Episode Transcript
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Speaker 1 (00:02):
Welcome to k MET fourteen ninety am ABC News Radio
in the Southern California Business Report with the Vett Walker,
a show dedicated to highlighting successful Southern California businesses and
the people behind them.
Speaker 2 (00:18):
Welcome and thank you for joining Southern California Business Report
on ABC News and Talks k ET fourteen ninety AM,
nine eight one FM and k m E T TV.
I'm Vettwalker Live, blessing our signals from the center of
Southern California serena population over twenty five million yet US
Crystal clear and on demand by downloading the free live
(00:39):
streaming app on the book play and the at Black Store.
Speaker 3 (00:42):
As always, a huge shout out to the team Mitch,
Bill and Sean I love you guys.
Speaker 2 (00:48):
Enter our special advisory committee that can be found at
www dot SCBR talk dot com forward Slash Advisory Committee.
Click on the link and learn about the incredible leaders
doing the work. And of course, speaking of incredible leaders,
I have two remarkable leaders today. We have John.
Speaker 3 (01:08):
Chapman and Terry jacobab John T.
Speaker 2 (01:11):
Chapman, president and CEO of San Antonio Regional Hospital since
twenty eighteen, stands at the forefront of healthcare innovation in
California's Inland Empire and beyond with national recognition. Leading the
three hundred and sixty three de Ben institution with more
than five hundred physicians and two thousand employees, Chapman has
(01:31):
orchestrated a remarkable financial turnaround and programmatic expansion, earning San
Antonio Regional Hospital a four star Medicare ranking and top
fifty Cardiology sit status. His vision brought forth the center
of Aging, expanded urgent care, initiated residency programs, and fostered
regional mental health collaborations with the Foundation in Clinical Microbiology,
(01:56):
and the executive experience at Highland Hospital and UCFS. Chapman
exemplifies operational excellence and transformative leadership. Terry Jaqua is a
trail blazing human resources executive with over two decades of
leadership shaping healthcare organizations. As Vice President and Chief Human
(02:17):
Resources Officer at San Antonio Regional Hospital, he steers human
resources for twenty six hundred employees and six hundred volunteers,
driving innovation and operational excellence. His tenure at a h
h MC Healthcare and Prime health Care Services was marked
by transformative workforce strategies and improved labor relations. A published
(02:41):
author and sought after speaker, Doctor Jaqua's influence extends.
Speaker 3 (02:45):
Nationally beyond the boardroom.
Speaker 2 (02:47):
He enjoys hiking with his wife, doctor Declaire Jegua, their
daughter Seline, and their two dogs.
Speaker 3 (02:54):
Thank you both for being here with us today.
Speaker 2 (02:56):
Thanks for having me on a wonderful So we're to
start as you've John, because this is a big conversation
and you've been very busy. The hospital has been very busy, working,
innovating and growing to meet the.
Speaker 3 (03:08):
Communities and needs.
Speaker 2 (03:09):
So how would you characterize the current hospital market when
I'm escape and you know, both statewide and nationally, I wish.
Speaker 4 (03:18):
I could be more positive about it, but I can't.
Just today in Fact and Actors Healthcare, there's an article
nationwide about the negative impact of finances on the hospital industry. So,
for example, in California, over fifty three percent of the
hospital's event are in the red. I mean they're losing
(03:40):
millions of tar millions of dollars a number of the
there's a number of reasons for so for the last
six years have been a thirty percent increase in costs,
whether it be labor or lord for supplies, In addition
to that, you have Medicaid, which hasn't had an increase
in over thirteen years, and the fact is being decreased
(04:04):
now at lea legislation that has hit nationally. So it's
been a very difficult time. Luckily, we are one of
the few hospitals struggling but profit a little. We hope
to continue that. But it is a bleak outlet for
(04:25):
the hospital industry right.
Speaker 2 (04:27):
And you know, just recently there has been a taizer
strike that's come online that's impacting the healthcare landscape as well.
What do you believe unions are seeking and how is
the role of unions evolving in healthcare?
Speaker 4 (04:41):
Oh, we both can talk a little bit about that.
San Antonio Original Hospital is actually a non union show.
But in my history, a lot of people don't know this.
My father was a union leader for thirty years ago,
and he always says, is unions are needed in the
if circumstances at specific institutions, but if you run your
(05:06):
business right, they're not even so I'm really unbiased again
see meetings. I'm an advocate at some places and but here,
for instance, we're doing okay.
Speaker 2 (05:16):
And so what do you believe unions are seeking doctor
Jacob and POWs a little of bes evolving in healthcare today.
Speaker 5 (05:25):
So I think, you know, unions tend to thrive in
employers that don't really address needs of their employees. I
think that's there what drives a lot of union membership.
Just like John said, I think San Antonio Regional Hospital
really has a different approach when it comes to things
(05:47):
like this. We we have a collaborative environment with our leaders.
Speaker 4 (05:53):
We have an open new policy, and a lot.
Speaker 5 (05:55):
Of these issues and grievances are addressed, you know, pretty regularly,
just because of our of the culture that that that
we have as an organization. And I think from that perspective,
we've been very successful in that engagement with our employees
because of that. And I think you know that that's
(06:16):
pretty much what drives a lot of the success that
the regional hospital you mentioned Kaiser. Kaiser is on strength.
I think it is asiatic.
Speaker 4 (06:30):
And it's wages. It's always a part. A component is wages,
but also making sure they have me staffing. Uh. The
unions are they're actually from glomeration of that piece together,
the strength representing Kaiser members and it's definitely having a
say in Ali hospital operates. As Terry said, as compared
(06:56):
to San Antonio, we already provide that, say we have
to meet wages whether a union or non union shop
in the area we're in independent hospital, we would lose
employees and make it very hard to run. So we
typically match the union industry and other hospitals in the
(07:18):
area that aren't uganized and many times exceed the type
of benefits that they're offering the employees that they represent
it well, and you.
Speaker 3 (07:28):
Know that makes a lot of sense.
Speaker 2 (07:29):
So this is a question for both of you, and
we'll start with doctor Jabub, what would you say the
key advantages and disadvantages of humanization for hospitals and health
care employees.
Speaker 5 (07:41):
Key advantages so, for for instance, a lot of organizations
that don't have established committees or forms or discussion groups
with employees. So when you have organizations that get organized
and unionized, that typically takes place. But again that's something
(08:01):
that we do fairly well.
Speaker 6 (08:03):
Here.
Speaker 5 (08:04):
We have several committees that employees get to participate with
that open their policy that employees contribute a lot to
a lot of the operation discussions that we have, and
we have the res of s lunche those are other
components that we do that we find very successful. So
all these are our strategies that we do in order
to meet the needs of ourntilizers. I think that's that's
(08:26):
one of the the reasons here.
Speaker 4 (08:29):
Yeah, and just to augment that in each of our departments,
then we actually ask the employees to participate in cost
efficiencies or operational improvements because we all agree there's no
doubt that it's the staff doing the work that knows
how to improve.
Speaker 3 (08:50):
That makes sense.
Speaker 2 (08:51):
Okay, doctor Jake, why has sent it to an original
hospital chosen not to unize its workforce and we have
you alluded to some of the organizational input that helps
form that decision making. Can you talk about other facets
that help shape that decision making as wet?
Speaker 5 (09:13):
So some of that has to do with the fact
that employees get to participate in that process. Right when
we have these committees that employees are there to, you know,
discuss things that they think that are improvements, will respond
and some of those are great.
Speaker 4 (09:28):
Phenomenal ideas that we implement.
Speaker 5 (09:30):
I think there as an example, even this week, we
had some President's launching questions that were just great in
terms of benefits, and we looked at that in our
committees and safety thinking that this is probably something that
we want to implement. So a lot of that idea
to those ideas, But from the employees, I think the
other thing that you mentioned earlier about why you know
(09:52):
we've been successful to not having unions in our facility,
I think it's because a lot of employees have greavenesses
and issues that they have, right it's it's the normal
force of business. But being able to address those issues,
it's it's very violent. And I think if you're able
to commit to the employees to addressing grievouses and issues,
(10:15):
I think goes a long way. I think, you know,
I have some examples of employees that have brought concerns
to our attention and we were able to resolve those
for instance, you know, either corrective action that.
Speaker 4 (10:31):
Was given to the employee.
Speaker 5 (10:32):
They felt that it wasn't investigated properly, so HR being
a a moutual party, we did the investigation found that
that there were some particular issues that occurred that we're
not shared with leadership, and that really changed. It wasn't
(10:53):
the at risk behavior, it was just a human error
and with the way that we functioned here as an
organization in terms of just culture, right, we looked at
that and thought, okay, this is not probably not appropriate.
