Fall 2011

International ACHE Profile:   

Venetta Symonds, FACHE Deputy CEO and Executive Vice President Bermuda Hospitals Board Hamilton, Bermuda

"It is critically important that every team member be competent but also have a diverse background and experience. This will ensure that decisions are well-informed and that the organization is positioned to respond to new challenges."

Q: Tell us briefly about your background in healthcare management.
A: I returned home to Bermuda and the Bermuda Hospitals Board (BHB) in 1980 after completing a bachelor’s degree in radiologic technology in the United States and working as a radiographer. In 1985 I was given the opportunity to oversee the implementation of the first CT scan service for our hospital and for Bermuda. This involved learning about the technology, designing an implementation strategy, identifying a team and educating the local medical community about the benefits of the service. I supervised the CT Unit until 1997, when I was promoted to diagnostic imaging manager.

In 2000 I was promoted to COO with responsibility for all clinical and nonclinical support services. Overseeing the introduction of an MRI service to Bermuda was a significant accomplishment. Achieving the Laboratory Service Accreditation from Joint Commission International and the Mammography Accreditation from the American College of Radiology helped to align quality standards with those in the United States and between 2000 and 2006, I oversaw operational improvement programs.

Q: How did you arrive at your current position?
A: In November 2006 I was promoted to deputy CEO to work alongside a newly appointed CEO. Under his leadership, BHB has successfully achieved key board targets such as raising patient satisfaction levels, establishing a talent management program and developing a successful procurement process for a new hospital. I was appointed as the executive sponsor of the new hospital project and also of the renovation of the current facility and now watch daily as progress is made with the construction. I was appointed CEO designate earlier this year and will take over as CEO in April 2012.

Q: What are your primary job responsibilities?
A:As CEO I will have complete responsibility for BHB, including the King Edward Memorial Hospital, Mid-Atlantic Wellness Institute and our associated properties, services and projects.

Q: What is the biggest challenge you face in your current position?
A: The biggest challenge will be assuming full responsibility as CEO in April and managing the leadership transition. We have an exciting agenda in place that must be supported as we influence and navigate health reform and economic pressures. Ensuring that a competent and committed team is supported to deliver the board objectives is imperative.

Q: What is the biggest reward?
A: BHB touches every life in the community. We are also the country’s second largest employer. When we do our job well, it benefits the community. The biggest reward I get is when there is external evidence of a job well done, such as achieving accreditation, which we received this year from Accreditation Canada, or when satisfaction scores go up. It is also satisfying to read and hear expressions of appreciation for the services provided. It has been rewarding to work with a brilliant leadership team that is balanced with Bermudian and non-Bermudian professionals.

Q: Briefly describe the overall healthcare atmosphere in the country in which you work.
A: Bermuda is impacted by economic pressures similar to the rest of the world. Much of the concern is around the cost of healthcare, so there is increased discussion regarding managing costs and improving quality. There is also a new focus on wellness. BHB responded to this by recently establishing a new wellness initiative targeting employee health.

Q: How do you see the field of healthcare management changing in the next 5 years?
A: Healthcare management requires collaboration and innovation. Doing more with less isn’t a new concept, but technology has created opportunities that did not previously exist. BHB has to work with partners and stakeholders when considering health reform strategies, especially because the public is now well-informed and challenges decisions around care. In addition, leaders will have to adapt to changes that are brought about by economics, technological change, clinical specialist shortages and overall recruitment challenges.

Q: What advice can you offer for other international affiliates?
A: It is critically important that every team member be competent but also have a diverse background and experience. This will ensure that decisions are well-informed and that the organization is positioned to respond to new challenges. Keeping our patients at the heart of what we do will guarantee that the best choices are made on their behalf.

Feature Article:   

Global Developments in Facility Planning and Sustainability

Healthcare organizations around the world are making inroads in sustainable design by addressing community needs and turning environmental challenges into opportunities for innovation.

By Megan Downey

Questions about sustainability in healthcare have generally taken a strategic and direct path: How do we increase energy efficiency? How can my organization reduce its carbon footprint? How can we leverage our sustainability efforts?

While these are all important questions to consider, the emphasis on sustainability efforts differs around the world.

Robin Guenther, FAIA, principal with global architectural firm Perkins + Will, says hospitals in Europe are generally constructed with an energy-efficiency level that is well below hospitals in the United States due to increased costs, and fossil fuel energy is more expensive overseas.

"Because of the expense, going sustainable is much more a part of the business case outside of the United States," Guenther says. "Health systems have to show the economic benefit for using less energy, and when the payment and the return to the owner/operator is knowable, that will make the first cross-capital decisions for energy conservation easier."

Although there are more than 30 green building certification bodies around the world, accreditation is also seen as an expensive undertaking. "There's a perception that it's being done by hospitals that have more money, and that’s fostering the belief that it costs more," she says.

But while the advances and accreditations that have come to define sustainable design in the United States have not yet had as much global impact, other green practices are growing.

