Leading with Intention

Game-Changing Leadership Ideas

INTRODUCTION:
You’re listening to Tiller-Hewitt’s Leadership Lens Podcast. If you’re a leader - or an aspiring leader - who wants to stay relevant and impactful… YOU’RE IN THE RIGHT PLACE.

At Tiller-Hewitt we believe it’s faster, smarter -- and less painful -- to learn from leaders who have walked before us. That’s why we invite top leaders to be our guests on the Leadership Lens.

Your host is Tammy Tiller-Hewitt – Founder of Tiller-Hewitt HealthCare Strategies. Let’s jump into the podcast.

TAMMY:
My guest is Darcy Craven, CEO at Archbold Medical Center. I think we all agree, we learn more from our mistakes than our successes – Darcy reveals his biggest leadership regret – one that I wished universities would do a better job teaching – but for many of our listeners could be a leadership game-changer. He shares his secrets for measurable “strategic” growth, his competitive principle, many fast and easy retention strategies as well as what leaders look for when looking to advance internal candidates.

TAMMY:
Hey Darcy, welcome to the Leadership Lens Podcast. Thanks for being my guest today.

DARCY CRAVEN:
I appreciate you having me. Thank you.

TAMMY:
You had a really cool journey to the C-suite, you were born and raised in Canada, and I believe you officially started your healthcare career as an occupational therapist and ran a rehab department, and then you’ve led great health systems, both for-profit and not-for-profit. So, let me ask you, did you always want to be in a leadership role or did someone convince you?

DARCY CRAVEN:
I tell people I kind of just fell backwards into it. It's not something I ever thought about. I was a therapist, that was my dream to be a therapist. I worked hard and become a certified hand therapist who was working at the BMW plant in South Carolina. Everything was going great. I just decided to go back and get my Master of Business. I was working for Spartanburg Regional Medical Center at the time and then kind of just fell into administration. Right when I was graduating with my MBA, a job opened up across town at Mary Black Hospital, which just happened to be home Community Health Systems at the time. I got offered a job as Director of Rehab and that kind of started it for me. Community Health Systems really developed me, they moved me around quite a bit, but they put me into their leadership development track and all of a sudden, I was running one of their hospitals.

TAMMY:
Wow, see what happens when you keep your head down and just keep doing a good job and not jockey for a position all the time. Do you feel like your clinical role or that clinical experience helped you in any way to be a better leader?

DARCY CRAVEN:
I think it definitely did. Age wise, I was quite a bit more mature than other people in the sense and what role that I was in. When I was an assistant CEO or Chief Operating Officer, I was well into my thirties. I wasn't in my twenties or just coming out of a MHA program. I think that helped me. Plus, the thing that only in the most is I've always worked in a hospital since I was counting my education, ever since I was twenty-two years old, I spent every day in a hospital. I have a really intimate knowledge of the clinical side of hospitals, how hospitals run, and that's certainly help me as a leader.

TAMMY:
Would you recommend to one of your colleagues if they're looking at a candidate that has that experience like you did versus someone who doesn't that they should place their bet on the one with the clinical experience and maturity?

DARCY CRAVEN:
I think it helps. I think personality is the most important thing. You can have clinical experience and still not be a great leader. A good clinician doesn't always make a great leader. I think we learn that all the time when we promote great clinicians into management roles. It certainly helps me create relationships with staff members when staff members know that I've sat where they’ve sat or sit now. And I've gone through the things they went through. I still try to remember that. When I make decisions, I try to make them through that kind of lens. When I was in that role in that position, how would that affect me? Or what would I think of that? That's one of the reasons I did get into administration because I was working at a staff therapist, and I remember every day I would go home and I thought, “what are these people doing? That's one of the reasons I went back. I'm like I can do a better job than these people, so I went back to school.

TAMMY:
Good for you. So, was that the pivotal point in your career when you're like, I think the animals are running the zoo here. I need to take over. Or what was the pivotal point?

DARCY CRAVEN:
My goal at that time was to be the Director of Rehab. I was so rehab-focused, that was my little world. I did believe that I could be a very effective leader in the rehab realm. I think going to a smaller hospital like Mary Black, where I got to really get to know the CEO and he got to know me and that's where he introduced me to his boss in Nashville and that's kind of where it all started for me is that introduction.

