Finance Monthly hears from José R. Sánchez, the President and CEO of Chicago-based Norwegian American Hospital, who discusses what it takes to be a CEO of a hospital and the initiatives that the hospital has been up to since we last spoke a year ago.

 

I have been President and CEO of Norwegian American Hospital since 2010 and have had a long career in healthcare, going back 30 years, mostly in New York. I spent almost 16 years with the New York City Health and Hospitals Corporation where I held a number of positions during my tenure in various leadership roles. I was the most senior leader within the system, responsible for the largest healthcare network that included 3 hospitals, 23 clinics and over 9 000 employees. Healthcare is a very competitive field in just about every part of the country. The rules I follow are excelling in any responsibility given to me and managing an efficient operation. I focus on quality improvement, best practices, growing business, expanding services, addressing community needs and having a viable bottom line.

A successful hospital CEO knows how to cultivate leadership within the organisation. I believe that inherent leadership skills that engender the support and confidence of the providers, patients, and the surrounding community are most important. Good leaders will not only engage with their executive team but the best leaders are those who engage at all levels of the organisation. Additional skills that have been helpful to me are those I have been able to gain through roles in management and understanding operations, while staying updated on current changes in the market. I focus on identifying and bringing in the best talent for the success of the organisation. It is also important to understand the politics of healthcare. I believe there is a very close relationship between understanding the fundamental principle of operations in the healthcare setting and understanding how policies are shaped. You need to be able to balance both equally and be able to identify critical priorities and act on those priorities, on behalf of, or for, the benefit of the organisation.

As we understand today, healthcare is an evolving system. The direction of healthcare is very unclear and this is probably the most disruptive time ever in healthcare. Therefore, there is greater demand for training the workforce to respond to those changes. In order to make every attempt to have high moral in the organization, it is important to value the roles and responsibilities that the workforce has. Communication is also key for high morale, taking time to explain trends in healthcare, and working in collaboration as a team. Celebrate the successes openly and openly address the challenges we have every single day. Staff development is key to improving and maintaining high moral. Standardisation of policies across the board is critical and transparency is key as well. Trust is a major driver to maintain and improve morale.

The successes of Norwegian are many but we have been able to keep the doors open by being a proactive organisation, representing the needs of the community by creating specific programs that address the health disparities in the community. We also have been able to have a very lean, efficient organisation and have been a financially viable institution, posting a profit for the last 6 years. We made significant improvement in quality across the organisation and have received numerous recognitions and awards, both nationally and locally. In 2015, NAH received the Healthgrades® Patient Safety Excellence Award™. This distinction put Norwegian American Hospital within the top 10% of all hospitals evaluated for their excellent performance in safeguarding patients from serious, potentially preventable complications during their hospital stays. We were recognized for having the lowest hospital inquired infection rate among 67 hospitals in Greater Chicago area. In 2017, our Pediatric Care-A-Van received the prestigious American Hospital Association NOVA Award. Only five NOVA Awards are given nationwide each year. We have engaged the community to be active participants in the hospital and to provide input to improve quality and community engagement. We also are very proud of our relationship with all the stakeholders in the community: community based agencies, schools and the business community. Some of our successes of pride include the financial investment for the renovation of the first floor of the hospital and the creation of our own family residency training program.

NAH has really addressed the healthcare needs of the community and taken responsibility to develop and grow the next generation of healthcare providers through our active participation with medical students and our resident program. We also are the largest employer in the Humboldt Park community, so approximately 65% of our workforce comes from residents of the community. We serve as the economic anchor to the surrounding communities. Norwegian American Hospital reinvests back into the community through programs to care for the underserved and uninsured, manage chronic conditions like diabetes, health education and promotion initiatives and outreach for the elderly. Our Comprehensive Diabetes Centre addresses the diabetes rates in our community that have risen exponentially. We also started a new Family Medicine Residency program to help attract new doctors to the area because physicians tend to remain in the communities where they complete their residency. Our partnerships with local faith-based organisations have opened doors to raise awareness of specific health needs in our community. Recently, Norwegian American Hospital donated land where a veterans’ home was constructed, a move that symbolizes a long-term commitment to Chicago’s homeless veterans and their quality of life. Our hope is that dependency on hospital services will be reduced. People living on the streets tend to cycle in and out of emergency rooms and in-patient stays. NAH is proud to be among the first hospitals in the City of Chicago to address homelessness and housing for veterans.