Should have been happened a little bit differently, and we
resented the correct defession, and we coach the leadership team
(11:14):
be next time, this is probably the best way to
have a situation. So again, we are there to support
the employee. We are a service department and we serve
our customers our employees.
Speaker 7 (11:27):
Yeah.
Speaker 2 (11:27):
Absolutely, it sounds like adaptability and quick response is really
what helps to continue that engagement. John, how is set
into our regional hospital's culture of transparency contribute to employee
retention and engagement?
Speaker 4 (11:42):
Well, that's the secret ingredient too. Why San Antonio is
different is it's an air of transparency and availability. So
I can't tell you how many times employees will come
in here with ideas or concerns, you know, using an
example like Terry just two weeks ago, I've had any
(12:04):
attorneys come in with I kid you not, it looks
like a Santa Bad full of supplies, And she said, John,
these are the supplies that we're basing in our C
section surgeries. There's got to be a way to be
more efficient now, how many places can say that someone
(12:27):
would have could come in, talk to a seat build
and have an idea generating safety and reduce weights. So
I can say that about the entire executive team from
a directors on them. They know we want to hear
about their ideas. They know we're a lean organization. Lean
(12:48):
meaning we're trying to get rid of waste, whether it
be cost, whether it be operational or waste and time.
We want our employees to be able to work to
the top of their license there'rection and not waste their
time on things that are undeeded and they know that
that makes sense.
Speaker 3 (13:07):
Is there anything you want to add to that well?
Speaker 5 (13:09):
In terms of transparency for instance, that you have asked
the question.
Speaker 6 (13:15):
When when we do wage analysis right, we use asks
you you know a lot of our decision making and
then we look at comparisons between other facilities such as you.
Speaker 5 (13:26):
Know, Promonga, lover Yeah, and other hostiles within our market.
That data is shared with the leadership team and even
employees that come in to discuss their wages are concerns
as directly no middle end, they're directly coming to us.
We share that with them and if there is opportunity
(13:49):
for improvement in terms of wages, we do make that
decision to make sure that we stay in pivot. I mean,
these are employees that we've hired, we have a vested
in in their well being right in these good benefits
and retirement funds. We want to make sure the stay right.
We want to be the last employer that they've worked for, right.
(14:12):
So in terms of transparency, we share this data with it.
Speaker 4 (14:17):
You know, this is what we.
Speaker 5 (14:18):
Found and if it's it's there and it shows a
difference that is a significant difference that we need to
a match. We make that adjustment and it's something that
we do regularly year.
Speaker 4 (14:31):
I think that's what you know. In my history, I've
never seen until we came here where you heard or
labor relations or human resources actually shares with employees what
they're looking at on market ranges uh and where it
will be fit. And we've had employees that we've met said, no, what,
(14:52):
you're absolutely right, the predem should be higher based on this.
And a lot of places only do this months every
two years. They keep it as if it's a biblical
you can't read that chapter of the Bible that doesn't exist.
That kind of thing here we share with employees. We've
given copies a bit. He talks about half. What that
(15:12):
is is the hospital associations out of California over one
hundred and forty hospital compared with and we want to
make the differences from employee. One of the things that
we did is like, boy, how can we reward some
of our most senior employees, because what's happened over the
years with salaries. Before it used to be a straight line, right,
(15:34):
everybody was the same dollar now apart by year. Then
what's changed for nursing is they increase the range in
salary in the first five years and then it kind
of flattened out. So all of a sudden you have
this compression. We have someone working twenty years who used
to make twenty dollars more hour than somebody's starting now
(15:57):
only makes maybe twelve dollars an hour. That doesn't feel
good if you've worked for thirty years. So we're one
of the hospitals that actually took a cat off the top.
That means our employees are here for four years are
making probably as much as one of the highest regions
in the US, whether it be New York or San Francisco.
(16:18):
So we never see someone over twenty years leaving our hospital,
and I think that says a lot about the culture
of transparency, family and in it together. And that's the
only downfall I have that's coming from union shops. It
always feels like there's a middleman and then it feels
(16:39):
like them versus us, which we don't want. We want
people to come here and say, hey, they're part of
something great, something that's benefiting the community, and they are
being respected and we're treating them correctly.
Speaker 2 (16:52):
And what's the overall tunnel owner feedback that you're getting
from your team members here at San Antonio Buy implementing
that we're responsiveness, the transparency and the innovative feedback that.
Speaker 3 (17:05):
You're seeking to update.
Speaker 5 (17:08):
Everybody with want to start absolutely, that's a great question.
And we do surveys throughout the year right to kind
of feel how the employees feel about the organization, right
employee engagement surveys. Another key indicator that really shows how
we're doing is our turnover. So if you look at today,
(17:32):
if you review the NSI data in terms of turnover nationally,
that's about fifteen percent fifteen point four percent. The organization
here does a nine foot four so we're way on
all the national fage. Part for turnovers, and I've been
in organization is that the turnover is between fifteen to
twenty two. So it really tells the law and says
(17:55):
a lot about this this hospital. So that's one indicator.
The other one is our engagement scores. What we compare
in terms of national benchmark averages. We we do overrue
week well, and a lot of that has to do
with the leadership team, right, that transparency, the the collaboration, right,
(18:18):
I think that tell us that really ship ship shines
and shows out.
Speaker 4 (18:24):
Yeah, they still care for it. You know, we have
what's full operations counselor every week where people our directors
ask for a replacement position or a new position. And
if it's a replacement position, I built in and we
follow this. We want to know who left and why.
What's the question I always ask, did you make an
(18:46):
account off? Did you make a counter over? There's something
maybe since we only check surveys on every six months,
maybe there was a hospital there who they suddenly raise
the raid and they're going there. Well, we eventually won
a match. You know, if we didn't see it first
and they did it, we'll offer the same rate if
(19:09):
we know, we're going to look if that's the ask average
that's coming, so we actually keep a lot of employees
that way.
Speaker 2 (19:15):
That's that's a great way to address those gaps. Right,
somebody leaves, that question is very important. Why would they
leave what their accounter offer me? Right, because you want
to keep the employees.
Speaker 4 (19:27):
So it's fantastic one monthly, even at the President's lunchons,
we share reasons that people do leave. You hear fifteen percent.
That still sounds high, but remember one of those positions
are pardeems, people who are this isn't your full tention.
We're a part time, we're retirement. So when we look
at reasons for leaving and we see pay or environment
(19:49):
as the reason for living leaving, it's now below the
top five reasons. The top reason that probably moving out
of the area, having a family, retirement, and those are
the ones I can live.
Speaker 2 (20:02):
Right, And so being six percent under the national average
of fifteen percent with only nine percent turnover here at
the hospital is a huge testament to how these different
policies are actually benefitting, bucking the trend.
Speaker 3 (20:18):
Of the healthcare landscape.
Speaker 2 (20:21):
Doctor Jaquin, how does stand Antonio original hospital promote workforce
development and growth opportunities for its employees.
Speaker 4 (20:29):
So we have several.
Speaker 5 (20:30):
Programs, but one recently that we that we like to showcases.
We've made some significant improvements in terms of our benefit
package for loan and college tuition renversement. That's partially what
we've what we implemented, so that allows employees to further
(20:50):
their education and then also allowing employees to use the
loan repay and to pay down there super loan debt.
Speaker 4 (21:00):
A lot of these young students coming down to school, Uh, they.
Speaker 5 (21:03):
Can't start a family because they have, you know, these
huge moments to pay and this as long as they
staying with us, we'll make their their manial payments start them.
So this is this is a great tool to keep
employees here with us while they continue the growing their career.
But yeah, that's you know partially how we develop you
(21:25):
know that that kind of you know, workforce. The other
things that we do too, is we look at opportunities
for growth within the organization. Uh and uh, you know
for employees that want to advance their careers. We have
problems to develop leaders and that's something that we just
now started, uh, which is the our leadership academy that
(21:48):
John and I are very proud of. So that's certainly
something that I think it's going to show, uh, you know,
a great payoff for their organization as we develop these
leaders and employees that identify that they want to continue
their growth.
Speaker 4 (22:01):
This is something that I think we're going to be
very proud in the future. So it's fantastic that you
can develop that type of talent within instead of not
doing anything about it, not getting them to the top
where they can be or silly, and instead of bringing
sound externally, right, I'd rather have them developed here. You know.
The other thing that I'd like to tie on is,
(22:23):
you know, one of the things that we do, for instance,
and some of the larger ones that even the one
who just said is on strike right now doesn't do,
is we take hundreds of new nurse breads. Now, what
does that mean? Okay, so let me take someone coming
out of school. Well, most hospibles won't take somebody to
work patient care until they have at least six months
(22:44):
to a year of experience. What we do is we
take the time to develop them ourselves. We'll take them.
