New Sutter Santa Rosa Regional CEO Tackles Disaster Preparedness

Dan Peterson talks about why all hospitals should emphasize disaster preparedness because it changes the way a hospital thinks about delivering healthcare.

Dan Peterson says he has "always loved" being in the healthcare space and that his passion has led him to several hospital leadership positions in southern California.

Peterson began his career as the director for ambulatory services at UCLA Health System and then served as CEO of The Surgery Center of Santa Rosa for nearly five years. Since 2017, he has served as chief administrative officer for Sutter Lakeside Hospital in Lakeport, California.

In early February, Sutter Santa Rosa Regional Hospital (SSRRH) announced that Peterson had been selected to succeed Mike Purvis, who served as CEO since 2009. SSRRH is a nonprofit hospital with 84-staffed beds.

In a conversation with HealthLeaders, Peterson describes how SSRRH is implementing value-based care and how organizations can better prepare for potential disaster scenarios such as wildfires.

This transcript has been lightly edited for brevity and clarity.

HealthLeaders: How has your time serving as CEO of The Surgery Center of Santa Rosa and director for ambulatory services prepared you for your new role?

Peterson: I've had a lot of experiences in many different areas, not just The Surgery Center or ambulatory care setting versus the acute care setting, but also working for federal government providers at the [Veterans Health Administration.] I've worked for state government providers and an academic institution at UCLA, [along with] working at for-profit and nonprofit [organizations].

I've seen a pretty broad spectrum when it comes to the healthcare delivery system. I even did an internship at Kaiser Permanente and it's a very different system than many of the others. Specific to The Surgery Center, I felt like that was a fantastic experience for me and did help prepare me, because a facility like that is an important piece of the way that our healthcare landscape is evolving as we continue to drive toward affordability and move care to a lower-cost setting. The growth of surgery centers and other ambulatory settings certainly does not mean that hospitals are going anywhere, it's just a growing piece of the puzzle.

It helped me gain an appreciation for the fact that as the healthcare industry grows and tries to adapt, particularly with the affordability focus, that those are all important pieces of the puzzle and equally important to what hospitals provide as well.

HL: What are some healthcare trends you're following that have a specific focus to the California market?

Peterson: I do see several trends. I see value-based care as something that clearly the industry is moving toward. Ultimately, what we all want are better patient outcomes at a lower price, and I think there are ways to do that.

Additionally, as the payer landscape changes and we face this ever-constant crunch of declining reimbursements with increasing per unit costs, we need to be innovative and think a little bit differently about how we deliver care and try to deliver enhanced value to our purchasers and to our patients.

I think there are other aspects of the healthcare landscape in California that are changing, particularly as it relates to the wildfires that we've experienced. I think disaster preparedness in a state like California changes the way that we think about how we deliver healthcare with the ever-constant issues that seem to be cropping up: wildfires, dams breaking, flooding, and earthquakes.

HL: How does disaster preparedness affect your thinking as a hospital leader, and what do organizations need to do to mitigate those risks?

Peterson: Wildfires are the big topic in California right now, but every hospital needs to think about disaster preparedness. While it might be a wildfire near SSRRH, it may be a mass casualty event for another hospital on the east coast. As hospitals, we are part of the epicenter of tragedy and tragic events [in which] we need to be there to serve the population.

You can only do as much as your team is prepared to do and you can only be as good as your team. I think we in California are learning a lot about the importance of making sure our teams are prepared at home. [We make sure] that our staff will be taken care of and that they can be in a good place personally, so that when disaster strikes, they can work.

We spent a lot of time last summer at Sutter Lakeside Hospital preparing for power outages. [Due to] these wildfires, we now experience public safety power shutoffs, so [the power company] shut off power to our hospital for almost a full week and we ran on our generator. We had to make alterations in our services [because] patients still need care.

It's difficult for staff to come into work if they're not prepared themselves, if they don't have a generator or haven't made plans for childcare coverage because schools are closed during disasters, too. I see that changing the way that we work with our team to help make sure that they are prepared to be here for our patients in an emergency.

Almost the entire county went without power for a week and yet we didn't have a single staff member unable to report to work during that entire week because we spent the summer preparing them. We made sure that they knew what they were going to do if there was a fire or a power outage. It makes a real difference how we deliver care, if the staff can come into work and still do what they need to do to take care of the community.

HL: Going back to value-based, could you detail some ways you have added incentives to programs that move care toward a value-based model?

Peterson: At Sutter Lakeside, if you take out the one week in 2018 where we evacuated and incurred costs despite zero patient volume, we watched our cost for adjusted discharges go down. It did not just increase at a rate lower than inflation, but it went down for five consecutive years. We attribute our success in doing that to working with our physicians and delivering better quality.

We're working on enhanced recovery after surgery (ERAS)—one of those initiatives that is taking hold in the industry—to take the right steps pre-surgery, throughout surgery, and immediately postoperative. Then, the patient's going to recover faster, have a better recovery, and go home healthier.

There are a lot of steps you can take around quality that impact the total cost of care as well. We've tried to embrace that, and we've seen a lot of success in delivering more value-based care by improving quality. We're looking at how do we align our physician leaders around our service lines and help work with them toward better patient outcomes. With our total joint program at SSRRH, we've seen improvement in both patient outcomes and length of stay by partnering with those physicians and taking a service line–based approach to that.

If we can get care right the first time, get patients on the right medications, get them to the right clinician, and get the right test done quickly, then we can get patients through the system and discharged home in a better state more quickly and at a lower cost of care.

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.