We have fully embraced the Affordable Care Act with participation during open enrollment periods to expand Medicaid for those individuals who are eligible for the program. We also support programs in the community and are active participants in health fairs. Community health fairs are go-to events for our local residents who want to learn more about a variety of health topics and wish to receive free or low-cost screenings. In addition, throughout the year, NAH offers numerous opportunities for the public to learn more about key health topics and how to incorporate healthy lifestyle changes. This year, we have a Care-A-Van that brings services to schools and children and families throughout the year. The state-of-the-art mobile clinic brings healthcare to 3 000 underserved children who otherwise would not receive care for asthma, obesity, diabetes, high blood pressure, lead poisoning and other preventable health disparities.

At the forefront of our agenda is our quality journey that has direct impact in patient outcomes. Each quality service line has a dashboard that reports clinical metrics. We have an external affairs committee that was developed several years ago with members who are residents of the community. They have become the ears of the community to provide input to hospital leadership as it relates to improving care and communicating community concerns and needs. We do a community assessment regularly to evaluate and understand the need for services required in the community. Our commitment to improve healthcare outcomes and patient safety is manifested in the performance results of several national clinical measures within the Centers for Medicare and Medicaid Impatient Quality Reporting Program. NAH exceeds the national scores or benchmarks in many categories which include mortality, patient safety indicators and Hospital Acquired Infections. We exceed the national benchmarks in five out five mortality categories and six out of seven patient safety indicators, with a slightly better overall patient safety score than the national benchmark. NAH is accredited by The Joint Commission for hospital and behavioral health programs; College of American Pathology for laboratory services; Healthcare Facilities Accreditation Program (HFAP) as a Certified Primary Stroke Center; and Illinois Department of Public Health’s (IDPH) Level II Perinatal Care Certification.

The goal of the hospital is to change and evolve every day. We need to be adaptable to a very disruptive healthcare environment. We have to focus on trends in healthcare which includes the triple aim of quality, population health and financial viability. The policies of the state continue to change and we need to adapt and respond quickly to those changes. It is clear that our goal needs to be on quality improvement, best practices, expansion of services, efficiency and using technology as a tool to help us accomplish our objectives. NAH recognizes that health is more than simply treating patients who come through our doors. We want to build not only a healthier, but a more prosperous community.

2018 has been a trying year for healthcare. We are beginning to see acceleration of mergers and acquisitions throughout the country and beginning to see merging models of care. In 2018 we are beginning to see other providers emerging in the market, such as CVS, Walgreens and others.

We are beginning to look at challenges and changes in healthcare and at opportunities to improve the current system. Certainly, in this very difficult time there are great opportunities to improve care, address the need of consumerism, growth and efficiency and develop new models to address the population needs. Healthcare today is about collaboration, we can no longer exist in silos. The solution to many problems will require a collective effort of sharing information, sharing responsibilities and focusing on innovation. I suggest that new leaders need to pay attention to demographic changes in the country as well as the elderly population that continues to grow. We need to not only focus on health, but the social determinate of health: food, housing and transportation. Prevention and education will continue to play a significant role to the outcome of interventions we will make.

2018 will be a year to focus on positioning ourselves strategically on many different fronts. Growth, efficiency, financial viability and adapting to the new healthcare order. We will focus on sustainability and leverage the gains we’ve made. We will create more growth opportunities for the hospital outside of our four walls. Our focus will be on shaping policies that address the needs of the people who comprise this community. We will continue to find funding solutions for the programs that have been subsidizing NAH. We will do all of this so that we can continue to provide the highest quality of care for the most vulnerable members in our community.

Positioning the hospital for 2018 is in the hands of the leadership of the hospital to create the vision and future to keep the tradition of Norwegian American Hospital alive, which has served the Humboldt Park Community for over 120 years.

 

Website: https://www.nahospital.org/