Robert L. (Bob) Smith, a retired Tenet Healthcare Corp. executive, has been named interim CEO of the beleaguered Parkland Health & Hospital System. His four-month agreement is effective Sept. 1.
"A little shell shocked but excited" is how Robert L. (Bob) Smith describes his mood one day after being named the second interim CEO for Parkland Health and Hospital System in Dallas.
The former Tenet Healthcare executive is leaving the comforts of retirement to help Parkland get on track. The safety net hospital must satisfy a large number of federally mandated requirements put in place after a series of surveys identified an extensive list of deficiencies deemed so serious as to create immediate and serious threats to patient health and safety. Parkland has until April 2013 to become compliant or face termination of its Medicare and Medicaid funding.
Smith succeeds Thomas Royer, MD, who retired in June 2011 as president and CEO of Dallas-based CHRISTUS Health and was named Parkland's interim CEO in Dec. 2011.
In an interview with HealthLeaders Media, Smith talked about his philosophy of problem solving, his preparation for the Parkland job, and why he decided to take on the challenge.
Q. How do you prepare for a job like this?
A. My preparation is 35 years of experience working at a number of hospitals in a number of states. I've been involved at multiple levels up and down the line, including CEO and COO. It's having seen things before and knowing what works and what doesn't.
Problems are solved by smart people who listen to one another, jointly make decisions, and then move forward. What you do to prepare is talk to people, listen to people, and work together as a team to deal with the tasks at hand. You pull from your experiences as well as the experiences of others.
Q. In your opinion, what is the root cause of Parkland's problems?
A. I have to say that I really haven't been there. I am at the facility today and I attended a few board meetings yesterday but I can't give a qualified answer right now. I didn't go through an interview process that included spending time in the hospital.
Q. How did you come to be named as Parkland's new interim CEO?
A. I was with Tenet Healthcare for quite a while and retired last year. I told a number industry contacts that I would be interested in working on assignments on an interim basis. One of those contacts was involved in some of the turnaround process here at Parkland and encouraged the board chair [Debbie Branson] to contact me. I spoke with the chair and some of the individual board members.
My agreement starts on Sept. 1 but I won't be on site yet. I will be doing a series of orientation calls to make sure that once I am physically here I will be up to speed.
Q. What authority will you have to resolve the problems at Parkland?
A. I think the board views me as the CEO on an interim basis. With the exception of hiring and terminating individuals in the executive ranks I will have full authority to continue the work that's underway and to make the changes that are necessary. I just won't be making high level executive changes without board involvement. No CEO would.
Q. You're credited with turning around Tenet's central states region. What problems did you face?
A. Facilities were going through leadership changes as a result of problems within Tenet. There was a lot of turnover among hospital and corporate executives. When I came on in 2003 I dealt with talent management and talent placement as a means to affect a change in the overall operation of the region. I put new leadership in place and refashioned the executive talent at the facilities. It took several years to get that in place.
Q. You've commented that you have seen similar problems at other hospitals—not to the same extent—but that the problems at Parkland are solvable. Can you provide examples of similar problems and the steps you took to resolve them?
A. I'd have to go through a lengthy list. It's all about people though. If it's a financial problem you help people understand how what they do has an impact on the overall financial well-being of the facility. When you have quality and safety issues, and they are usually the same thing, you focus on becoming a highly reliable organization.
I'll work to help each individual who works here to understand how they impact the culture of safety, the overall reduction of risk, and the improvement of quality. You solve problems through communication, visibility, and leadership by example. That means making sure the frontline supervisors understand how they impact and sustain the improvement process by leading by example.
Q. The June progress report from Alvarez & Marsal noted ongoing concerns about patient safety and adverse events that continue to happen at the hospital. How can large-scale, systemic issues be resolved?
A. Rather than take isolated incidents and look at them one at a time, it's important to look at trending commonalities. It's really understanding how we can get immediacy of reporting data and metrics to improve that process. Tom was working on this. We need to continue that effort, The organization needs to have a robust reporting process in place so we can address the issues.
Q. Have you had any discussions with Dr. Royer?
A. I know Tom. We both worked at Christus. I spent time with him yesterday and I'll spend time with him today.
Q. Your current contract is for four months. Are you committed to staying until a permanent CEO is named?
A. I am, but that's at the will of the board. I am not a candidate for the permanent CEO position. At this stage in my career it's not something I am interested in. If I were at a younger stage in my career it would be an attractive position.
Q. Why did you take on this job?
A. I didn't just get a telephone call and say, 'okay I'm in.' Parkland has had a great reputation over the years for saving lives and performing miracles. There are a large number of very dedicated people at Parkland who are doing the right thing but are faced with a challenge right now. Who wouldn't want to be part of this?
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
