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Becker’s Healthcare Podcast
Michael Cureton, MHA, FACHE, CEO of Sutter Davis Hospital at Sutter Health
00:20:22
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Transcript18 lines
- [00:01]
A
This is Laura Dirdo with the Beckers Healthcare podcast. I'm thrilled today to be joined by Michael Kirtan, CEO of Sutter Davis Hospital, part of Sutter Health. Michael, it's a pleasure to have you on the podcast today.
- [00:12]
B
Thank you. Pleasure to be here.
- [00:14]
A
Absolutely. Now, I'm excited for our conversation because I know there's so much happening in healthcare right now and particularly a lot within the workforce and workplace needing to make some adjustments as well as find the right culture and innovation to really meet the needs of the healthcare workforce today. So I'm excited to talk with you about that. But before we dive in, could you briefly introduce yourself, your role and kind of the scope of what you do at Sutter Davis Hospital?
- [00:41]
B
Yeah, absolutely. So I am the CEO at, like you said, Sutter Davis Hospital. We are a 57 bed community hospital west of Sacramento, California by about 30 minutes, give or take traffic. We have 35 med surg tele beds, telemetry, we have 6 ICU beds, 24 ED Bay, and we serve the county of Yolo county and located, like I said, in Davis, California. We have approximately 700 employees and 150 active medical staff. And yeah, we've seen about 4,500 discharges last year. So we are crucial in the community and one of the many hospitals within the Sutter Health system.
- [01:32]
A
Fantastic. And you know, it's so helpful to understand kind of the breadth of the organization and clearly, like you said, critical services that you're providing to the community. Now, what's currently commanding most of your attention as a leader?
- [01:45]
B
Right now it's really partnering with our foundation partners, the ambulatory care leaders within our organization, in particular around growth and access. In Yolo county we have some services that to next available appointment is much too long. We have an issue where the demand is strong and our ability to supply physicians is right now weak. And the reason for that is really there is no physical space to place anybody. And so we are actively looking about how we can create growth opportunities in the community to keep it local. Like I said, we're about 30, 35 minutes from Sacramento and many of our residents can go across what we call the causeway, you know, over the freeway to be able to see some providers in that community. But our goal is really to keep care local and as best we can, we want to make sure that people don't have to travel to be able to see primary care and specialty care. And so we are working with great pace to try to figure out where is the best place to grow, what are the right physicians to put there. And. And that's really kind of our attention and our focus this year.
- [03:01]
A
Absolutely. That's helpful to understand and, you know, so interesting to see how you've been able to kind of grow that care locally and keep it in that space. I know so many hospitals and organizations across the country are having that same challenge in conversations with their teams and what they need to do in order to kind of expand and make access to care really more broad for their communities. So in the last year or so, that's been marked by a lot of rapid change. Could you talk about a recent decision or pivot that has required the most leadership conviction from you, particularly when it's come to aligning people, resources or capabilities?
- [03:41]
B
Yeah. You know, to set this up, I want to just kind of throw out there a model that was shared with me once about decision making, and I really love it. It's the concept of good, better and best. I'm not talking about for the Chicago Bears fans out there. I know Ben Johnson has a phrase, good, better, best. Never let it rest till your good gets better and your better gets best. Our COO of the organization loves that. But I'm really talking about as it pertains to decisions. We have good decisions, we have better decisions, and there's the best decisions. And with finite resources, really thinking about this model is important. And so the example I would love to give is, you know, over the past quarter, I would say we've been really looking into expanding or whether we should expand our birthing center capabilities. And particularly we're thinking about expanding to a NICU level 2. And if that is the right move, at Sutter Davis Hospital, we have a birthing center. We've actually where I know a lot of the organizations out there are seeing a decline and the number of births that are being performed at their hospital, we've actually seen an increase over the past few years by about a 300. And part of this is because we started increasing our primary service area to include other geographies that are now coming to the Sutter Davis Hospital. And so with that, our thought was if we increase our level, our ability to a NICU level two, that would help decrease the number of transfers out that we have to do. It would improve our unexpected newborn complication rate. It would help retention of some of our physicians. We have a hospitalist model and many of them would love to have a NICU level 2 available. But we did the math and in order to do this, we would have to physically expand our campus by another 1200 square feet. It would include having an intensivist on site. It would include additional training for our nurses. And while expanding might be a good decision, it wouldn't be the best decision for us at this time because we do have other priorities, like I mentioned, other ambulatory care needs in the community that we really need to focus on. You know, we looked back at the past 10 years, and even within our county, we saw about a 30% decline in the fertility rate. And the number of births that were coming from Yellow county and some of our other encatchment areas were approximately 20 to 25,000. Sorry, 20 to 25% decrease. And if that trend continues, we would hate to build out only to not be able to fill it five, 10 years later. And so thinking about all the benefits that would go in expanding our services, but then weighing it against, you know, what are we giving up, really? We decided that we had to forego this opportunity and to not move forward within NICU level 2 expansion. And so, you know, I'm sure many other health care leaders are facing the same thing. There's a limited amount of capital, a limited amount of resources. We invested a lot in just trying to see if this plan would even, you know, take wings, but ultimately we decided against that. And I think sometimes you have to make really difficult decisions about where you want to invest resources and where you're going to serve the most amount of people. And so weighing those options, I think, is just something that's ever increasingly important in today's day and age.
