Leading with Transparency

Embracing Crucial Conversations

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 Devon Hyde, CEO of Lake Charles Memorial Health System. His health system is located in Lake Charles, LA – a city coined as the most weather-battered city in the United States – wait until you hear what they endured to earn that designation.

Devon has leadership experience in both non-profit and for-profit health systems and shares great insight into the different leadership lessons learned from both environments. Devon is a leader who never takes his foot off the gas as it relates to strategic growth. You’ll enjoy what he has to say as he talks candidly about leadership transparency and crucial conversations.

TAMMY:
Devon, welcome to the Leadership Lens Podcast. I appreciate you being our guest today.

DEVON:
Tammy, thanks so much for having me. I always appreciate it.

TAMMY:
Awesome. Well, hey for our listeners Devon recently spoke on our Year of the Leader Webinar series, which is available on our website at tillerhewitt.com. He was introduced as a leader who never takes his foot off the gas related to strategic growth, physician relations, and innovation.

Devon, you're known in the industry for being an action-orientated change leader and visionary, but I want to understand some of the “how”. So, my first question is about your experience in The Tale of Two Worlds, For-profit and non-profit healthcare worlds. Knowing most leaders stay in one or the other for the majority of their career, for you, you've held top executive leadership roles in both worlds as a COO and a CEO, and as you look back, I would love for you to share with me, and our listeners, the pros and the cons or the best and worst lessons that you learn from either side, that may be valuable to our listeners?

DEVON:
That's a great question, Tammy and thank you for the introduction. You're correct. I started my career in the investor-end space with Health Management Associates. One of the lessons that I learned very early on was really the focus on execution. This really resonated with me throughout my career, particularly in the for-profit space. That focus on execution, developing a plan, ensuring that we had the right resources, the right people at the table, and as you mentioned in your introduction of me, not taking your foot off the gas until you accomplish that goal. And when we would look at our strategic plan, it would be filled with different initiatives and activities that we would need to take to execute as flawlessly as possible to reach our goals and to really stretch the organization, whether that be from a growth perspective, quality perspective, acquisition perspective, market redirection – all of those things that really fall under the nomenclature and what we would look at from a strategic perspective. That was instilled in me from an assistant administrator role all the way through my COO roles within the for-profit sector and certainly as the CEO of Deaconess Hospital, Oklahoma City.

When I made the transition to non-for-profit, one of the skills that I had to develop was really inclusiveness of a wide variety of stakeholders within the respective organization. When I went to Albuquerque, Presbyterian is a large organization, a large hospital, it was learning the highly matrixed organization and the ability to create and sustain relationships on multiple different levels. Also, the element that while the hospital is one of the driving economic, revenue-producing engines for the organization, there were other matters at stake. How are we taking great care, particularly in New Mexico, of a vulnerable population? Really learning and becoming more adept that collegiality, that collaborative nature across the enterprise to meet the organization's goals and not just the hospital’s goals.

TAMMY:
And now that you've switched over on the nonprofit side, what have you brought with you that continues to drive value in your role to your stakeholders?

DEVON:
Absolutely. We put together a very robust, strategic plan that has measurable goals, measurable outcomes that we review on a monthly basis as far as where we're tracking. And then a broad reach across our enterprise, with our physicians, our community, board engagement and helping us achieve those objectives. So, it's multifactorial and really a blend of both of the worlds. High focus on execution and achieving our results, but also ensuring that we're meeting the needs of the community and looking outside the four walls of the hospital for where our impact within Lake Charles is.

TAMMY:
Okay, so let's just cut it down real quick. For our listeners who are from the for-profit world, what is one thing that you would say you learned on the other side? Not that they are on opposing sides, but the other side that you would recommend to a for-profit leader?

DEVON:
Engage your physicians early and often because they will be the ones that are responsible for executing your strategic objectives.

TAMMY:
For the non-for-profit leaders, share the one thing that you would recommend that they do that you learned that made you a better leader on the for-profit side.

DEVON:
I would say really that relentless focus on execution of strategic items. Put them out in front of your leadership team. Widely, publicized them to your physicians and your board. Get that buy-in and really push for execution.

