For A Healthier Hospital Manage The CEO

June 7, 2002
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CHICAGO — Hospitals can have healthier bottom lines if CEOs focus more of their time and attention on staff members instead of finances and building projects.

That opinion comes from Bill Gonzalez, a former top executive at Butterworth Hospital and Spectrum Health for 15 years and a 35-year veteran of health care management.

Two years after being pushed out of his CEO spot by the Spectrum board of directors, Gonzalez now heads his own advisory firm — Wm. Gonzalez & Associates.

From his Chicago office, Gonzalez told the Business Journal that he mostly works today with some of the nation’s smaller hospitals — those with only 100 to 150 beds, a much smaller amount than the thousand he was responsible for at Spectrum.

Still, the biggest problem that he has found facing the smallest of hospitals also plagues many of the larger providers — and that is, how to attract quality medical staffers.

“The thing that hospitals always ask me to speak on is, how do we become the employer of choice, so that we can get staff,” said Gonzalez. “What I’d rather say is, instead of becoming the employer of choice of all hospitals, they should learn how to focus more on staff rather than billings, collections, bottom lines, more revenue or buildings.”

Gonzalez said that CEOs should leave the money matters to the finance gurus. Instead, they should make regular rounds on the hospital’s floors to let the medical staff know that the everyday care they provide is vital to the business.

He called it just people working through people, and he felt if CEOs did that, then hospitals wouldn’t have the staffing problems they have. He has some recent data from the University of Pennsylvania to support his claim.

“Some PhD nurses do these research programs and they’re finding that from country to country, and not only in America, that where you have a high degree of workplace satisfaction at the bedside, you literally have better patient outcomes,” said Gonzalez.

“At hospitals where you have poor workplace satisfaction, lower patient outcomes absolutely, directly correlate with that.”

And the main reason for an unhappy staff leads directly to the front office.

“One of the most frequently given reasons for lower workforce satisfaction is that the executive leadership does not engage adequately the clinical mission. That is to say, that they spend most of their time in their offices focusing on budgets and bottom lines. They’re not out there learning about what is happening at the point of care,” he said.

“They do exit interviews on why people are leaving their jobs, or why the workforce is unsatisfied. The most often repeated statement is, ‘Because nobody cares about me. Nobody asks for my opinion and they don’t care.’”

So what can a hospital do to cure this situation?

Gonzalez prescribes managing the managers.

It’s a process that involves defining the values that a hospital wants to be known for, and then laying out a plan that the top executives will follow to reach those goals.

Some values are fairly simple to set, such as being on time and being prepared for meetings. Others are a bit tougher, like not putting up with backbiting and bad-mouthing between executives and staff leaders at those meetings.

But he said perhaps the most difficult to establish today is getting the CEO out from behind the desk and making, at least, weekly rounds.

“You want to be seen in clinic units. You want to absolutely demonstrate the high value that you place on why you’re here, which is the clinical mission. And a hospital doesn’t exist, if it doesn’t have a clinical mission,” said Gonzalez.

“If the workforce rarely sees high-level people at events, little things like holiday dinners and award and retirement ceremonies, it’s quickly understood that nobody cares about the workforce, or they’d be there.”

Gonzalez believes that CEOs can create the opposite environment, a positive one, and make it so that everyone in the hospital feels that leadership values them.

He felt once that prescription was filled, then a hospital wouldn’t have to be concerned with how to become the medical employer of choice in its area, because it would already be that.

Gonzalez understands this value well because he had a knack for showing up regularly on Butterworth’s floors. Some said his inclination to make these visits clashed with the new culture that was created when Butterworth and Blodgett merged in 1998, and also was a reason why he was sent packing halfway through his board-approved 18-month stint as Spectrum CEO.

“After we merged and I made my first rounds at Blodgett,” he said, “they didn’t know what to do with me in a patient care unit because executives never went there.”

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