TAMMY:
I love it. What do you think the top leadership challenges are today, both professionally and organizationally? And if you would, add how do you face these challenges?

DARCY CRAVEN:
Organizationally, it's matching resources with revenue nowadays. We always want to be moving the quality needle forward. We always want to be moving the patient experience needle forward. How do you do that in today's environment where resources are so scarce? Staffing is just such a challenge. Physician relationships. Physicians just like staff, have become so mobile, people no longer just stay in an area because that's where they live and they're going to live there forever. At the drop of the hat, will pick up and move somewhere else. We just have to have a great environment for people to work in and it's very tough nowadays. That's the biggest challenge for organizations I think. As professionals always trying to stay on top of the constant changes in healthcare, they’re just never-ending. How do we make sure we're meeting the needs of our community, and our staff, and our physicians. At the same time, we're responsible for the financial well-being of the organization, and matching those things can be challenging to say the least.

TAMMY:
Isn't it funny how ten years ago we would talk about how health care changes so radically and it was nothing like it is today and we thought it was so crazy then?

DARCY CRAVEN:
Something's going to have to change in healthcare with the way hospitals are reimbursed. The risk hospitals take nowadays in terms of value-based purchasing it's just doesn't afford a lot of margin in terms of investing in your people and that’s the real problem.

The biggest issue here in Thomasville there is not a lot of daycare opportunities for staff. I get asked all the time, ‘Can Archbold help whether it's running the daycare or help for daycare?’ We certainly want to do those things but those things all cost money. Do you have the resources to do those things long-term? You can't just enter into something like that for a year or two; that's a 25-year commitment.

TAMMY:
Is that something you guys are looking at doing?

DARCY CRAVEN:
We are looking at that seriously. I think it's important thing for our staff. It's important for retention and recruitment. We're really just trying to decide whether we should do it ourselves or partner with a local YMCA to do it. Like everything else, we can't find those people whether it’s patient care techs or unit secretaries. It's very difficult to find that class of staff member. Daycare is no different. It’s very difficult to staff those things. One of them locally closed this year. That's why there's such a huge problem.

TAMMY:
I read a book recently it was called The 7 Hidden Reasons Employees Leave. It was a study of 200,000 employees and they asked them to cite the reason that they quit their job. 79%, almost 8 out of 10, said it was due to the lack of appreciation. I think there's a lot of things we can do around showing our appreciation. And so many people say, ‘Oh, that's too basic. That's too simple.’ But. What are some ways that you tangibly show appreciation to your staff?

DARCY CRAVEN:
I think it comes from my background. I know that it's the little things that matter to the staff. Not just the annual picnic that every hospital does or the hospital week of activities that we do once a year. It's just got to be constant little things that we're doing whether it's food trucks in the parking lot. My CNO and I was walking around the hospital talking to people. One thing I did in Buffalo before coming here, and we're going to start doing here, is when we do our rounding, we take the candy wagon with us. That sounds ridiculous but the staff love it. They just love seeing it coming. They love grabbing a granola bar or bag of chips or whatever they want out of it, and it costs nothing to do that. It means something to people.

Another thing I do, here that I've done everywhere I've been, is birthday lunches. That sounds corny too but every month, every employee who has a birthday in that month is invited to lunch with me. We just talk. We feed them pizza and wings and we just talk. It’s an opportunity for everyone to get face time with administration once a year and they appreciate that. It doesn't cost anything or very little.People do like that. We have 50-60 people a month showing up to that.

TAMMY:
Well listen, I'm I have a such a sweet tooth that candy wagon. Instantly that song, The Candyman Can came to mind. You’ll be singing that as you walk through the halls. I love that. Darcy, that's awesome! What do you think are the warning signs that an organization is getting close to running off the track?

DARCY CRAVEN:
I think you can feel it. I think if you listen to staff members, and you can feel the stress, and morale going down in your staff. I really think that's where it starts. You can feel the tension in a hospital. I think that's the number one place, if you're always talking to your staff or always getting feedback and you develop relationships where they’re comfortable talking to you and saying things that maybe aren't great, that's where you'll really get the warning signs that something's going wrong.

Same with the physicians. Physicians are not quiet. They're more willing to come to the CEO and talk about when things aren't going right. I've been in hospitals where the environments can be defined as toxic, and I think you can sense those things when you’re round and talk to people.

