Amy E. Lee, President and COO of Nantucket Cottage Hospital

Summary

Becker’s Healthcare Podcast: In-Depth Summary of Episode Featuring Amy E. Lee

Podcast Information:

• Title: Becker’s Healthcare Podcast
• Host: Laura Dearda
• Guest: Amy E. Lee, President and Chief Operating Officer, Nantucket Cottage Hospital
• Release Date: August 2, 2025

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Introduction and Background

The episode opens with Laura Dearda welcoming Amy E. Lee to the podcast. Amy introduces herself and provides an overview of Nantucket Cottage Hospital, highlighting its unique position as a rural community hospital located 30 miles off the mainland, accessible only by ferry or plane.

Notable Quote:

"Nantucket Cottage Hospital is very unique in that we are a rural community hospital located 30 miles out to sea. We're only connected to the mainland by either ferry or plane."
[00:25]

Amy emphasizes the hospital’s dual capability of offering personalized local care while leveraging the extensive resources of Mass General Brigham, one of the world’s leading academic medical centers.

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Key Successes Over the Past Year

When asked about recent successes, Amy highlights the hospital's efforts in expanding access to care. Key accomplishments include:

• Expansion of Urgent Access Services:
  Renovations have allowed the hospital to offer walk-in services, increasing access by approximately 72%, which is particularly impactful during the summer months.
  [01:31]

• Efficiency in Emergency Response:
  Both the emergency departments and Urgent Access have achieved a door-to-provider time of less than 15 minutes, a significant achievement given the hospital’s size and the population it serves.
  [02:00]

• Staff Recruitment and Retention:
  The hospital has successfully expanded its care team by attracting primary and specialty care professionals, both local residents and visitors. This includes innovative arrangements where specialists can maintain their skills through partnerships with Mass General while providing care on Nantucket.
  [02:45]

• Workforce Development Initiatives:
  A noteworthy investment is the $50 million capital campaign aimed at building housing for staff, addressing the high median home prices on the island and ensuring a stable living environment for caregivers. This effort supports high staff retention and quality patient care.
  [03:10]

Notable Quotes:

"We are small and mighty... our door to provider time is less than 15 minutes."
[02:00]

"We're in the thick of a $50 million capital campaign to build housing for our staff."
[03:10]

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Addressing Housing and Workforce Sustainability

Amy delves into the critical issue of housing, noting that the high median home price on Nantucket makes home ownership unaffordable for most staff. To combat this, the hospital:

• Provides Housing Solutions:
  Utilizes a housing coordinator to assist staff in finding secure and stable housing, and invests in building community housing projects.
  [03:38]

• Focuses on Workforce Development:
  Emphasizes education and career advancement within the hospital, with over 50 employees pursuing further education, including six nurse leaders obtaining doctorates. This commitment fosters a dedicated and highly skilled workforce.
  [04:54]

Notable Quotes:

"We have to make sure we're taking care of our caregivers so that they can really focus on the job at hand."
[03:38]

"We have over 50 of our employees who are furthering their education in one way or another."
[04:54]

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Current Focus Areas: Housing, Workforce Sustainability, and Access to Care

When discussing top priorities, Amy outlines three main drivers:

1. Housing:
   Continued investment in housing remains foundational to attracting and retaining talent, ensuring that caregivers have a secure living environment.

2. Workforce Sustainability:
   Strengthening internal staff development and fostering partnerships with the community, such as the school-to-career pipeline program. This initiative involves high school seniors spending a year within the hospital across various departments, gaining hands-on experience and setting the stage for future careers in healthcare.
   [05:04]

3. Access to Care:
   Maintaining and expanding services to ensure that the majority of patients receive care on the island, minimizing the need for off-island transportation. Amy proudly states that only 3% of patients require transport off-island, showcasing the hospital’s efficiency and comprehensive care capabilities.
   [07:50]

Notable Quotes:

"We have a simulation lab that has been funded through philanthropy that is just state of the art."
[05:04]

"We only transport 3% of patients off island. We can take care of 97% of the patients that walk through our doors."
[07:50]

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Future Growth Opportunities

Looking ahead, Amy identifies several growth areas:

• Preventative Care and Chronic Condition Management:
  Focusing on high-touch preventative services to reduce off-island travel and promote healthier lifestyles for both year-round and seasonal residents.