Different Definitions for Sustainability

While U.S. hospitals define sustainability more in the technological advancements and equipment they use, hospitals elsewhere view sustainability as designing a hospital where the materials and labor practices relate to the natural environment, Guenther says.

In the developing world, for example, highly sustainable buildings are being built with local materials by local communities using renewable energy technologies and local building traditions. The buildings may not be certified, and might actually be described as low-technology facilities. More often than not, these buildings are the product of innovative solutions in challenging climates. Following are three examples of hospitals that have achieved sustainable design through differing focuses:

Butaro Hospital, Rwanda
Built with local labor materials and naturally ventilated. Built in response to health buildings in Rwanda that were mechanically ventilated like U.S. models but have become incubators of disease.

Ubuntu Africa, South Africa
A low-energy building where food is grown on-site and has become an anchor for the community. The center was built to destigmatize the treatment of AIDS.

Salam Centre for Cardiac Surgery, Sudan
A building run entirely on solar power and that collects its own water, to overcome the limited infrastructure of the surrounding area. Patient wings are naturally ventilated; operating suites are mechanically ventilated.

"Sustainability has become a catalyst for developing more sophisticated medical delivery for places that have no infrastructure," Guenther says.

"In a lot of ways, there are lessons about resilience in extreme climates and during natural disasters to be learned from the developing world," adds Gail Vittori, LEED AP, co-director of the Center for Maximum Potential Building Systems in Austin, Texas. "The learning for hospital executives goes both ways in sustainability."

New Global Resources for Sustainable Design

As the focus on sustainable healthcare grows, more international resources are becoming available. The World Health Organization offers a Health Promoting Hospitals Network, which promotes the notion of hospitals as anchors in their communities. Health Care Without Harm, an international coalition of more than 450 organizations in more than 50 countries, recently published the Global Environment Health Agenda for Hospitals. The agenda is aimed at providing a framework for healthcare organizations to reduce their ecological footprint and lead the way in addressing major environmental health challenges.

Three organizations also offer health-focused sustainability accreditation programs: BREEAM, based in the United Kingdom; the LEED International Program, from the U.S. Green Building Council; and the Green Building Council of Australia.

Embracing sustainability in healthcare is also about making sure the right people from all levels of the organization are at the table. "The people who are spearheading this are healthcare professionals who care passionately about their patients and their community," Vittori says. "They take on sustainability above and beyond their day job because they want to do better."

Additional Resources

BREEAM
Global Environmental Health Agenda for Hospitals, from Health Care Without Harm
Global Climate and Health Resource Center, from Health Care Without Harm
Green Building Council of Australia
Health Promoting Hospitals Network, from the World Health Organization
LEED International Program
United Nations Environment Programme

ACHE Resources:   

Below are new ACHE resources, such as books, study courses and websites, to help you excel in your career.

Books:

Getting It Done: Experienced Healthcare Leaders Reveal Field-Tested Strategies for Clinical and Financial Success Kenneth H. Cohn, MD, MBA, FACS, and Steven A. Fellows, FACHE Risk Management and the Emergency Department: Executive Leadership for Protecting Patients and Hospitals By Shari J. Welch, MD, FACEP, Kevin Klauer, DO, EJD, FACEP, and Sarah Freymann Fontenot, JD

Self-Study Course:

• Coordinated Care: Improving Clinical and Financial Performance

Professional Pointers:   

How to Lead, Motivate and Retain Key Talent During Uncertain Times

With more organizations laying off staff, slashing budgets and reorganizing departments in an attempt to cut costs and increase cash flow, many leaders struggle as they attempt to do more with less. But in their quest for increasing productivity and maximizing talent, organizations can lose key employees.

Effective leadership is always the key element to motivating and retaining staff. Help your managers and executive-level employees lead effectively and retain key talent through the following practices.

Set clear expectations

Each employee needs a clear focus, especially during uncertain times. Tell them what you want, what they did right, what you expect of them and how you will measure their progress.

Share the organizational vision and goals so employees understand the big picture. Realize that your team members want to know where the organization is going and how that direction impacts their personal objectives.

Show respect

When resources get tight, respect within an organization can decline, causing some leaders to show a lack of concern for the needs of their employees. As you ask employees to produce more, stay attuned to their need for work-life balance. Be creative about building in the flexibility.

Make the workday meaningful
Employees want to contribute to the big picture and help the company sustain through the tough times. Provide challenging and meaningful work assignments.

Give appropriate praise and recognition
Recognize and celebrate even small accomplishments. One simple way to give praise and recognition is with a simple thank you.

Continually coach
To keep morale high, encourage employees to try things their own way and allow for mistakes. When you need to correct employees, do so constructively by offering ways they can improve.

In addition to coaching from management, suggest that team members coach each other. The encouragement, teaching and support increase dramatically when all team members provide it.

This is an excerpt from the article "How to Lead, Motivate, and Retain Key Talent During Uncertain Times," written by Joanne G. Sujansky, PhD, with KEYGroup. Sujansky has been helping leaders to increase productivity and inspire loyalty for more than 25 years. View the full article here.

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