TAMMY:
See, I think the answer to this first question is worth the cost or price of admission. It's really just two “E” words, right? You talked about engaging early and focusing on execution. And why is it that, that sounds so intuitive, right? So, common sense, but why do you think we don't just intuitively, as leaders, remember those two pieces?

DEVON:
I would say, for the execution perspective, we have so many different influences and inputs that come at us on a daily basis. It can be hard to really maintain focus on those items that you know are going to ultimately drive the organization forward. It could be a weather event, it could be a facilities issue, to any number of things that can pull a CEO or a C-Suite away from that focus on execution. From the engagement perspective, particularly in light of Covid, particularly in the light of all the different challenges that healthcare organizations have faced over the past two years, engaging staff, engaging physicians can be difficult. It requires being on the front line. It requires being present within the organization. It requires communicating as effectively and efficiently as possible. And the reality is, even when you do your very, very, very best, you're going to have situations where somebody doesn't feel that they have been communicated to effectively. It does come down to communication. It comes down to that engagement and that willingness to say, we know we don't know everything, help us understand. Seeking to understand is one of the fundamental elements: A. of engagement and B. of execution.

TAMMY:
That's very good. Well now that we got all the secret sauce for everyone - don't hang up. Don't stop listening. We still have some really great questions, but that was good stuff, Devon. Did you always know you wanted to be in a leadership role?

DEVON:
I've been pondering this question and I think maybe inherently I would say, yes. I I wanted to be a good leader and we all want to be good leaders of course. I was very blessed early in my career to have some absolutely fantastic leaders that inspired me to be better and to learn more on a daily basis. And that really started early in my career when I worked at Dell Computer Corporation at one point in time. I had a really fantastic manager there. Certainly, as I moved into the healthcare space, I've been extremely, extremely fortunate in my career to have inspiring leaders that wanted to mentor me. And conversely, I've had a couple of leaders that I learned lessons the hard way from and things that I've taken away from their leadership style that I've said, you know what that's not the leader I want to be. So, we're going to move in a different direction.

TAMMY:
That's good. Any deeper dive or insight on what you learn the hard way that you don't want to emulate?

DEVON:
Sure. I think it's become comfortable in having difficult conversations with people. Particularly in today's society, and at certain times of my career, I've witnessed leaders, those that I have chosen or desired not to emulate, shy away from difficult conversations, shy away from coaching conversations, shy away from difficult physician conversations, and I don't really know why. Because, as I have found in my career, and becoming more adept and more comfortable at having challenging conversations with people, most adults, most people in general, if you approach them with a level of respect, honesty, and transparency, they will absorb bad news or difficult news much more easily perhaps, than we anticipate. I think we often fear the worst, that the conversation is going to go so badly that the physician is going to leave, that the executive is going to leave, or even if you're helping the executive find a different path, it's okay to have just direct conversations. The other thing is coach people, mentor people. I have witnessed in my career, where all of a sudden somebody becomes a problem, and they don't know it. I've seen people's careers negatively impacted when the person that is being impacted thinks they're doing a good job. And for whatever reason, particularly in this case, senior leadership, chose not to have the conversation which was baffling to me to watch. Because you have an employee that is engaged. They want to do the right thing. And yet the rhetoric going around is, well they're not doing a good job. And when I ask, senior leader, does this person know they're not doing a good job? The answer was, no we really liked them. We haven't had that conversation. I thought that was an enormous disservice to an engaged employee that had the intellect, had the skill, needed direction, but for whatever reason that coaching didn’t come across. And that person ended up leaving the organization and they found a better job.

TAMMY:
So, we make the mistake because we fear the worst, we just avoid it altogether, and everyone loses.

DEVON:
That's exactly correct. As opposed to when you talk about the expense, the cost, the training of bringing new physicians on board, bringing new executives on board, you would think that we would have more focus on integration, and ensuring their long-term success. And you would think that we would have more investments in coaching when people find themselves in challenging situations. There are books written about crucial conversations and all of those different avenues for education, yet that seems to be an area, particularly in healthcare, that we shy away from.