• Cancer Detection and Behavioral Health Services:
  Investing in advanced cancer detection methods and expanding behavioral health services to provide comprehensive care.

• Holistic Aging Care:
  Developing services that support aging in place, enabling residents to live independently at home.

• Technological Modernization:
  Enhancing telehealth capabilities and adopting new clinical technologies to improve care delivery and support providers. An example is the tele newborn program, which has significantly reduced the need to transport newborns off-island.
  [06:31]

Notable Quotes:

"We see major growth potential in those high touch preventative care areas, particularly managing chronic conditions."
[06:31]

"We have a tele newborn program that supports our labor and delivery unit and our physicians so that more moms can deliver their babies here."
[07:50]

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Strategic Investments and Resource Planning

Amy discusses strategies to secure necessary investments and resources amidst tight finances and an uncertain healthcare environment:

• Housing as a Foundational Investment:
  Reinforces that providing housing not only attracts talent but also ensures the quality of life that Nantucket offers, making it feasible to retain skilled professionals.

• Leveraging Partnerships:
  Utilizes the relationship with Mass General Brigham to access specialized care and technological advancements economically, ensuring that the hospital can provide cutting-edge services without overextending financially.
  [08:45]

Notable Quote:

"It truly is an amazing place to live here and you know, to raise children here, those kinds of things."
[08:45]

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Leadership and Organizational Vision for the Future

In concluding the discussion, Amy shares her vision for leading a thriving organization over the next five years:

• Vision and Agility:
  Emphasizes the importance of having a clear vision and the ability to adapt swiftly to changing circumstances.

• Deep Collaboration:
  Highlights the necessity of close-knit teamwork across departments, fostering a unified mission and collaborative culture.

• Proactive Workforce Management:
  Stresses ongoing investment in staff development and maintaining a motivated, skilled workforce as the hospital’s greatest asset.

• Embracing Innovation:
  Advocates for being open to new ideas and technologies, positioning the hospital as a "guinea pig" for innovative practices that enhance patient care and reduce administrative burdens.

• Patient-Centered Care:
  Focuses on reimagining care models that prioritize patient needs, protect caregivers, and address the unique demands of island life.

Notable Quote:

"It really takes vision, agility and deep collaboration... We like to be the guinea pig. So if there's something new... we take that on and we really embrace that change as part of our culture."
[09:51]

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Conclusion

Laura Dearda wraps up the conversation by appreciating Amy's insights and the dedicated efforts of Nantucket Cottage Hospital in serving their unique community. Amy expresses her passion for the hospital and the community, underscoring the fulfilling nature of their work.

Notable Quote:

"I love talking about Nantucket. It's very passionate about our people and our community."
[11:28]

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Key Takeaways:

• Unique Healthcare Delivery: Nantucket Cottage Hospital effectively balances personalized local care with the advanced resources of Mass General Brigham, providing comprehensive services despite its remote location.

• Strategic Investments: Significant investments in housing and workforce development are crucial for attracting and retaining skilled healthcare professionals in high-cost, remote areas.

• Innovative Programs: Initiatives like the school-to-career pipeline and telehealth programs demonstrate the hospital’s commitment to community engagement and technological advancement.

• Future Growth: Focused on preventative care, chronic disease management, and holistic aging care, the hospital aims to enhance patient outcomes and reduce the need for off-island medical transportation.

• Leadership Vision: Emphasizes agility, collaboration, and a forward-thinking approach to maintain excellence and adaptability in a rapidly evolving healthcare landscape.

This episode provides valuable insights into how a rural community hospital can thrive by addressing unique challenges through strategic investments, innovative programs, and a strong commitment to both staff and patient care.

Transcript

[A]

This is Laura Dearda with the Beckers Healthcare podcast. I'm thrilled today to be joined by Amy Lee, President and Chief Operating Officer at Nantucket Cottage Hospital. Amy, it's a pleasure to have you on the podcast today.

[B]

It's a pleasure to be here.

[A]

Thank you so much again for your time. I am really looking forward to learning more about some of the cool things you're doing at Nantucket Cottage Hospital and how you're thinking about the future. But before we do, can you introduce yourself and tell us a little bit about the hospital?

