Becker's Hospital Review

48 F our health system CEOs from different parts of the country weigh in on the most important thing they do, the biggest chal- lenges they've faced in the past year, the complexi- ties of healthcare technology and what in health- care is most in need of change. Question: What is the most important thing a hospital or health system CEO can do today? Dr. Steven Altschuler: When people talk about what makes a leader great — and I think this is especially true when they are referring to CEOs — they talk about the leader's ability to simul- taneously manage the present, selectively forget the past and create the future. We know there is change on the horizon. The change is prob- ably not moving as quickly as we once thought it would, based on the [Patient Protection and] Affordable Care Act and other forces, but there's definitely a need to focus on the work underway today while at the same time understanding what the future might hold for the organization. Dr. Steven Safyer: At Montefiore, our most im- portant focus is the patients and their families, and the patient experience is our first priority. This means tending to [patients'] medical needs as well as their mental health and social needs, treating the whole person. Montefiore physicians, nurses and others on the care team have always responded to our patients' needs in innovative ways. We incorporate that emphasis on the pa- tient experience at our Centers of Excellence in cardiovascular services, oncology, transplantation and pediatrics, offering multidisciplinary exper- tise and well-coordinated care. We foster and vigi- lantly work to support a culture and environment in which all Montefiore associates can succeed in providing an optimal patient experience. Warner Thomas: The most important thing a hospital or health system CEO can do is create a clear strategic direction for their organization and make sure it's properly communicated to the board, management and employees — and that it is fully understood throughout the organization. As CEO, my job is to lead the team. The CEO also has to set the tone for the culture of the organization and the expectations within the organization. At Ochsner, we always talk about patients first in everything we do. We started our Power of One communications initiative to re- mind every employee that each one of us makes a difference and that each one of us plays an impor- tant role, no matter what your job title, in how we take care of our patients. Dan Wolterman: The most critical thing an execu- tive leader can do is set a clear and compelling vi- sion with easy-to-understand strategic initiatives. All constituencies, including employees, physi- cians, boards and the community, should clearly understand where our system is going and how it will get there — that's the most critical thing. Q: What has been the biggest challenge for you or your organization in the past year? How are you overcoming it? SA: The biggest challenge for CHOP is keeping up with the demand for our services. One of the things that sets us apart is that we are much more than a hospital – we are an integrated pediatric healthcare delivery system that attracts patients from throughout our region, across the country and around the world. We offer very high-end, specialized quaternary pediatric healthcare ser- vices, and there is great demand for those services — especially for things like in utero surgeries and unique cancer therapies. Keeping up with this de- mand has been our greatest challenge, but it has also kept us operationally and financially healthy. We're in the midst of a very large construction pro- gram, with about $2.5 billion invested over the next seven years. The ability to manage that type of con- struction and development and pace of growth is a challenge. CHOP has invested more than $1 billion in construction on our main campus — hundreds of millions in facilities in our Care Network, invest- ments in IT and other infrastructure. Our Care Network is an important part of our growth strategy, and one way we build the net- work is by forming relationships with providers in our region. Right now we're evaluating six new relationships with other community providers that we could potentially include in our network. SS: Opportunities arise out of challenges; once you understand that, you can embrace them as vehicles of change. Our most recent challenge has been the expansion of our health system. The ad- dition of two new hospitals, a freestanding emer- gency department, a nursing home and range of ambulatory services has created a broader geo- graphic reach, transforming our entire system. In addition, a redefined relationship with our academic partner, the Albert Einstein College of Medicine, is enhancing our ability to respond to changing healthcare and medical education landscapes. Over the past several years, the part- nership has enabled us to recruit the nation's leading clinicians, scientists and researchers, so that we may offer the most advanced bench to bedside treatment for our patients. The new re- lationship, in which we will play a more active role in daily operations, ultimately strengthens each institution. Our continuing growth is certain to bring new challenges. We must support our strategic expan- sion and maintain our successful model while integrating best practices that exist in the new institutions. WT: Like everyone in our industry, we are manag- ing a significant amount of change as we aggres- sively transform from volume to value. Managing this change, such as the impact health exchanges, innovation and technology will have on the in- dustry, can be challenging for both the manage- ment team and for the employee base. We have to make sure we understand the change and can communicate how we intend to address it. That's why it's important to have the right people in our organization…and the right people in the right positions. Our leaders need to be good at managing change and being master communi- cators. If not, you have to make the appropriate adjustments to ensure success. DW: We're blessed at Memorial Hermann to be in the wonderful market of Houston. We are in a strong, vibrant economy with the population growing by more than 1 million people every eight years. Our biggest challenge is capital allocation among many worthy strategic initiatives. We have to grow our system since most of our hospitals are full every day. How do we continue to provide needed services to the community and grow with the community during these changing times? This is a unique characteristic of the Houston market, the hottest economy in the U.S. for the last five years. Is that a long-term phenomenon? Probably not, but Houston has a population of about 6.5 million people, soon to be 7 million. So when I say resource allocation, it includes both capital and people. How do we attract and retain the best people, particularly clinical personnel, when there is such a shortage of them? Q: What are some unique circumstances facing your organization? Are any espe- cially helpful or thwarting? SA: We do have a good payer mix for a children's hospital, but we serve patients in southeastern Pennsylvania and from at least two states that border our Main Campus — New Jersey and Del- aware. All have different Medicaid plans and dif- ferent Medicaid managed care players, and some of these plans are difficult to maintain relation- ships with. I think that's definitely a challenge. SS: As the national healthcare system shifts, we are in a unique situation to support our way of pro- viding care. Montefiore was an accountable care organization before ACOs existed to manage our patients' chronic conditions and keep them out of the hospital. This has been Montefiore's model and we know from experience, including having the best performance of 32 Pioneer ACOs in the first year of the program, that the model works. We embrace the opportunity to be accountable for the quality of our care, our patient outcomes and the cost of our care. WT: In Louisiana, we have a fairly large indigent population and a significant amount of chronic disease such as diabetes, stroke and heart disease. As the largest nonprofit healthcare provider in the state, it's extremely important to us that we play a major role in improving the health of the commu- nities we serve as well as helping the state address the health challenges of the overall population. Additionally, one of the unique things about Ochsner is that we play an important role in each of the Southeast Louisiana communities where

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