Joshua Lenchus' leadership style is to seek consensus and to try to ensure that everyone's voice is heard.
Broward Health has elevated Joshua Lenchus, DO, from interim chief medical officer to chief medical officer.
In September 2018, Lenchus joined the Fort Lauderdale, Florida-based health system as chief medical officer of Broward Health Medical Center. He was named as the health system's interim chief medical officer in July 2021.
Before joining Broward Health, he served as chief of staff and as an internal medicine/hospitalist at Jackson Memorial Hospital in Miami. He was also associate program director for the University of Miami Jackson Internal Medicine Residency Program.
HealthLeaders recently spoke with Lenchus about becoming the permanent chief medical officer at Broward Health and a range of issues, including physician engagement, patient safety, and quality improvement. The following transcript of that conversation has been edited for clarity and brevity.
HealthLeaders: What are the primary elements of physician engagement?
Joshua Lenchus: Physician engagement is predicated on credibility, networking, and relationships. To engage folks as a fellow physician, you need to build those foundational elements to be successful. This helps us in problem solving, appropriate communication, and timely responses.
The office of chief medical officer is responsible chiefly for problem solving. So, on a day-to-day basis, we have people who bring up issues and we must understand the mindset of the individuals that bring up the issues. That level of understanding is predicated on networking and relationship building.
HL: What are your goals for patient safety at Broward Health?
Lenchus: Our patient safety goals at Broward Health are similar to other healthcare organizations across the nation. We are trying to create the safest environment in which patient care can be provided. There are always opportunities for improvement through identifying issues that preclude us from achieving a 100% patient-safe environment. Once those issues are identified, we put them through a root cause analysis to try to identify system-based solutions to mitigating future events from happening. We are always looking at providing the safest care that we can to our patients, who entrust us to do so.
HL: Are there particular safety issues that you are personally interested in?
Lenchus: I have a predilection for the more clinical patient safety goals such as prevention of infections. I have a background as a pharmacist, so medication safety is a personal and professional interest of mine. Of course, all patient safety issues are equally important, and we focus on all of them.
HL: What are your goals for quality improvement at Broward Health?
Lenchus: Similarly to patient safety, we obviously want to provide the best quality to the patients that we care for. We are doing a good job on that path. We have a graduate medical education program at two of our four hospitals. Involving residents in education necessitates keeping up on the transformation of medical practice throughout the health system, which only emboldens us to continue to take steps in a positive direction by providing high-quality care.
We recognize that standardization has its limits—each patient is an individual—but to the extent that we can standardize the care that we provide in an evidence-based manner is a primary goal in quality improvement.
HL: What is your vision for the role of the CMO at Broward Health?
Lenchus: My goal is to collate best practices, not just across our institution but also among other institutions with whom I have relationships, in an effort to apply best practices at Broward Health. I realize that not everything that works at another site may work at Broward; but to the extent that we can bring transformation here, my job is to navigate and spearhead transformation along with the medical staff, nursing leaders, and administrators to move the health system forward.
As the highest-ranking clinician in the organization, it also is my job to ensure that clinical practice is front-and-center in everything that we do. That means that the care of the patient takes precedence over everything else. The health system has been a part of the community for nearly a century, and the patient has always been at the heart of what we do. I see my job as furthering that mission to provide the high-quality care that our community should expect when they come to see a Broward Health physician or when they come to seek care at a Broward Health facility.
HL: How do you view the CMO as a member of the C-suite team?
Lenchus: At finance meetings, operational meetings, and strategic meetings, it is my job to keep the clinician within that conversation. So, when we have conversations of a nonclinical nature, it is important to have a clinical voice in the room because, sometimes, we may want to make a move financially or operationally that discounts the role that the clinical workforce has in the organization. Frankly, the workforce that we have at Broward Health is largely clinical, so it would be a grave omission for the CMO's voice not to be heard. I carry the torch for the clinical folks—doctors, nurses, therapists, and support staff who work in the health system.
HL: How do you see your role as CMO as the coronavirus pandemic continues?
Lenchus: I work with a host of specialists and representatives of diverse departments. From the outset of the pandemic, we have developed several task forces for different aspects of our preparedness and interventions. With medications, there are specialists in infectious disease, pharmacy, nursing, and the emergency room that we work with to gain experience and insight. If we are talking about masking, testing, vaccines, and the host of other facets in our response to the coronavirus pandemic, we have created task forces to leverage talent so that you can hear a multitude of perspectives and interests to come to a palatable solution in trying to move the institution in the right direction. My role is to work closely with these specialists and task forces.
HL: How would you characterize your leadership style?
Lenchus: I have had the pleasure over my years in medicine of working with incredibly talented and knowledgeable people. My leadership style has always been to try to recognize the talent in the room and leverage folks for their strengths. When I must manage a situation, I try to engage the people who are going to be affected downstream. Even if I create a solution in draft form, I want to give people something to build upon. I try to engage people, so they have ownership over whatever solution we are going to implement.
I do not rule by executive fiat—I operate more on a consensus method. In management, as any leader will tell you, you cannot appease everyone at all times. However, the objective is to ensure that everyone's voice is heard, and everyone is at the table to provide their unique perspective. It would be incredibly presumptuous of me to think that I have all of the answers. That is why I try to include as many people as possible in change management.
Related: New Mass General Brigham CMO Shares Goals and Perspectives
Christopher Cheney is the CMO editor at HealthLeaders.
KEY TAKEAWAYS
Physician engagement requires credibility, networking, and relationships.
Once patient safety issues are identified, a root cause analysis should be conducted to identify system-based solutions to avoid future adverse events.
Joshua Lenchus' approach to serving as CMO is to promote the adoption of best practices and to make sure clinical perspectives are considered in all decision-making.