Pay for an extra nurse. Think of paying for an
extra one hundred nurses. We pay our experienced nurses to
train them so they're trained revenue. We give them a
stipend of uh several dollars an hour and a lot.
(23:07):
Most hospitals want to do that. Our goal is to
that's how we keep you tention. That's how the the
community knows, Hey, my daughter or my son going to
maybe they have a chance to get in the dort
San Antonio. So Nurse new Grass is just one part
of the many workforce to development pipelines that we have
(23:30):
developed or are development.
Speaker 5 (23:32):
Yeah. In fact, we have a safe of College of
melt Sach Western AZUSA. All these are our schools that
we have in this agreements with the employees are the
uh as soon as they come and they do rotations
at our facility and uh so we have a constant
pipeline and new students and that are ready to during
(23:56):
the workforce, you know, and they're train here at our facilities,
are trained at our EARR system.
Speaker 4 (24:02):
So it's that sort of.
Speaker 5 (24:07):
It decreases the amount of training that is necessarily to
do because they're ready to trade.
Speaker 4 (24:12):
Another one that we do is.
Speaker 5 (24:13):
CLS is at Hill State, the Glen Scientists so that's
another PARTO I'm going to be up to.
Speaker 4 (24:19):
And people don't think about this, but physicians are considered
workforce even though in California a hospital can't employee physicians. Well,
we need physicians. So how do we do with els
Kiser that they create a foundation model. We created a
medical work We've talked before under program about the lack
of physicians at San Berna County. Now we have an
(24:42):
approved two residency programs that when max they will be
graduating twenty students a year at our goal is to
keep them. So as far as I'm concerned, that's part
of the pimeline too.
Speaker 2 (24:54):
Well, that's great and we're going to pick up on
that after the break the Vet Locker with ABC News
and Talks California Business Report with visionary leaders John T.
Chapman and doctor Terry Jacob, who have propelled San Antonio
Regional Hospital to national prominence, earning top Medicare honors, and
pioneering innovative care and workforce strategies that set new standards
(25:17):
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Speaker 2 (28:33):
Welcome back, everyone, Give that Walker with ABCUS and Southern
California Business Report here today with dissary leaders John T.
Chapman and doctor Terry Jacob, who have propelled San Antonio
Regional Hospital to national prominence, earning top Medicare honors, and
pioneering innovative care and workforce strategies that set new standards
(28:55):
for healthcare excellence across California and beyond.
Speaker 3 (28:59):
Thank you both so much for joining the program and
sharing your insight and expertise.
Speaker 2 (29:03):
So you know, prior to the program, we were talking
a lot about the innovative approach you have to responding
to your workforce and.
Speaker 3 (29:10):
How you're able to basically not.
Speaker 2 (29:13):
Need unions to represent your stuff because you're so responsive
and transparent.
Speaker 3 (29:19):
And I know that in that innovative process.
Speaker 2 (29:22):
Since you've joined, John, there have been critical steps in
San Antonio Regional Hospital's financial renaissance, and talk about the
leadership principles that have guided this transformation.
Speaker 4 (29:37):
Sure, I'm a big believer you can't manage what you
don't measure. So when I came here, and this was
before Terry has talked by a few years, we found
a beautiful community hospital. However, the hospital is using over
twenty four the land here right, And when I came in,
(29:58):
they said, okay, you're coming in. You don't find a
way to turn the round, so show me the metrics.
And actually that made me actually see the opportunity that
was there, because, you know, we'll talk to the embarrassing story.
We were hardly any metrics. So you know, we started
(30:19):
from finance to operations, the staffing to volume. We looked
at everything. So for instance, in finance, we noticed we
didn't have the latest in terms of the pri organization
of bill paying right to insurance. You would take the
they would take the oldest insurance claim which might be
(30:39):
one thousand dollars and there's a three million dollars one
that's going to expire in twenty four hours, and they
never saw. So bringing in an outside company to leave
the company's name out, we actually put metrics in place,
put operations in place, invested in new software, had their
team of over forty people here for half a year
(31:00):
and they found fourteen million a year, so that kind
of costs them by ten them. The second one was
in terror. You could appreciate this. We have over twenty
five hundred employees and they were all benefited full time.
So what are you supposed to be when census goes
now and census goes down. You typically want to reduce
the amount of labor unings book periods, just like you
(31:22):
want to raise it when you're high periods. Well, we're
sending people home that are going to get paid regardless
if they're here or not. See, really not saving any dollars.
A good organization, even for employee burnout, will have a
huge I want to say huge. Well, let's say ten
to fifteen percent of pardeons or part timers, those who
(31:43):
can call in an emergency who aren't guaranteed hours are
the same people you can call off. Mean you don't
beat them. So being able to be deficient with the
number of employees we need based on each day, we
actually have metrics, daily products, every reports that got us
the break even and then using the employees like we
(32:06):
talked about before, in terms of looking for a waste
was another mechanism to us, that's say several more newms.
You know, I I share this example one time in
the last a few weeks. Is as an example, we
had another employee group. You said, let's look at the
(32:28):
crash parts. Each crash part has about thousand to two
hundred and fifty thousand dollars supplies. The bad thing, which
you might about though, is if we ever have to
open a crash cart because someone is having a cold deliver,
anything that's left in the crash card has to be
tossed because no longer stare they would go in. Typically
for things that would have to do with opening an airway. Well,
(32:52):
you know that's probably about a thousand dollars of that
one hundred thousand to two hundred thousand dollars to equipment.
So we said, god, we're losing millions of dollars, and
we had one places, why don't we just put the
air ways on top and a separate, smaller crash bin
on top of the crash car. We did, and just
(33:13):
that one simple idea, and whatever's listening, this is simple, right,
saved over two and a half million a year. I
thought it was one of it.
Speaker 3 (33:21):
It was two and a half by that one adjustment.
Speaker 4 (33:25):
To imagine staff in every department, they're sharing how we
can make operations together. And that's why we're one of
the few hospitals, i'd say the only hospital I can
say that in southern California actually breaks even Medicare in
terms of what they pay to work costs. So we're
(33:47):
very proud of the turnarounds. In fact, over the last
eight years seven to eight years will be eight years
this time, we've had credit up rates every year while
the hospital industry, according to Moody's credit downgrades every year.
We're going in the opposite direction from healthcare. And again
we're so proud adding the caregiver or executlips. I'll take
(34:11):
a team approach to finding these types of solutions.
Speaker 2 (34:14):
It's remarkable, doctor Jacob, how have these philosophies and leading
into these key analytics assisted or trade into your role
leading HR Sure, I'm glad you asked that question.
Speaker 4 (34:32):
So essentially what John was sharing in terms of the.
Speaker 5 (34:37):
If you look at your statuem office and you see
that you know with John Gott here the majority of
the staff are full time employees. You should have a
mixture of full time, part time, and for dem we
had a very very small full of pretty employees. And
when John was sharing about benchmarks about tent fifteen percent,
(35:01):
that's pretty standard in the industry.
Speaker 4 (35:03):
You're supposed to be out of.
Speaker 5 (35:04):
That because of that variables of people leaving, call offs,
leading absence and such.
Speaker 4 (35:13):
You should be able to be able to have staff
available to meet those needs.
Speaker 5 (35:19):
And where do you have that Why of that has
to do with the preview staff, where you have a
per neeme staff that are able to flex in some
of the holes in the schedule. So that was one
of the things that was implemented here and you could
really see a difference in terms of your neighbor over
net revenue because of not having to spend so much
(35:43):
dollars on let's say registry because you have staff that
are internal and they are able to meet those needs.
So that's one of the ways when John also shared
it touched on what was the operations means that we
have every week that we look at, for instance, when
there's new positions that become available. What's very interesting you
(36:06):
meet about this organization that I didn't quite experience in
others is that we have.
Speaker 4 (36:12):
That that teaching mentality.
Speaker 9 (36:14):
Right.
Speaker 5 (36:15):
Uh, it's very impressive to sit in those wides and
watch our leaders grow in terms of their financial abilities,
to understand different concepts in terms of operations, for instance,
recover every every new role, and we look at work
productivity versus budget very versus flex pay in order to
(36:40):
make a decision whether this position is needed or not.
I don't see a lot of organizations do that. What
they tend to do is they sort of get stuck
in old ways and habits, and that really puts you know,
your net, you know, labor overt everything. Just that's sixty
seventy percent, which is just you know, really a follow
(37:03):
when it comes to the overall operations.
