Becker's Hospital Review

28 Special Section: Leadership & Development 10 Ideas That Hospital and Health System CEOs Need to Ditch By Bob Herman T oday's hospital and health system leaders can learn a lot from George Bernard Shaw, the famed Irish writer and social critic. He is renowned for the following passage: "The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man." healthcare leaders shouldn't rest on those types of laurels, though. They need to watch and listen to their employee and patient base continually to ensure they get as close as possible to total systemic satisfaction. Now, more than ever, hospitals and health system CEOs cannot sit on their hands as new care delivery models, payment systems and other changes flood the healthcare system. For CEOs and other leaders who may believe the new healthcare reforms and social norms will not apply to their institutions, there is no more time to be "unreasonable," as Mr. Shaw put it. "The reality is, we don't think it's good enough," Dr. Feinberg says. "Despite having the best doctors, an incredible nursing staff, great new buildings, the highest level of quality, the 99th percentile means that only 85 out of 100 patients would recommend us to family and friends. That's still failing. That's someone's mom or brother or co-worker. New patients that come don't care what we've done. They just care how we treat them and what's affecting them at that moment. It's a very focused environment on the current patient because we want perfect care today." Several of the nation's most progressive CEOs have signed onto this thought process — David Feinberg, MD, Chris Van Gorder, Dean Gruner, MD, Bill Carpenter and many others outlined below. More specifically, here are 10 ideas that CEOs need to cast aside and what the alternative leadership strategy should be, and how those hospital and health system CEOs embody "new school" ways of being "reasonable" and progressive. 3. Old: Knowing everything and dictating the work. New: Knowing your leadership and trusting them. The title of hospital or health system CEO has the most name recognition of anyone on staff, but that does not mean an authoritarian type of leadership should prevail. Instead, Mr. Spiegelman says CEOs need to have loyal staff around them, especially in the C-suite and upper management positions. 1. Old: Micromanage your employees. New: Empower your employees. Micromanagement usually has the reputation of being occasionally effective but highly unpopular with employees. Employees may get their tasks done if leaders consistently round in, but that lack of trust and overt shoulder-watching could erode the employee base. Bill Carpenter, CEO of LifePoint Hospitals based in Brentwood, Tenn., says that idea is at the forefront of his company — and it has to be for health systems as large as LifePoint. LifePoint operates 56 hospitals across the country. Without his individual hospital C-suite leaders, division managers and other headquarters management team members, Mr. Carpenter says he would not have a culture conducive to progressive change. Paul Spiegelman, author and founder/CEO of BerylHealth, a firm focused on improving healthcare experiences, says this new school strategy of empowering employees — along with the other nine strategies he outlined — is vital for CEOs to adopt if they want to attain success within today's healthcare environment and their own organization. David Feinberg, MD, CEO of Ronald Reagan UCLA Medical Center and president of the UCLA Health System, agrees that a forward-thinking health system leader must empower his or her employees to do the right work instead of hounding for results. If a hospital or health system is looking for the right physicians, nurses, frontline staff and other caretakers during the hiring process, then trust should come easily. "It's very clear no matter how skilled I am as a physician, I can't care for 1.5 million patients per year," Dr. Feinberg says. "That requires a workforce that's completely engaged. We just have the expectation that [employees] will treat everyone with the highest level of care and will be kind to everyone along the way." 2. Old: Management by walking around. New: Management by watching and listening. CEOs that believe roaming the halls will suffice as a positive management style may need to think again. Hospital administrations need feedback and criticism to know what they are doing right and what needs improvement, and those elements can only be found by talking to the lifeblood of the organization, Mr. Spiegelman says. Dr. Feinberg takes this idea to heart at UCLA, especially when it comes to the health system's patients. Every day for a couple of hours, he meets with patients to ask how they are doing and what he can do to assist in their care. He even dishes out his business card and cell phone number — available 24 hours a day — to make sure patients have what they need. Consequently, UCLA has some of the highest patient satisfaction rankings in the country, hovering around the 99th percentile. Dr. Feinberg says "I don't think any single leader can make an organization successful on his or her own," Mr. Carpenter says. "I think leaders have to surround themselves with talented people in order to be successful and for the organization to be successful. The primary responsibility of a CEO is to establish a culture and strategy that will guide an organization through a period of time. Great leaders help other people understand what their role is, what their contributions are and help keep them focused on the key things that are going to make a difference for the organization." 4. Old: No mistakes are allowed. New: We learn from our mistakes. While this is not groundbreaking news, it never hurts to remember that humans are not error-free. Mistakes happen, and ignoring that fact would only be an impediment to becoming a more "reasonable" leader. Gary Newsome, CEO of Health Management Associates based in Naples, Fla., believes learning from decisions gone awry makes CEOs and other executives stronger — and at the very least, mistakes give a dose of humility for future decisions to be made. "I think probably what I've learned the most [over the years] is when I failed to make a hard decision that needed to be made in a timely basis," Mr. Newsome says. "When you're dealing with people and dealing with people's lives, it's hard to make difficult decisions. In reality, to guide an organization of this size, 40,000 associates, you have to make hard decisions sometimes…and the best way is to hit [those decisions] head on." 5. Old: Physicians are the customers. New: Physicians are our partners. Physicians have always been the cornerstone care provider in the health delivery system, and they are becoming even more important as hospitals and health systems partner with physicians through employment agreements, accountable care organizations, bundled payments and other physician-centric reform efforts.

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