Becker's Hospital Review

35 THOUGHT LEADERSHIP Amid 'hard decisions,' Jefferson Health CEO puts culture front and center By Kelly Gooch J efferson Health is on a journey toward building a unifying culture as it adapts to growth and changes, according to its leader. The Philadelphia-based system has gone through a number of changes in recent years. It grew from three hospitals to 18 between 2015 and 2021 via mergers and has more than 42,000 employees. In 2021, it also acquired Health Partners Plans, which will be rebranded as Jefferson Health Plans, beginning with its Medicare plans in 2024. And in July, the system said it would cut 400 jobs. "It's been a rapid change in our rapid expansion without really accounting for a unifying culture," Joseph Cacchione, MD, CEO of Thomas Jefferson University and Jefferson Health, told Becker's. "And I think we're taking a step back, and we're going to be [considering], what kind of unifying culture are we looking to build? And what are we going to be doing to help enable that culture in a way that it sticks across the system?" Dr. Cacchione, who recently made the CEO Forum Group's latest list of the "Top 10 CEOs Transforming Healthcare in America" under the culture category, views the process of building unifying culture as starting with an organization's core values. He said this means identifying what the organization wants its culture to represent, then creating repetitive behavior. "That starts at the leader level," Dr. Cacchione said. "When I talk about things, I'm talking about things that we're trying to instill in this culture, and we repeat that over and over" across the organization. He gave the example of empowering people. "We want that to be part of culture here, that people feel empowered, [no matter] the part of the business they're in, to solve problems," Dr. Cacchione said. "They're empowered to be the best stewards of the people they're serving, whether it be a patient, a student or a beneficiary." He said he believes humility is also "very important from the top all the way down, because what humility allows you to do is to be open to others. It allows you to listen better and listen more intently. And it allows you to be more empathetic. So humility is, to me, a key component of the culture we're trying to build, [along with] empowerment." Jefferson Health is on this journey of building a unifying culture amid business changes. In January, the system announced a reorganization plan to operate as three divisions instead of five to flatten management and improve efficiency. The system noted the change would result in layoffs, primarily among executives. In July, Jefferson Health announced it would reduce its workforce by approximately 1 percent, or about 400 positions. "Culture will always supersede, but there are business realities that we need to address," Dr. Cacchione told Becker's. "In any healthcare organization today, there are a lot of hard decisions being made. The way we approach this is to be open and communicate and be very transparent, that we always start with the truth. And the truth is this was part of helping to make Jefferson more financially sustainable." He added that this "doesn't change the fact that Jefferson Health is trying to build a culture, but in every business, hard decisions have been made." n "I was just Linda the new person," Ms. Matzigkeit said. "I didn't want them to know. I wanted to be treated like anyone else, checked up on my skills." Now, Ms. Matzigkeit works one shi a month in the emergency room. e challenge has given her a better understanding of what front-line staff go through, and how the C-suite can meet them where they are. For example, she quickly learned that existing methods of communication were not the most effective. "I think we [as executives] thought everybody reads their emails and everybody looks at the internet, but what I realized is that you are so busy, particularly when you're working in the emergency department, that you aren't looking at your emails. You are taking care of patients," Ms. Matzigkeit said. Now, the hospital has pivoted, showing important information on screens in the break room and on handouts people can mull over while taking meals. Managers play a more hands-on role in information transmission during daily huddles, ensuring the pressure to keep up doesn't fall squarely on front-line staff themselves. She has also learned the value of a good preceptor — hers was the same age as her son — in showing new workers the ropes. And she recognizes how important a strong supply chain is, since running out of gauze or a single needle size can "really impact a shi." "I think I've become a better listener," Ms. Matzigkeit said of her leadership style. "I can say [to the rest of the C-suite], 'Let me tell you how it really works' — I can advocate better for the front lines because I've walked in their shoes." e dual perspective has illustrated gaps in the C-suite and front-line staff 's understanding of one another, according to Ms. Matzigkeit. e front lines don't understand how challenging it is to make all the executive decisions, how much heart and consideration goes into every choice. And leadership doesn't understand just how hard it is on the ground, trying to provide patient care while understaffed and under- resourced. If every C-suite leader was required to spend time in a front-line worker's shoes, "it would be a game-changer," Ms. Matzigkeit believes. "e front-line staff would learn so much from them, and the executives would see that it's a tough job," Ms. Matzigkeit said. "It really is." n

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