Cultural revolution Featured

7:00pm EDT January 29, 2008

Forget that Dr. David T. Feinberg has more college degrees than the average small company’s staff, the best lessons he got in life didn’t come from a professor — and they didn’t cost him a dime in student loans.

Growing up in Burlington, Calif., Feinberg’s father taught him a very important lesson about business: Refuse the desire to get sidetracked.

“He said, ‘Stick to your business; don’t get sidelined,’” Feinberg says. “So he really taught me about being single-focused and sticking to what you do because that’s the business you know.”

On his path to becoming CEO and interim associate vice chancellor for UCLA Hospital System, Feinberg realized that in his profession the main focus of his job was his patient care. When he took over at UCLA, he had the realization that he had the medical technology to do his job, so if he could get the staff at the $1.3 billion hospital system, the hospital portion of academic medical enterprise UCLA Health System, focused on that people-first attitude, then there would be an improvement in patient care.

So Feinberg has created a culture where he leads the charge for taking care of people by making sure that he and his leadership team are out touching the front line, and then circles back to meet with employees to ensure that they’re happy so they’ll take better care of patients, then he continues to add people-oriented staff members to keep the culture going.

“We are in the business of taking care of people, and leadership has to show that, just like the nurses or other staff, we’re just people, with strengths and weaknesses, but with this common goal of coming in every day to make sure we take care of our patients,” Feinber says.

Pushing that culture led to UCLA Medical Center being ranked as one of the top three hospitals in America — including the best in the Western U.S. — by a 2007 U.S. News & World Report survey that ranks hospitals on various care factors, including patient care.

Here’s how Feinberg maintains his winning culture while continuing to move the organization to new heights.

Set the tone

Opening the lines of communication is vital to creating and maintaining a culture. Feinberg starts by meeting his customers — the patients.

“The business that we’re in, we have to remember to stay focused every day that we’re here just to take care of those patients, and I meet as many of them as possible,” Feinberg says.

That commitment to meet with people is something that he knows not every leader will make, but Feinberg insists it makes all the difference in setting an example for his culture. And, whether it’s patients or customers, you need to make that a priority so they can understand what is going on at the ground level. That means Feinberg makes a conscious decision to schedule a great deal of his time for speaking with patients.

“I spend 40 percent of my time not at the bedside but literally on the bed,” he says. “I introduce myself to the patient. I say, ‘I’m the director here, how are you feeling, how’s your care, have we communicated to you in a way that you understand? Here’s my card, give me a call if there’s anything I can do to help you.’”

While most leaders would be concerned that those kind of visits lead people to come to them with more trivial matters, that’s exactly what Feinberg wants. When he hears how the little things are going with patient care, he can work on the core problems with the system and see what’s working.

“Whether it’s that leukemia patient who calls my office to say a TV doesn’t work, to a patient who says, ‘I want you to compliment this nurse,’ to me, that’s our business, so I see that as my No. 1 job,” he says.

With so much of his schedule purposefully tied to these meetings, Feinberg sets an example for the culture at UCLA — after all, if the CEO makes time to sit with a patient, so can a nurse.

“It’s incredibly rewarding to have that direct connection with patients and families where we are literally changing their lives,” he says. “That’s why our 7,000 employees come to work every day, so to be able to do that shoulder to shoulder with them provides an inspiration to them. Despite the many challenges of the business, if you can be out there to help them remember why they come to work every day, it makes it much more rewarding.”

When you are pushing a culture that promotes an emphasis on people, the ability to talk with those on the front line can give you the greatest asset of all: a good story. For Feinberg, talking with patients means he gets examples of nurses and residents who did things right.

“When a mom says to me, ‘We’ve been to four hospitals; no one got it right, but we’re getting the right answer here,’ or somebody says to me, ‘We wouldn’t go anywhere else; this is our hospital,’” he says. “Those things come to me and I’m able to share them with everybody. I’m fortunate that those come to my office. They’re not about me, they’re about staff, but that energizes me, and I’m able to take those stories with me and share them with the staff.”

Shake a few thousand hands

While Feinberg appreciated the lesson on staying single-minded, he notes another tidbit he got from his father as even more important.

“The most important thing that he taught me was to have integrity,” Feinberg says.

