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HL20: Wright L. Lassiter III—Getting Better All the Time

 |  By John Commins  
   December 13, 2011

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is the story of Wright L. Lassiter III.

This profile was published in the December, 2011 issue of HealthLeaders magazine.

 "Organizations like ours are large and complex and if you are going to drive accountability in your organization, then everybody has to play a part in solving problems."

In September, Alameda County Medical Center was recognized as a Top Performer in Key Quality Measures by The Joint Commission, which placed the safety-net health system among the top 14% of 3,099 accredited hospitals in the United States.

That distinction marked the latest affirmation of a remarkable turnaround for the Oakland, CA–based six-facility public system, which only six years earlier had been near collapse. That turnaround trajectory started in 2005—and not coincidentally—with the arrival of Wright L. Lassiter III as CEO.

In the year before his arrival at age 41, the federal government had threatened to pull the health system's accreditation for a number of jaw-dropping infractions, the most notorious of which was the strangulation death of a physician by a patient at ACMC's John George Psychiatric Pavilion. A few months before Lassiter took the job another patient at the pavilion had hanged herself in a doorway.

"I had some reservations about pursuing the job as I began to understand what some of the issues were. I had some natural trepidation about 'Is this something that is a wise career move?'" says Lassiter, who chose ACMC over the relative security of his executive post at JPS Health Network in Dallas. "I had a combination of private hospital experience with a public hospital inclination. This specific set of skills is very important."

"When I came out here my hope was that I could engineer the type of turnaround that would create a sustainable path for the organization," he says. "It wasn't just about money and quality indicators. It was about driving a different kind of culture. That stuff doesn't take a short period of time."

It wouldn't be accurate to say that there was a crisis in leadership at ACMC before Lassiter arrived, because there was no leadership. ACMC had chewed up and spat out 10 CEOs in the 10 years before him.

"What I inherited was the view that the CEO was a turnstile and a place of instability," he says. "Because the CEO role rotated so much, there was a fair amount of churn in the senior leadership and there was instability in leadership and direction."

ACMC's finances were a disaster. The health system's balance sheets were hemorrhaging red ink. ACMC owed the county about $200 million, with no immediate prospects for repayment. The mostly unionized staff was mired in a status quo culture of frustration, suspicion, and apathy.

Even with that uncertainty, Lassiter took the job because he was assured by the system's newly appointed board that it would support a change in culture. The public had also demonstrated its support for the mission before his arrival when it approve a sales tax hike that would generate about $75 million annually for the health system.

With the system's financial problems apparently stabilized, Lassiter says he planned to spend his first few weeks at ACMC "learning and listening to understand what the key priorities were, and then deciding where to go." That listening tour was scotched within the first week, however, "when I arrived and the first set of financials I saw showed that the organization was losing about $1 million a month," he says. "That was not something that was projected in the budget and it was something the board had not been made aware of. I had to plug a hole in a ship that was leaking oil badly. That was first priority."

With challenges come opportunities. Rather than wielding a budget cleaver and chopping staff, Lassiter hired a like-minded C-suite team that engaged staff to find savings across the organization and that would result in fewer job eliminations.

"We used a team approach to garner revenues, enhance cost savings, and find contract savings," he says. "We also had a (Centers for Medicare & Medicaid Services) survey of our psychiatric facility that happened six days on the job that wasn't particularly flattering.

It was the first time in my career that I had had a survey go that badly. I used that as a rallying cry for the organization and I challenged the organization. 'Do we believe we should go from survey to survey riding correction plans, or are we going to focus on creating discipline to demonstrate that we are better all the time?'"

While the first months on the job proved stressful, Lassiter says they also demonstrated his commitment to the mission, and his willingness to listen. 

"I thought it was important early in my career—and still to some extent now after a number of years—to make sure that the organization understands that the problems can't get solved in just the CEO's office, the proverbial ivory tower," he says. "Organizations like ours are large and complex and if you are going to drive accountability in your organization, then everybody has to play a part in solving problems."

Now, after six years, ACMC still faces challenges, including the prospect of lower Medicare and Medicaid payments. However, Lassiter believes ACMC has turned a corner. In addition to The Joint Commission recognition of improved quality, ACMC has also eliminated its leadership turnstile, and is operating—mostly—in the black. The system now looks to generate between $3 million and $5 million in net income each year, has whittled down its debt to the county to about $140 million, and plans to repay the debt by 2018.

From his office window, Lassiter can monitor construction of ACMC's $670 million expansion. When he walks the hallways he encounters dedicated professional staff providing quality care, often to the most vulnerable people in our society.

The son of an ordained minister, Lassiter says he gains spiritual fulfillment from the success of ACMC. "You get great satisfaction creating a high reliability, high quality, high patient experience organization and one that treats the people who don't have lots of options," he says. "So, to take care of this population is one of those things that gets me up in the morning."


This article appears in the December 2011 issue of HealthLeaders magazine.

 

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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