- [07:23]
A
That's such a great way to illustrate those tough decisions that I know leaders are making on a continuous basis. And, you know, great example of, again, how you can look at the information, look at the data, and assess the different options so you can make those decisions, even if they are hard ones or not. Always popular. I'm curious, how did that moment or decision challenge your assumptions and what did it change about how you approach decision making in the talent or organizational readiness today?
- [07:54]
B
Yeah, I think right now there's a lot of people who are looking for creative ways to create access while at the same time trying to face the headwinds that are coming with us. And I think it's important to consider any and all options, but at the same time not invest. Don't put a stake in the ground where it doesn't need to be right. And so there are times where, even though we might want to sell our idea and be really excited about the potential of a new service or a new program, there Are times that we have to really take a look at it and make the hard decision and walk away. And for some it will be disappointing news, but in reality we have to think what's going to best serve the most amount of people and do the most amount of good. And so again, it's that good, better, best concept is that, you know, if we were to expand that, that's a good thing. However, it wouldn't be the best thing right now. And so I think ever increasingly looking at the decisions to be made and really consider all options. And so we are being bombarded with new technology that we have to decide do we want to put the investment in, is this really going to make a difference? And again, it's worth taking a look at, but we have to be careful where we hit your wagon.
- [09:22]
A
Absolutely. I think that's such a critical piece of advice because there are so many opportunities out there and a lot of things that healthcare leaders could be looking into or investing in or people they could be partnering with. But at the end of the day, you know, those that select wisely are the ones that are going to be positioned for the most success in the future. When you think about some of these forces that are reshaping healthcare right now, where do you believe leaders need to be more decisive? Especially when it comes to balancing that speed as well as risk and having the right teams in place?
- [10:00]
B
Yeah, more than ever it's about having the right people on the bus with you. And sometimes having those right people is simply just investing in their professional development and growth. I think as an organization, that's where Sutter Health is really shining. As we are doubling down and ensuring that, you know, our managers, our directors, our first time leaders are getting the support that they need to be able to drive change at the frontline level. You know, it is ever more important to be watching our costs. And if a leader really hasn't had the experience of how to manage, you know, a profit and loss statement or manage their productivity tools, they need the education and the assistance in order to do that. And so we are doubling down in ensuring that. You know, we have at Sutter Health, for instance, Sutter Health University, we are ensuring that leaders get into almost on a quarterly basis some sort of professional development opportunity. There's LinkedIn learning, there's books that we are passing out to leaders, just helping them become their best selves, often in health care and I'm sure other industries as well, is that you have leaders who don't never expected to become leaders. Right. They were Great bedside nurses. They were great housekeeping technicians, EVs, techs. And you see them, you know, you see the talent in them. And as we bring them up and have them become supervisors and then managers and then directors, are we giving them the adequate tools to be able to address the changes that are forthcoming? Because things like, how do we make throughput more efficient? How do we ensure that we are reducing our premium pay and overtime if our people are not equipped to address these concerns, if they are not equipped to become credible leaders to where their frontline staff are going to follow them, we're not setting ourselves up for success. And really, we need strong leaders more than ever at this time. And so that's really where I think the emphasis that we need to be making. At least that's what we're doing here at Sutter Davis Hospital.
- [12:15]
A
That makes a lot of sense. And I know that especially a lot of new leaders are up and coming through the ranks in spending time trying to not only learn the industry, but transform the way that their teams are operating. And it takes a lot of leadership in order to do that. I think the other element that we haven't talked a ton about today is just some of the uncertainty in the healthcare space. Of course, looking at staffing and some of the financial dynamics are a challenge, but also policies across the board are changing quickly. And there are good amount of economic factors, too, that are affecting how hospitals and health systems are operating. So from your perspective, as this uncertainty becomes more of a norm, what leadership habits or mindset has been most critical in keeping your organization and people moving forward?