TAMMY:
I wonder if there's not been enough education around that in the MHA programs and MBA programs? That's a really great point, Devon, that we might have to go upstream to help with that a little bit more. I also think that's how you build awesome teams. Even if you're training someone up to leave you, that's your legacy, like some of the inspiring leaders that you remember today and are still thinking about in this interview.

DEVON:
Absolutely.

TAMMY:
Was there a pivotal point in your career, good or bad, that kind of affirmed you're in the right place, you chose the right path or not?

DEVON:
You know it’s interesting. I can answer this question a couple of different ways. I would say, the first is the first COO job that I was offered was a new acquisition for the organization I was working for. It was really an exciting time in my career where I felt like the parent organization had the faith in me to go be a part of that executive team and a new acquisition. It was a good-sized hospital, 300-bed hospital in Florida. To me, that really meant that I had worked my way up from an assistant administrator, associate administrator, and then became the Chief Operating Officer of that hospital. That was really exciting to me. I think probably more personally, that solidifies my decision to go into healthcare administration. I've never imagined myself doing anything differently. And while we all have good and bad days, where we think about our toes in the sand and looking out at blue water, I'm very passionate about what I do. I am extremely blessed to have found this healthcare career, to have had the success that I've had, to be amazingly blessed with leadership teams that I have been able to partner with and have the opportunity to partner with over my career – that have made a difference in the communities that we've served. To this day, I have friends in every industry across the country. I count myself very, very, very lucky to have had the opportunity to move into healthcare administration when I did.

TAMMY:
That's awesome. I know you work countless hours, but it probably doesn't feel like a job like other people think of because you love it so much and you're so passionate about it.

DEVON:
I think one of the great things, for me, about healthcare administration, is I say I go from the boardroom to the boiler room, each and every day. We have the opportunity to interact with and participate with across the organization each and every day there's something new to be working on. There is something that myself and the rest of the leadership team are actively engaged in that's driving the organization forward and better meeting the needs of the community, and that's exciting. And it can be very small things and it can be great big things. But those projects are always they're always entertaining and they seem to resonate with me.

TAMMY:
I know, personally you're good at this, but why don’t you share with our listeners, some of the best tips for engaging staff (as you talk about the boiler room and everything in between the boardroom) and physicians? You do such a great job of engaging physicians. What's your strategy and secret tip?

DEVON:
First and foremost, I think being visible within the organization, whether it's rounding, we created something called “Town Halls to You” that are our small group, Town Halls where we created a dyad leadership, it's myself and my chief nursing officer. We are the dyad leadership team today that's going out on different units within the organization. That's not only in the in the four walls of the hospital but out in our clinics and it's bringing the leadership conversation to the frontline staff - at the intersection of care and where they're working. That has really seemed to resonate with our team here and it's not just myself and the CNO, I should say we have ten dyads of leaders that go out to the organizations on a weekly basis.

The other thing, particularly with the physicians, is dyad meetings or Executive Council meetings thatare bringing physicians and physician leadership to the table with administration on a monthly basis - to sit down and talk about really frankly anything they want to talk about right now. What's working well? What are the challenges that they're seeing? What are they hearing in the community? What do they need from us as a leadership team to ensure that their practices are as robust as they want them to be, that they’re as efficient as they want them to be, and honestly, that our physician satisfaction is where it needs to be. That has yielded a tremendous amount of information in the couple of months that we've been doing those. But It is also helping us as a leadership team really engage our physicians on a monthly basis, but it also gives us the opportunity to follow up and create that bilateral accountability, that is so important. If we asked our providers to do something, then it gives us the opportunity to follow back up with them, and as well, to say you asked us to follow up with this, you asked us to execute this, here's where we are. It creates dynamic conversation that again, is really helping us to ensure that our physicians are being heard, their needs are being met, and that we're driving the organization forward.

TAMMY:
So then more on a ground-level, you're meeting with them monthly, you're doing Town Hall to You (I love the name of that) where you're going out meeting with all of the staff. You also recently started a new Provider Integration Program to really change the culture from recruitment to retention. Can you tell us a little bit about that?

