Human Resources
Rx for success
How David Fine prescribes outside-the-box thinking to all employees at St. Luke’s Episcopal Health System
By Erik Cassano
Smart Business Houston | September 2007
Page 1 of 1
When David Fine wants to escape the world of work, he goes to
his garden. It’s one of the few places where the president and CEO
of St. Luke’s Episcopal Health System can find some quiet time.
“I find it relaxing. It helps me clear my head from some of the
complicated work in the field,” he says.
But like most driven business leaders, all roads seem to lead
back to the office eventually. Even Fine’s gardening hobby found
its way into his work.
Shortly after starting at St. Luke’s in 2004, Fine gathered about
200 of his top managers and executives for a meeting to begin mapping out a future for the 7,000-employee health system. During the
meeting, he recalled a gardening-related quote about leadership
that was once uttered by a leader in a totally different arena: “Let
a thousand flowers bloom.”
The phrase is attributed to Chinese military and political revolutionary Mao Zedong. Though Zedong’s words were political in
nature, Fine still finds them relevant in the world of business.
“Its meaning was that you have to try things differently,” he says.
“You have to do them differently, you have to experiment.
“In (Zedong’s) case, his objective was to really upset the apple cart.
I don’t subscribe to radicalism, but I do believe in the notion of making room for alternative ways. Having alternative approaches is very
important.”
It’s why, since starting at St. Luke’s, Fine has strived to create an
environment where every employee is challenged to think about
new ways to make things happen and think outside the box.
For Fine, who has been a chief executive in various companies
since the mid-1980s, new ideas from within are one of the essential fuels that will propel a business to bigger and better things in
the future. He says as the company leader, your job is to make sure
your employees feel enabled to think that way.
Here’s how he’s handled some of the challenges of motivating his
people to think in new ways.
Focus on people
If you want to focus on new ideas, Fine says you have to focus
on the people who generate ideas.
The obvious place to start might be with your company’s big
thinkers — the engineers, marketers and executives who are
charged with shaping your company’s future.
But don’t stop there.
Gathering ideas should be an all-inclusive process. Fine wants
everyone, top to bottom, to become involved in pushing St. Luke’s
forward.
He forms collaborative teams that are aimed at bringing together employees from all over the system, no matter what their level
is in the organizational hierarchy.
“One of the challenges of many hospitals is that hierarchy can
readily develop, where people of a higher employment status
won’t recognize people who aren’t paid as handsomely,” Fine says.
“Here, we work continuously to develop collaborative teams that
are very broad, that include nursing assistants, housekeeping and
food service aides. It’s a very powerful and distinguishing characteristic for us.”
During the collaborative meetings, Fine and his management
team stimulate new ideas by rallying everyone in the organization
around a common goal of patient service. With that as the broad
template, everyone in all levels of the company are challenged to
come up with ways to make the experience of the patients — the
customer lifeblood of St. Luke’s — even better.
“Bringing our people together around a common goal helps
make what can be a very frightening and stressful time for a
patient as humane and as focused on them as possible,” Fine says.
“We need to make sure that the people who come through our
doors for treatment are universally welcomed in a loving and supportive way.”
While bringing employees together on a large scale can be effective for encouraging communication and the flow of ideas, he says
it also needs to happen on a more grassroots level.
At department-level meetings and at individual facilities within
the St. Luke’s system, Fine has created many of the same structures for enabling employees to communicate with each other and
management.
“We have periodic town-hall meetings that our facility chief executives hold,” Fine says. “Employees are free to discuss anything
that’s on their minds. We have ways for employees to put suggestions into the system, even if they don’t want to be identified. So
we structure a variety of parallel opportunities and hope people
will pick up and use the format they are most comfortable with.
“It’s important because I think it’s the best way to assure yourself
of engaged, enthusiastic workers. It’s a big team, and health care,
in particular, requires many different kinds of skills to produce
good outcomes for patients.”
Make your vision clear
Your employees want to have their voices heard, but they also
need to hear your voice. Fine says soliciting new ideas and perspectives from your work force won’t really help the company if it
doesn’t occur within the boundaries of your company vision.
Daily communication is an integral part of keeping your work
force on the same page and driving toward the same goals.
Fine says consistent communication is critical for any leader of
a large organization, and he spends a large part of each day communicating through various means.
“Since we have over 7,000 employees, the evolution and advancement of a common vision requires good listening and good communicating,” he says. “It’s not easy, and it takes very long work-days.
