When Madeline Bell, president and CEO of Children's Hospital of Philadelphia, and her physician husband, Louis, go on vacation, they have a pact.
They alternate between "Madeline Days" and "Lou Days." The latter entail recharging by the pool and reading good books. And Madeline Days?
"We're going to have eight adventures," says Bell, 56, from the executive offices that offer a bird's-eye view of the campus. "I'm more of a can-do, driven person." Not that her husband, CHOP's chief of the division of general pediatrics, is any slouch.
Bell calls this inability to dial down her "fatal flaw." On the job, though, that drive has propelled the onetime pediatric nurse to CEO — the first woman to lead CHOP. Along the way, she has steered the nation's first pediatric hospital, with 12,000 employees and a $2.7 billion budget, to ever-greater heights.
Since Bell assumed the top spot in 2015, CHOP has seen its footprint explode by 40 percent — 1.2 million square feet — with the addition of the new Roberts Center for Pediatric Research across the Schuylkill and the Buerger Center for Advanced Pediatric Care.
One of Bell's pride points is CHOP Care Network, the largest pediatric ambulatory network in the country. As chief operating officer for eight years and CEO, she oversaw the buildout of satellite locations from Lancaster to New Brunswick down to Cape May. King of Prussia, for one, has a 135,000-square-foot Specialty Care and Ambulatory Surgery Center.
"If a child has cancer, [he or she] can just go there," Bell says. "So not everyone has to travel to the main campus."
Bell also has spearheaded creative partnerships, such as the $42 million South Philadelphia Community Health & Literacy Center, where CHOP and city agencies offer under one roof a range of health, wellness, literacy, and recreational programs.
"We're raising the bar on ourselves all the time," she says, "and being the person who is motivating it, enabling people to do that is amazing fun."
A top priority is supporting research and innovation, Bell says. Over the last year, she increased the hospital's investment in research by $10 million. Much of the focus is on groundbreaking gene therapy and immune therapy, and last year, CHOP created the Roberts Collaborative for Genetics and Individualized Medicine. In August, the U.S. Food and Drug Administration approved the first-ever genetically engineered immune therapy to treat an aggressive type of leukemia — a drug developed at CHOP and the University of Pennsylvania.
Innovation, though, doesn't come cheap, and this year has proven particularly challenging.
"We've had incredible headwinds, greater headwinds than I feel I have had in my career," she says, pointing to the four major attempts to repeal and replace the Affordable Care Act this year. She lobbied against those efforts on Capitol Hill because "all four of those were really bad for children." Nationally, the taxpayer-funded Medicaid and the Children's Health Insurance Program covered 43 percent of all children last year, she notes.
To support its research, CHOP recently announced the public phase of its $1 billion fund-raising campaign "For Tomorrow's Breakthroughs."
"I have to constantly figure out revenue streams to support our mission," she says.
For all her success, Bell says nursing, not the C-suite, was her initial focus. In 1983, the Villanova University nursing graduate was thrilled to land her dream job at CHOP.
"I just wanted to take great care of children," she says. Bell keeps a picture of herself at age 3 under a Christmas tree wearing a white nurse's cap; as a teen, she was a candy striper.
But after a while, she started asking questions about how things are done. "Nurses have a tendency to sit around and complain," she says. "I can say that because I'm a nurse. I used to think to myself, there's something wrong with this. I need to be part of the solution vs. commiserating with everyone."
As a home-care nurse, Bell got a taste of managing nurses and that shift, she says, "got me thinking, `Gee, this is the way to influence the future.' "
In 1989, Bell left CHOP for Main Line Health, where she worked in planning and new business development and performed home care on weekends.
"I learned a lot," she says, a mantra that is a hallmark of hers. CHOP lured her back in 1995 as director of home care and case management — and Bell was on her way to executive positions.
Her path to the top, though, was not a straight shot.
"Careers are anything but linear," Bell says. "I did a lot of lateral moves." Often, she says, she was asked to take on responsibilities — say, manage revenue cycle or clinical portfolios — before she thought she was ready.
"The moral of the story is just say yes," she says.
In 2007, Bell earned a master's in organizational dynamics from Penn, wanting to cement skills in influencing people and changing culture.
But she says her most useful skill is one expected of nurses, but not always of business leaders: empathy, "not only for our patients but for the people who work here."
Bell says she makes time to interact with CHOP's frontline medical staff.
Each month, she holds a gabfest over lunch with a dozen employees. "I get great ideas," she says and often confirms or dispels rumors. "I love the rumors. Sometimes they are so funny."
Bell also takes "safety walk-arounds," visiting a unit and talking with doctors, nurses, and patients. She mentors female physician leaders, whose high qualifications don't inoculate them from the gender-based attitudes that women in all fields experience.
"They say, 'I'm an imposter. I can't do this,' " Bell says. "There is still an incredible amount of bias that exists for women."
So many young women seek her out as a mentor — more than she could ever advise — that a couple of years ago she began writing the blog "Heels of Success" with help from her daughter-in-law Kaitlin Cleary, who owns a communications business.
It offers practical tips and advice, such as where to keep business cards to avoid digging through a big purse (carry a bag with a side pocket). In one post, Bell advises a woman to "fake it 'til you make it" and what that really means.
"I've learned over time to be much more aware how I position myself," Bell says. "I've been part of groups where I'm the only woman. I feel like I have to prepare more, be more on my game."
And, she might add, never slow her pace — even on vacation.