Latest / Becker’s Healthcare Podcast / Leading Rural Hospitals Through Financial Pressure and Change with Joe Caristi

Transcript

Leading Rural Hospitals Through Financial Pressure and Change with Joe Caristi · Becker’s Healthcare Podcast

• 0:00
  At Insight Global Health, we are dedicated to
• 0:02
  helping you and improving health care for everyone.
• 0:05
  That means building stronger teams and delivering sustainable
• 0:08
  solutions that truly make a difference.
• 0:10
  We offer a full spectrum of talent and
• 0:12
  technical services and deliver cross industry expertise
• 0:15
  to bring you innovative best practices to solve
• 0:18
  the problems that we face in health care.
• 0:20
  We're not just promising you results, we are
• 0:22
  delivering them. Visit us at insightglobal.com.
• 0:26
  Welcome to the Becker's Healthcare podcast recorded live
• 0:28
  at Becker's sixteenth annual meeting at the Hyatt
• 0:30
  Regency in Chicago.
• 0:32
  I'm Ella Reuter, a writer for our behavioral
• 0:34
  health line, and your host today. I'm joined
• 0:36
  by Joe Caristi,
• 0:38
  CFO and of Sphere Memorial Hospital based in
• 0:41
  Plymouth, New Hampshire. Joe, thank you for being
• 0:43
  here. Thank you for having me. Could you
• 0:45
  please briefly introduce yourself, your role, and the
• 0:48
  scope of your organization,
• 0:49
  and kind of what's top of mind and
• 0:51
  commanding most of your attention as a leader?
• 0:54
  Sure.
• 0:55
  So,
• 0:56
  so I'm the CFO of Spear Memorial Hospital.
• 0:59
  We're a 25 bed critical access hospital located
• 1:01
  in, sort of Northern Central New Hampshire. We're
• 1:04
  one of the few, hospitals in our area
• 1:06
  that are still fully independent,
• 1:09
  and that also offer labor and delivery services
• 1:12
  to our community.
• 1:13
  We we serve a population of around 48,000
• 1:16
  residents.
• 1:17
  And, you know, what well, I guess what's
• 1:19
  top of mind, especially in, kind of the
• 1:21
  the market of the next two to three
• 1:23
  years is,
• 1:24
  just really making sure that our finances,
• 1:28
  trend in in,
• 1:30
  a positive direction or at least try to
• 1:32
  mitigate as much negative impact as possible.
• 1:34
  You know, it's certainly a a very, challenging
• 1:37
  and maybe at some point scary time from
• 1:39
  a finance perspective in rural health care.
• 1:42
  But, you know, so I I guess to
• 1:44
  put it a little more eloquently, you know,
• 1:46
  making sure we keep the doors open for
• 1:47
  our community. 100%. Well, thank you for that
• 1:50
  intro. And in a year marked by rapid
• 1:52
  change, what recent decision or pivot required the
• 1:55
  most leadership conviction
• 1:57
  from you, particularly when it came to aligning
• 2:00
  people, resources, or capabilities?
• 2:03
  Sure. So, so post COVID, actually, at Spear,
• 2:05
  you know, we've we've been posting a loss
• 2:07
  from operations.
• 2:08
  And knowing that the years to come are
• 2:10
  actually gonna get harder, That's had a lot
• 2:12
  of internal conversations about how do we right
• 2:14
  the ship in a time frame that that
• 2:16
  is,
• 2:16
  a lot tighter than normal, let's say.
• 2:19
  And so we've had a lot of internal
• 2:21
  conversations.
• 2:22
  Some of those have been,
• 2:24
  I would say, tried and true
• 2:26
  things we often focus on in health care,
• 2:28
  fixing schedules and maximizing productivity,
• 2:31
  you know, pursuing growth opportunities when appropriate,
• 2:34
  but then also investing in in technology to
• 2:37
  try to help our staff be more effective
• 2:38
  and more efficient in the work that they
• 2:40
  do,
• 2:41
  without burning them out. So, you know, that
• 2:43
  kind of merriment of,
• 2:45
  what we've always done, but also,
• 2:47
  really bringing new technology to bear,
• 2:50
  has really helped us. And I I think
• 2:52
  our finances are definitely moving in the right
• 2:54
  direction.
• 2:55
  And and some of these, investments and improvements
• 2:57
  we're making are really gonna position us well,
• 2:59
  in the years to come.
• 3:01
  And how did that moment challenge your assumptions,
• 3:04
  and what did it change about how you
• 3:06
  approach decision making, talent, or organizational readiness today?
• 3:11
  It's a great question. I think we had
• 3:13
  to implement some changes at a pace and
• 3:16
  a scale
• 3:17
  that really didn't lend itself well to change
• 3:20
  management, I guess you could say. And,
• 3:23
  I'm a firm believer in in relationships,
• 3:26
  and investing in relationships when it's easy so
• 3:28
  that when you have to do the hard
• 3:29
  work, it's a little bit easier.
• 3:31
  Unfortunately, I've I've only been at Spear for
• 3:33
  two years, so I didn't have the time
• 3:34
  to make some of those, relationships.
• 3:37
  And so, you know, when we really had
• 3:39
  to start moving the needle on some of
• 3:40
  these things,
• 3:41
  it really required, I think, leadership presence, not
• 3:44
  just leadership decisions.
• 3:46
  And,
• 3:47
  we really had to to to to be
• 3:50
  available to our staff to,
• 3:52
  have vulnerable moments with them, be authentic,
• 3:55
  but also really try to help them understand
• 3:56
  the the decisions that we're making are for
• 3:58
  the right reasons.
• 4:00
  And really, I I would say more you
• 4:01
  know, as a as a true community hospital,
