Becker's Hospital Review

12 CEO Roundtable Strategic planning can make or break a hospital or health system's ability to adapt to changing times, best serve patient populations and preserve fragile margins. Each hospital has a slightly differ- ent way of navigating these murky waters. Here, four CEOs share their processes for building or- ganizational strategy, including who plans, when planning occurs and the biggest surprises they've faced so far. Question: Who, exactly, is in the C-suite these days? Which executive positions does your hospital or health system em- ploy, and why? Barry Arbuckle, PhD, CEO of MemorialCare Health System (Fountain Valley, Calif.): We have what you might consider traditional positions: CEO, COO for the health system, to whom hospi- tal CEOs report, CFO and CIO. We recently made a few changes in the health system positions to reflect the changing environment and to transition from a hospital system to an integrated healthcare delivery system. I recently split the CFO and treasurer posi- tions, because of the complexity of issues related to the balance sheet. The CFO is focused on system operations and responsible for all CFOs, and the treasurer is a chief investment officer. The chief transformation officer is new to us, to others and is something we'll see more of. Also, we have a new vice president for population health, vice president of business integration and vice president of real estate. For us, these new positions are reflective of where we're going; we're interested in making sure every aspect of our system is wholly integrated. Paul Bengtson, CEO of Northeastern Vermont Regional Hospital (St. Johnsbury, Vt.): We've had the same positions for a number of years. We have a CEO, the vice president for professional services (CNO), a vice president for finance, a vice president of quality services, a vice president for information services and a vice president of hu- man resources. We also have a vice president for marketing and community health improvement. I've always felt strongly that we need to focus on the health of populations where we reside, and as a critical access hospital, we do that with the many physician practices we own and manage. Toby Cosgrove, MD, President and CEO of Cleveland Clinic: Our C-suite consists of clinical and non-clinical leadership that run the business side of the health system (vs. the clinical areas in- dividually). This area includes our CEO, chief of staff, chief of clinical operations, CSO, CIO, chief legal officer, CFO, chief of human resources, chief patient experience officer, CNO, chief marketing officer, chief of quality and patient safety, chief compliance officer and others. Catherine Jacobson, President and CEO of Froedtert Health System (Milwaukee): Our C- suite includes a CEO, COO, CFO, CMO, CSO, chief legal counsel, a human resources executive and the president of our medical group. We will soon bring on a health IT [executive]. I think nowadays the CMO plays a bigger role than ever before, because redesigning the care model touch- es on everything any hospital or health system does. Essentially, what the CMO does is a big part of where you're going to be. Q: How often does your C-suite strate- gically plan, and with whom? On which areas do you focus? Dr. Arbuckle: We follow a structured, disciplined process in terms of who is involved and the tim- ing of planning. Planning begins with a strategic retreat with our parent board of directors and the heads of strategy committees for each of our enti- ties. The committee annual retreat is in Novem- ber for the fiscal year that begins seven months later. Sometimes we'll bring outside speakers with expertise or perspectives on strategy. Then the C- suite has an annual meeting in January to queue up the planning process, in which we go over what needs to be done, when and by whom. We are all very involved in setting the plan and tactics for the health system. We plan for the next year, for three years and five years out. In late February the plan is distributed to all entities, whose task is to develop their own strategic plan that fits into the umbrella of the system plan. A key component of our planning process involves communicating with every manager and every employee so they understand their role in where the organization is heading — how their job fits into that picture. Mr. Bengtson: We have a written strategic plan, but we keep it summarized as a one-page matrix with mission, vision and values. Every single thing we do in our monthly working committee meet- ings has to relate to that planning matrix. We of- ficially update our strategic plan once a year, but I like to think we're continuously planning. We also are connected through the New England Alliance for Health to the Dartmouth-Hitchcock Medical Center [in Lebanon, N.H.], which is our main referral center in the area. We strategically plan once a month with them as well. Dr. Cosgrove: Cleveland Clinic has a strategic plan developed and driven by the CEO, the chief strategy officer and with great input and involve- ment from leaders across the organization and its physician leaders. We have used input from consultants, but the primary responsibility is with the key leadership. We have a focus on seven key areas such as, but not limited to: safety and quality initiatives, enhancing patient experience, strategic growth, continuous improvement and efficiency, cost reduction to drive affordability, regulatory CEO Roundtable: The Evolution of the C-Suite By Ellie Rizzo Barry Arbuckle, PhD Toby Cosgrove, MD Paul Bengtson Catherine Jacobson

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