TAMMY:
From an insider's perspective, how would you describe the current state of the US Healthcare System?

DARCY CRAVEN:
I think it's heavily tilted towards the payers right now. And I think the pandemic has exacerbated that. I think that's what we're seeing when hospitals and the challenges of inflation and cost of labor, cost of supplies at a time where hospitals are all losing money. If not for government stimulus, the payers are announcing record profits and I think that's a problem for us. The average consumer has high-deductible health plans. So, they're coming in. They're paying a lot of their pocket. Hospitals are trying to make ends meet, trying to get pay their staff as much as they can so they can retain them and all the time, the commercial payers are getting fat and happy and I think that's something that has to change in our country. Growing up in Canada, I do like the private base system that we have in the States, but I think it's got to be a little more fair.

TAMMY:
What are some of the major lessons, or a major lesson that you learned as you led through the last almost three years of a pandemic?

DARCY CRAVEN:
Never move during a pandemic!

TAMMY:
Oh, that is good. I forgot you came right in the middle.

DARCY CRAVEN:
In August of 2020. So, I was in New York, in Buffalo for the start of the pandemic for the first six months and came down here and been here since August 2020. What I learned up there and here, is the teamwork. Hospitals are full of great people. People get into healthcare because they want to work with people. It doesn't matter whether it was housekeepers, doctors, nurses, administrators – people, they want the best. The pandemic did bring the best out of people even though it's been incredibly tough on people, especially nurses and staff working in emergency rooms and ICU’s, floors where we're staffing COVID units, it's been incredibly, incredibly tough on people.

TAMMY:
Is there one piece of advice you would give to a young leader starting off today?

DARCY CRAVEN:
Spend time listening and learning. I think that I've seen this in my career where young master's-prepared come out of college with their MHAs or MBAs and they get jobs in administration, but they really don't know anything about healthcare. They've spent their time in an academic setting and that's so different than the real world of hospital operations. Spend time learning, listening, and talking to people. The staff and the doctors really understand what's important in the hospital and we need to listen to them.

TAMMY:
You did a good job as an OT and clearly you were spotted and identified by leadership as a future leader that helped open some doors and exposed you, and I think there's a huge myth around that thinking that people have to grandstand and raise their hand. How do you think, again, advice for a young leader of, that balance between wanting to be acknowledged or recognized but not wanting to stay quiet so you get passed over? As a leader, what would you be looking for across your organization, as well as with your experience, what advice would you give?

DARCY CRAVEN:
I think you're always looking for someone that does a great job in their role, whatever that role is. You know, willing to do more. I would tell young people that want to get ahead to volunteer for extra projects. Ask to work on a project. I think that means a lot to a hospital Administrator, CEO, Chief Operating Officer if someone says, Hey I heard you talking about this at the last staff meeting, I'd really like to get to learn more about that, I’d like to get involved in that.’ Those are the kind of people that I think really do get ahead.

TAMMY:
Awesome. Is there one decision you made in your career that you regret making?

DARCY CRAVEN:
The biggest regrets I have, in my career, and I think as you grow as a leader you learn how to do this better, never gets easy, but not dealing with low performers early enough.

I can think back in my time to, even as a Rehab Director, where I had a therapist or therapy assistants working for me that I didn't deal with in a timely fashion. It really did affect the entire team. People are watching to see how your deal with people. They know this person called in sick every Friday or when they're at work, they only take half a load. Those people, they don't want to work with low performers. If you don't deal with those people, the good people, the high performers, are going to leave. I think it takes time to learn that. I can think of a couple of times early in my career where I should have dealt with somebody earlier.

TAMMY:
We've had the opportunity to work together in a couple organizations, but for the listeners, Tiller-Hewitt works with healthcare leaders, who want to consistently deliver strategic growth and measurable results. Can you share a couple of your secrets or what you would say are your secret success strategy, around growth and results?

