One in a series of profiles of Modern Healthcare’s Top 25 Minority Executives in Healthcare (sponsored by Furst Group)
Michael Ugwueke is CEO of Methodist South and Methodist North hospitals in Memphis, Tenn., where he also serves as senior vice president of the Methodist Le Bonheur Healthcare system. He came to Methodist in 2007 from Provena St. Joseph Medical Center in Joliet, Ill., where he worked as vice president of operations. Ugwueke, who came to the U.S. from his native Nigeria as a college student, turned around the troubled Methodist South facility, instituting a 30-minute emergency-room guarantee to the community in the process. His success led his bosses to add Methodist North to his responsibilities. Following is an edited transcript of the conversation:
Do your ERs still have the 30-minute guarantee in place?
Yes, we’re still doing it. When I first got into town, Methodist South was not very highly regarded. We were trying to turn the hospital around. There were a lot of issues stemming from perception of poor quality, low volume and low employee morale.
And one of the things that occurred to me is that most of our patients – over 80 percent – came through the emergency room. To make any noticeable impact, change had to start from the emergency room. When we went about trying to improve the turnaround process in the ED, that equally meant that we also needed to improve the turnaround process for major ancillary departments, specifically the lab and radiology departments. We wanted to make sure we streamlined our operations to remove all bottlenecks that affect quality and efficient delivery of service to our ED patients.
The 30-minute guarantee was part of my overall strategy, because what I really wanted to do was to create a new story about Methodist South. I knew that if we were able to create a new story, it would eventually take over and the old story of Methodist South would gradually die away.
So we took the 30-minute guarantee very seriously, and made it happen. That was almost five years ago, and it hasn’t stopped. Back then, we saw 37,000 visits a year. We ended 2011 with more than 61,000 visits and, with the current first quarter trend, we’re probably going to end up with 69,000 in 2012.
It helped to change the whole dynamic of the hospital, not just the emergency department. The operating room has to be efficient, the floors have to turn over very quickly, and everything from the laboratory to housekeeping is critical in our success.
There’s a sense of pride for all the associates who were involved in this initiative, especially when they hear from their family or other members of the community.
Tell me about your role and Methodist’s role in domestic violence prevention. How did that come about?
Community involvement is very, very important to me, but my involvement in working to end domestic violence came about strictly by accident. There was a nurse at another hospital who was killed in the parking lot when she came to work by an ex-boyfriend who was stalking her. It became a big news story here. It prompted one of our doctors, Todd Motley, to start talking about incidents of domestic abuse he believed were happening to some of his patients. He created a program so that victims of abuse could call his office for an immediate appointment, receive some shelter and notify the police. He came to me and it didn’t take but a minute for us to get behind what he was doing.
So we ask our associates to donate clothes and toiletries, among other things, to help these women. But Todd Motley is the brains behind this.
You recently paid a visit to the White House. What will you remember from that day?
It’s the first time l’ve ever been there. I lived in D.C. for a brief period of time and always said, “I’ll do this, or I’ll go there,” and I never did.
Steve Cohen, the congressman from my hospital district, extended an invitation from the White House to meet with key minority business leaders to brainstorm about job creation and various other opportunities. So about 20 business leaders from Memphis sat down with the White House staff. I was truly honored to be invited as part of the delegation that met with them.
Where have you learned the most about leadership? And from whom?
Actually, it started at home. My dad was the primary person in my life that I felt believed in me and provided guidance to me as a kid growing up in Nigeria. I watched him as he struggled to raise us up with limited resources; he was my inspiration in every way imaginable because he was looked upon in the community as a leader even without a formal education. Having the guts to leave your country at the age of 21 to come to the U.S. where you don’t know anyone, and believe that you’re going to survive with no money – that came from my dad’s ability to instill in me the knowledge that the world did not owe me anything and I had to create opportunities for myself.
My dad did not have a formal education. He was self-taught but was able to become a foreman in a construction company and eventually was able to start his own construction business. He wanted to make sure all his kids had the opportunities for education he didn’t have. I was very fortunate to have such a person in my life during my formative years.
A number of other people also have been very instrumental in my life. I’m forever grateful to Michael Covert. I met Covert when I was working at Sarasota Memorial Hospital in Florida. He provided me with lots of growth opportunities and was my first formal mentor. When he left the hospital to become the CEO of Washington Hospital Center, he asked me to come with him as one of his executive team members. He was very instrumental in mentoring me and providing needed guidance as I continue to take on additional challenges within the hospital. The second person is my current System CEO Gary Shorb – he is one of the people who nominated me for this award. He is a wonderful mentor and the reason why I came to Memphis; he too has provided me with lots of growth opportunities. He is a servant leader who is extremely passionate about patient care.
