Latest / Becker’s Healthcare Podcast / Leading with Quality and Culture from the CEO Seat with Les Hirsch

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Leading with Quality and Culture from the CEO Seat with Les Hirsch · Becker’s Healthcare Podcast

0:00
This is Laura Dierdo with the Becker's Healthcare
0:02
podcast. I'm thrilled today to be joined by
0:04
Les Hirsch, president and CEO of St. Peter's
0:07
Healthcare System. Les, it's a pleasure to have
0:09
you on the podcast today. Well, thank you,
0:11
Laura. It's great to be with you.
0:13
Absolutely. Now I'm excited for our conversation. We're
0:15
gonna be talking about quality and patient safety
0:18
from the CEO's perspective and how you at
0:20
Saint Peter's has made really an important impact
0:23
on the culture of patient safety and quality
0:25
and more. So I'm I'm excited to dig
0:27
into that discussion. But before we dive in,
0:30
can you introduce yourself and just tell us
0:31
a little bit more about St. Peter's Healthcare
0:33
System?
0:34
Sure.
0:36
As we said, my name is Les Hirsch,
0:37
and I am the president and CEO at
0:39
St. Peter's Healthcare System. We are located in
0:42
New Brunswick,
0:45
Jersey. We are neighbors of Rutgers University.
0:47
And we are, one of the few remaining,
0:50
what I like to refer to as, single
0:52
hospital health systems in the state. We are
0:55
not part of a larger system.
0:57
We are still on our own operating independently.
1:01
We are anchored by Saint Peter's University Hospital,
1:05
which also as part of that, we are
1:07
a licensed children's hospital,
1:09
by the state of New Jersey. So we
1:11
have the what we refer to as the
1:14
children's hospital
1:15
at Saint Peter's right here.
1:18
We also have a network of ambulatory
1:20
sites.
1:21
Our biggest center of which is a a
1:24
70,000
1:24
square foot facility,
1:26
about five miles away
1:28
known as our family health center, the Saint
1:30
Peter's Family Health Center.
1:32
And, we have a variety of services there,
1:35
about 84,000
1:37
visits a year.
1:39
And, again,
1:40
medical services, outpatient medical, women's, children's,
1:45
we also have our child protection center there,
1:47
which is one of four state
1:49
designated
1:50
centers.
1:51
And, and and then we have a network
1:53
of physician offices. But the the largest part
1:56
of our system is Saint Peter's University Hospital.
1:59
We are affiliated with Rutgers,
2:02
largely as, our academic affiliate.
2:06
We have numerous,
2:08
relationships with,
2:09
Rutgers,
2:10
and we are a major teaching hospital where
2:12
we have about a 130
2:15
residents and fellows,
2:16
some of which come from Rutgers,
2:20
but the majority of which are programs that
2:23
we sponsor
2:24
in
2:25
medicine, OB GYN, peds,
2:27
and then also some fellowship programs in pulmonary
2:30
medicine and GI.
2:32
So,
2:33
you know, that's a little bit of a
2:34
thumbnail about us. And we've been at it
2:36
here in New Brunswick,
2:37
in Central New Jersey,
2:39
and serving New Brunswick and the greater,
2:43
Central New Jersey region
2:45
for
2:46
about going on a hundred and twenty years.
2:48
And we are a Catholic hospital. I I
2:50
should also obviously mention that. We are one
2:53
of the few remaining Catholic hospitals
2:56
in the state, one of about five that
2:58
are left. And and when you look at
2:59
Catholic hospitals in the country,
3:02
probably among the few that are not part
3:05
of a larger Catholic health system.
3:07
And so we are also unique in that
3:09
regard as well and have a very strong
3:12
mission, charitable mission
3:14
in the care we provide for, those who
3:17
are less fortunate and more vulnerable.
3:19
So that that I think rounds
3:21
out Saint Peter's.
3:23
That's amazing to hear. And, you know, what
3:25
a great synopsis
3:27
of who you are in in the history
3:29
of the organization plus, you know, the mission
3:30
within the community, which is such an important
3:32
aspect of everything you do. Now could you
3:35
tell us a little bit about St. Peter's
3:36
culture of quality and patient safety? What makes
3:39
the health system different?