- [13:08]
B
Yeah, I think one is being a transparent leader. I think that's going to be very important here in the future, is to let people know why we are doing what we are doing. You know, I've just had some conversations lately with some providers. They are. We're making a change that they're not necessarily excited about. We believe it's the best thing for our patients and for the hospitals and quite frankly, many of our physicians. But they don't necessarily understand the why behind it. And so it kind of was like a aha moment where we need to talk to them about the current state of healthcare and where things are headed, you know, with the one big beautiful bill or the HR one. How is that impacting hospitals? And not just, you know, here at Sutter Davis, but around the nation where we're seeing a shift in how, you know, payments are going to be coming, there's questions about 340B. All of these things are happening and rather than, you know, when there is a vacuum, people fill it with their own thoughts and their own ideas. And I think it's important that we are transparent about the realities that we face. You know, just yesterday I stood in front of our leaders. We had a. One of our best surgeons is going to be leaving the area, and that's going to be a significant impact on our hospital. And as a result, I was quite frank with our leaders, is that more than ever, it's going to be important that we watch our costs, that we watch our utilization, that we are making sure that we are doing everything that we can to be able to keep the hospital strong, and that we're being good stewards with the finances that we have because of the not for profit organization, we reinvest back into the community. And that's really important. And so I think being just real with our frontline leaders about what's ahead and with our physicians about what challenges we face, that's going to be the key, I think, to making sure we're all rowing in the same direction.
- [15:19]
A
I love that and thank you so much for sharing it and being very candid with the situation that you have at Davis Hospital and how you're thinking about it and communicating with that to your teams. I think it's so critical, like you mentioned, to be focused on how you can really be good stewards of the financial and other resources that are in the organization and then continue to support those who are supporting the hospital as well. Before we wrap up here, I have one more question. What signals or metrics how your workforce strategy is actually working and where are you still experimenting or course, correcting to some degree.
- [15:56]
B
Yeah, you know, I want to go back and touch the. The comments I made about professional development. You know, as a technology comes in, I joke, anybody's going to sound intelligent these days through email. Right. I can write any draft and, you know, write like a third grader and make it look like, you know, choose which writing style you want. I can sound like Shakespeare. I can sound like Jared Tolkien. I can sound like the most perfect professional person. But when it comes time for me opening my mouth and speaking, people truly know what type of person I am. Right. And so with that really building on this authenticity and we are trying to ensure that we are getting authentic individuals into our hospital. I'm very proud of the results that we've been able to get as a recent. At Sutter Davis Hospital, we are in the 90th percentile for patient satisfaction. Last year, our employee engagement was at the 94th percentile nationally. And there's a lot of great work that is happening. There's still some opportunities. And so we are being very aware about who we bring into our hospital and we're actually doubling down on that. I currently have our leaders, frontline leaders, working on trying to find best practices about, you know, determining who comes in as a new hire. How are we ensuring that someone is going to not only just be good clinically, I think that's like the bar. But how do we know that they are going to be somebody that is collaborative? How are they going to be somebody that is caring and empathetic? And how can we be better at hiring the superstars? Because, you know, at the end of the day, that's what patients really want. I think all patients go into a hospital expecting to have great quality and, you know, with a few exceptions here. But I think where when I read patient comments on patient satisfaction surveys, it's rarely about the clinical care that they got right. It is truly about the care that they received. It's about how the person made them feel, it's about the comments that were shared with them. That's what really patients are talking about and that's what we see and that's what we hear. So going back the metrics that we know that is working is one, we see our patient satisfaction scores. I have this firm belief that in order to have happy patients, you first need to have happy employees. We've been successful. We have less than a 10% turnover rate at our hospital. We have individuals who are committed to this community and we just want to continue on that. So again, it's making sure, doubling down and ensuring that our leaders have the tools, the development, the training, everything that they need to be the best, their best self within their departments. As our CEO Warner Thomas has shared with us, you know, everybody is the CEO of their responsibility and I love that concept, right, Is that the best ideas are going to come from closest to the patient and from those departments. We just need to make sure that our leaders are prepared and we think it's working. There is still some opportunity out there. Like I said, we're revamping our interview questions. We're thinking about how we make new employees feel more welcome because that is one area that we're looking at is how can we reduce our first year turnover. But by and large, we're excited about the direction we're headed.
- [19:40]
A
Fantastic. That's amazing to hear. Michael, thank you so much for joining us on the podcast today. This has been a really fun conversation. I've learned a lot and inspiring to everything that you've accomplished at Sutter Davis Hospital and look forward to connecting with you again soon.
- [19:55]
B
Thank you so much for the invite. My pleasure.