John Ernst, MHA, Senior Vice President and Chief Operating Officer at Froedtert Hospital & The Medical College of Wisconsin

Summary

Becker’s Healthcare Podcast: In-Depth Conversation with John Ernst, MHA, Senior VP & COO at Froedtert Hospital & The Medical College of Wisconsin

In the July 1, 2025 episode of the Becker’s Healthcare Podcast, host Laura Deardow engages in a comprehensive discussion with John Ernst, MHA, the Senior Vice President and Chief Operating Officer at Froedtert Hospital, part of Froedtert ThetaCare Health, and affiliated with The Medical College of Wisconsin. This episode delves into the operational dynamics, strategic initiatives, and leadership philosophies shaping one of southeastern Wisconsin’s premier academic medical centers.

1. Introduction to John Ernst and Froedtert Hospital

John Ernst opens the conversation by outlining his role and the scope of Froedtert Hospital. As part of Froedtert ThetaCare Health, Froedtert Hospital stands as the only academic medical center and Level 1 trauma center in southeastern Wisconsin. With 770 beds in Milwaukee, the hospital handles approximately 80,000 emergency department (ED) visits and conducts around 24,000 surgical interventions annually. The recent merger into Froedtert ThetaCare Health has expanded the organization’s reach across 18 hospitals statewide, enhancing opportunities for innovation and growth.

2. Organizational Integration and Current Trends

Laura highlights the complexities of merging two esteemed organizations, prompting John to discuss the primary trends they are monitoring:

• Staffing Challenges: John emphasizes, “the number one thing that keeps me up at night is staffing” [02:17]. He underscores concerns over retention rates, vacancy, and voluntary turnover, stressing the importance of internal development programs to foster mobility within the hospital system.

• Operational Efficiency: Maintaining optimal length of stay (LOS) is crucial. John notes, “we're always in our compare group, one of the top two or three in the country” [02:17], with an outstanding LOS of 0.71. However, the focus remains on reducing avoidable days to ensure patients receive appropriate care levels promptly.

• Case Mix Index (CMI): The rising CMI at Froedtert Hospital indicates a higher complexity of patient cases, which is seen as a positive challenge. John discusses leveraging system-wide resources to manage patient acuity effectively.

3. Strategies for Enhancing Efficiency and Team Collaboration

When probing how Froedtert maintains its efficient operations, John attributes success to robust team collaboration and dedicated leadership:

• “I have some really good teams that focus on that on a day-to-day basis and other good leaders that do that” [04:10].

He highlights the roles of clinical teams in daily patient reviews, accountable care teams coordinating with social workers for patient placements, and the seamless efforts of support services like EVS and transport teams. This collective approach ensures smooth operations and optimal patient throughput.

4. Focus on Growth and Community Outreach

John shares his enthusiasm for Froedtert’s growth initiatives, aiming to extend specialized care to broader communities. This expansion is balanced with addressing staffing and capacity challenges to meet increasing demand. Key initiatives include:

• Coordination Center Development: Enhancing the coordination center as a hub for patient distribution and system-wide resource management.

• Training Programs: Establishing programs like the surgical tech training, which develops internal employees into certified professionals, thereby supporting career advancement and system staffing needs.

5. Recent Achievements and Quality Recognition

Reflecting on recent accomplishments, John expresses pride in Froedtert Hospital’s recognition for quality care:

• Vizient Awards: Froedtert was ranked 8th out of 115 academic medical centers for quality, securing a top decile position within their system. “We received for Froedter Hospital, we were ranked 8th out of 115 academic medical centers for the quality” [06:53].

• Team Development: Promotions within the team, such as the ED manager becoming the director of the coordination center, signify successful internal growth and leadership development.

6. Leadership Insights and Advice for Emerging Leaders

Towards the episode's conclusion, John offers valuable advice for aspiring leaders in healthcare:

• Transferable Leadership Skills: “Leadership's transferable, and so you can lead in different positions in different… whether it's healthcare or just different types of jobs” [08:47].