3:41
Well, one of one of the things that
3:42
certainly makes us different is that we don't
3:44
have the support of a larger ecosystem
3:47
in, being
3:49
a a single hospital health system. So,
3:52
you know, what we do largely, we do
3:54
here as a result of who we are,
3:56
what we are about,
3:58
and what's important to us. And at the
4:00
core of everything we do
4:02
is our Catholic mission. There's nothing more important
4:05
to us
4:06
than that mission.
4:08
And Saint Peter's
4:10
has really a family
4:13
like culture here. We have a strong culture
4:16
of service, a strong culture of quality,
4:19
and providing our patients with excellent care. We
4:21
just don't talk about it. It's a very
4:24
intentional effort. But overall, I think if you
4:27
were to speak with not only our employees
4:29
here, but people who interact
4:31
with us, our patients, families,
4:34
one of the things that is usually mentioned
4:36
is how warm and friendly the people are
4:39
here,
4:40
and,
4:41
the fact that,
4:43
you know, that,
4:44
we have a culture
4:46
that is palpable. And,
4:48
as I greet new employees as they come
4:50
on and join us,
4:52
and welcome them, I share about that and,
4:54
you know, share with them that they are
4:56
now a part of it, the newest members
4:58
of our family.
4:59
And they're not here by accident. They're here
5:01
because we thought they
5:03
would fit well with our culture and
5:06
and that they will meet many people that
5:08
have been here for many years.
5:10
And, you you know, and hopefully, you know,
5:12
they will some of them at least will
5:14
become those people in the future.
5:16
So, we it's kind of a legacy issue
5:19
for us here
5:20
and something we're very proud of.
5:22
So culture really underpins everything about an organization.
5:27
Absolutely. I love that. And, you know, being
5:29
able to have it and foster that family
5:31
like culture
5:32
is such a a unique opportunity that you
5:34
have and and certainly an important aspect of
5:36
comfortability
5:37
and, truly building an organization that can thrive
5:41
and have that right type of relationships between
5:44
the team members.
5:45
I'm I'm curious. You know, when you look
5:47
at,
5:48
your role as CEO, how are you taking
5:51
active role in building that culture of quality
5:53
and patient safety? What does that look like
5:55
from the top of the organization down? I
5:57
know in some space places, you know, they
6:00
they more have, other leaders kind of leading
6:03
those efforts, while the CEO,
6:05
you know, deals with other things. And so
6:06
why was it so important for you to
6:08
really have quality and patient safety front of
6:10
mind, and, you know, what does that look
6:12
like from the top seat? Sure. Well, you
6:16
know, everything here, so to speak, is a
6:19
team sport.
6:20
And,
6:21
you know, I'm honored,
6:23
to be the leader of St. Peter's, a
6:25
wonderful organization.
6:27
And that's obviously a role that I take
6:30
very seriously because the only reason anyone is
6:32
in a position of leadership is because
6:35
that means that someone placed their trust,
6:38
in in that leader. In this case, you
6:41
know, here, our bishop of,
6:43
you know, that is the sole member of
6:45
our corporation
6:46
and the board,
6:48
and the board,
6:49
takes an active role in quality.
6:52
And then our leadership team. It's not just
6:54
me as the CEO. Certainly, as the CEO,
6:56
it's my responsibility to set the tone in
6:58
the organization
7:00
and,
7:01
provide leadership in that way.
7:03
And people know, I mean, as part of
7:05
our culture that I have a strong
7:07
interest in quality and patient safety and culture
7:10
and all that we do and the service
7:12
that we provide
7:13
because,
7:15
you know, I speak a lot about it
7:17
and, you know, they hear from me about
7:19
it. And, you know, even personally,
7:21
I know what it is to have an
7:23
infection.
7:24
I suffered with an infection. I had a
7:27
hip implant that got infected. It caused me
7:29
to have three additional
7:31
surgeries.
7:32
And, over a seven month period,
7:35
I was on a walker until I got
7:36
that final implant and could be on my
7:39
own two feet. And I know what it
7:41
is to administer
7:43
IV for,
7:45
IV antibiotics
7:46
and, you know, do that for myself and,
7:48
you know, have, everything that goes along with
7:51
that. So I've had some personal experience with
7:53
that. That transcends my role here.
