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MarinHealth CEO's Pandemic Advice: 'Remain Focused,' Don't Get Distracted

Analysis  |  By Melanie Blackman  
   November 12, 2020

Dr. David Klein shares how his background as a practicing surgeon has shaped his leadership style and his experience with starting a new role during the pandemic.

September brought significant changes to MarinHealth, the Northern California–based health system.

First, Dr. David Klein succeeded Lee Domanico, who retired at the end of the month, as the health system's new CEO.

Secondly, MarinHealth also opened a new hospital pavilion called The Oak Pavilion on the North Bay Medical Center campus. The pavilion has 114 private patient rooms, a larger emergency department and trauma center, a new maternity area, and surgical and procedural areas.

Klein recently spoke with HealthLeaders about how his background as a practicing surgeon has shaped his leadership style, his experience leading through the pandemic, and what upcoming strategies he has in mind for MarinHealth post-pandemic.

Dr. David Klein, CEO, MarinHealth (photo courtesy of MarinHealth)

This transcript has been lightly edited for clarity and brevity.

HealthLeaders: How has your background as a practicing surgeon shaped how you lead?

David Klein: Having been on all sides of the healthcare equation, [from] being a provider, a patient, the father of a sick child, and now an administrator, allows me to see the entire spectrum of healthcare and how it can be delivered better.

As a surgeon, my first focus has always been quality and safety. I have a clinical mind so when I address problems, I do a couple things. Number one is to make sure that we're ensuring the highest quality and safety. Number two is to make sure that we always put the patient at the center of everything we do and every decision that we make.

The other thing that has helped me is achieving and maintaining good, strong physician relationships. I think that it's important that we have a high quality physician network, and the ability to relate to our physicians and having walked in their shoes, if you will, has been beneficial for me during my administrative career.

HL: You had the opportunity to work with Lee Domanico, the previous CEO of MarinHealth, for the month of September before he retired. Can you talk about your transition during that month, and what it was like having an overlap with the previous CEO?

Klein: Lee's been at the helm of this organization for over 10 years and has done just a remarkable job getting MarinHealth to where it is today, including overseeing the construction of our new hospital pavilion. He has deep knowledge of the Marin network, and all the stakeholders in the market. That transition period was beneficial, mainly because he introduced me to a lot of the stakeholders in the community, [staff] in the hospital, and gave me a good understanding of the background of the community.

HL: The press release announcing your new role stated your highest priorities for MarinHealth are “maintaining safety, excellent outcomes, and creating an outstanding patient-centric experience." What strategies do you plan to put in place to achieve these goals during the pandemic?

Klein: There [are] several of them. One is that we must acknowledge the challenges that we're experiencing right now. Currently, our biggest challenge is the significant financial impact of COVID and how we need to be prepared for future surges, and make sure that we can always meet the essential needs of our community, COVID and non-COVID related, and above all, protect our patients and our staff.

Longer-term we need to prepare the organization for whatever the future might bring. We need to make sure that we have strong financial security, that we'll continue to provide a real high quality level of care, that we're taking care of our community addressing the needs including social determinants of health, and making sure that we're eliminating healthcare disparities.

Finally, we need to make sure that we have a strategic plan as we move forward so that we can operate efficiently, improve our consumer platform, and [know] that the organization is in a good position to take care of all the potential future needs of the community that we serve.

HL: What has the pandemic looked like at MarinHealth since the beginning of September?

Klein: The Bay Area has done quite well compared to the rest of the country. What we've seen in our organization most recently is fewer and fewer patients that have needed to be hospitalized. We've also noticed that [patients] haven't been quite as sick as they were early on in the pandemic.

MarinHealth did a good job in the early days by establishing a safe place for care, making sure we were following all the protocols, making sure that above all our staff was safe and protected, and that we had adequate PPE to ensure that our patients have a safe way to get in the hospital and receive the highest level of care.

Now we're focusing on making sure that we're prepared for the next potential surge or wave.

Our staff is better prepared. We have stockpiled PPE. We are working on increasing the number of testing platforms that we have so that we're able to not only test our patients, which we do currently, but all of our staff and providers, and of course we would like to also provide support to the community.

