Becker's Hospital Review

15 CEO / STRATEGY These CEOs are leading by listening By Madeline Ashley W hile the commotion of a hospital and health system CEO role can make it difficult to keep one's finger on the pulse of an organization, many leaders are taking a step back to authentically connect with their employees, so they feel not only seen, but heard. In fact, a strong culture in a healthcare setting makes everything easier, Lee Boyles, president of Intermountain Health's Montana and Wyoming market and president of St. Vincent Regional Hospital in Billings, Mont., told Becker's in June. rough leadership engagement with caregivers and physicians, hospitals and health systems can see positive effects in areas such as cost effectiveness and patient experience. "At the end of the day, all strategies boil down to the culture of the organization," Mr. Boyles said. "A positive, engaged culture supports caregivers and ensures success in all areas. People are more mobile now and they move for better opportunities. Focusing on culture is critical; it's the foundation for quality, safety and patient experience." At Altru Health System in Grand Forks, N.D., CEO Todd Forkel uses his "Shadow Me, Todd" program to strengthen that culture. In the program, Mr. Forkel shadows a different health system employee two to four times a month. From sitting in on surgeries to physical therapy, the program has allowed him to improve his leadership skills by getting firsthand experience of the challenges his employees deal with on a daily basis — in addition to the successes they achieve. "Every time I do it, I walk away with something that is a learning for me, or something that I wasn't aware of, or a challenge that maybe I could help out with," Mr. Forkel told Becker's. "I think it always helps you as a leader to remember that decisions you make have a trickle- down effect to where, in our case in healthcare, where the care is delivered." Matthew Love, president and CEO of Miami-based Nicklaus Children's Health System, runs a similar program at his organization called "Chat With Matt." is program allows health system employees, mainly front- line workers, to connect with Mr. Love for informal and intimate conversations. e discussions can run anywhere from five minutes to over an hour and are held multiple times a quarter. "ey can ask me anything they want. It's very open-ended, transparent," Mr. Love told Becker's. "ese 'Chats With Matt' really have proven a way to hear what's happening in the organization from the people that are actually doing the work." In Atlantic City, N.J., AtlantiCare CEO Michael Charlton had learned of challenges faced by his organization's on-call staff, such as the potential cut to on-call pay and disruption to employee schedules, and decided that he needed to act. Holding true to a leadership mantra of "be visible, be kind," Mr. Charlton began spending time in the emergency department at night. From being forced to shut off water one night at the hospital due to citywide water contamination to multiple shooting victims seeking care, Mr. Charlton was able to see the nightly happenings his employees experienced by putting himself in their shoes. ese experiences are what led to a change at the health system, with Mr. Charlton ensuring that administration is in the building nightly and on weekends to create a structured presence of support. "We talk about retention, employee engagement and employee satisfaction and how to solve those challenges," Mr. Charlton told Becker's. "e answer is boots on the ground. It's being there, engaging with the people doing the work to understand their challenges." n 'A huge economic issue,' per Scripps' CEO By Mackenzie Bean A surge in hospital boarding is straining the finances of San Diego-based Scripps Health, forcing the health system to make tough decisions about its care services, Newsweek reported June 18. Scripps cares for nearly 35,000 patients annually who remain admitted — even when not medically necessary — because there are no openings for them at long-term or post-acute care facilities. This tally is up 109% from three years ago and comes at an average cost of $1,912 per patient per day. Many of these patients are covered by Medi-Cal, which pays the system about $704 per patient daily. The health system spent $45.7M caring for these patients in the 12-month period ending this April, according to the report. "This boarding issue, it's a huge economic issue for us," Scripps President and CEO Chris Van Gorder told Newsweek. "It's a patient care issue, but it's also forcing us to make very difficult decisions about the services we can offer so that we can have enough beds to put the patients in." In March, Scripps shared plans to transfer its obstetrics services from Scripps Mercy Hospital Chula Vista (Calif.) to its Scripps Mercy Hospital San Diego campus. Mr. Van Gorder said the move will help free up beds at its Chula Vista campus in anticipation of intensified boarding challenges expected to come this January when California's Senate Bill 43 takes effect, expanding the criteria for involuntary 72-hour hospital holds. To help alleviate the strain on hospitals, Mr. Van Gorder has advocated for higher federal reimbursement rates and for extending regulations such as the Emergency Medical Treatment and Active Labor Act to require post-acute facilities to accept more complex, federally- insured patients. He contends that some facilities perform "wallet biopsies," prioritizing admissions for commercially insured patients over those covered by Medi-Cal or Medicare. n

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