Speaker 4 (37:06):
I'd love to add onto that, not only do we
look of whether eight positions needed. I'll give you an
example where you've actually told our employees had new positions.
So there are certain we've had certain departments say we're
at one hundred percent. But to keep hearing them be around,
the learned out we're burnt out. We're burnt out. It's like,
(37:28):
how can that be? What we found out is they
looked at one hundred percent like they have enough bodies,
but they really didn't. They're working people over time through
their breaks. Now if we knew that, that tells us Okay,
now we know why you're at one hundred percent. They're
burning out and you're paying them time and a half
(37:49):
double time. So we'd say go open three positions because
when we look at the actual number of bodies, they
didn't have enough, but it looked like they did because
as they were working people past their routinia hours. So
we can both we coach them on how to find
new positions that doesn't impact the organization financially, actually improves
(38:12):
the well being and how our employees feel about thoughts.
So when he says teaching, you can tell I really
loved that component. That's why I send in those OPS
counsels to Right.
Speaker 2 (38:24):
So, given all of this innovation and keen attention to
the analytics that are really driving these costs either up
or down. I mean, that's been the foundation of the
financial turnaround we've been able to experience. And with that
come the expansion of the hospital. Right, And so recently
(38:44):
you've been expanding in urging care and specialty programs at
San Antelo Regional Hospital.
Speaker 4 (38:49):
Can we speak to those John, Yeah, So when the
hospital is profitable. And let's be honest about profitability. When
I say profitability of seven or eight years, we're talking
in margins, right, We're talking one to two percent margins.
That's why it's I'm always having anxiety. What's the latest
(39:11):
cost to healthcare? But as a nonprofit independent aren't goals
to reinvest in the community. So how do we determine
what the community needs? Of community Health Needs Assessment Report?
We do this every two years or by zip code.
We look at, okay, what are the issues, what are
(39:32):
people having sickness from are people? What are people dying?
What's the average age, what's their illness? And we want
to target those populations for programs. So as an example,
earlier we bet you mentioned center of Beating the Center
of Aging. Well, we've found out that over the next
ten years this county will have the highest growth rate
(39:54):
in seniors. Well, it's a no brainer. We should focus
on seniors. So the Center of Aging, as I had
mentioned in the previous program, is a one stop shop
for seniors. Almost every specialty, almost every family medicine, cheriatrics, lab, radiology,
(40:14):
behavioral health, while all be in one large building, share
scheduling system where they can have multiple well, they can
see multiple providers on the same day. Why is that
important Because even a senior with Medicare, if they need
a transport vehicle for the wheelchair, it's still one hundred
(40:35):
dollars out of pocket for every time. So we said,
not only are we going to cohort visits together, we're
going to provide free rides if they have a problem
with getting here. As long as they're in a twenty
square mile area, the problem, and it's a good problem
to have. We have cities fifty square miles away saying
can you bring the same program to us? So I
(40:56):
feel that actually feels good. We're confident that we're doing
the right thing. And at the same time you mentioned
Virgin Cares. We've opened up selling urgent cares in the
last few years. And why is that well, I had
mentioned the lack of family investment doctors in our area,
which is easy to see because when we look at
(41:16):
the number of visits in hospitals, the number of visits
in the ers are tripled the national average. When you
look at the Inland Empire, especially Sandberg County, it's not
because of lack of postles, because no one can go
in and see their primary care when they really need to.
So our goal is to increase those family practitioners. At
(41:38):
the same time offer a lower level where hey, if
you're going in and you're sick, you know you're not
having a heart attack, at least have another place to go,
which is an urgion care, right, So we're investing that
can do.
Speaker 3 (41:50):
That's terrific.
Speaker 2 (41:51):
So doctor j put earlier, you alluded to employee burnout
as being something that is at the top of mine
talk about wellness programs got influence organizational performance at San
Antonio Regional Hospital necesses to eliminate or mitigate the burnout effect.
Speaker 5 (42:11):
Sure, we we have so a lot of hospitals have
similar programs, but we we do it a little bit further, right, So,
for instance, a lot of hospital staff what we call
it a program.
Speaker 4 (42:23):
We're discussed burnout and other.
Speaker 5 (42:25):
Issues, but how many AP is employe Assistant program, which
what we provide. The program essentially provides a counseling, legal experts,
and a whost a little different things that we offer.
Speaker 4 (42:41):
But we also have a.
Speaker 5 (42:42):
Wellness program that's part of our our benefit package where
employees get discounted rates.
Speaker 4 (42:49):
For the MPU Medical benefits.
Speaker 5 (42:53):
As long as they follow the program in terms of
getting the at least one the field medical examination per
year and then.
Speaker 4 (43:03):
Some labs you get this discount. And there's all these
other activities that we have throughout the.
Speaker 5 (43:07):
Year, for instance, you know, hiking our set San Antonio
Mountain range right the mountain moldly that we do all
these little activities with our employees which really helps emphasize
that you know that that that wellness opponent.
Speaker 4 (43:26):
We also implemented something new.
Speaker 5 (43:27):
For the care for the caregiver, which we have a
number of different leaders and employees that want to participate
in the program, which we identify employees or at least
they come to us that they're going through some kind
of a struggle either mental health issues or struggling at home,
and we're able to help them right coach them, I'll
(43:51):
provide assistance even financial.
Speaker 4 (43:53):
So that's something that we're very product seric. Yeah. Part
of that we call here for you, We love the
here for you, care for you approach. That there are
many employees who during a workwaker, while they're on shift,
may see a little would die that they're caring for,
(44:14):
may think they made mistake and have a panic attack.
We actually had what was it? Outside of our hospital.
There is police action. People are threatened and scared about that,
so we consider it almost like an emergency response for
these employees. We have other employees who are trained to
be there for them. That's what we call it care,
(44:37):
So they see that employee on that shift and talk
things through them. Well.
Speaker 2 (44:42):
More innovative programs and solutions to very common outcomes and
challenges that I imagine healthcare workforce sees. And with that,
you know, the SANATOI Regional Hospital teams have been shining recently,
achieving a four star Medicare ranking and hospital also was
recognized as a top fifty cardiology hospital in renovation. What
(45:08):
does that mean for Sanato Regional Hospital and his patients.
Speaker 4 (45:11):
Well, I think it's just validation to the community with
these types of awards. US News and World Report just
gave us a specialty hospital to five percent in the
US for art bypass, but we're really proud of as
well as the same thing US News and World Report
(45:33):
recognizing US as a top maternity hospital. He was using
World Report recognizing US as a top orthopedic joint replace
in hospital. These are all specialties that we spend a
lot of time and to make sure their quality and
efficient and meets the needs of the community. So these
(45:57):
service lines, we'd love to see those awards right right,
It just tells the community you're.
Speaker 2 (46:03):
Going to the red place, right, doctor Jacob, What does
that tell you when you're leading human resources, to see
the accumulation of so many awards, including as I mentioned,
Top fifty Cardiology in the nation and for Star medicare
making well, I'm very proud.
Speaker 5 (46:20):
Of this organization and what we have achieved, you know,
I think you know, I'm very proud of our place.
I mean, I think that's our the most important assets
any corporation or in the industry, and you know, being
able to value our employees and make sure that they're
(46:40):
taken care of, I think that's really important and really.
Speaker 4 (46:44):
Shows and shines all these accolades that we see. And
you know, tying that back to your original question about unions,
we're giving you the type of things that we do
that unions after coming in other places that aren't doing so,
I said, places where unions are eat it. They're trying
to do the same things we're doing, except we're doing
(47:05):
it without our employees having to pay you dues to
have an outside and do what we as leaders should
be doing and hard.
Speaker 3 (47:15):
Well, that's exceptional. And you know, recently, through the ability
to invest and innovate and.
Speaker 2 (47:22):
Grow the footprint of the hospital, there was a recent
launch of the ACGNY accredited residency programs. What impact has
that had on the Star community internally and externally?
Speaker 4 (47:36):
Oh all right, you got another program, right.
Speaker 3 (47:40):
Right, I mean we're just scratching the surface. So and
we're coming to the end of the hour, but just
wanted to throw this next.