What makes a good leader?
For me, a number of things make up a very good leader. A leader is someone who is willing to step up and do those things that most folks are unwilling to do, to have the intestinal fortitude to make tough decisions, who is visionary and willing to lead from the front. A leader creates the environment that empowers others to equally step up and lead.
You have to make sure that you have clarity in your organization with total transparency in all communications with your associates as well as other key stakeholders. For example, we conduct four town halls a year to ensure that everyone is on board with our goals and objectives. We share the results of our activities during these sessions – good, bad and ugly – so everyone knows exactly what is happening at any given time. It takes away the “we” and “they” mentality which ultimately leads to trust.
What are the keys to building a good team?
No one can do anything by themselves. In my early years, I realized the importance of teamwork. There are certain guiding principles one develops. In my case, I like to have a very diverse team that reflects the community we serve.
I also like to pick out people who are much smarter than me and passionate about making a difference because that’s what it takes to do this kind of work. I inherited the leadership team here; my philosophy is not one of blowing things up and bringing in all new people without giving the existing team members the opportunity to prove themselves. I like to believe that most leaders, given the opportunity with clarity in expectations and support, can get the work done. I like to make sure they understand the reasons behind the new vision and what implications it has on their success. Obviously, you give everybody a chance, and some will self-select when they realize that they’re better suited for another environment.
But I try to build my team in four ways:
The first is to try to create a culture of accountability, to be very clear with the goals of the organization. We set clear priorities and expectations with timelines and metrics to gauge and measure our progress. All my leaders have actionable plans that support their goals and priorities for all of their areas. To be effective, one has to know their business in and out and able to explain positive or negative variations from their goals.
We track our goals on a quarterly basis, and plan for where the metrics need to be on a monthly basis in order for us to accomplish our 90-day goals.
It’s very important in developing a high-performing team that you have a sense of trust. You have to create a level playing field – no one has a monopoly on good ideas. Everybody’s goal is shared with everyone. There are no hidden agendas.
Second, is to create a culture of rapid execution of ideas. We don’t want analysis paralysis with several meetings and no results. We try not to wait till we have 100% of the data before execution of great ideas, What typically happens is that if we are comfortable with 70 percent of what we need, we will go ahead with our plans, with the expectation that we may have to refine and course-correct as needed. If you try to wait till everything’s perfect, you’ll never get off the ground.
When we started the 30-minute guarantee for our emergency department, we met every afternoon. We shared yesterday’s data – everybody knew exactly how we did, and then we made immediate changes to address variations from our targets.
Third, is leadership and associate engagement. I strongly believe that the engagement factor with your team is important. I conduct 90-day meetings with all new associates to ensure that we are still meeting their expectations and I often meet with leaders and seasoned associates to learn about their challenges to ensure that we are providing adequate resources and tools that they need to accomplish their goals. In addition, it provides me the opportunity to recognize their efforts. You need to devote time to this and make those connections.
Fourth, is total transparency in everything that we do – data and results are shared liberally, with clear understanding of our strengths and shortfalls with no excuses. We do this during our town hall meetings, annual retreats and operational efficiency presentations by department leaders.
You’ve spent a lot of time at faith-based institutions. How different are the challenges there?
For one thing, the mission is very clear. There is very little ambiguity as to what the mission is. I believe that the difference is how we go about providing care for everyone regardless of their ability to pay. Also, we invest a lot in the community, trying to improve the health of our community – as you well know we don’t expect for anyone to reimburse us for the things that we do in the community. By virtue of being a faith-based organization sponsored by the United Methodist Church, you feel like you have the moral authority to look at things in a slightly different way. At the end of the day, my expectation is that we are going to treat the patient holistically in a patient-, family-centered environment. We do the best we can with limited resources to make sure people who ordinarily don’t have access to healthcare have the opportunity to experience excellence in healthcare.
In terms of diversity in healthcare, what kind of changes have you seen since coming to the U.S.?
No doubt there’s been some improvement, but we still have a ways to go. As long as we are still talking about disparity in care among different groups, we know that we are not there yet. I think the gap is closing within the ranks of supervisors and middle managers. The area of greatest opportunity is within the director level and senior teams.
Is leadership harder today given all the uncertainty around reform?
It will be easier to say yes, but I am certain that every generation of healthcare leaders probably thought that things were harder for them. I think that healthcare reform definitely presents lots of challenges which are opportunities in disguise. Regardless of the outcome of the Supreme Court ruling, changes have been made throughout the industry because the payment model that we have is just not sustainable. The challenge is having one foot on the throttle and the other foot on the brakes as we move from a fee for service to value-based purchasing.