Becker's Hospital Review

Special Section: Leadership & Development With that in mind, it's essential for CEOs to not make the mistakes of the past. Namely, don't treat physicians as if they are merely consumers that need to be sold something. Glenn Fosdick, president and CEO of The Nebraska Medical Center in Omaha, says hospital leaders need to foster an environment of collaboration in both recruitment efforts as well as ACOtype initiatives because hospitals need physician support to have a chance of being successful. "When it comes to our staff, it's not just one physician. Our high-performing staff is physicians, their supporting staff and the environment that is needed to attract these types of high-quality physicians," Mr. Fosdick says. "We've been fortunate that we have some incredibly talented people here, and in my years of experience, good physicians attract other good physicians." 6. Old: Having clinical competency is enough. New: Clinical competency is expected, and collaboration is required. In order to be a CEO of a hospital or health system, it is generally expected that person knows the basics of clinically important routines. This is not to say a CEO must be a physician or other provider, but a certain level of "clinical competency" is expected, Mr. Spiegelman says. However, clinical competency is not enough anymore. Case in point is Fred Hunter, RN, president and CEO of Marina Del Rey (Calif.) Hospital. Mr. Hunter began his career as a nurse, and as he worked his way up the ranks, he realized his clinical background and ability to collaborate with clinicians gave him an advantage, especially when it came to communication. Physicians and nurses becoming CEOs of healthcare organizations is certainly on the rise, but the business-minded CEO certainly still has a place — he or she just has to take that clinical competency to the floors to further communication. "Even to this day, I'm able to put myself in the nurses' place or employees' position, understand what they [may be] experiencing at a point in time and explain my vision," Mr. Hunter says. "I'm able to empathize with them [regarding] the challenges they're going to experience and put in safeguards to address those concerns that they may experience." 7. Old: Buy a lot of new technology. New: Invest in people and culture. While new CT scanners and electronic health records are vital components of any 2000s-era hospital and health system, they alone do not keep patients well. It is the physicians, nurses, staff — the people — that create a culture of comfort and stability. Two health system CEOs epitomize this leadership strategy: Dean Gruner, MD, president and CEO of ThedaCare in Appleton, Wis., and Chris Van Gorder, president and CEO of Scripps Health in San Diego. Both men are so convinced their employees and people make for the best environment that they have adopted "no layoff " philosophies, meaning their employees will not see layoff notices unless there is a catastrophic event or hospitals close down. A "no layoff " philosophy sounds bold amidst the toughest economic recession since the Great Depression, but both Dr. Gruner and Mr. Van Gorder say their organizations have become better holistic institutions due to their commitment to their employees. "I'd get emails from employees, saying thank you because they were the only person in the family who has a job," Mr. Van Gorder says. "People can count on their job at Scripps to get through the recession without families falling apart. By supporting people, you end up with a much better culture and employees that are more motivated to help you through these challenges ahead." 8. Old: Demand change. New: Nurture change. CEOs who desire to become more "reasonable" in their leadership styles must define the fine line between demanding change and nurturing change. Demands can often come across as commandeering and overbearing, but CEOs still must prod employees toward a new norm.   29 Paul Levy, former CEO of Boston-based Beth Israel Deaconess Medical Center, recommends hospital leaders lose the old idea of martial law leadership and instead nurture new outcomes through Lean principles. Lean techniques, which are centered on preserving a group's value-based motives, aim to reduce the waste, and leaders can drive Lean principles by training the staff to identify immediately when something goes wrong. This process allows CEOs to set a framework for the change desired, but physicians, nurses and other employees are the actual agents of change. 9. Old: Gloss over drivers of chronic diseases. New: Promote holistic health and well-being programs. Chronic diseases are the leading drivers of higher healthcare costs, and many chronic diseases can be avoided through improved lifestyle decisions. For example, many of the nation's preeminent health systems, such as Cleveland Clinic, have honed in on one specific lifestyle decision: eliminating fried foods from their cafeterias. Hospitals and health systems are going after fried foods and unhealthy diets for one obvious reason: They contradict health systems' visions of curbing chronic disease. Kaiser Permanente in Oakland, Calif., recently signed a commitment with Partnership for a Healthier America, an initiative to solve the country's obesity crisis, to improve food offerings in its 37 hospitals, and other hospitals are also looking to end contracts with fast food chains like McDonald's. Executives at Children's Mercy Hospitals and Clinics in Kansas City, Mo., took an extra step, as they recently announced the hospital will no longer offer soda or sugary beverages in its cafeteria, vending machines or gift shops. UCLA Health System also does not sell fried food, encourages "Meatless Mondays" and always has a vegetarian option on hand. Additionally, any revenue from soda and other sugary drinks is used to subsidize UCLA's salad bar, which is organically grown and locally sourced, which Dr. Feinberg believes helps root out a major cause of today's chronic disease epidemic. "We believe in promoting health," Dr. Feinberg says. "We serve roughly 12,000 meals a day, and none involve fried food. We are trying to promote this type of healthy eating." In addition, many large hospitals and health systems throughout the country — Detroit Medical Center, Baylor Health Care System in Dallas, Henry Ford Health System in Detroit, Geisinger Health System in Danville, Pa., Massachusetts General Hospital in Boston and most hospitals in California, among numerous others — have banned tobacco and/or smoking from their campuses due to the undeniable link between tobacco and cancer/chronic disease. Some health systems have even stopped hiring smokers and tobacco users altogether. 10. Old: Formal leadership. New: Informal leadership. While formal business attire was practically mandatory decades ago, the same is not true today in many work environments. In fact, the example of business attire is only a metaphor for the evolving informality of today's businesses. Mr. Spiegelman says hospital CEOs have to let go of the idea that suit coats are the only way to present oneself — in other words, don't be constricted to the formalities of the past because they will only hinder from embracing the widely accepted informalities of today. Mr. Spiegelman says all of the 10 "new school" ideas revolve around the theme that leaders must conduct introspective evaluations of their own leadership styles. To reiterate George Bernard Shaw, no CEO should want to be the "unreasonable" person that stands in the way of healthcare reform. "Everyone is scrambling to do things a different way," Mr. Spiegelman says. "While there is a big focus on patient-centric care, I believe we're missing the point if we don't realize that before we improve patient care, we have to change the way we lead in our organizations. It requires looking inside first, and all of these ideas relate to methods of leadership if we're going to survive over time." n

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