One of the nice things that MarinHealth did is work with the healthcare district to provide funding to do outreach into vulnerable areas of our community. Those areas are particularly underprivileged or have healthcare disparities, [in addition] to our nursing homes in some of the more vulnerable populations. We had mobile vans going out to deploy equipment, [conduct] testing, and make sure that we were serving the entire community.

HL: How did taking over in the middle of a pandemic change/steer your priorities and strategies for the health system?

Klein: No matter whether you're starting in a pandemic or during more common times, the key is being able to be strategic and innovative, and above all else, customer-focused.

I always say that we need to adapt quickly. One of the things about MarinHealth that was attractive to me is that it's an independent system. It's an excellent organization, and because it's independent and small as compared to [places I've worked] before, it's fairly nimble. We're able to adapt quickly. I think that ability to move and to change things quickly has helped us to navigate the pandemic more efficiently and it'll also help prepare us for the future.

The key for me in starting during a pandemic is to remain focused, not get distracted, and work on our long-range plan and forming strategic goals.

HL: Outside of the pandemic, what future initiatives are you aiming to pursue as CEO?

Klein: We're going to be starting a brand-new strategic planning process. Although we are always going to want to provide a high quality, safe, efficient, patient-centered care, we want to make sure that we're utilizing strategic discipline and operational efficiency to make sure that we provide the best healthcare in the area.

That comes with several growth opportunities that we're able to look at. New alliances and partnerships, including physicians and increasing our physician recruitment. We have a strong academic affiliation with the University of California, San Francisco (UCSF) and are looking at better ways that we can leverage that relationship to improve the healthcare in our community by providing additional services, and improve upon the services that we currently provide.

I think the future is bright. There's a pandemic that's helped us to look at new and better ways to provide care, and I think that we just need to focus on what we should be doing, what we do well, and then looking at our growth opportunities while maintaining good cost control and operational efficiency.

HL: What was the strategy behind opening The Oak Pavilion at MarinHealth Medical Center, and how has it helped during the pandemic?

Klein: We opened on September 29 and moved most of our acute care into that pavilion in one day.

It's a patient-focused, healing environment. It has so many enhanced safety features and care features that appeal to me and my clinical background. This is one of the most technologically advanced facilities that I've ever worked in.

The other thing that's exciting to note is in addition to all the advanced technology that we have, this building is ideal for caring for patients during this pandemic. I say that because we have much wider spaces, we have a separation between our staff corridors and our patient quarters, every room in the new hospital can be switched over to negative pressure, which is sometimes needed in a pandemic such as COVID.
All the surfaces are easily cleanable, all our rooms have advanced video monitoring capabilities so that in situations where it's feasible and patient centric, doctors or providers don't have to always enter the room to communicate with patients. Equally as important, the patients can communicate with their families if they're in isolation. For example, they can do video visits in chats with their families in their rooms in a comfortable and safe manner.

We have all private rooms which makes a big difference, and we don't have to shift patients around. The other great thing, as you would hope, is that it's environmentally sustainable. We're LEED Silver designated.

It's quite a facility, and as it turned out, it's serendipitous.

Related: MarinHealth names successor to retiring CEO Domanico

Related: MarinHealth Flips Virtual Care Model to Protect Staff From COVID-19

Related: 3 Traits Independent Hospitals Need to Succeed

Related: MarinHealth CFO Eric Brettner on Putting Capitation to Use for a Rural Patient Population

“The key for me in starting during a pandemic is to remain focused, not get distracted, and work on our long-range plan and forming strategic goals.”

Melanie Blackman is the strategy editor at HealthLeaders, an HCPro brand.

Photo credit: MarinHealth Oak Pavilion (photo courtesy of MarinHealth)


Dr. David Klein's training as a practicing surgeon has kept quality and safety of patients as his primary focus serving as MarinHealth’s new CEO.

“The key for me in starting during a pandemic is to remain focused, not get distracted, and work on our long-range plan and forming strategic goals,” Klein told HealthLeaders.

Additionally, he discussed MarinHealth’s new hospital pavilion, which opened on September 29.

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