Speaker 4 (47:46):
So I mentioned that in Leanland Empire, it is the
lowest county in California for a number of primary care
Family of Medicine tree hundred thousand populations. Right, we want
to close the gap in zan burgagain county. No one
else is doing it. Fifty three percent of hospitals are
(48:06):
losing money. They're not investing in these things. We're investing
in growing training for a residency program, getting more important,
keeping these physicians in our community, representing San Antonio and
treating our patient population. That's the external. Intern Well, when
(48:27):
you're dealing with the tending doctors, the tending doctors are
seeing their patients and clinics all the time. Right, if
you have a loved one who you've spent an in patient,
what's the first thing you are always looking for? When
is that doctor going to visit? I have questions and
let's be honest now for those who have experienced it,
we're lucky revires to one hospital where you have to
(48:48):
see a physician once or twice to give of you
what's the update on your you or your loveless condition residents,
when you've have thirty residents running around representing those doctors. Oh,
the families love it because they can talk and find
out five, six, seven times a day and answer to
questions because that those residents are internal in the hospital.
(49:13):
We're seeing a big improvement on our physician communication scores
on our national averages for how we're doing with in
patience duey like us, they scores ten out of ten
on every category. Well, one of them has always been
for every hospital physician communication and soaring internally with the residency.
Speaker 3 (49:37):
That's exciting.
Speaker 2 (49:38):
So last questions of both of you and all, starting
with doctor Jacua, what is your visions for the teacher
of sanch on your origional hospital as a beacon of
care innovation and community partnership.
Speaker 4 (49:51):
I think it's in terms of you know my area,
which is you know, the employees.
Speaker 5 (49:57):
I think it's continued to be you know, the top
employer in our region by offering good you know, wages
and benefits keep employees engaged. And I think as long
as we do that well, we continue to bring being
the kind of sort of the beacon for for and
(50:17):
what other possibles in our region will strive.
Speaker 4 (50:20):
To be great. And to JOm, I'm going to get
this right because a vision you get to close it
out right. You know, our our vision is to prove
the heleph of the community. And that's measuring right. How
do we measure that? We measure what is the how
(50:44):
how long are people living? We mentioned zip codes? Are
the conditions that we're tackling by zip code improving over
the years?
Speaker 5 (50:54):
Uh?
Speaker 4 (50:55):
You mentioned innovation? Are we bringing the type of services
that most people would have to travel to an academic
medical center forty miles away, like bringing City of Hope
next doore to have all their cancer care right here
in this community instead of getting in their car and
(51:16):
going and driving those thirty miles to where' support right,
I've had a mom who's had chemotherapy. It's not easy
just to get up and let alone have to travel.
So our goal is to find those cunning edge technologies,
(51:37):
find those community partners, make this hossible, incredibly known for
its quality and care, and keep this care in the
community and share with the community. Yeah, we are making
a difference, and here's the metrics that prove it.
Speaker 2 (51:56):
And your team and you on your leadership are a
definitely making that difference and moving the needle in healthcare.
And it's exciting to see the growth and transformation in
real time. So thank you both so much for your time,
for your expertise, and for just doing what you do
to continue to serve our communities.
Speaker 4 (52:15):
Weaken.
Speaker 3 (52:16):
Thank you for letting you share our story all right
for everybody listening.
Speaker 2 (52:20):
Don't forget to find us on Facebook, YouTube, LinkedIn, and Instagram.
Don't forget to check us out on SCBR talk dot com.
And don't miss my conversation with Randal Lewis, executive vice
president and principal at Lewis Operating for his visionary leadership
and unwielding commitment to community has transformed the landscape of
California and Nevada.
Speaker 3 (52:42):
Next week We will have Janice.
Speaker 2 (52:44):
Rutherford, from leading Girl Scout watershed cleanups to shaping California
public policy. Jane's lifelong devotion to service is woven through
every chapter of her life.
Speaker 3 (52:55):
You do not want to miss it, and we will
see you all next week.
Speaker 4 (53:11):
The sip the E stat
Welcome to k MET fourteen ninety am ABC News Radio
in the Southern California Business Report with the Vett Walker,
a show dedicated to highlighting successful Southern California businesses and
the people behind them.
Speaker 2 (00:18):
Welcome and thank you for joining Southern California Business Report
on ABC News and Talks k ET fourteen ninety AM,
nine eight one FM and k m E T TV.
I'm Vettwalker Live, blessing our signals from the center of
Southern California serena population over twenty five million yet US
Crystal clear and on demand by downloading the free live
(00:39):
streaming app on the book play and the at Black Store.
Speaker 3 (00:42):
As always, a huge shout out to the team Mitch,
Bill and Sean I love you guys.
Speaker 2 (00:48):
Enter our special advisory committee that can be found at
www dot SCBR talk dot com forward Slash Advisory Committee.
Click on the link and learn about the incredible leaders
doing the work. And of course, speaking of incredible leaders,
I have two remarkable leaders today. We have John.
Speaker 3 (01:08):
Chapman and Terry jacobab John T.
Speaker 2 (01:11):
Chapman, president and CEO of San Antonio Regional Hospital since
twenty eighteen, stands at the forefront of healthcare innovation in
California's Inland Empire and beyond with national recognition. Leading the
three hundred and sixty three de Ben institution with more
than five hundred physicians and two thousand employees, Chapman has
(01:31):
orchestrated a remarkable financial turnaround and programmatic expansion, earning San
Antonio Regional Hospital a four star Medicare ranking and top
fifty Cardiology sit status. His vision brought forth the center
of Aging, expanded urgent care, initiated residency programs, and fostered
regional mental health collaborations with the Foundation in Clinical Microbiology,
(01:56):
and the executive experience at Highland Hospital and UCFS. Chapman
exemplifies operational excellence and transformative leadership. Terry Jaqua is a
trail blazing human resources executive with over two decades of
leadership shaping healthcare organizations. As Vice President and Chief Human
(02:17):
Resources Officer at San Antonio Regional Hospital, he steers human
resources for twenty six hundred employees and six hundred volunteers,
driving innovation and operational excellence. His tenure at a h
h MC Healthcare and Prime health Care Services was marked
by transformative workforce strategies and improved labor relations. A published
(02:41):
author and sought after speaker, Doctor Jaqua's influence extends.
Speaker 3 (02:45):
Nationally beyond the boardroom.
Speaker 2 (02:47):
He enjoys hiking with his wife, doctor Declaire Jegua, their
daughter Seline, and their two dogs.
Speaker 3 (02:54):
Thank you both for being here with us today.
Speaker 2 (02:56):
Thanks for having me on a wonderful So we're to
start as you've John, because this is a big conversation
and you've been very busy. The hospital has been very busy, working,
innovating and growing to meet the.
Speaker 3 (03:08):
Communities and needs.
Speaker 2 (03:09):
So how would you characterize the current hospital market when
I'm escape and you know, both statewide and nationally, I wish.
Speaker 4 (03:18):
I could be more positive about it, but I can't.
Just today in Fact and Actors Healthcare, there's an article
nationwide about the negative impact of finances on the hospital industry. So,
for example, in California, over fifty three percent of the
hospital's event are in the red. I mean they're losing
(03:40):
millions of tar millions of dollars a number of the
there's a number of reasons for so for the last
six years have been a thirty percent increase in costs,
whether it be labor or lord for supplies, In addition
to that, you have Medicaid, which hasn't had an increase
in over thirteen years, and the fact is being decreased
(04:04):
now at lea legislation that has hit nationally. So it's
been a very difficult time. Luckily, we are one of
the few hospitals struggling but profit a little. We hope
to continue that. But it is a bleak outlet for
(04:25):
the hospital industry right.
Speaker 2 (04:27):
And you know, just recently there has been a taizer
strike that's come online that's impacting the healthcare landscape as well.
What do you believe unions are seeking and how is
the role of unions evolving in healthcare?
Speaker 4 (04:41):
Oh, we both can talk a little bit about that.
San Antonio Original Hospital is actually a non union show.
But in my history, a lot of people don't know this.
My father was a union leader for thirty years ago,
and he always says, is unions are needed in the
if circumstances at specific institutions, but if you run your
(05:06):
business right, they're not even so I'm really unbiased again
see meetings. I'm an advocate at some places and but here,
for instance, we're doing okay.
Speaker 2 (05:16):
And so what do you believe unions are seeking doctor
Jacob and POWs a little of bes evolving in healthcare today.
Speaker 5 (05:25):
So I think, you know, unions tend to thrive in
employers that don't really address needs of their employees. I
think that's there what drives a lot of union membership.
Just like John said, I think San Antonio Regional Hospital
really has a different approach when it comes to things
(05:47):
like this. We we have a collaborative environment with our leaders.
Speaker 4 (05:53):
We have an open new policy, and a lot.
Speaker 5 (05:55):
Of these issues and grievances are addressed, you know, pretty regularly,
just because of our of the culture that that that
we have as an organization. And I think from that perspective,
we've been very successful in that engagement with our employees
because of that. And I think you know that that's
(06:16):
pretty much what drives a lot of the success that
the regional hospital you mentioned Kaiser. Kaiser is on strength.