7:56
But, you know, besides that,
7:58
I I would say over the last twenty
8:00
to twenty five years especially, I've I've worked
8:03
in hospitals since my first administrative job,
8:07
forty seven years ago, literally.
8:09
And I'd say
8:11
after about the first 20, I had the
8:13
epiphany
8:14
where
8:15
people I was working with and, you know,
8:18
just what I was exposed to at the
8:19
time, I won't go into the detail of
8:21
that.
8:22
But I I really took on a different
8:24
perspective about quality and patient safety.
8:27
And it's one thing to talk about quality
8:30
and, you know, we assure the highest quality
8:32
of care. Well, what does that really mean?
8:35
As a lay executive, especially,
8:37
about I guess it's gotta be close to
8:40
twenty five years ago,
8:42
I committed myself
8:44
to really learning that much more about it
8:46
and being familiar
8:48
with what what are the attributes,
8:51
for instance, that drive whether or not you
8:53
have a safe environment?
8:55
You know, things like hospital acquired conditions,
8:58
ventilator associated
9:00
pneumonias, surgical
9:02
infections,
9:03
rates of
9:05
cesarean
9:06
section,
9:06
patient falls, you know, all all of the
9:09
various
9:10
metrics and indicators that go into that. And
9:14
then how
9:16
how as a leader
9:17
do you look at that and
9:20
see quality and patient safety
9:23
with an equal
9:24
not that it's never been it's always been,
9:28
very, very important. But how do you really,
9:30
in an intentional way,
9:33
be able to integrate your efforts around quality
9:36
and patient safety, around the overall culture and
9:39
strategy of the organization,
9:42
and the financial performance of the organization?
9:45
I mean, really, your financial operations, your strategy,
9:48
your culture, and your quality, they all intersect.
9:51
And so,
9:53
back then, I committed myself to
9:55
really learning more about it, and I was
9:58
always comfortable,
10:00
certainly as my career evolved.
10:02
It's typical for lay executives
10:05
that are not clinicians
10:06
to become more comfortable
10:08
talking about strategy and finances and operations.
10:13
And frankly, now and for many years, I'm
10:16
equally as comfortable to talk about quality, and
10:19
I understand the metrics and, you know, in
10:22
very functional in that respect. And I think
10:24
all, especially lay executives,
10:28
need to understand that to the greatest degree
10:30
they possibly can.
10:32
And it's a very,
10:34
you know, it's something that can be learned
10:36
and an acquired skill and and,
10:39
knowledge set. So,
10:41
from my perspective as a CEO, it's very
10:43
important, but we also have a very committed
10:45
leadership. I don't micromanage
10:47
quality. I I may if I see that
10:49
something happened because I get a report every
10:52
day,
10:53
knowing how many days since we've had, you
10:55
know, this or that infection,
10:58
hospital acquired conditions.
11:00
And if I see a one on that
11:02
report when I wake up in the morning,
11:04
because it because it is one of the
11:05
first things I look at,
11:08
People know that probably within fifteen minutes of
11:11
that report going out, they're gonna hear from
11:12
me with a question, what happened and how's
11:15
the patient doing?
11:16
So, you know, that helps to set a
11:18
tone and a culture
11:19
of leadership.
11:21
But it's a team sport all the way
11:23
down to the hundreds of people that are
11:25
involved every day
11:27
that impact whether or not, you know, a
11:29
one does show up on that report because,
11:33
it's just so complex when you're thinking about
11:36
managing patient care
11:38
and doing all that you can to
11:40
avoid things that could be frankly dangerous for
11:43
patients and have a negative impact on morbidity
11:46
or even mortality.
11:48
Absolutely. I think that makes so much sense,
11:50
and I love you talking about, you know,
11:52
that culture that you built so that you
11:54
have strong leaders on the front lines and,
11:57
you know, within the organization that can manage
11:59
the day to day of the culture, but
12:01
knowing, you know, that you have your eyes
12:03
on it so that, you know, if there
12:05
is an issue, they'll be talking through it
12:07
with you, and and you'll have the opportunity
12:09
to make sure accountability,
12:11
is pulled through and the patient is okay.
12:13
So I think that's, you know, really helpful
12:15
to understand, and
12:17
I I I think it makes a lot
12:19
of sense and gives, you know, leaders that
12:22
time and space and perspective too, in order
12:24
to lead their own teams. And so,
12:27
that is really cool to hear. What lessons
12:30
have you learned along the way? What are
12:31
some of the things that you've been doubling
12:33
down on that on goal as well as
12:35
things that you've pivoted away from?
