Karen Feinstein and the Foundation That Refuses to Think Small
Type: Profile
Karen Feinstein receiving the Impact Award at the Pittsburgh Business Times Women of Influence event on May 14. Photo courtesy of the Pittsburgh Business Times and Jim Harris.
Dr. Karen Wolk Feinstein has spent much of her life asking a deceptively simple question: how do societies change for the better?
Over more than three decades leading the Jewish Healthcare Foundation (JHF), she has pursued that question with intellectual rigor, strategic persistence, and moral urgency, helping transform Pittsburgh into a national center for healthcare quality improvement, patient safety, women’s health advocacy, and healthcare innovation.
The roots of that mission stretch far beyond the Foundation’s walls. They begin in war, loss, activism, civic reinvention, and an abiding belief that institutions—if led boldly and ethically—can improve human life.
History Major wants to Make History
The story of Dr. Feinstein, known to partners and colleagues as simply Karen, begins before she was born. Her father, a Navy pilot from Des Moines, Iowa, fought in nearly every major air battle in the South Pacific during World War II. He was shot down over Tokyo near the war’s end, months before his daughter was born.
Four years later, her mother remarried a Pittsburgher, and Karen became part of a large, blended family that deepened her appreciation of community, caring and belonging. Five generations of her family remain rooted in Pittsburgh’s Squirrel Hill neighborhood — a continuity she treasures deeply.
“The bottom line is that I love large, close-knit families who connect across generations. I’m fortunate that my three children and spouses all returned to Pittsburgh and gifted us with six remarkable grandchildren. We live close to each other in Squirrel Hill within walking distance. That is my gift,” Karen said appreciatively.
While family grounds her now, it did not necessarily shape her intellectually or politically in her early years. Karen describes herself as the “crazy social activist” in her childhood home, an independent thinker whose interests and politics often puzzled her family. That individualism would become a defining characteristic of both her leadership style and her career.
Her activist spirit was first ignited when she was 12 years old and visited a friend in Georgia during the Jim Crow era. The racism she witnessed shocked her. Later, while pursuing her bachelor’s degree at Brown University during the turbulence of the 1960s, she immersed herself in the Civil Rights Movement, working with the Urban League on school and housing desegregation and voting rights after class.
Karen Feinstein and family
During those years, three landmark Civil Rights Acts became law. Karen came to believe not only that social systems could change, but that ordinary people had both the power and responsibility to push them forward. “My brother claimed I never met a movement I didn’t like.”
“I had two wonderful professors in Constitutional Law and American Social and Intellectual History who believed I could fashion a career out of my academic interests,” Karen said. “And I believed that big social change was possible.”
That belief propelled her into public service.
Her early work in the War on Poverty movement gave her extraordinary responsibility at a young age. At just 24, she was entrusted with millions of dollars to establish Head Start programs, senior centers, and youth development initiatives in Worcester, Massachusetts. The experience reinforced her conviction that institutions were not fixed structures, but systems capable of reinvention.
“I understood the power of social change,” she recalls. “We were ambitious. We were trained as activists. We thought that we were entitled to change the world, and that we could. I took that chutzpah from the War on Poverty, and I brought it to the foundation world.”
Building a Foundation at the Intersection of Activism and Philanthropy
Health care itself was not initially her calling.
In 1990, when Karen was approached to lead what would become JHF, she repeatedly declined the offer.
After graduating from Boston College School of Social Work with a master’s degree in social planning and earning a PhD in economics from The Heller School for Social Policy and Management at Brandeis University, she was a faculty member at Boston College and then Carnegie Mellon University (CMU). While at CMU, she also accepted a position as senior vice president at the United Way of Allegheny County.
Those years at the United Way placed her within a remarkable generation of leaders working to reinvent Pittsburgh from an industrial city in decline to a center of education, health care, and innovation.
The experience also profoundly shaped her understanding of leadership.
She credits those business and civic leaders of the 1980s and 1990s — figures like Paul O’Neill, Chuck Queenan, Alvin Rogal, Drew Mathieson, Rick Stafford, Justin Johnson, Moe Coleman, Dan Rooney and Dave Roderick —with teaching her how transformative leadership could operate. What stayed with her most was not simply their vision, but the way they shaped the next generation.
“Mentorship is inviting new faces to the table—into the room where it happens,” Karen recalls. “They believed in cultivating a younger generation of leaders, and they were there to smooth out wrinkles and provide a helping hand. It was needed often.”