I think it is asiatic.
Speaker 4 (06:30):
And it's wages. It's always a part. A component is wages,
but also making sure they have me staffing. Uh. The
unions are they're actually from glomeration of that piece together,
the strength representing Kaiser members and it's definitely having a
say in Ali hospital operates. As Terry said, as compared
(06:56):
to San Antonio, we already provide that, say we have
to meet wages whether a union or non union shop
in the area we're in independent hospital, we would lose
employees and make it very hard to run. So we
typically match the union industry and other hospitals in the
(07:18):
area that aren't uganized and many times exceed the type
of benefits that they're offering the employees that they represent
it well, and you.
Speaker 3 (07:28):
Know that makes a lot of sense.
Speaker 2 (07:29):
So this is a question for both of you, and
we'll start with doctor Jabub, what would you say the
key advantages and disadvantages of humanization for hospitals and health
care employees.
Speaker 5 (07:41):
Key advantages so, for for instance, a lot of organizations
that don't have established committees or forms or discussion groups
with employees. So when you have organizations that get organized
and unionized, that typically takes place. But again that's something
(08:01):
that we do fairly well.
Speaker 6 (08:03):
Here.
Speaker 5 (08:04):
We have several committees that employees get to participate with
that open their policy that employees contribute a lot to
a lot of the operation discussions that we have, and
we have the res of s lunche those are other
components that we do that we find very successful. So
all these are our strategies that we do in order
to meet the needs of ourntilizers. I think that's that's
(08:26):
one of the the reasons here.
Speaker 4 (08:29):
Yeah, and just to augment that in each of our departments,
then we actually ask the employees to participate in cost
efficiencies or operational improvements because we all agree there's no
doubt that it's the staff doing the work that knows
how to improve.
Speaker 3 (08:50):
That makes sense.
Speaker 2 (08:51):
Okay, doctor Jake, why has sent it to an original
hospital chosen not to unize its workforce and we have
you alluded to some of the organizational input that helps
form that decision making. Can you talk about other facets
that help shape that decision making as wet?
Speaker 5 (09:13):
So some of that has to do with the fact
that employees get to participate in that process. Right when
we have these committees that employees are there to, you know,
discuss things that they think that are improvements, will respond
and some of those are great.
Speaker 4 (09:28):
Phenomenal ideas that we implement.
Speaker 5 (09:30):
I think there as an example, even this week, we
had some President's launching questions that were just great in
terms of benefits, and we looked at that in our
committees and safety thinking that this is probably something that
we want to implement. So a lot of that idea
to those ideas, But from the employees, I think the
other thing that you mentioned earlier about why you know
(09:52):
we've been successful to not having unions in our facility,
I think it's because a lot of employees have greavenesses
and issues that they have, right it's it's the normal
force of business. But being able to address those issues,
it's it's very violent. And I think if you're able
to commit to the employees to addressing grievouses and issues,
(10:15):
I think goes a long way. I think, you know,
I have some examples of employees that have brought concerns
to our attention and we were able to resolve those
for instance, you know, either corrective action that.
Speaker 4 (10:31):
Was given to the employee.
Speaker 5 (10:32):
They felt that it wasn't investigated properly, so HR being
a a moutual party, we did the investigation found that
that there were some particular issues that occurred that we're
not shared with leadership, and that really changed. It wasn't
(10:53):
the at risk behavior, it was just a human error
and with the way that we functioned here as an
organization in terms of just culture, right, we looked at
that and thought, okay, this is not probably not appropriate.
Should have been happened a little bit differently, and we
resented the correct defession, and we coach the leadership team
(11:14):
be next time, this is probably the best way to
have a situation. So again, we are there to support
the employee. We are a service department and we serve
our customers our employees.
Speaker 7 (11:27):
Yeah.
Speaker 2 (11:27):
Absolutely, it sounds like adaptability and quick response is really
what helps to continue that engagement. John, how is set
into our regional hospital's culture of transparency contribute to employee
retention and engagement?
Speaker 4 (11:42):
Well, that's the secret ingredient too. Why San Antonio is
different is it's an air of transparency and availability. So
I can't tell you how many times employees will come
in here with ideas or concerns, you know, using an
example like Terry just two weeks ago, I've had any
(12:04):
attorneys come in with I kid you not, it looks
like a Santa Bad full of supplies, And she said, John,
these are the supplies that we're basing in our C
section surgeries. There's got to be a way to be
more efficient now, how many places can say that someone
(12:27):
would have could come in, talk to a seat build
and have an idea generating safety and reduce weights. So
I can say that about the entire executive team from
a directors on them. They know we want to hear
about their ideas. They know we're a lean organization. Lean
(12:48):
meaning we're trying to get rid of waste, whether it
be cost, whether it be operational or waste and time.
We want our employees to be able to work to
the top of their license there'rection and not waste their
time on things that are undeeded and they know that
that makes sense.
Speaker 3 (13:07):
Is there anything you want to add to that well?
Speaker 5 (13:09):
In terms of transparency for instance, that you have asked
the question.
Speaker 6 (13:15):
When when we do wage analysis right, we use asks
you you know a lot of our decision making and
then we look at comparisons between other facilities such as you.
Speaker 5 (13:26):
Know, Promonga, lover Yeah, and other hostiles within our market.
That data is shared with the leadership team and even
employees that come in to discuss their wages are concerns
as directly no middle end, they're directly coming to us.
We share that with them and if there is opportunity
(13:49):
for improvement in terms of wages, we do make that
decision to make sure that we stay in pivot. I mean,
these are employees that we've hired, we have a vested
in in their well being right in these good benefits
and retirement funds. We want to make sure the stay right.
We want to be the last employer that they've worked for, right.
(14:12):
So in terms of transparency, we share this data with it.
Speaker 4 (14:17):
You know, this is what we.
Speaker 5 (14:18):
Found and if it's it's there and it shows a
difference that is a significant difference that we need to
a match. We make that adjustment and it's something that
we do regularly year.
Speaker 4 (14:31):
I think that's what you know. In my history, I've
never seen until we came here where you heard or
labor relations or human resources actually shares with employees what
they're looking at on market ranges uh and where it
will be fit. And we've had employees that we've met said, no, what,
(14:52):
you're absolutely right, the predem should be higher based on this.
And a lot of places only do this months every
two years. They keep it as if it's a biblical
you can't read that chapter of the Bible that doesn't exist.
That kind of thing here we share with employees. We've
given copies a bit. He talks about half. What that
(15:12):
is is the hospital associations out of California over one
hundred and forty hospital compared with and we want to
make the differences from employee. One of the things that
we did is like, boy, how can we reward some
of our most senior employees, because what's happened over the
years with salaries. Before it used to be a straight line, right,
(15:34):
everybody was the same dollar now apart by year. Then
what's changed for nursing is they increase the range in
salary in the first five years and then it kind
of flattened out. So all of a sudden you have
this compression. We have someone working twenty years who used
to make twenty dollars more hour than somebody's starting now
(15:57):
only makes maybe twelve dollars an hour. That doesn't feel
good if you've worked for thirty years. So we're one
of the hospitals that actually took a cat off the top.
That means our employees are here for four years are
making probably as much as one of the highest regions
in the US, whether it be New York or San Francisco.
(16:18):
So we never see someone over twenty years leaving our hospital,
and I think that says a lot about the culture
of transparency, family and in it together. And that's the
only downfall I have that's coming from union shops. It
always feels like there's a middleman and then it feels
(16:39):
like them versus us, which we don't want. We want
people to come here and say, hey, they're part of
something great, something that's benefiting the community, and they are
being respected and we're treating them correctly.
Speaker 2 (16:52):
And what's the overall tunnel owner feedback that you're getting
from your team members here at San Antonio Buy implementing
that we're responsiveness, the transparency and the innovative feedback that.
Speaker 3 (17:05):
You're seeking to update.
Speaker 5 (17:08):
Everybody with want to start absolutely, that's a great question.
And we do surveys throughout the year right to kind
of feel how the employees feel about the organization, right
employee engagement surveys. Another key indicator that really shows how
we're doing is our turnover. So if you look at today,
(17:32):
if you review the NSI data in terms of turnover nationally,
that's about fifteen percent fifteen point four percent. The organization
here does a nine foot four so we're way on
all the national fage. Part for turnovers, and I've been
in organization is that the turnover is between fifteen to
twenty two. So it really tells the law and says
(17:55):
a lot about this this hospital. So that's one indicator.
The other one is our engagement scores. What we compare
in terms of national benchmark averages. We we do overrue
week well, and a lot of that has to do
with the leadership team, right, that transparency, the the collaboration, right,
(18:18):
I think that tell us that really ship ship shines
and shows out.
