Ian Worden says he’s not looking at how Bartlett Regional Hospital got itself into a difficult period, but rather where he’s able to take it during the coming months in his role as interim CEO.
Worden, who has more than 25 years of healthcare leadership experience, is the hospital’s eighth CEO since January of 2021 and third in the past few months. He started the job on Oct. 30, inheriting problems with finances, employee morale, staff shortages, behavioral health care, and other issues brought up by staff and board members in recent months.
[New Bartlett CEO has lots of experience with mergers, transitions as hospital confronts struggles]
In an interview Wednesday, Worden said his impression after his first two weeks is the hospital’s staff and operations are fundamentally solid, offering the elements necessary to revive its standing among people at the facility and in the community.
“The way I like to look at things is as a CEO I have to deal with the reality they have on hand and then move the group forward,” he said. “I don’t spend a lot of time assessing what went on before, it’s just not the best use of my time. What I do is I try and do an environmental assessment at this day forward. And what I’ve liked about the situation that I have come into is we have all the elements to make Bartlett live up to what its goal is to be — the best hospital in Alaska.”
Worden most recently was the chief operating officer for Virginia Mason Franciscan Health, headquartered in Tacoma, Washington, until taking a sabbatical beginning in January of 2022 for reasons related to COVID-19. Prior to that he was chief operating officer of CHI Franciscan Health from 2015 to 2021 before it merged with Virginia Mason, and executive vice president and COO for 12 years of St. Vincent Health System, a 23-hospital system in Indiana.
His hiring at Bartlett came after David Keith resigned as CEO on Aug. 1, less than a year after starting the job, with Nate Rumsey — the hospital’s executive director of business development and strategy — serving as acting CEO during the interim.
Worden said he hasn’t put a limit on how long he will serve as Bartlett’s interim CEO, but is envisioning remaining at the job for six to 13 months.
“I have to go through a budget cycle,” he said. “I have to go through a Capitol cycle. I’d like to see what the summer adds because you have all these cruise ships coming in.”
The permanent CEO job isn’t of interest, Worden said, due to his age and “I think that the organization needs someone who can commit to this area for the long term — 10 to 15 years.”
In outlining his goals for Bartlett during an interview with the board of directors in September, Worden said the most important was “the care and feeding of clinicians.” On Tuesday he added stability and sustainability to that goal, given the current difficulty of luring and retaining permanent employees, as well as the high cost of hiring temporary employees that has become a common practice at many hospitals nationwide.
“There’s a national shortage everywhere so you’re competing nationally with health care professionals,” he said. “And so one of the most important things that I have to do is as a leader here is I have to be in service to clinicians, and by clinicians I mean nurses and physicians and (physical therapists) and (occupational therapists) and all those sorts of things, so that we can be different enough that people won’t want to come and go.”
Acute workforce shortages for a multitude of professions in Juneau and throughout the state have been a major ongoing issue, particularly coming out of the COVID-19 pandemic. Some Bartlett officials earlier this year said the best healthcare employees are going to private companies, leaving smaller and more remote facilities such as Bartlett with what one doctor called “end of the road” employees.
Worden said he believes Juneau — and the hospital’s role in it — can be a selling point to healthcare workers.
“Juneau is a beautiful area,” he said. “It has a beauty in and of itself that will attract a certain person — we just have to find them. There are people that can’t work in cities. There’s people that need the large hospitals, (but) there are people that want to work in a community where they can have a broader-based practice. And that’s how we attract people is to make sure that that they understand the benefits and the commitment Bartlett has to the community, and the benefits that the community provides for them, and their spouses and their children.”
As for the Bartlett employees here who are expressing concerns about various aspects of the hospital, Worden said that’s where his emphasis on bringing a stable presence comes in.
“I’m a very calm, deliberate sort of individual,” he said. “I want to make sure that I listen to individuals. The importance of listening is to make sure that they understand that their position is understood and considered in the decision-making, and that I am not capricious in making quick, rash decisions. So that stability is something that provides them with a better environment in which they can focus on their patients.”
However, as an interim CEO who envisions staying a little more than a year at most, the inevitability is a new permanent CEO will step in who likely will have goals for the job as well. Worden said one thing he’s doing is talking to various employees throughout various departments to see what’s needed to ensure they’re functionally sound so that a focus on longer-term goals is possible — what he calls the sustainability aspect of his efforts.
“First of all it’s very hard to sustain a medical community if you’re not staying up to current practice patterns,” he said, referring to specific recent acquisitions by the hospital such as a da Vinci Surgical System robot. “So it’s not only staying up with the current medical practice, but it’s also making sure that people understand that when they come here they can remain current in their practice. So that’s a very important part of not only the care, but also the attraction of predominately surgeons in that one example.”
One area of treatment that came under particular scrutiny during Keith’s time as CEO was behavioral health care, with staffing shortage and other issues leading to what was described in a July board meeting as “inhumane treatment” of some patients who — due to violent outbursts and other issues — were also was putting others at the hospital at risk. The issue was largely attributed to a shortage of available psychiatrists — a situation officials said was known months before it reached a crisis level.
Since then Bartlett hired two psychiatrists now on staff, which was announced during the first board meeting Worden attended Oct. 30, and Worden said since becoming CEO he’s hired a third who is scheduled to start soon.
“So they’re already managing that area in terms of being able to be at full complement,” Worden said Tuesday, adding “the fact that they’ve been able to get two physicians up here in a relatively short time frame speaks volumes.”
Bartlett also has two locum psychiatrists — essentially fill-in-as-needed providers — and additional locums have been identified to support full staffing for psychiatry, according to Erin Hardin, a spokesperson for the hospital.
Another ongoing issue for Bartlett is its financial situation, with the most recent report to the board of directors showing an average monthly loss of $756,000 for a one-year period ending in August. Sam Muse resigned as the hospital’s chief financial officer in late July, with Joe Wanner — who was Bartlett’s controller from 2011 to 2013, and its CFO from 2017 to 2018 — rehired for the CFO job starting this week.
Worden said his long career — including mergers and other major financial shifts in hospital operations — offers some insight into what he believes will work to help Bartlett’s bottom line, where so far the feedback from people he’s talked to about the hospital’s future is “independence is something this community values.”
“You have to grow in the context of what the community needs are, or it’s not really growth,” Worden said. “And so that’s one area that that we’ll look at. The second area is outmigration — is there a way that we can take a look and see whether or not we can keep more healthcare local? It’s better for the patient and it’s better for the community if we can keep that care local. There might be little things that we can do that will improve that.”
“And we can take a look at how our computer systems are working, we can make it easier for the physicians and be more efficient. So there’s a lot of things you can do in terms of that without just going to what most people fear.”
When asked what he would consider a successful model for Bartlett at the end of his tenure compared to the hospital’s situation now, Worden started by citing “leadership believes that it’s in service to our community.”
“Our physicians and our nurses, they’re working actively to do that,” he said. “That we have a more sustainable footing for operations. That people feel that they are listened to. And that we have reduced turnover. And that we have a list of strategies that we are executing on. It’s as simple as that.”
• Contact Mark Sabbatini at mark.sabbatini@juneauempire.com or (907) 957-2306.