12:37
Well,
12:38
I I guess, practice doesn't always make perfect.
12:41
You know, you have to realize that that
12:43
that, you know, you're never in a position,
12:46
even though you can be proud of all
12:48
the things you accomplished as an organization,
12:51
it's always a work in progress. And the
12:54
one thing certainly that,
12:57
that I've learned over time,
12:59
whether it's this issue or any because things
13:01
could change from day to day is it's
13:03
not a matter of getting to a point
13:05
where, you know, we're gonna declare victory, so
13:08
to speak.
13:09
It's always a work in progress. It always
13:12
requires continued
13:14
improvement,
13:15
reinforcement
13:16
of what we're doing. Practice does not make
13:19
necessarily
13:20
make perfect. Practice helps you avoid things that
13:23
you don't want to happen.
13:25
But the fact is, you know, there's always
13:28
that possibility. So, you know, that's a strong
13:31
suit here, and, you know, it really begins,
13:33
you know, with our patient care teams and,
13:36
you know, that that function within that culture.
13:39
I mean, as an example,
13:41
we have a very strong nursing practice here.
13:44
Not to say that we don't have a
13:46
strong medical staff. We do. And a strong
13:48
support
13:49
supporting cast. We do. But, especially, we excel
13:53
in the area of the the nursing care
13:55
that's provided.
13:56
We just received our seventh consecutive
13:59
magnet designation.
14:01
We were the fifth hospital in the world
14:03
to achieve seven consecutive magnet designations,
14:07
and we're only one of
14:09
six
14:10
in the in the world, literally,
14:12
that have achieved
14:14
seven consecutive magnet designations. And this last
14:18
magnet designation
14:19
was with distinction.
14:21
And, basically, if if an organization
14:23
achieves magnet with distinction, which is a new
14:26
recognition
14:28
by the,
14:30
by the organization that oversees magnet,
14:34
the ACCN,
14:36
I believe it is,
14:38
for nursing.
14:41
The fact is you have to have a
14:42
perfect survey and a perfect application
14:45
to and the application is a very detailed
14:48
takes months to prepare,
14:50
but a perfect application with no rewrites,
14:54
and a perfect survey
14:56
to achieve distinction.
14:58
And of those
14:59
of those six that have
15:02
achieved seven consecutive magnets, we're only the second
15:05
one to do it with distinction. So, you
15:07
know, if you think about that, there are
15:09
650
15:10
hospitals or so that have magnet designation about
15:13
less than 10% of the hospitals,
15:16
certainly in The United States, let alone in
15:18
other parts of the world that participate in
15:20
magnet.
15:22
So to think about being one of six
15:24
with seven consecutive magnets and one of two
15:27
of that six
15:28
with a
15:30
doing it with distinction.
15:31
You know, that's a real core
15:34
issue for us and a core competency here
15:36
at Saint Peter's,
15:39
that really anchors the care that is provided.
15:42
And care that's provided, we're we're known not
15:45
just for our excellence in the care that
15:47
we're we provide,
15:48
but also
15:50
the compassion with which that care
15:52
is provided, you know, from our nursing and
15:55
the the people that touch the patients largely.
15:57
So,
15:58
so that's something as an example that really
16:00
is an anchor. Now we we could I
16:03
could go through a whole long list of
16:06
accolades
16:07
of quality accolades because hospitals love to,
16:10
you know, to to brag about all of
16:12
the accolades that they have,
16:15
whether it's from,
16:16
you know, Beacon Awards, Lantern Awards,
16:20
Healthgrades,
16:21
US News and World Report, Newsweek.
16:24
You know, we have many, many of those,
16:26
the joint commission,
16:28
and certifications.
16:29
But really what anchors all of that,
16:32
I would say more than anything,
16:34
is our commitment
16:36
to nursing and clinical excellence
16:39
that we,
16:41
use magnet
16:42
as a barometer
16:43
of, and as the gold standard of are
16:45
we achieving that level of care.
16:48
So, that that's very important to us.