• 4:04
  we're independent.
• 4:06
  We answer to a board of volunteers from
• 4:08
  the towns that we serve.
• 4:10
  You know,
• 4:11
  we have such an investment in making sure
• 4:13
  that we exist for our community.
• 4:16
  That really helps us when it comes to
• 4:17
  some of those chief management things because we
• 4:19
  can talk to our own staff who are
• 4:21
  also taking care of their family and friends
• 4:23
  who live in the same area and and,
• 4:25
  help them understand that we'd have to do
• 4:27
  this to keep the hospital here.
• 4:29
  And when you think about the forces reshaping
• 4:32
  health care right now, where do you believe
• 4:34
  leaders need to be more decisive,
• 4:36
  especially when balancing
• 4:37
  speed, risk, and having the right teams in
• 4:40
  place?
• 4:41
  I certainly think, leadership teams need to be
• 4:43
  investing in relationships.
• 4:46
  And that's not necessarily
• 4:48
  town halls, but that's,
• 4:49
  you know, rounding and,
• 4:51
  you know, meeting your staff one on one,
• 4:54
  knowing their names,
• 4:55
  you know, and that's something that I'm very
• 4:58
  much still trying to do myself.
• 5:00
  But I think, again, those relationships are gonna
• 5:02
  allow us to implement change at a much
• 5:04
  faster pace.
• 5:06
  And we're going to have to implement change
• 5:07
  at a very rapid pace,
• 5:09
  in in the years to come. I also
• 5:12
  think from a decisive perspective,
• 5:14
  I think organizations
• 5:15
  really need to to have a hard look
• 5:17
  at their,
• 5:18
  their technology solutions, their architecture,
• 5:22
  how are they staffing their IT teams, do
• 5:24
  they have the right talents to, execute the
• 5:26
  projects that they want. We've done a lot
• 5:28
  of investment in our IT team and Spear
• 5:30
  over the past couple of years, really trying
• 5:32
  to to round out that skill set, make
• 5:34
  sure that we have the right folks in
• 5:35
  place. And it's truly enabled us to execute,
• 5:40
  some of these projects at a much, more
• 5:42
  rapid pace, a much more effective pace.
• 5:45
  It it's actually I'm super proud of what
• 5:47
  our IT team can do at a critical
• 5:48
  access hospital. So
• 5:50
  It's incredible.
• 5:51
  As uncertainty
• 5:52
  has become the norm, what leadership habit or
• 5:55
  mindset has been most critical in keeping your
• 5:58
  organization
• 5:59
  and your people moving forward?
• 6:01
  I think
• 6:02
  really focusing on the things that we can
• 6:04
  control is really important. There's so much noise
• 6:07
  out there, especially from the political spectrum around
• 6:10
  health care.
• 6:11
  But much of that is really outside of
• 6:13
  our span of control.
• 6:14
  Right?
• 6:16
  And I would even argue, though, larger organizations
• 6:18
  that might have lobbyists and things like that,
• 6:20
  their true ability to influence any of those
• 6:22
  outcomes or decisions at a policy level or
• 6:25
  or anything to that effect
• 6:27
  are are rather limited. Right? And so, you
• 6:29
  know, I I think a healthy habit is
• 6:33
  let that noise be noise,
• 6:35
  and really try to focus on the things
• 6:36
  we actually can control,
• 6:38
  which is usually within the four walls of
• 6:40
  our building, how do we become more effective,
• 6:42
  more efficient, things like that.
• 6:45
  And looking ahead five years,
• 6:47
  how do you expect global labor dynamics to
• 6:50
  shape the health care workforce, and what strategic
• 6:54
  shifts are you making now to stay ahead
• 6:56
  of that change?
• 6:57
  I think,
• 6:59
  this question really lends itself well to the
• 7:01
  advent of AI and the impact that AI
• 7:03
  is going to have on health care. I
• 7:06
  very much view AI as another tool. It's
• 7:08
  a massive tool. It's gonna help us step,
• 7:11
  in a very big direction in the right
• 7:13
  way.
• 7:14
  I really think it's gonna help us,
• 7:17
  do some of the the things that staff
• 7:18
  hate doing the most
• 7:20
  so that we can focus our efforts on
• 7:22
  more complex problems.
• 7:24
  You know, I I'm a systems engineer by
• 7:26
  by training to some degree. At least that's
• 7:28
  what my education is.
• 7:30
  And so I I really believe in this
• 7:32
  notion that we're running highly complex systems in
• 7:35
  health care.
• 7:36
  And I think AI is going to allow
• 7:38
  us to lead those complex systems to achieve
• 7:40
  a higher purpose.
• 7:41
  And so when I relate that back to
• 7:43
  workforce,
• 7:44
  you know, there there's so many aspects of
• 7:46
  our workforce that, that are understaffed,
• 7:49
  that are overworked, that are, just frustrated, constrained.
• 7:53
  I think AI can help eliminate a lot
• 7:55
  of that burden and that frustration
• 7:57
  and, and really open us up to do
• 7:59
  the things that we all actually enjoy today.
• 8:02
  So it's a really exciting time,
• 8:04
  but it's also a challenging time to say
• 8:07
  the least. For sure. Well, Joe, thank you
• 8:09
  so much for joining us today, and thank
• 8:11
  you for tuning in to the Becker's Healthcare
• 8:13
  Podcast brought to you by Insight Global Health.
• 8:16
  If you enjoyed this discussion, be sure to
• 8:17
  follow us for more conversations from Becker's sixteenth
• 8:20
  annual meeting. I'm Ella Reuter, and thanks for
• 8:23
  listening.