2021 InCharge Healthcare: Arkansas Healthcare Update and Post COVID Perspectives
Leaders from Four Different Regions of Arkansas Weigh in on Leading the State Through a Healthcare Crisis...and more!
As Arkansans begin to see the light at the end of the COVID tunnel, we spoke with leaders from four different regions of the state to get an update on their organizations and the regions they serve. Reporting from Northwest Arkansas is Dr. David Hunton, President of the Mercy Clinic in Fort Smith, Sam Lynd, CEO of NEA Baptist weighs in from Northeast Arkansas, Bubba Arnold, CEO of CHI St. Vincent in Morrilton represents North Central Arkansas and Scott Street, CEO of the Medical Center of South Arkansas reports from that region. Arkansas Medical News talked to them about how they began, who influenced them, the tumultuous past year, and asked what kind of advice they would give someone beginning a career in healthcare administration. Enjoy.
Where did you grow up and when and how did you decide to pursue a career in healthcare?
Arnold: I lived in McGehee, Arkansas through junior high. While in 7th grade, my Dad began losing his eyesight to glaucoma, so at the age of 45 my Mom decided to attend nursing school at UAM. After receiving her RN license, Mom accepted a charge nurse position with the VA at Fort Roots, so we moved to Cabot, Ark., where I graduated high school. She worked on the night shift and came home most mornings tired but happy. I knew she had a very difficult job and at some point, I asked her what she liked about her work. She said many of these veterans have had traumatic experiences that we cannot even imagine, and she wanted to do what she could to help them. I felt the compassion in her heart, and it struck a chord with me. After high school, I completed prerequisites for pharmacy school, then attended UAMS College of Pharmacy where I received my degree in 1983.
Hunton: I grew up in Benton, Arkansas. My dad was a chemical engineer, and my mother was a music major and grade-school teacher. I had planned a career in the military, with, in all likelihood, an engineering degree. I had also been recruited to play college football at the Air Force Academy. Before I was due to report that first summer, however, I felt that this was not going to work out. I don't know exactly why or how this feeling came about. My parents were not happy with me, and I ended up at the University of Arkansas. My family physician had been a mentor for me along with my dentist. They encouraged me to take a pre-medical tract and to work at the hospital as an orderly that next summer. I did so and never looked back; I knew I loved the hospital, sick patients and the opportunity to make a difference in their lives.
Lynd: I grew up in the Memphis area where my first job during high school was in commercial construction. I was part of a demolitions and clean-up crew for the summer but had the opportunity to replace a friend leaving behind a pharmacy tech job upon heading to college. Since air conditioning sounded pretty good at that point, I jumped at the opportunity. I was instantly hooked. I loved working with patients, providers, and payers trying to find the most cost-effective options for treatment. I was the nerd that would spend time reading medication package inserts during downtime so I could have a better understanding of what we were providing our patients. But most importantly, I was part of a great team with some great mentors who still keep up with each other to this day. I was hooked on healthcare from this moment on. I didn't know what I wanted to do, but it had to be part of a strong team with a strong mission. I learned quickly that not every team was as strong as this first experience, but also that building that team was something I was passionate about and a critical part of any mission in health care.
Street: I am native of Arkansas from Cherokee Village, a quaint little town in the northeastern part of the state. Because of this, I have always had a calling to serve in rural areas; especially in Arkansas. I knew in the eighth grade that I wanted my career path to lead me to becoming a hospital CEO. It always helps to have good examples to learn from. My uncle was a CEO of a hospital, and my dad was a businessman that I respected a great deal. For me, those two career paths merged. I liked the business side of healthcare and being able to help communities and individuals receive access to quality healthcare.
Arnold: I've been very blessed to have had several mentors in my life, but the one that stands out the most is Merle Lewis. Mr. Lewis is a successful architect and the father of a dear high school friend, David. He was very involved with our group of boys growing up so I watched how he interacted with us and others. His heart for giving both time and resources along with his leadership style made a great impression on me.
Hunton: Yes, my family physician and my dentist were instrumental in guiding me toward a medical career.
Lynd: There are so many generous people that have guided me over the years, I cannot even begin to start naming names. The most special mentors are those that have been leaders at every level in the organizations I have been privileged to be a part of - CEOs, CNOs, department leaders, et cetera. They are the ones who have taught me the ropes, shaped my perspectives, and made me look much smarter than I am over my 10 years at Baptist. My Aunt Debbie was a game changer, too. She is a long-time nurse who pushed me toward thinking about health care administration and using my experiences and leadership skills to improve care delivery through complex teams and systems. That obviously changed my whole world. I also had a special mentor that once told me I would never be a CEO in this business so I can't think about this question without remembering the fire that got me to push harder, learn more, and develop skills that would allow me to be an effective contributor at the highest level. Maybe they knew exactly what they were doing when they made that statement.