• Building Relationships: Emphasizing that “leadership is about relationships… guiding, motivating, inspiring, developing, coaching, empowering individuals”, John highlights the necessity of fostering strong interpersonal connections to drive team success.

• Empowering Teams: He advocates for empowering team members by providing accountability and support, allowing them to achieve and exceed their goals.

Conclusion

This episode of the Becker’s Healthcare Podcast offers a deep dive into the operational excellence and strategic foresight of Froedtert Hospital under John Ernst’s leadership. From tackling staffing challenges to expanding community reach and maintaining high-quality care standards, John’s insights provide a blueprint for effective healthcare management and leadership. Emerging leaders can draw inspiration from his emphasis on relationship-building and team empowerment, essential components in navigating the complexities of today’s healthcare landscape.

Notable Quotes:

• “The number one thing that keeps me up at night is staffing.” [02:17]
• “I'm just the pretty face.” [04:14]
• “Leadership is about relationships, and the relationships are guiding, motivating, inspiring, developing, coaching, empowering individuals to achieve their goals.” [08:47]

Transcript

[A]

This is Laura Deardow with the Beckers Healthcare podcast. I'm thrilled today to be joined by John Ernst, senior Vice President and Chief Operating Officer at Froedtered Hospital in the Medical College of Wisconsin. John, it's a pleasure to have you on the podcast today.

[B]

It's my pleasure to be a part of it.

[A]

Now, I'm excited for our conversation because I know there's so much happening in healthcare and you're in a particularly unique position with academic health system in Wisconsin. So a lot going on, but also a great reputation for innovation and, and growth. And so I'm excited to hear more from you. But before we dive into that, can you just tell us a little bit more about yourself and the Froedtert Hospital and the Medical College of Wisconsin?

[B]

Sure, yeah. Thanks, Laura. So again, John Ernst, senior Vice president, Chief Operating Officer for Froedtert Hospital, which is part of a south region of Froedtert thetacare Health. Right. We have a partnership with Medical College Wisconsin which makes us the only academic medical center in southeastern Wisconsin, along with being the only Level 1 trauma center in southeastern Wisconsin. Altogether, it's 18 hospitals up the state of Wisconsin. But when for me it's really talking more about Froedter Hospital, which we are 770 bed hospital located in Milwaukee. And that affiliation with the Medical College of Wisconsin again makes us that academic center and level one trauma. You can go through the kind of the breakdown like the ED. We'll see about 80,000 patients a year, you know, about 24,000 surgical interventions during the course of the year make up Froedtert Hospital. So Froedtert Health and ThetaCare Health within the last year became Froedtert ThetaCare Health, which is really exciting and provides us with great opportunities throughout the state.

[A]

Absolutely. That's such an amazing combination. I know a lot goes into bringing together two great organizations into one and so would love to hear a little bit more about that as well from your leadership vantage point. I know a lot of work goes into that. So what are some of the trends that you're watching currently? What's top of mind for you as you look ahead and really see what's going to be important for you to continue to provide care for your communities?

[B]

Yeah. So as the COO for Froedter Hospital and the academic medical center, the number one thing that, you know, keeps me up at night is staffing. Right. So just we're in a good situation with a lot of growth. So what's our retention rates, our vacancy or voluntary turnover? You know, the ability for internal development so we can have programs to have people move within our hospital and then through our system. Right. And then as you go through things like our coming together as a system, you know, the leadership team and the connections and the ability to leverage each other is also exciting. But for Freighter Hospital, then the length of stay, right. Our. Our ODE is really good. Like we're always in our compare group, one of the top two or three in the country. We're at like a 0.71 I think right now. But we have some avoidable days that we can work on because those are the things that again, we try to do to make sure that we're doing the best thing for the community. So to move people to the right level of care. So the CMI at Froedtered Hospital is very important to us and it continues to rise. Again, good problem to have. But then how do we leverage the system with other patients to make sure that we have the highest acuity of patients at the place that can take care of them the best?

[A]

I love that, you know, and that's such an important way to think about the health system and how you're using your resources efficiently. I know it's no easy task to achieve those right length of stays in, kind of get things running efficiently. So when you think about where you're at right now, you know, how did you do that? How did you work with the teams and what really is making the difference in keeping you on time and just being efficient with it?