Speaker 4 (18:24):
Yeah, they still care for it. You know, we have
what's full operations counselor every week where people our directors
ask for a replacement position or a new position. And
if it's a replacement position, I built in and we
follow this. We want to know who left and why.
What's the question I always ask, did you make an
(18:46):
account off? Did you make a counter over? There's something
maybe since we only check surveys on every six months,
maybe there was a hospital there who they suddenly raise
the raid and they're going there. Well, we eventually won
a match. You know, if we didn't see it first
and they did it, we'll offer the same rate if
(19:09):
we know, we're going to look if that's the ask average
that's coming, so we actually keep a lot of employees
that way.
Speaker 2 (19:15):
That's that's a great way to address those gaps. Right,
somebody leaves, that question is very important. Why would they
leave what their accounter offer me? Right, because you want
to keep the employees.
Speaker 4 (19:27):
So it's fantastic one monthly, even at the President's lunchons,
we share reasons that people do leave. You hear fifteen percent.
That still sounds high, but remember one of those positions
are pardeems, people who are this isn't your full tention.
We're a part time, we're retirement. So when we look
at reasons for leaving and we see pay or environment
(19:49):
as the reason for living leaving, it's now below the
top five reasons. The top reason that probably moving out
of the area, having a family, retirement, and those are
the ones I can live.
Speaker 2 (20:02):
Right, And so being six percent under the national average
of fifteen percent with only nine percent turnover here at
the hospital is a huge testament to how these different
policies are actually benefitting, bucking the trend.
Speaker 3 (20:18):
Of the healthcare landscape.
Speaker 2 (20:21):
Doctor Jaquin, how does stand Antonio original hospital promote workforce
development and growth opportunities for its employees.
Speaker 4 (20:29):
So we have several.
Speaker 5 (20:30):
Programs, but one recently that we that we like to showcases.
We've made some significant improvements in terms of our benefit
package for loan and college tuition renversement. That's partially what
we've what we implemented, so that allows employees to further
(20:50):
their education and then also allowing employees to use the
loan repay and to pay down there super loan debt.
Speaker 4 (21:00):
A lot of these young students coming down to school, Uh, they.
Speaker 5 (21:03):
Can't start a family because they have, you know, these
huge moments to pay and this as long as they
staying with us, we'll make their their manial payments start them.
So this is this is a great tool to keep
employees here with us while they continue the growing their career.
But yeah, that's you know partially how we develop you
(21:25):
know that that kind of you know, workforce. The other
things that we do too, is we look at opportunities
for growth within the organization. Uh and uh, you know
for employees that want to advance their careers. We have
problems to develop leaders and that's something that we just
now started, uh, which is the our leadership academy that
(21:48):
John and I are very proud of. So that's certainly
something that I think it's going to show, uh, you know,
a great payoff for their organization as we develop these
leaders and employees that identify that they want to continue
their growth.
Speaker 4 (22:01):
This is something that I think we're going to be
very proud in the future. So it's fantastic that you
can develop that type of talent within instead of not
doing anything about it, not getting them to the top
where they can be or silly, and instead of bringing
sound externally, right, I'd rather have them developed here. You know.
The other thing that I'd like to tie on is,
(22:23):
you know, one of the things that we do, for instance,
and some of the larger ones that even the one
who just said is on strike right now doesn't do,
is we take hundreds of new nurse breads. Now, what
does that mean? Okay, so let me take someone coming
out of school. Well, most hospibles won't take somebody to
work patient care until they have at least six months
(22:44):
to a year of experience. What we do is we
take the time to develop them ourselves. We'll take them.
Pay for an extra nurse. Think of paying for an
extra one hundred nurses. We pay our experienced nurses to
train them so they're trained revenue. We give them a
stipend of uh several dollars an hour and a lot.
(23:07):
Most hospitals want to do that. Our goal is to
that's how we keep you tention. That's how the the
community knows, Hey, my daughter or my son going to
maybe they have a chance to get in the dort
San Antonio. So Nurse new Grass is just one part
of the many workforce to development pipelines that we have
(23:30):
developed or are development.
Speaker 5 (23:32):
Yeah. In fact, we have a safe of College of
melt Sach Western AZUSA. All these are our schools that
we have in this agreements with the employees are the
uh as soon as they come and they do rotations
at our facility and uh so we have a constant
pipeline and new students and that are ready to during
(23:56):
the workforce, you know, and they're train here at our facilities,
are trained at our EARR system.
Speaker 4 (24:02):
So it's that sort of.
Speaker 5 (24:07):
It decreases the amount of training that is necessarily to
do because they're ready to trade.
Speaker 4 (24:12):
Another one that we do is.
Speaker 5 (24:13):
CLS is at Hill State, the Glen Scientists so that's
another PARTO I'm going to be up to.
Speaker 4 (24:19):
And people don't think about this, but physicians are considered
workforce even though in California a hospital can't employee physicians. Well,
we need physicians. So how do we do with els
Kiser that they create a foundation model. We created a
medical work We've talked before under program about the lack
of physicians at San Berna County. Now we have an
(24:42):
approved two residency programs that when max they will be
graduating twenty students a year at our goal is to
keep them. So as far as I'm concerned, that's part
of the pimeline too.
Speaker 2 (24:54):
Well, that's great and we're going to pick up on
that after the break the Vet Locker with ABC News
and Talks California Business Report with visionary leaders John T.
Chapman and doctor Terry Jacob, who have propelled San Antonio
Regional Hospital to national prominence, earning top Medicare honors, and
pioneering innovative care and workforce strategies that set new standards
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Speaker 2 (28:33):
Welcome back, everyone, Give that Walker with ABCUS and Southern
California Business Report here today with dissary leaders John T.
Chapman and doctor Terry Jacob, who have propelled San Antonio
Regional Hospital to national prominence, earning top Medicare honors, and
pioneering innovative care and workforce strategies that set new standards
(28:55):
for healthcare excellence across California and beyond.
Speaker 3 (28:59):
Thank you both so much for joining the program and
sharing your insight and expertise.
Speaker 2 (29:03):
So you know, prior to the program, we were talking
a lot about the innovative approach you have to responding
to your workforce and.
Speaker 3 (29:10):
How you're able to basically not.
Speaker 2 (29:13):
Need unions to represent your stuff because you're so responsive
and transparent.
Speaker 3 (29:19):
And I know that in that innovative process.
Speaker 2 (29:22):
Since you've joined, John, there have been critical steps in
San Antonio Regional Hospital's financial renaissance, and talk about the
leadership principles that have guided this transformation.
Speaker 4 (29:37):
Sure, I'm a big believer you can't manage what you
don't measure. So when I came here, and this was
before Terry has talked by a few years, we found
a beautiful community hospital. However, the hospital is using over
twenty four the land here right, And when I came in,
(29:58):
they said, okay, you're coming in. You don't find a
way to turn the round, so show me the metrics.
And actually that made me actually see the opportunity that
was there, because, you know, we'll talk to the embarrassing story.
We were hardly any metrics. So you know, we started
(30:19):
from finance to operations, the staffing to volume. We looked
at everything. So for instance, in finance, we noticed we
didn't have the latest in terms of the pri organization
of bill paying right to insurance. You would take the
they would take the oldest insurance claim which might be
(30:39):
one thousand dollars and there's a three million dollars one
that's going to expire in twenty four hours, and they
never saw. So bringing in an outside company to leave
the company's name out, we actually put metrics in place,
put operations in place, invested in new software, had their
team of over forty people here for half a year
(31:00):
and they found fourteen million a year, so that kind
of costs them by ten them. The second one was
in terror. You could appreciate this. We have over twenty
five hundred employees and they were all benefited full time.
So what are you supposed to be when census goes
now and census goes down. You typically want to reduce
the amount of labor unings book periods, just like you
(31:22):
want to raise it when you're high periods. Well, we're
sending people home that are going to get paid regardless
if they're here or not. See, really not saving any dollars.
A good organization, even for employee burnout, will have a
huge I want to say huge. Well, let's say ten
to fifteen percent of pardeons or part timers, those who
(31:43):
can call in an emergency who aren't guaranteed hours are
the same people you can call off. Mean you don't
beat them. So being able to be deficient with the
number of employees we need based on each day, we
actually have metrics, daily products, every reports that got us
the break even and then using the employees like we
(32:06):
talked about before, in terms of looking for a waste
was another mechanism to us, that's say several more newms.
