospital in Philadelphia.

In the mid-1970s, she wrote a $225,000 Department of Health, Education and Welfare nursing grant for the education of neonatal nurses.

"That was big money then, so they asked me to fill in as vice president of nursing for a few weeks until they could find a replacement," she remembered.

Goodbye, academia
Vautier kept the job for four years and never went back to teaching.

"I thought education was the way to make changes, but when you have the money and can see what isn't working and can think strategically about what will work - then changes happen. I stayed in nursing administration, " she said.

After earning her master's degree, Vautier honed her skills working for a nursing consulting firm. That experience gave her exposure to different management styles and opportunities to fix problems at several hospitals.

That led to a job as vice president of patient services at Cabell Huntington Hospital in Huntington, W. Va., where she started a helicopter transport system.

"That's one of my proudest accomplishments, " Vautier said. "Ambulances traveling over twisty mountain roads could take three hours to reach us, but a helicopter could get a patient here in 20 minutes. How those EMTs saved people's lives was incredible.

"I had always been inspired by a photo of Mary Breckenridge wearing leather boots on horseback for the Kentucky Frontier Nursing Corps. I never did get to wear boots, but I'm proud to have helped build that service."

Another career-defining event came unexpectedly about 18 months ago.

"An elderly patient came to see me. I thought it was a complaint, but he wanted to give me the name of the nurse who saved his life," she said.

"Later, on the boat, I realized that we get so involved in the minutiae of working that we forget that we save people's lives every day. I knew it, but I didn't know it. Now, in staff meetings, we talk about that daily, and I hear the most amazing stories."

Vautier plans to move to Key Largo, Fla., but not to leave nursing.

"If I taught at Florida International University, I could take my boat to work," she said with a grin. "Wouldn't it be neat to ask students to meet me at the dock and throw me a line?"