[B]

Well, sure. So first of all, I didn't do any of it. Right.

[A]

Of course.

[B]

So I have some really good teams that focus on that on a day to day basis and other good leaders that do that. With the clinical teams really driving that daily review of the patients. Right. And accountable care teams that are reviewing and working with social work for placements. And so it's such a team effort from EVS and turning over the room, transport, getting patients back and forth. So surgery, making sure that you can get your inpatients in as quickly as possible as they needed the throughput from the ed. So all those converging things coming together with just some really connected teams that do all the work. I'm just the pretty face.

[A]

Absolutely. Well, that's amazing to hear. I wanted to ask too, what are you most focused on, excited about right now? What is something that you're just really looking forward to?

[B]

Well, it's the growth. Right. It's the ability to see more people in the community. Right. To be able to spread that expertise to more people that need it. It's really exciting. It's challenging because like I said before, staffing is an issue and capacity is an issue. So that challenge to get to all the people that need us is really exciting. And what we're focusing on. Right. So in order to do that, we have to develop our coordination center and continue to get that as kind of the hub of where to get the patients to and to keep us pushing as a region and then also as an organization. So, you know, that's extremely important. And we talked about staffing before, which keeps me up. So some of the things that I'm focused on and excited about is we have a surgical tech program where we take internal employees and develop them and train them and get them through their clinicals to become a surgical tech. Right. And so. Or certified nursing assistants, different programs like that that keep people at FRATER and then give them the opportunity and their families the opportunity to grow and within and even getting into a new profession.

[A]

That seems like an amazing program and certainly would be very beneficial for anyone who's trying to advance their careers and also really help the health system in patient care teams. So that's amazing to. To have that opportunity. When, you know, you think about the last six to 18 months or so, what are you most proud of? What kind of projects or initiatives have really come to light and been successful?

[B]

Well, for us, it always starts with patient quality and outcomes. Right. So the thing that probably most proud of in the last year or so was for Vizient Awards. So Vizient's kind of our quality North Star. And so we received for Froedter Hospital, we were ranked 8th out of 115 academic medical centers for the. For quality. And then within our system, we were one of only two systems to actually have top decile. For the academic medical center, the complex medical center. I think there was community hospitals and so there's four different regions. So to get that quality award and that affirmation of what you're doing is probably what I'm most proud of. From the position perspective, from a personal perspective, that connects me is the promotion of some of the teams. So we had an ed manager that became the director of the coordination center, a manager, the regional director, assistant nurse managers to managers. The. Those are all fun and rewarding. So, you know, from the work perspective to the patients, it's that affirmation from Vizient that we're doing all the quality things that we should do. We want to be in the top five, though, but eight's pretty good. And then from a personal perspective, it's just development and growth of the. Of the people that I work with.

[A]

Got it. That sounds amazing. And, you know, definitely it's easier said than done to build that kind of team and to see those who are you working with closely grow. And to that point, what advice would you give evolving leaders today? I know a lot of folks who listen to our podcast are emerging leaders, are looking to grow and build their careers. So what advice do you have for them, especially given some of the unique challenges as well as great opportunities in the healthcare space today?

[B]

Yeah, the first thing I would say is, you know, leadership's transferable, and so you can lead in different positions in different, whether it's healthcare or just different types of jobs throughout the country. Right. But leadership's about relationships, and the relationships are guiding, motivating, inspiring, developing, coaching, empowering individuals to achieve their goals and not only achieve them, but reach heights that they never thought were possible. Right. And to do that, you got to stand there and take the heat. You gotta step away when it's positive and deflect the credit when things are going well. And you can do all that. And that's kind of the sweet spot. I tell people, I try not to hold people accountable. I give them the accountability and then help them achieve those goals.

[A]

That is amazing insight. John, thank you so much for joining us on the podcast today. This has been a fun conversation. I really appreciate learning more about what you're doing at Friederhardt Hospital and will be excited to connect with you again soon.

[B]

Sounds great. Thank you, Laura. Appreciate it.