DARCY CRAVEN:
Number one it’s relationships, right? Building relationships with not just employed doctors, but independent physicians and making sure you are always developing a culture of growth. A lot of markets, especially this one I think when I came to it, it’s a smaller market, a sole provider, more or less in the market, and I think the team was kind of just focused on, ‘Hey, we get all the business already.’ When I came here, I'm like, you always have to be looking for growth because someone's always looking to take your business away from you. You always have to be looking for that little extra half a percent of market share. Where is that? You get that from data, right? Always looking at data market, share. Where is the opportunity? Where are we, call it bleeding, but where are we losing business? What service lines can we shore up? And I think it's important to constantly be looking at that data and talking to physicians about where they think opportunity is. Because they know too where referrals are going and where there might be opportunities, what communities they would like to go. And that's one of the reasons I think your firm is so valuable – is the physician liaison and, and setting up those programs where we're taking doctors out to meet referral sources, and talking to them, and shaking hands, and asking for business, and not everyone does that.

TAMMY:
Well, I know because I've seen first-hand twice in two different large organizations, that you're just a very physician-centric leader. You don’t move forward without having them at the table. I think that is a huge secret that a lot of people either shy away from, think that they know what the doctors want instead of having them involved. I've had the privilege of seeing that firsthand. I think that's one of your secrets.

DARCY CRAVEN:
It's a firm belief in mine that the doctors have to participate in strategy or else your strategies will fail. You can want to build the service line, or you want to grow a service line, but if you don't bring the doctors to the table and talk to them about it, get them on board; it's just not going to work. I really do believe whether it's the employed physicians network, I want them to participate in managing the network. I want them invested in it, not just feel like employees. That's justnever works. I think that comes from my background as a therapist too, though. I've spent my entire career talking to doctors. It's not something that scared of and I've been yelled at and had bad conversations with doctors. But that's part of life, right? As an administrator, you have to be willing to have hard, difficult conversations with everyone, not just doctors. I think some people just shy away from those things and it never works out for the best. Doctors want you to be straight with them, transparent with them, even if it's something they don't want to hear.

TAMMY:
If you could be doing anything other than hospital administration, curious, what would it be?

DARCY CRAVEN:
I guess if it wasn't doing this, I’d still be a therapist, but I like to think that'd be tending bar or somewhere in the Caribbean.

TAMMY:
There you go. I love it. I would come there for sure. I know you have crazy weeks, starts early and goes late, but what do you look forward to doing on the weekend?

DARCY CRAVEN:
Really, just spend some family time my wife and I still have my daughter at home. My son is in college and he's going to be so we try to see him as much as we can. We really do a lot of family time. I love to watch football on TV during football season. We love to travel. Thankfully, I think the pandemic is hopefully winding down. We're actually going on a cruise in three weeks for the first time in two and half years. We love to go on cruises so getting back to normal.

When the kids were young, we did Disney. Now, we've graduated to real Caribbean now that they're older.

TAMMY:
Oh, very good. I want to do some rapid, fire questions. We call it the fast five. So, what are you currently reading?

DARCY CRAVEN:
Well, I have two books. One, that was for personal use and that is Sailing for Dummies. I have a goal of learning how to sail.

And the other one is a book that my board chair just gave me that I just started reading. It's kind of a leading through change called Switch and I just started reading it. It seems very good though.

TAMMY:
How do you start your day?

DARCY CRAVEN:
If I'm really energetic, I do work out. I try to work out five days a week usually - sometimes that's before work, sometimes it's after. If I don't swim or get on the rowing machine, I just have a cup of coffee and read the Wall Street Journal, just try to kind of get my engine going.

TAMMY:
Yeah, Get your head in the game? What's the most important characteristic of a leader?

DARCY CRAVEN
100%, integrity! If you cannot build trusting relationships with people, you are going to fail.

TAMMY:
And last, what’s one word or piece of advice, you would give to your younger self?

DARCY CRAVEN:
Don't waste so much time. I went back to school for my MBA when my daughter was born. So my second child was a baby. I could have ten degrees in the time I wasted before I had kids.

TAMMY:
Oh, that's good. Well Darcy, thank you so much. This has been awesome. I so appreciate you being on the Leadership Lens and hope we can have you back again soon.

DARCY CRAVEN
Yeah, anytime. Thank you.

CLOSING:
Tiller-Hewitt works with leaders who want to consistently deliver strategic growth and measurable results.

The organization is recognized as the leading experts in strategic growth, network integrity, and physician engagement. Thanks for listening to this episode of the Leadership Lens. For more leadership resources and strategic growth solutions, visit tillerhewitt.com.