Street: The most important mentor I have had in my life was my mother. Through her support and guidance, my mother instilled a sense of drive and determination in me. As a tenacious woman with grit, when things got tough, she would coach me through using a mix of motherly love and tough love. To this day, when I meet a challenge or obstacle, I look back to those lessons she taught me to guide me through.
Arnold: I strive to be a servant leader. I realized early on that teamwork is essential for our success and my role as leader is to make sure that we have the right players on the team, the team has the tools needed to do their job and I do all I can to make the team's work easier.
Hunton: I would say that I lead by example and that I try not to micromanage. That has not always been easy given my background in surgery.
Lynd: I aspire to be a "coach" more than anything else; someone who works toward building the collaborative teams I mentioned. As a leader, I try to hold myself to some very simple principles, that are not always easy to execute. Respect, humility, empathy, generosity, and vulnerability. You have to give of yourself in order to build trust. I call that emotional labor. Building relationships is everything, but you can't do it without the hard work of emotional labor. Be generous, expose talent and creativity, be patient in developing a vision and then do something about it - primarily letting people off the hook, better known as empowering them to take action.
Street: I would describe my style of leadership as being a coach. Due to my athletic background of previously being a college football player at Ouachita Baptist University, I use many analogies that transfer from the field to leading a team. My primary focus is always bringing out the best in my team by giving them the resources and guidance they need to tackle goals and obstacles.
Arnold: COVID activity in Morrilton and surrounding communities has dropped dramatically and appears to be holding. Hopefully this trend will continue, however, we are concerned that the drop in vaccination rates may reverse this course.
Hunton: We have seen a marked decline in both the number of cases in the hospital and the number of sick patients we are testing. The second week in January was the apex for us, and we were very close to having to open the GI center as an additional ICU and to mobilize the ambulatory staff to hospital-based roles.
Lynd: We have certainly seen a decline in COVID patients and deaths over the last few months. We have a steady case count today, but it is a fraction of what it was just a couple of months ago. We're watching closely for the emergence of variants and remain diligent in the precautions to prevent continued spread, and are encouraging people to take advantage of the availability of vaccines. Many other countries are clamoring to get more, and today, we have plenty available at our walk-in clinic, and invite those interested in having an on-site vaccination event at their business or church to reach out and let us help.
Street: In the past few weeks, we have seen a dramatic decline in COVID-19 cases. As vaccine rates increase, I hope that we will continue to see a decline. We remain diligently prepared to care for any COVID-19 positive patients and serve our community.
Arnold: Our volumes took a major hit in April 2020, declining approximately 80 percent. Volumes began returning in the summer of 2020 and are now running at 85-90 percent of pre-COVID levels. The COVID stress level is down due to the decline in activity and the fact that we have adjusted to this environment.
Hutton: I would say yes to both. We have been able to resume all surgeries for the most part having had to defer elective cases requiring an ICU stay for all of January and part of February. Our ICU, which had gotten up to about 50 percent with COVID patients, remains full, but with conventional problems, trauma, heart issues, sepsis, etc.
Lynd: Some COVID stress has subsided, but our team is still working hard to ensure people are able to avoid the emerging variants and limit continued spread. Our team has worked so hard over the last year there is definitely some weariness and burnout, but I couldn't be prouder of the way they have stepped up to care for the Northeast region of our state. We are fortunate that compared to many others, we've weathered this storm pretty well. We had no layoffs, a steady supply of PPE, continued to hire and recruit, and struck a balance between caring for people in the present, but also looking to the future and ensuring we were ready to care for whatever needs our communities might identify in the near or distant future.
Street: I could go on and on praising our frontline workers who have stepped up to care for our patients and community when they needed us the most. I attribute their determination to help others to an organization wide vision of compassionate care. I would like to challenge everyone to look toward the future and the new normal for life post COVID-19. We are not yet past the danger but instead are now seeing a glimpse of light at the end of the tunnel.
Arnold: Financial viability is a major challenge due lower volumes and higher expenses for all hospitals now. The nursing shortage has a significant impact. We are using agency nursing staff for the first time in my nine-year career at CHI St. Vincent Morrilton to supplement our core staffing. We also expect significant supply cost inflation to begin impacting operations as we move forward.
Hunton: Dealing with physician and co-worker engagement and burnout, for one. Everyone is tired from having dealt with both COVID and a reduction in force. A second issue would be reducing the spend on travelers and temp staff in order to get our labor costs back to where they were. We were concerned that patients would be reluctant to come back to the hospital and to a lesser extent the clinic. That issue, however, continues to get better. We remain concerned about those patients with undiagnosed illnesses who put off being seen during the worst of COVID.
Lynd: One of the biggest challenges I foresee is unpacking all we have learned during the pandemic, the good and the bad, identifying each constraint and deciding how to turn them into opportunities. Our management system is designed such that we are able to do this when we are deliberate and intentional about the process of ideation, developing hypotheses, and validating with data and stakeholder input. There is a major opportunity to build on all we accomplished in the last year and accelerating forward delivering on our vision for building the optimal patient experience through truly integrated care delivery.