DEVON:
You bet. Unfortunately, in my career and I've certainly been guilty of this and have witnessed this, where you hire a doctor, the doctor shows up, you hand them their keys. You hand them their badge. You show them where the physician lounge is, where the med staff office is, and maybe where physician dining or parking are located, you sort of pat them on the shoulder and say, okay well, I'm here for you. Let me know if you need anything. That does a great disservice to the physician (or executive or leader), but let's say physician as in this case, that does a great, great disservice to them. And for all the effort that they have spent, and that you as an organization have spent to not ensuring their long-term viability. And so we've really paused our onboarding process. We’ve shifted or pivoted to physician integration. That starts 120-days prior to their start date, or really frankly at the execution of their contract. We believe that this will go until 12 to 18 months after they've started – and it's multifactorial. It is not only the physician, but it is their family, it is their children. We’re assigning mentors. We’re working with our community leaders, to get them involved in the community.

Tammy, as you know, I’m relatively newly married and we moved to Lake Charles from Albuquerque, New Mexico. We've had challenges at times with integrating and how do we find the certain things? It's great to have people to reach out to, it's great to have a mentor that you can reach out to. Playing on our own experience, and what I've seen previously, we're developing this integration plan that again, it’s not only encompassing the needs of the physician, but of their family as well.

TAMMY:
I love it. I always love hearing a CEO talk about the classic mistakes that we made. The new term for going across our country right now is “the great resignation” about losing staff. But you said the great disservice to new physicians - that's going to be a new term that I may coin or steal from you because that is a very classic disservice. But only the great leaders like you recognize it and are quick to change it. Thank you for sharing that.

Can you think what the top leadership challenges are today, professionally and organizationally? I mean you did just speak about this recently, but I'd love for our listeners here just to kind of a quick summary of what you think the top leadership challenges are today.

DEVON:
I think it starts with communication and resiliency. Our physicians, our frontline staff, certainly have experienced innumerable, immeasurable challenges from Covid, from Delta, Omicron. As you know here Tammy, we have the distinction of being the most weather battered city in the United States, having survived two hurricanes, a massive ice storm, and then a flood in conjunction with Delta and Covid. For us, really the focus has been on that resiliency and ensuring that our staff, our physicians, our organization as a whole, has the tools and resources. It's a little unique here because we're talking about helping people find suitable housing, getting out of the trailers that they've been living in for almost two years, in some cases. Our Human Resource team has done a great job in reaching out. Our community has done a great job in supporting our organization and our staff. But it really does come down again to communicating. What can we do? Through those Town Halls to You, through the adoption of different units in the organization, we're learning more and more, on a daily basis from our frontline staff about how do we meet their needs? How do we communicate effectively? I think that's been a very powerful question that we’ve asked. Oftentimes, we make assumptions as leaders, of how we're going to communicate; whether that's through email, or through an app, or through any of the different medium that we use to communicate. It's a good question to ask your frontline staff and your leadership, how do you want us to communicate with you? I've yet to be a part of an organization that has an employee and / or physician engagement survey where communication wasn't one of the top needs as expressed by the staff as well as the physicians.

TAMMY:
Absolutely. That's good stuff. As I told our listeners in the intro that you had the designation of the most weather battered city in the country, that was on top of Covid. I mean, where everyone else is sharing their stories about their nightmares around Covid, you had just a crazy, crazy year and a half. And for the Hurricanes, they were how many months apart?

DEVON:
They were six weeks apart. The first one was Laura, which was a direct hit on Lake Charles, which was a Category 4 Hurricane, followed up by Delta, which was six weeks later, which was Category 2. The devastation in the community was – catastrophic.

TAMMY:
So, when people talk about staffing issues, you have people that left town, literally had to relocate, and hadn't come back. Compound staffing with all of that, it ups the challenge tenfold.

DEVON:
That's exactly correct.

TAMMY:
One last question before we moved to the fast 5 wrap up. What would you say are the warning signs of when the organization or healthcare organization is getting close to running off the track?

