Concerns about low morale among employees at Bartlett Regional Hospital were a key issue as the board of directors held its first meeting with its new interim CEO on Tuesday, following high-level resignations last month in the wake of staffing and treatment crises.
A key question was what leaders are going to do to resolve the problems.
Better communication between leaders and staff about the staffing and treatment concerns was a generally agreed-upon starting point, but there were some differences about what that means.
For some board members, it meant discussing specific issues and remedies with staff; for others — and the acting CEO — it also meant being careful about public statements as well as when meeting individually with employees.
“Going forward, the (medical) staff has tasked me with improving relations with both the board and with the administration,” said Nicholas Rosenfeld, the hospital’s chief of staff, summarizing the situation to those at the board meeting. “Because again we can’t do anything on our own, the administration can’t do anything on their own and the board can’t do anything on their own. But together, that’s how we’re going to get it.”
Bartlett has suffered a series of leadership and operational issues the past few years, due to actions by leaders and the COVID-19 pandemic. The current problems have been building up in recent months, particularly with behavioral health care, and became publicly prominent following a July 25 board meeting when a doctor and board member presented a letter claiming “inhumane treatment” of patients that was putting other patients and staff “in harm’s way.”
CEO David Keith and Chief Financial Officer Sam Muse resigned within a week of the meeting, with both denying a connection to the issues raised. Both had served less than a year in their respective positions. Nathan Rumsey, the hospital’s executive director of business development and strategy, was appointed interim CEO by the board effective Monday.
Kim McDowell, the hospital’s chief nursing officer and chief operating officer, said during Tuesday’s meeting she met with employees on Friday and Monday, and “morale was pretty low overall.”
“It wasn’t too long ago since we went through a CEO transition and a bulk of the employees remember that time,” she said, referring to a tumultuous period between the retirement of CEO Chuck Bill in early 2021 and Keith’s appointment last August. “And then COVID hit. We (then) felt like we were kind of on the road to something bigger and better. And now we’re looking at replacing a CFO and a CEO again, and the teams are nervous. They are feeling uneasy.”
Among the questions employees have are the causes and suddenness of the leadership turnover, McDowell said.
“Some people feel like it just came out of left field and it was all of a sudden, and there was no communication about it as to the whys or as much transparency as could be allowed surrounding that situation,” she said. “I especially think that it’s hitting our middle managers and directors a lot harder than the frontline staff, but there’s been a large amount of folks that feel a lot unsettled with where we are right now and they’re pretty uncertain at the moment.”
Rosenfeld said the foremost concern expressed to him by medical staff is the hospital’s behavioral health treatment situation. While hospitals nationwide are suffering workforce shortages, Bartlett is experiencing what officials call a critical shortage of psychiatrists qualified to treat behavioral health patients who show up. Staff say that deprives patients of necessary care while exposing other people nearby to potentially risky situations.
“We’ve worked with McDowell and other senior leadership on reaching out personally to psychiatrists, and trying to get that issue resolved as fast as we can,” Rosenfeld said.
He said the current situation at Bartlett, while difficult, is part of a cycle.
“In the past the relationship between the administration and med staff has fluctuated between very adversarial to working well together,” he said. “I don’t think we had reached a point where we were very adversarial.”
However, in this instance, the behavioral health crisis is what caused the tensions to become prominent, Rosenfeld said.
“I think there are a few things that will get physicians up out of their chair and speaking out loud, and that’s when you see direct patient care being affected,” he said.
Rumsey, during his first board meeting as CEO, presented a report detailing the hospital’s progress on goals set by senior leadership last September. He said that as he continues to try to follow through on some of those goals “I also want to take the time to recognize that we’re operating in an uncertain environment.”
“And with that I want to focus as much of my attention also from the senior leadership’s attention on our employees and making sure that they feel like they’re set up for success moving forward,” he said. “It’s kind of at a time where there’s naturally going to be some restorming, renorming, reforming, all that. But I want to keep some of that focus and attention on our employees to make sure that they’re getting what they need.”
At the same time, Rumsey expressed concern about some of the comments made about the current problems during public portions of board meetings.
“I do have some concerns about the degree that we discuss this topic in the open,” he said. “I’m not trying to hide anything. But I think with the way some of the recent events shook out that it would be wise for us to make sure that we can communicate in a way that is as constructive as possible. Sometimes this format makes it challenging to do so. That’s my opinion. But I just want to caution about where this conversation may otherwise go.”
Similar caution was voiced by board member Brenda Knapp, who emphasized board members don’t have the authority individually to address concerns brought up in discussions with employees.
“It’s not our role (that) we would make false promises that can’t be kept when talking to staff, and assuring them that this is going to happen or that’s going to happen,” she said. “And so to the extent we are approached by people we should encourage them to come to a board meeting. There is time for them to speak to the whole board, not to individual board members. We don’t need hearsay information, that isn’t going to help. So let’s keep that in mind and keep our place.”
• Contact Mark Sabbatini at mark.sabbatini@juneauempire.com or (907) 957-2306.