16:51
Absolutely. And, you know, when you put it
16:53
in that perspective, it just shows how,
16:56
extraordinary this accomplishment is and how truly, truly
16:59
focused your teams are and have been on
17:01
that quality of patient safety
17:03
across the board.
17:04
Yep. And Yeah. Absolutely.
17:06
Absolutely. And, you know, I I think, being
17:09
able to have those metrics that in in
17:11
everything that kinda paints the picture
17:13
is so critical,
17:14
you know, for for your teams to
17:18
have in place as they're going about their
17:20
day to day business. But how do you
17:21
see the culture continuing to evolve in the
17:23
next year or two? I know,
17:25
with things changing very rapidly and and continued
17:28
pressures on the workforce,
17:30
you know, there are are certain
17:33
aspects of, health care that are likely to
17:35
change, but how do you see the culture?
17:37
You know, of course, patient safety and quality
17:39
is always gonna be important. But what does
17:42
that look like as new technologies come into
17:44
play and more?
17:46
Yeah. No. I think, we we continue to
17:48
build on this foundation
17:51
that,
17:52
and it's it's within that, you know, clinical
17:55
quality.
17:56
Service excellence is also critical. And
17:59
when we compare ourselves to the others that
18:01
we benchmark against, you know, we we perform
18:04
at a very high level. We are one
18:06
of the highest, if not the highest in
18:08
the state of New Jersey,
18:10
certainly at any given time
18:12
for patient satisfaction. When we look at HCAHPS
18:15
and we look at
18:16
other metrics, you know, related to emergency care.
18:20
You know, quite often, you know, we are
18:22
among the tops and sometimes, you know, the
18:25
top.
18:26
So, you know, that's an important part of
18:28
our culture too. And, again, all of this
18:30
doesn't happen by accident. We are very intentional
18:34
in the discussions we have, the meetings we
18:36
hold, the information that we share, including
18:39
to our board and, of course, our medical
18:41
staff and our leadership and to our people.
18:45
And part of that culture is also
18:47
transparency
18:48
and encouraging,
18:50
people and be having them feel comfortable and
18:53
safe that if they have concerns,
18:56
you know, our team can bring that forward.
18:58
You know, it's not an environment of retribution.
19:00
It's an environment of knowledge transfer and
19:03
education
19:04
and doing all that we can to advance
19:07
our practice. So that's the foundation on which
19:10
we build. Certainly,
19:12
we're in the process of planning for an
19:14
epic installation
19:17
in the early part, probably the first third
19:19
of the year in 2027.
19:22
We believe that the new
19:24
clinical information system will be helpful for us
19:28
in terms of technology,
19:30
other aspects of AI, and
19:32
some of the the tools that we're using
19:35
to help,
19:37
extend the staff's ability to more effectively and
19:40
efficiently
19:41
take care of patients. So, you know, we're
19:43
looking
19:44
at solutions along
19:46
those lines. We'll continue
19:48
to go forward. We're not planning to merge
19:50
with anyone.
19:52
My sense is we will continue to look
19:54
for strategic partnerships and
19:56
alignment where it makes sense and as we
19:59
continue to grow out beyond
20:01
the walls of,
20:03
of the hospital as we've done already. But,
20:05
you know, the ambulatory
20:07
environment is something I think that's exploding.
20:10
And we have to be able to expand,
20:12
and we have,
20:14
but we'll even more so expand those practices
20:18
and that intention,
20:21
as we expand in the ambulatory
20:23
space as well.
20:24
So, you know, a lot of exciting things
20:26
are are planned, and, you know, we're just
20:29
gonna keep moving forward. And, you know but
20:32
the good news is we have a
20:34
strong foundation on which to build
20:37
and and, go into the future.
20:39
Leslie, thank you so much for joining the
20:41
podcast today. This has been such a fantastic
20:43
conversation, and I look forward to connecting with
20:45
you again soon. Yeah. Thank you, Laura. And,
20:47
you know, we appreciate it. We appreciate your
20:49
interest in St. Peter's and the opportunity to
20:52
share a little bit about our story. So,
20:55
we're always happy to help. And if there's
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something we can do to help,
20:58
you know, anyone else and if anything that
21:00
we're doing here is helpful for others, we're
21:02
we're certainly,
21:04
happy to share and, you know, feel strongly
21:06
about knowledge transfer. So thank you.