DEVON:
That's a great question. One of the things that we instituted here, that has been really a part of the process of leadership for me from the inception of my career in healthcare, is that that monthly operational review, looking back and then really looking to see what are the key metrics or key drivers that you have access to that can help forecast when changes are going to your occur or if there's something on the horizon that you need to be aware of. My CFO has done an amazing job of instituting the monthly operational review, not from a punitive manner, not from a pejorative manner, but to really help our directors and managers understand the key metrics and key levers in their book of business that are going to indicate positive or negative attributions or movement. A perfect example of how that has been very beneficial. Pardon the hurricane pun, but given all the headwinds this organization faced in 2020/2021. We were projected in 2021 to lose more than $15 million. We were able to close that gap and actually ended 2021 in the positive, in the black. That is through amazing work within the leadership team, engaging our physicians to help us understand how to be more efficient, how to be more effective. Then really the very diligent and methodical work by our CFO, by our finance team, by the managers, directors, engagement with physicians and has helped us really rectify a very challenging situation.

TAMMY:
Wow, that's impressive. So you think that the warning sign is when you don't have some kind of an MOR that's going to help you keep your eye on the gauge, if you will?

DEVON:
As a C-Suite, there needs to be a barometer, and whether that's through a monthly ops review, whether it's through daily dashboards, or any of the different types of reporting metrics that somebody may have access to. If you're not paying attention to it, and understanding the key drivers to that, on a daily/weekly/monthly/quarterly basis, that gives the organization the opportunity to be headed in the wrong direction, and not give you the time to rectify it.

TAMMY:
Do you know of organizations who don't have that practice or that discipline in practice?

DEVON:
Well, we did not.

TAMMY:
Okay. Yes. As a matter of fact, I do I'm sitting in the office right now.

DEVON:
As a matter of fact, I do. I think organizations, most, would have some elements of that. I think part of what we certainly implemented at a previous organization is ensuring that the dialogue with your directors, with your executive team is meaningful dialogue and people are not just coming in and regurgitating numbers that they've read on an income statement or in whatever productivity measure that they may have. That they understand and that, as a leadership team, we have spent a lot of time ensuring that our managers and directors really understand the numbers that they're reporting. It has made a significant difference in their ability to function as managers and directors and to be very effective in their management techniques.

TAMMY:
I think it Was it Einstein who said, if you can't explain it, simply you really don't understand it. So, you're really forcing them to understand their book of business and share that with others.

DEVON:
That's exactly correct.

TAMMY
Who can pick it apart, which is the scary part, but if you're in an astute leader or director, you want them to pick it apart because we want to keep getting better and better.

DEVON:
That's exactly right.

TAMMY:
Let's do the rapid-fire wrap up. My first question is, what are you currently reading or have read that you would highly recommend to our listeners?

DEVON:
Sure. I would say I just finished reading The Five Temptations of a CEO by Patrick Lencioni. It's been around forever. What I would say that really resonated with me in this was temptation #5, which is choosing invulnerability over trust. I think certainly working with the leadership team and coming in as a CEO that's new to the organization, that ability to be vulnerable, to engage, and create trust within the leadership team is invaluable and gives people the understanding that you have the ability to say, I was wrong.

TAMMY:
That's good. What word or mantra do you live by?

DEVON:
Be kind. There's a lot of challenges in the world today, I very rarely find somebody reacts negatively when you're kind.

TAMMY:
That's good. How do you start your day?

DEVON:
I try to get to the gym. There is amazing, amazing food in Louisiana. To appreciate and to indulge at times into some of the amazing food and souffles that exists here, I find it very beneficial to get to the gym.

TAMMY:
I love it. What's the most important characteristic of a leader?

DEVON:
I would probably go back to The 5 Temptations of a CEO, be vulnerable and be transparent. I think all too often we shy away from being transparent when it is the best thing for you, as the CEO, and certainly the best thing for the organization, as a whole.

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

DEVON:
Enjoy the process.

TAMMY:
Well, Devon, I could stay on this line all day and listen to your insights. I just want to say how much I appreciate you taking the time out of your busy schedule for being a guest on the Leadership Lens Podcast.

DEVON:
Well, I appreciate the opportunity and always enjoy the conversations with 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.