[B]

Sure. So I'm Amy Lee. I'm the president. I've been with the hospital about three years. Nantucket Cottage Hospital is very unique in that we are a rural community hospital located 30 miles out to sea. We're only connected to the mainland by either ferry or plane. So it's a very unique setting when it comes to providing healthcare. We proudly serve a year round population of almost 24,000 and our seasonal population which grows to more than 80,000. On top of our regular year round population, we provide a very broad range of healthcare services. And as part of Mass General Brigham, we have the ability to provide both that local personalized care with the resources of one of the world's leading academic medical centers. So we have that very unique ability to provide very personalized care, but also have services that community hospital would not normally have.

[A]

That's amazing to hear and truly, truly helpful. I know especially in times like these to have that resources and partnership. Now, what's your biggest winner success story from the last year?

[B]

So our biggest success has been expanding access to care for our populations. We had the ability to expand a lot of different services, including our Urgent Access we provided or we did a renovation that we're now able to provide walk in services and increase the Access by about 72%, which is a huge number, especially in the summer. One of the things we're very proud of is that both in our emergency departments and in our Urgent Access, our door to provider time is less than 15 minutes, which is an incredible number when you think about the population that we're serving. And I mean, we're small. We're small and mighty. I say it all the time, but yet we've really got that process down so that patients are getting in as quickly as possible. We've grown our care team so we've had the ability to recruit, we have recruited primary care, specialty care and we do that through a unique mix of people living on island but also visiting the island. And so that way if we have, for example, a surgeon who really wants to keep their skills up. We don't have robotic surgery here on island, but because we have a partnership with Mass General, they can do a week off island doing robotic surgeries and then three weeks on island so that they still get that personal touch and care here on Island. We have a very high staff retention rate. We really, really work very hard to make sure that we're developing our workforce and we're working with the community. I mean, right now, it's all about housing. We're in the thick of a $50 million capital campaign to build housing for our staff. It's an investment that really makes sure that we can provide stable environment for our caregivers so that they can maintain that high quality of care that we expect for our community.

[A]

That's fascinating to hear. And, you know, I think most people, when they look at hospitals and, you know, what they're investing in and how they're continuing to expand, they don't think of building houses and trying to do some of those kinds of things. And what is it like to kind of embark on those projects and figure out that as a resource definitely needed for your teams to make sure they're thriving and able to provide care in a strong way?

[B]

Yeah. So the median home price here on island is over three and a half million dollars, which that puts a house, Owning a home out of the range of most people. And so we really need to provide housing solutions that are stable, secure, and allow our caregivers to focus on our patients. So, you know, we have a housing coordinator who works with our staff looking for solutions. We have, you know, we work on not only building our own housing, but also working in the community to provide housing solutions so that people really feel comfortable being here. And, you know, I never. I knew it would be part of my job, but I never realized how much it would be of my job. But, you know, that's. We have to make sure we're taking care of our caregivers so that they can really focus on the job at hand. Also, because we are such a small organization, really, with workforce development and focusing on education and advancement that way, as opposed to going up through leadership levels, is incredibly important. And I'm very proud that we have over 50 of our employees who are furthering their education in one way or another, including six of my nurse leaders that are getting doctorates. That's pretty significant, especially when you consider we're again, 30 miles out to sea and so attending classes and doing all those things. It's a little bit more complicated, but they really are devoted to doing that.

[A]

That's amazing to hear and just a true testament to the culture and mission you've been able to build. Now what are some of the top two to three issues that you're focused on right now?

[B]

Yep. So like I said, housing, workforce sustainability and access to care. Those are our three biggest drivers. You know, housing. I just spoke about the workforce development. Again, it's, it's not only our internal staff, but also we work very closely with our community. One of the things that we do is the school to career pipeline. So the high school students their senior year actually spend the full year in the walls of our hospital either on a nursing, physical therapy, radiology track. And so they start out at the beginning of the year looking at all the different departments. Then we help them with resume development and really focusing on their areas of interest. And then they interview for those areas and then they spend the rest of the year in those areas really getting hands on experience. We have a simulation lab that has been funded through philanthropy that is just state of the art. And so they get a lot of hands on with the mannequins and with the education department. Really giving them those skills that set them up for a career in healthcare. That's a big one for us and we're very proud of that because you know, if we can help our local community really develop skills and a career that helps the entire community absolutely makes.