Eventually, the opportunity to build something entirely new became too compelling to refuse, persuading her to consider the role at JHF.
The Foundation was created following the sale of Montefiore Hospital, itself founded by women in Pittsburgh’s Jewish community in 1908. Karen had aspirations that it could become a variation on a traditional grantmaking institution. She hoped to create what she calls an “activist foundation”, a think tank with an endowment —an entity that went beyond simply studying problems or providing funding for others but intervened directly in finding solutions.
“I wanted to create something original at the time,” she said. “I realized early on that being conventional, ‘going along to get along,’ wasn’t fruitful. Carving out unique space allowed us to expand our vision of what a foundation could accomplish.”
Building that vision wasn’t easy.
Operation KidShot, a project to immunize children in Southwestern Pennsylvania against preventable childhood diseases.
Karen encountered resistance from some within Pittsburgh’s Jewish community who did not share her vision of what this new foundation whose assets came from the sale of Montefiore should be. At one point, she seriously considered leaving. Her position at CMU was still available.
Her mentors ultimately convinced her to stay.
“They cheered me on, even as a few people within my own community were downright hostile. They (my mentors—many on the new JHF Board) told me, ‘You can’t just walk away. You made a choice. Now make it work for you’.”
She did.
JHF quickly distinguished itself through an unusually hands-on, action-oriented approach to philanthropy. Rather than scattering grants broadly, it concentrated on a few problem areas where it believed measurable change was possible and where she saw a path to success. She is still working on those same issues.
“I took the ‘seed’ and with the help of some extraordinary leaders in the Jewish and outside community, started to plant an orchard. We took on focus areas that others didn’t want or weren’t addressing,” Karen says. “And I’m glad I stayed.”
At a time when many organizations hesitated to engage with HIV/AIDS because of stigma and fear, JHF stepped forward wholeheartedly, eventually becoming the state’s fiscal agent for HIV/AIDS programs in southwestern Pennsylvania, a role it still holds today.
Steve Halpern, Nancy Zionts, Karen Feinstein, Dodie Roskies, and Chuck Cohen review blueprints for the Squirrel Hill Health Center in 2006.
Under Karen’s leadership, JHF developed a reputation for identifying urgent problems before they entered the national mainstream. The Foundation launched public health campaigns focused on immunizations, breast cancer screening, HPV vaccination, maternal health, workforce development, nutrition and healthy aging, while also expanding into policy reform. JHF broke ground in integrating behavioral health into primary care, healthcare workforce training, and community-based care models for older adults. JHF even secured funding for what became the Squirrel Hill Health Center.
Beyond grantmaking, JHF increasingly functioned as a laboratory for systems change — funding collaborations; advancing the use of data for quality improvement; creating four fellowships; producing books, serious academic papers, a podcast series, and two documentaries that went on to major film festivals. JHF took on leadership roles in promoting Children’s Health Insurance (CHIP) and the Affordable Care Act.
“We didn’t set limits on ourselves. We incentivized patient safety technology innovation by funding prizes at hackathons and competitions on college campuses; we even took the stage at the Consumer Electronics Show.”
Its work increasingly reached national and global audiences through national training programs, international study tours, statewide convenings and innumerable panels and conferences, helping position Karen as a thought leader, the Foundation as a think tank, and Pittsburgh as a recognized center for healthcare innovation and patient safety. In 2025 alone, the Foundation secured roughly $30 million in outside public and private funding to support its educational and programmatic initiatives.
But perhaps no issue became more closely associated with Karen than patient safety.
In 1997, she partnered with then-Alcoa CEO Paul O’Neill — nationally known as “The Safety CEO” — to launch the Pittsburgh Regional Health Initiative (PRHI), an ambitious effort to apply industrial safety principles to healthcare systems. At the time, preventable hospital errors were claiming tens of thousands of lives annually across the United States.
Karen and O’Neill believed health care’s fragmented systems, diffuse accountability, and tolerance for avoidable harm could no longer be accepted as inevitable.
The results proved transformative. Beginning in 2001, PRHI convened infection-control practitioners and infectious disease physicians from 30 Pittsburgh-area hospitals to share data, identify best practices, and reduce deadly central line infections. Through its Perfecting Patient CareTM methodology, PRHI helped frontline clinicians redesign care processes and pursue the ambitious goal of eliminating preventable infections—efforts that dramatically reduced infection rates and established Pittsburgh as a national leader in healthcare quality improvement.