Street: We have experienced many challenges, triumphs, and changes over the past year and look forward to continued progress in the future. Our biggest challenge over the next year is continuing to move forward from the COVID-19 pandemic. During the pandemic, many people cancelled preventive health screenings, annual wellness visits and routine surgeries. Reeducating our community to get back to prioritizing their health remains a priority.
Arnold: Our short-term goals are responding to the challenges mentioned above, working to improve volumes and recruiting nurses. We are also renovating the exterior of our hospital with a big thank you to our wonderful CHI St. Vincent Morrilton Auxiliary for raising the funds necessary for this work! Our long-term goals include continuing to provide quality patient care and being a conduit to centers of excellence across the CHI St. Vincent ministry for our community.
Hunton: I think we have made several changes for the better. The COVID pandemic accelerated our use of technology, video visits and other aspects to become more patient-centric. We have used the past year to be innovative in how we "see" patients and how they are scheduled, treated and followed. We will be concentrating on quality metrics more so than on how many patient visits we can do. We have become more patient centric than we were formerly.
Lynd: Our goal is to always be improving health care for our patients. We believe we are on track to deliver a better care delivery system for the next era of health care. Our focus is on driving the patient experience and service model in a radically different and improved way through our integrated system. Our management systems support communication, collaboration, and constant improvement that will deliver on this vision and blaze a new trail for the outcomes and experiences our patients, employers, payers, and providers all dream of.
Street: Medical Center of South Arkansas is on the precipice of making progress on goals that we have had for several years. We are in the process of completing a 2.6-million-dollar renovation of our intensive care unit that is projected to be completed in two months. After this renovation is completed, construction crews will turn their focus to a 2.75-million-dollar construction project for an 18-bed behavioral health unit. The 6-8-month project will include the build out of 10,000 sq. ft. of space located on the second floor south wing of the hospital. Our goals continue to be centered on expanding patient healthcare access and increasing quality of care.
Arnold: The work is not easy, but I cannot think of a more rewarding career. Where else can you work and see how your efforts improve the lives of others? I want to add, there's a lot to learn when beginning a career in healthcare so you'll have many questions along the way. When you get to a point where you must make a decision and are unsure, do what's best for the patient. It's always the right way to go.
Hunton: I have learned much from the different roles that I have had. I started out in patient care as an orderly, at the bottom of the pyramid. I have always had a soft spot for the nursing team as a result of this. I certainly learned a lot about decision-making and a bias toward action as a general surgeon for 30-plus years. When I transitioned from a full-time physician to an administrator, I had to learn about the business end of health care and had to become more of a team player. That said, my advice would be to learn as much about all the aspects of health care that you can, and that you never forget your roots or humility if you are fortunate enough to get into a leadership role. Compassion, communication, honesty and humility are to me the keys to success.
Lynd: Raise your hand and volunteer for everything. Collect experiences. Observe and evaluate leaders (even me), and keep notes on what resonates with you, and what doesn't, as you shape your leadership style preparing for the day your name gets called. Don't hesitate to ask people for 20 minutes of their time to ask them a few questions and learn from their perspective. Spend time exploring various segments of our industry, including digital health, and gain an understanding of the problems people are trying to solve and offer to help. Be generous with your time, be vulnerable and honest about what you do and don't know and understand that we are all here to make an impact on people's lives.
Street: One piece of advice I would give someone thinking about going into healthcare administration would be to practice perseverance. Overcoming challenges and reaching goals all require perseverance. Choosing perseverance is often the difference between success and failure. As you navigate through the world of impossibilities and challenges, learn from your struggles and turn what seems impossible into possible through perseverance.
Arnold: As we all know, teamwork is the key to success, so I want to share my favorite 'teamwork' quote.
"Teamwork occurs when people are united in action and in passion for a common cause. Their shared goal is so strong that it removes hostilities, puts away disagreements and gives previously divided people a reason to take their place alongside each other. When this occurs, different gifts, talents and anointing's become connected together, and the result is an amazing river of divine power that achieves the supernatural and accomplishes the impossible." (Renner)
Hunton: Like others I have talked with, we have all been impressed with the improved collaboration and teamwork with both our competitors, and especially with courage and tirelessness of our co-workers.
Lynd: Given the talent and passion in this state, I'd end by saying competition is good, but true collaboration is better. When we collectively decide the path to a new era of healthcare innovation is through creative partnerships and alignment, we can outpace all other states in delivering the care and service for which our patients are desperate.
Street: The last year has been a challenge and has reminded many healthcare professionals of why we got into the healthcare field in the first place. Delivering medical care in the midst of a global pandemic has required teamwork at the highest level. Life has been disrupted by lockdowns and subsequent restrictions but chronic diseases and medical crises have remained. While there have been many challenges, our healthcare community has stood strong through one of the worst medical crises in decades. Thank you to all MCSA team members and healthcare professionals across the state for their unwavering commitment to patient care.