HealthLeaders Media extends congratulations to James J. Bleicher, MD, president and CEO of Verde Valley Medical Center in Cottonwood, AZ.
Bleicher is the 2012 winner of the American Hospital Association's Shirley Ann Munroe Leadership Award, which recognizes the feats of small hospital leaders who have improved healthcare delivery in their communities.
AHA has cited a number of achievements at the nonprofit, 99-bed VVMC since Bleicher, a hospitalist, became CEO in 2009. They include collaborative health initiatives with community physicians, school districts, and an academic center designed to improve community health and access to healthcare, particularly for underserved groups that include Native Americans, Latinos, the uninsured, the elderly, and those with no access to primary care.
Under Bleicher's leadership, cancer treatments are available in the North Central Arizona region that VVMC serves as part of the Northern Arizona Healthcare system. VVMC has also embraced telemedicine and other remote communications that allow for programs and services that include research trials and tumor boards led by expert clinicians.
AHA says the success of VVMC under Bleicher's tenure is measurable. When he became CEO, VVMC's Hospital Quality Alliance measures averaged 65%. Three years later they are average 92%.
VVMC has had no central line infections for three years and no ventilator-assisted pneumonia for four years. Employee engagement has increased from the 18th percentile to the 90th percentile.
Bleicher recently spoke with HealthLeaders Media about his success at VVMC.
HLM: Why did you win this award?
JB: "It was a team effort. We started off as a whole hospital concept and it became our culture. It was involving everybody including the community, all the staff, all the physicians. It really made a difference for this hospital and community, which is the one of the most important things, especially for a smaller community.
Hospitals have to understand that symbiotic relationship; us being the largest employer in town and being in an Arizona retirement community. People will move to a retirement community if they have great healthcare and we put that together for everyone and delivered some results that really made a difference."
HLM: What did you change that allowed VVMC to flourish?
JB: "It was the measure of focus. It wasn't about me or them. It was about all of us. It was about the community. It was about the patient. A lot of places talk about putting the patient at the top of the pyramid and doing everything for them but we really live that.
Every decision we make was based on something for the patient; quality, service, safety, and that is how we based our decisions. That permeated throughout the hospital. Every worker understood that.
When we had forums with the staff, I'd say 'look there is a reason why I'm not talking about finances first because that is not the most important thing.' Every hospital talks about 'no margin no mission' but we really put quality and safety and service above finances appropriately to make the changes. It is easy to get healthcare workers to rally around that because it means something to them."
HLM: What changed at VVMC when you took over as CEO?
JB: "We had a strategic planning meeting with the board about the time I was transitioning from chief medical officer to CEO. They came out of this big session with a big (Strengths, Weaknesses, Opportunities, and Threats) analysis which said that people weren't nice, service wasn't good, quality was low, the community doesn't think we have a good product.
They said 'let's go out and develop service lines and new marketing.' I basically said 'OK,' and then transitioned and said 'no we aren't going to do that. We need to improve all of these other things first. It matters much more.' So it was a 180-degree turn really from where we were going before."
HLM: What special skills are needed to be an effective leader at a smaller hospital?
JB: "It is imperative that you are—and it sounds cliché—a man or a woman of the people. That includes all of the constituents of the hospital as well as the community. It means trying to walk a day in their shoes. I spent a lot of time just walking around, being in different departments and in different areas of the community. Not there to preach or orate, but to listen and get to know people on a personal level.
That is an advantage in a smaller hospital. I have about 800 employees in total and I may not know all their first names but I recognize all of them, talk to all of them, have conversations about their children, about the community, about sports, or whatever happens to be their interest.
But it's about their interests. Not 'Hey I'm Dr. Bleicher, CEO. What are you doing for me?' It was totally flipping it. Obviously if you have 5,000 employees that makes it a lot more difficult. But if you only have 800 you need to do that."
HLM: How has being a physician affected your role as a hospital leader?
JB: "I have to be careful because the people who read this who aren't physicians will say 'wow what the hell does he think?'—but you are running a hospital. There are conversations in every board meeting and staff meeting that involve care, that as a physician I understand at a much deeper level having been a practicing physician.
I can have those one-on-one conversations with a cardiologist or a general surgeon or an internist about what the call or the case is like. When I say we are going to put quality and safety first I can really mean it.
Obviously that is a trend nationwide. There are more physicians running hospitals whereas 20 years ago you had maybe one at Cleveland Clinic and a few academic medical centers. Now people are saying 'well hey it kind of makes sense if you have the right person.' It doesn't mean that every physician should be a CEO, obviously."
HLM: How do you see healthcare reform affecting your hospital?
JB: "It's going to become more of a community asset. We have to work together with limited resources in the community and get the job done together. We are trying to work more closely with the school district and other volunteer groups that normally have nothing to do with the hospital.
We need to be the conduit for all of that and bring everyone together if we are going to improve the health of the community. We can't do it alone. They can't do it alone. We need to do it together. It's going to tighten that relationship even more."
HLM: Will VVMC be part of any mergers or acquisitions?
JB: "The board has evaluated that several times and at this point they don't see an advantage in doing that. But they are always watching to see what is out there and what makes sense.
Because we are so rural and distant from a big city—we are 100 miles north of Phoenix—there may not be that many economies of scale. But the board is keenly aware and every couple of years re-evaluates it."
HLM: How can other hospital leaders emulate your success?
JB: "First, you have to be true to yourself and do what is right for the patient. If you're doing what is right for the patient good things will happen. It simplifies the process. A lot of people say it but they don't necessarily live by it.
You have to put the accountability and all of the processes behind that but when you do it makes decisions a lot easier. Does this make sense for the patient? Whether it is an operational thing or an efficiency thing in the past you'd say 'it makes sense for the nurse or doctor, but look what it's doing for the patient.'
Then you'd say 'we'd better switch back.' But if you are truly doing it with the patient in mind it does make decisions easier. There are things you wouldn't see before because of your own personal biases. If you're a nurse or a doctor or a tech or an administrator you'd think things should go this way but if you follow the patient path it becomes more efficient."
John Commins is the news editor for HealthLeaders.