Karen Feinstein on the cover of Modern Healthcare magazine in 2007.
Karen speaks about patient safety not simply as a technical issue, but as a moral one.
In recent years, she has advocated nationally for the creation of a National Patient Safety Board modeled in-part after the National Transportation Safety Board and Anesthesia Patient Safety Foundation, arguing that health care should investigate and prevent medical errors with the same rigor and transparency as aviation disasters.
Throughout her career, Karen has consistently demonstrated an instinct for identifying emerging issues long before they become mainstream concerns. Women’s cardiovascular health, maternal mortality, healthcare workforce shortages, longevity, and teen mental health all became major priorities under her leadership. She founded the Women’s Health Activist Movement Global (WHAMglobal) to empower women to improve healthcare systems worldwide and helped launch statewide collaboratives to reduce maternal and infant mortality in Pennsylvania.
Karen’s leadership philosophy combines idealism with a disciplined strategy.
She introduces every employee and board member at JHF to the Foundation’s “home run” model, a strategic framework designed to ensure that every initiative begins with a long-term vision, strong partnerships, implementation planning, communications strategy, and measurable impact.
“Why do something unless you can see the whole game; unless you have marked out the path to home runs and even grand slams,” Karen said. “It’s always been a decision-making filter for us at the Foundation.”
That systems-oriented mindset also informs the advice she gives younger leaders.
“Don’t swat at spiders with a Kleenex,” she said. “That gets you nowhere.”
At the center of Karen’s philosophy is a belief that meaningful social change is fundamentally collaborative. She repeatedly credits the Foundation’s success not on individual leadership, but to the networks of people who sustained and expanded its work over decades.
“If someone asked me, ‘what is your own secret sauce for making JHF effective,’ I’d say two things: superb staff and superb networks,” Karen said. “Positive social change comes from networks of capable, ethical, and smart people. It’s a collective sport and you need a team of extraordinary people to accomplish anything of value.”
Over the years, those networks have expanded across local, state, national, and international partnerships — from city and county governments to the White House, from healthcare systems to philanthropic collaboratives. “You build these these long-standing relationships and they’re priceless,” she added. “Someone once told me that my most valuable possession was my contact list.”
Today, more than 35 years after reluctantly accepting the role she once tried to avoid, Karen’s influence and networks extend far beyond Pittsburgh. National healthcare leaders have described her as both “a tour de force” and “a force of nature.”
Karen Feinstein speaks at the White House Healthcare Safety Forum in September 2024 in recognition of World Patient Safety Day. Invited by the Biden-Harris administration to represent leading patient safety organizations, she emphasized the need for real-time data, research and innovation to improve healthcare safety.
When asked what legacy matters most to her, she speaks less about awards or policy victories than about people: former fellows, interns, employees, collaborators, and young leaders who passed through JHF and went on to build meaningful careers and make change of their own. She begins each of our fellowships with: “Hello and welcome. You are our army of the revolution.”
She remains optimistic about the possibilities of social innovation but is candid about the challenges she sees ahead.
She is deeply concerned about the current political moment as public distrust rises, attacks on scientific institutions stall innovation, and the erosion of empathy takes a growing spiritual toll. Yet she still believes institutions can improve.
And perhaps that is the thread running through her entire life story: an enduring conviction that even the most complicated systems can evolve if courageous people are willing to challenge them, build coalitions, stay strategic, and persist long enough to see transformation take root.
“Be bold. Be aspirational. But above all, be strategic,” Karen advises younger leaders. “Remember that social change takes time, and perseverance pays off. BE PERSISTENT.”
More than three decades after arriving at JHF determined to “break the mold,” Karen Feinstein still believes that life is a game of scrabble. “After every major hand is played, look for opportunities, anticipate challenges and do something. Don’t linger waiting for perfection.“
From left to right: JHF Executive Vice President Danny Rosen, Karen Feinstein, and Pittsburgh Business Times Market President & Publisher. Photo courtesy of the Pittsburgh Business Times and Jim Harris.
Recognition for a Lifetime of Impact
In recognition of her leadership, Karen received the Pittsburgh Business Times Women of Influence Impact Award, the event’s highest honor, on May 14 at Acrisure Stadium. During the event, which gathered many of Karen’s closest colleagues and family, Karen was honored with a tribute video and received an introduction from JHF’s longtime grantee and partner in the community, Susan Kalson, CEO of the Squirrel Hill Health Center.
