Change agents

In­terim CEOs can be more than place­hold­ers

Modern Healthcare - - From The C-suite - John Osse

Af­ter 31 years in ru­ral health­care ad­min­is­tra­tion, the thought of re­tire­ment was ap­peal­ing. I was ready when it hap­pened on July 1, 2005. The first few months were great, how­ever, I found I was get­ting bored as time went on. Af­ter a year, I did sub­sti­tute teach­ing, kinder­garten through high school. Al­though it helped, it did not fill the void. It was at that point I de­cided to be­come an in­terim CEO.

The role of an in­terim CEO is not de­fined, so I fig­ured I would use my tal­ents ac­cord­ing to the chal­lenge, what­ever it was. Dur­ing my ca­reer, I have been a di­rec­tor of com­pre­hen­sive health plan­ning for six ru­ral coun­ties; a hospi­tal ad­min­is­tra­tor of fa­cil­i­ties that in­cluded at­tached nurs­ing homes, home-health agen­cies, hospice, al­co­hol detox­i­fi­ca­tion unit, well­ness pro­grams, geri­atric psy­chi­atric unit, am­bu­lance ser­vice and at­tached clin­ics; a con­sul­tant re­gard­ing com­mu­nity-based health plans; and a con­sul­tant in­volved in clos­ing a ru­ral hospi­tal.

I have worked as a CEO in free-stand­ing, owned and man­aged hos­pi­tals. Be­cause of my di­ver­si­fied ex­pe­ri­ence, I felt I had a lot to of­fer. I was ready. I up­dated my re­sume and mailed copies to re­cruit­ment com­pa­nies, hospi­tal sys­tems, man­age­ment com­pa­nies, hospi­tal con­sor­tiums and state hospi­tal as­so­ci­a­tions.

It was al­most a year be­fore I re­ceived my first call. It was from a crit­i­cal-ac­cess hospi­tal in a west­ern state with an at­tached nurs­ing home, home health, hospice, am­bu­lance ser­vice and clin­ics. They needed an in­terim CEO with a nurs­ing home li­cense im­me­di­ately un­til the CEO they hired would ar­rive in 6½ weeks. An is­sue arose re­gard­ing the new hire, and I ended up stay­ing 5½ months.

Dur­ing that time, it be­came ap­par­ent sig­nif­i­cant changes needed to be made. The is­sues were dis­cussed with ap­pro­pri­ate man­agers, physi­cians and hospi­tal board and were im­ple­mented. The re­sults im­proved ef­fi­ciency, dis­ci­pline, ap­pear­ance of fa­cil­ity, staffing is­sues, ex­pan­sion of ser­vices and morale. Shortly af­ter that, I ac­cepted two ad­di­tional as­sign­ments for crit­i­cal-ac­cess hos­pi­tals in the Mid­west, where I ended up clos­ing two ob­stet­ri­cal units and made staff changes im­prov­ing ef­fi­ciency. In the process, I was able to im­prove ser­vices, add new ones or do both.

Sev­eral facts be­came ap­par­ent dur­ing the past two years. An out­sider has the ben­e­fit of be­ing ob­jec­tive. An in­terim CEO can make de­ci­sions that could be ca­reer-end­ing for a full-time CEO.

Af­ter the de­ci­sions and changes have been made by an in­terim CEO, the in­com­ing CEO can con­cen­trate on op­er­a­tions. If changes that have a sig­nif­i­cant im­pact on a com­mu­nity are to be made, the in­terim CEO and hospi­tal board should be pre­pared to deal with the news me­dia. Ex­pe­ri­ence in con­flict man­age­ment and res­o­lu­tion is im­por­tant. A bal­anced ap­proach should be main­tained in mak­ing changes, e.g., look for op­por­tu­ni­ties to ex­pand and cre­ate new ser­vices to in­crease rev­enue in ad­di­tion to re­duc­ing ex­penses.

The most im­por­tant prin­ci­ple is: Be ob­jec­tive. The im­por­tance of com­mu­ni­ca­tion with hospi­tal boards, med­i­cal staff, depart­ment man­agers, hospi­tal staff, se­nior man­age­ment if a hospi­tal is part of a sys­tem, and com­mu­nity dur­ing a tran­si­tion is of sig­nif­i­cant im­por­tance.

I have found that be­ing an in­terim CEO is re­ward­ing and chal­leng­ing and not for the faint of heart. One mem­ber of a com­mu­nity, who was crit­i­cal of my in­volve­ment in the clos­ing of an ob­stet­ri­cal unit, asked me if I could sleep at night. I said, “Yes,” be­cause I knew that in five years that hospi­tal would still be open.

To some, the role of an in­terim CEO is to “hold the fort” un­til a full-time CEO is re­cruited and in place. Al­though this is some­times true, an ex­pe­ri­enced in­terim CEO can play a much broader role. With sig­nif­i­cant chal­lenges fac­ing health­care fa­cil­i­ties, I be­lieve there will be an in­creas­ing need for ex­pe­ri­enced in­terim or con­sul­tant CEOs. For me, age has given me ma­tu­rity and pa­tience, while ex­pe­ri­ence has pro­vided the tools.

There is life af­ter re­tire­ment. John Osse is an in­de­pen­dent in­terim health­care ex­ec­u­tive who lives in Casper, Wyo.

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