“I start my workday at about 4 a.m. and from 4 until 6, try to do
the electronic communication part of my job. It’s not uncommon
that on any given day, I’ll collect 150 e-mails. Then I’ll try to get to
the office between 7 and 7:30 and see as many people as the day
will permit, and often see more in the evening.”
Fine says an effective leader can’t manage solely from an office.
While e-mail and voice mail are important tools in any executive’s
communications cache, there is no substitute for walking the halls,
going into the field and engaging employees in person.
“It’s a little bit of a truism now, but you can’t really manage the
enterprise if all you see (are) the walls of your office,” he says. “You
have to manage by walking around. You have to see what is going
on with your customers, with your employees and with your board
members, and stay connected.”
Fine says it’s no easy task to stay connected in person, particularly if your business is spread across multiple locations, but every
little bit of in-person communication you can do helps to drive
home not just that you value your employees’ ideas and input, but
that you are willing to get down in the trenches with them.
“It’s not easy, and it takes very long workdays,” he says. “But no
one is successful at this level by staying within the boundaries of
40 hours a week.”
It’s a matter of prioritizing, which can be a challenge, in and of
itself.
“In the spirit of true confessions, I am probably a person who finishes a lot of major tasks just in time,” he says. The reason being,
there are so many tasks and things demanding your time.”
In some cases, Fine says it comes down to a choice of getting a
leg up on paperwork or engaging employees. Each time, he says he
will always choose employee interaction over desk work.
“I’d perhaps be more fulfilled personally if it were more possible
to work ahead and have next week’s work done this week,” he
says. “But I will trade that off for the opportunity to speak with
employees for half an hour or pick up the phone and congratulate
someone within the organization for a success.”
Evidence-based management
Fine says that there is a science to managing people. He calls it
“evidence-based management,” and it is the subject of his fourth
book, which he is currently authoring with a professor at New
York University.
Evidence-based management involves measuring your performance as an organization against comparable organizations, measuring the differences and working toward best practices.
“A good example for us is measuring the quality of clinical observations in a particular diagnosis,” he says. “We benchmark various
clinical outcomes against these other top-performing institutions
to see how we can get the next incremental improvement. We are
very introspective on this, we are very hard on ourselves. If you
aren’t that critical of yourself, you are never going to improve the
efficiency and effectiveness of the institution.”
However, Fine says that unless you can drive the research results
down to the level of your employees, it will simply be abstract data
to them. So Fine takes it a step further and uses the organizational data as a means to make each of his employees examine his or
her own role at St. Luke’s and how each person can perform better in that role.
“We have a chief quality officer for our system,” he says. “A big
part of her job is measurement. We’ll measure anything that anyone can. How long does it take to get from the emergency department to the cath lab for a patient who is in need of a cardiac
catheterization? How long does it take to do a surgery from initial
incision to closure? How long under anesthesia? So you seek out
variables by which you can compare and contrast particular parts
of the enterprise.”
Through rigorous self-examination and creating an environment
where employees feel encouraged to speak up, Fine says he wants
to cultivate a work force that is never satisfied with standing pat.
In the world of business, you can carve out a niche in a specific area,
and it becomes something of a comfort zone. There is nothing wrong
with that, Fine says, but resting on your laurels can kill your company’s momentum down the road, making it a potential sitting duck for
the competition.
“Staying the course is safe, generally,” Fine says. “Striking out in
a new direction can be dangerous. But if you take as an example
some of the gifted medical scientists working at St. Luke’s, people
whose careers span teaching, research and patient care, a lot of
times these people have to go against contemporary norms.
Oftentimes, it’s the out-of-the-box experiment that reveals a whole
new tradition in medical treatment.
“We have a surgeon at St. Luke’s who has done more heart transplants than anyone in the world. Along the way, he has become
one of the most internationally recognized leaders in the use of left
ventricular assist devices. But when he started out, nobody
thought it would amount to anything. Other prominent surgeons told him he was wasting his time. But as the years have
gone by, he has really used experiments and interventions to
get closer and closer to the possibility of having a true artificial
heart.
“I think that’s what my job as the CEO is about — to encourage people who take prudent risks that are somewhat outside
the norm for the sake of the breakthroughs that can transform
a patient’s experience.”
HOW TO REACH: St. Luke’s Episcopal Health System, www.sleh.com