[A]

A lot of sense and you know, is a really cool way to uplift the team you have there as well as the community around you. Now I'm curious, curious when you think about the future, where are some of the big growth opportunities over the next few years?

[B]

Yep. So we see major growth potential in those high touch preventative care areas, particularly managing chronic conditions. And what that does for our, our community and our, our patients is really reducing the off island travel for treatment. It allows them to live a healthier lifestyle even if they're a seasonal, seasonal person. So that way that they're getting that care while they're here. And, and it's holistic, so it's taking them even when they, they go back home throughout their lifespan. We're working towards a deeper investment in cancer detection, behavioral health services, holistic aging care that meets people where they are so that they can age at home. We see a huge opportunity to modernize how care is delivered through technology. Again, our resources are limited here and the fact that we're 30 miles out to sea really creates a challenge in providing Care, especially in specialties. So the more that we can really enhance our use of technology so that patients can stay here but still get care is a really important thing. And it also helps support our providers. For example, we have a tele newborn program that supports our labor and delivery unit and our physicians so that more moms can deliver their babies here and we can take care of babies without transporting them off island. One of the things that our providers and our staff are very, very proud of is the fact that we only transport 3% of patients off island. We can take care of 97% of the patients that walk through our doors. And that's huge. And that is because of that collaboration of technology and specialists and then the talent that we have on island that.

[A]

Is amazing to hear and really truly a testament again to just the organization there and the commitment from the community in order to have care and accessibility right there on the island. I know, you know, being part of a larger system too, I can imagine is helpful. But when you think about, as you mentioned, the resources and finances can sometimes be tight in order to do the modernization or bring in the right technology and things that you need. And I know now is kind of an uncertain time in healthcare as well when you're looking at, at the future. So is there anything new that you're trying or ways that you're looking at trying to make sure you're getting the right investments or additional resources into the organization to plan for the future?

[B]

Yeah, like I said, housing is, is really a foundational piece of this because if we can provide housing, we can attract talent who want the quality of life of what living on Nantucket means. It. It truly is an amazing place to live here and you know, to raise children here, those kinds of things. And so the housing piece of it is such an important part of giving people that security. When we do that, we get amazing talent. And so that really helps build the bench that we have providing care at the hospital. And then it's our relationship with Mass General and the fact that we have these specialties either visiting or coming on island or through telehealth. So it really gives us a lot of skill set and it also gives us the ability to provide care economically because we have those relationships.

[A]

Makes a lot of sense. Thank you for digging a little bit deeper there. Now, before we wrap up, I am curious, what do you think it will take to lead a thriving organization in the next five years or so, given all the changing environment, technology and accessibility that you're looking for?

[B]

Yeah, so it really takes vision, agility and deep collaboration. We don't have the luxury of having lots of fragmented departments. People wear a lot of hats here and really work very, very closely together. So every department, every caregiver, every partner aligns towards our shared mission because we have to be so focused on that, which means strengthening our relationships with our community organizations, our schools, our donors. Every part of that is incredibly important to really being able to provide the clinical excellence that we want to. We have to be very proactive in addressing our workforce needs, really investing in our people, because that is our greatest resource and we have to be open to innovation. We like to say we are very small and mighty and we like to be the guinea pig. So if there's something new coming down the pike and we think that it will really help our patient care or the way our providers provide care so that they don't have as much busy work, we take that on and we really embrace that change as part of our culture. And it has served us well in quite a few areas. So it really, you know, that that ability to be flexible and open to what's coming is really part of what we like to do. So really to focus that it's housing, it's telehealth, it's the new clinical models, we just have to reimagine care on the way it centers around our patients. It really protects our caregivers and it meets the unique demands of our island life because that's what makes us who we are.

[A]

I love that. Thank you so much, Amy, for joining me on the podcast today. This has been such a fun conversation and I look forward to connecting with you again soon.

[B]

Thank you. I love talking about Nantucket. It's a very passionate about our people and our. Our community, so it's. It's fun to share.