Applied to business, that means if you say you want employees to be happy so they’ll take care of people, you need to have the integrity to prove it. Feinberg has to show the same commitment to that effort that he does to leading the charge in taking care of patients. He shows up at events that are important to the staff and makes his presence known by engaging in conversations. He says that if employees see you, it will be easier for them to feel comfortable coming to you with a problem.

“I invite 10 people to lunch once a week randomly from different departments,” he says. “As I’m walking the floors meeting patients, I meet with departments. I attend as many ceremonies as possible, I attend memorial services — any of the things where the staff is coming together. I go on rounds with the medical team. I try to be out of my office as much as possible because I’m 100 percent about the relationships.”

If you want to make employees care about others, you have to make sure they know someone cares about them. When Feinberg was the medical director at Resnick Neuropsychiatric Hospital before being promoted to the head of the hospital system, he knew all 400 of his employees by name and made it a point to know something about their family lives. He can’t do that now with his 7,000 employees, but he sure tries.

“When I took on this role, I made the commitment that my efforts are to meet all 7,000 people,” he says. “Now, I can’t tell you I remember everyone’s name, but I can’t imagine anything more important than those people who are so important to what we’re doing having access to me and to others in the executive suite. That’s why we’re here is to make sure those people do the job that we’re supposed to be doing.

“Now, obviously, I can’t listen to every single employee, so the whole leadership team is set up to have open lines of communication.”

Creating communication lines by having other senior leaders at company events or mixing with employees at luncheons, titles can be removed and opinions can be shared. Those conversations, mixed with Feinberg’s intense front-line work, help him see smaller, day-to-day changes that can help employees.

Feinberg’s leadership team did an employee satisfaction survey last year to address any gaps, trying to avoid letting one opinion slip through. While he knows that UCLA is afforded the technological luxuries of the field, he ensures that his leadership team follows up on employee happiness in other areas by responding to that survey. In showing that you care about the little concerns of employees, Feinberg notices that morale goes up — and that can be tied to patient care.

“We have focused very heavily on making sure our people felt on top of their game and the morale was good,” Feinberg says. “All my communication is around how to improve the patient experience — while connecting to the idea that we’re going to continue to take care of our people and we’re going to get the best support systems for them.”

Creating avenues for employees to feel supported is something that you have to stay on top of every day, but if it’s a priority to connect the mission with employee happiness, you will see the results in the efforts they put in to take care of people.

“I believe in the servant model, where the top of the organization chart is the bedside nurse, the residents are at the second level and the very top level is the patient,” Feinberg says. “I’m really at the bottom of the chart. My job is to support those that are taking care of those patients. When you think about the offering we deliver, it’s a very people-intensive process, so we have to make sure that our people feel heard and feel part of the team so they can stay focused on that offering.”

Hire for your culture

Feinberg could spend 99 percent of his time meeting patients and working with current employees and still miss the mark. In order to light a fire under employees he has to make sure UCLA is continuing to hire those that have the right spark for the culture.

“You need to hire people that want to care for people,” he says. “The place that we always need to continue to improve is that we can’t get so focused on [medical technology] exclusively so that we have a nurse that doesn’t have the time to sit down and hold the hand of a patient who is dying.

“We need to balance the high tech with some high touch, so we need to find those that really have that unique combination of being both brilliant and human — that’s the challenge.”

Calling that a challenge may be a bit of an understatement, but Feinberg says you can start the process by admitting that technology can show you a bit more than you think. Instead of continuously dealing with false positive interviews that allow potential employees to talk about how great they are with people, UCLA has started using Talent Plus Software, an assessment for personality and recruiting used by famed luxury hotel chain Ritz-Carlton, to get to the core of how people’s personalities truly match up with the job of taking care of people.

“You need to be a little more thoughtful in that process,” he says. “It’s a very time-intensive interview, but in the end, it tells you this is the kind of person that would go out of their way for a patient or a guest, so we use that as part of our hiring.”

That doesn’t mean that interviewing should be thrown out the window; it just means that Feinberg and his team see the benefits of relying on technology to help them make the harder decisions on candidates they can already see as qualified.

“Often in an interview, everyone talks about how they want to care for people,” he says. “It doesn’t necessarily translate when they get the pressures of their daily assignments, so we’re trying to be a little more thoughtful and objective in using this tool to get at that exact team because I know that you can’t do all that very well in an interview.” 

HOW TO REACH: UCLA Health System, (800) UCLA-MD1 or www.uclahealth.org