You know, I I share this example one time in
the last a few weeks. Is as an example, we
had another employee group. You said, let's look at the
(32:28):
crash parts. Each crash part has about thousand to two
hundred and fifty thousand dollars supplies. The bad thing, which
you might about though, is if we ever have to
open a crash cart because someone is having a cold deliver,
anything that's left in the crash card has to be
tossed because no longer stare they would go in. Typically
for things that would have to do with opening an airway. Well,
(32:52):
you know that's probably about a thousand dollars of that
one hundred thousand to two hundred thousand dollars to equipment.
So we said, god, we're losing millions of dollars, and
we had one places, why don't we just put the
air ways on top and a separate, smaller crash bin
on top of the crash car. We did, and just
(33:13):
that one simple idea, and whatever's listening, this is simple, right,
saved over two and a half million a year. I
thought it was one of it.
Speaker 3 (33:21):
It was two and a half by that one adjustment.
Speaker 4 (33:25):
To imagine staff in every department, they're sharing how we
can make operations together. And that's why we're one of
the few hospitals, i'd say the only hospital I can
say that in southern California actually breaks even Medicare in
terms of what they pay to work costs. So we're
(33:47):
very proud of the turnarounds. In fact, over the last
eight years seven to eight years will be eight years
this time, we've had credit up rates every year while
the hospital industry, according to Moody's credit downgrades every year.
We're going in the opposite direction from healthcare. And again
we're so proud adding the caregiver or executlips. I'll take
(34:11):
a team approach to finding these types of solutions.
Speaker 2 (34:14):
It's remarkable, doctor Jacob, how have these philosophies and leading
into these key analytics assisted or trade into your role
leading HR Sure, I'm glad you asked that question.
Speaker 4 (34:32):
So essentially what John was sharing in terms of the.
Speaker 5 (34:37):
If you look at your statuem office and you see
that you know with John Gott here the majority of
the staff are full time employees. You should have a
mixture of full time, part time, and for dem we
had a very very small full of pretty employees. And
when John was sharing about benchmarks about tent fifteen percent,
(35:01):
that's pretty standard in the industry.
Speaker 4 (35:03):
You're supposed to be out of.
Speaker 5 (35:04):
That because of that variables of people leaving, call offs,
leading absence and such.
Speaker 4 (35:13):
You should be able to be able to have staff
available to meet those needs.
Speaker 5 (35:19):
And where do you have that Why of that has
to do with the preview staff, where you have a
per neeme staff that are able to flex in some
of the holes in the schedule. So that was one
of the things that was implemented here and you could
really see a difference in terms of your neighbor over
net revenue because of not having to spend so much
(35:43):
dollars on let's say registry because you have staff that
are internal and they are able to meet those needs.
So that's one of the ways when John also shared
it touched on what was the operations means that we
have every week that we look at, for instance, when
there's new positions that become available. What's very interesting you
(36:06):
meet about this organization that I didn't quite experience in
others is that we have.
Speaker 4 (36:12):
That that teaching mentality.
Speaker 9 (36:14):
Right.
Speaker 5 (36:15):
Uh, it's very impressive to sit in those wides and
watch our leaders grow in terms of their financial abilities,
to understand different concepts in terms of operations, for instance,
recover every every new role, and we look at work
productivity versus budget very versus flex pay in order to
(36:40):
make a decision whether this position is needed or not.
I don't see a lot of organizations do that. What
they tend to do is they sort of get stuck
in old ways and habits, and that really puts you know,
your net, you know, labor overt everything. Just that's sixty
seventy percent, which is just you know, really a follow
(37:03):
when it comes to the overall operations.
Speaker 4 (37:06):
I'd love to add onto that, not only do we
look of whether eight positions needed. I'll give you an
example where you've actually told our employees had new positions.
So there are certain we've had certain departments say we're
at one hundred percent. But to keep hearing them be around,
the learned out we're burnt out. We're burnt out. It's like,
(37:28):
how can that be? What we found out is they
looked at one hundred percent like they have enough bodies,
but they really didn't. They're working people over time through
their breaks. Now if we knew that, that tells us Okay,
now we know why you're at one hundred percent. They're
burning out and you're paying them time and a half
(37:49):
double time. So we'd say go open three positions because
when we look at the actual number of bodies, they
didn't have enough, but it looked like they did because
as they were working people past their routinia hours. So
we can both we coach them on how to find
new positions that doesn't impact the organization financially, actually improves
(38:12):
the well being and how our employees feel about thoughts.
So when he says teaching, you can tell I really
loved that component. That's why I send in those OPS
counsels to Right.
Speaker 2 (38:24):
So, given all of this innovation and keen attention to
the analytics that are really driving these costs either up
or down. I mean, that's been the foundation of the
financial turnaround we've been able to experience. And with that
come the expansion of the hospital. Right, And so recently
(38:44):
you've been expanding in urging care and specialty programs at
San Antelo Regional Hospital.
Speaker 4 (38:49):
Can we speak to those John, Yeah, So when the
hospital is profitable. And let's be honest about profitability. When
I say profitability of seven or eight years, we're talking
in margins, right, We're talking one to two percent margins.
That's why it's I'm always having anxiety. What's the latest
(39:11):
cost to healthcare? But as a nonprofit independent aren't goals
to reinvest in the community. So how do we determine
what the community needs? Of community Health Needs Assessment Report?
We do this every two years or by zip code.
We look at, okay, what are the issues, what are
(39:32):
people having sickness from are people? What are people dying?
What's the average age, what's their illness? And we want
to target those populations for programs. So as an example,
earlier we bet you mentioned center of Beating the Center
of Aging. Well, we've found out that over the next
ten years this county will have the highest growth rate
(39:54):
in seniors. Well, it's a no brainer. We should focus
on seniors. So the Center of Aging, as I had
mentioned in the previous program, is a one stop shop
for seniors. Almost every specialty, almost every family medicine, cheriatrics, lab, radiology,
(40:14):
behavioral health, while all be in one large building, share
scheduling system where they can have multiple well, they can
see multiple providers on the same day. Why is that
important Because even a senior with Medicare, if they need
a transport vehicle for the wheelchair, it's still one hundred
(40:35):
dollars out of pocket for every time. So we said,
not only are we going to cohort visits together, we're
going to provide free rides if they have a problem
with getting here. As long as they're in a twenty
square mile area, the problem, and it's a good problem
to have. We have cities fifty square miles away saying
can you bring the same program to us? So I
(40:56):
feel that actually feels good. We're confident that we're doing
the right thing. And at the same time you mentioned
Virgin Cares. We've opened up selling urgent cares in the
last few years. And why is that well, I had
mentioned the lack of family investment doctors in our area,
which is easy to see because when we look at
(41:16):
the number of visits in hospitals, the number of visits
in the ers are tripled the national average. When you
look at the Inland Empire, especially Sandberg County, it's not
because of lack of postles, because no one can go
in and see their primary care when they really need to.
So our goal is to increase those family practitioners. At
(41:38):
the same time offer a lower level where hey, if
you're going in and you're sick, you know you're not
having a heart attack, at least have another place to go,
which is an urgion care, right, So we're investing that
can do.
Speaker 3 (41:50):
That's terrific.
Speaker 2 (41:51):
So doctor j put earlier, you alluded to employee burnout
as being something that is at the top of mine
talk about wellness programs got influence organizational performance at San
Antonio Regional Hospital necesses to eliminate or mitigate the burnout effect.
Speaker 5 (42:11):
Sure, we we have so a lot of hospitals have
similar programs, but we we do it a little bit further, right, So,
for instance, a lot of hospital staff what we call
it a program.
Speaker 4 (42:23):
We're discussed burnout and other.
Speaker 5 (42:25):
Issues, but how many AP is employe Assistant program, which
what we provide. The program essentially provides a counseling, legal experts,
and a whost a little different things that we offer.
Speaker 4 (42:41):
But we also have a.
Speaker 5 (42:42):
Wellness program that's part of our our benefit package where
employees get discounted rates.
Speaker 4 (42:49):
For the MPU Medical benefits.
Speaker 5 (42:53):
As long as they follow the program in terms of
getting the at least one the field medical examination per
year and then.
Speaker 4 (43:03):
Some labs you get this discount. And there's all these
other activities that we have throughout the.
Speaker 5 (43:07):
Year, for instance, you know, hiking our set San Antonio
Mountain range right the mountain moldly that we do all
these little activities with our employees which really helps emphasize
that you know that that that wellness opponent.
Speaker 4 (43:26):
We also implemented something new.
Speaker 5 (43:27):
For the care for the caregiver, which we have a
number of different leaders and employees that want to participate
in the program, which we identify employees or at least
they come to us that they're going through some kind
of a struggle either mental health issues or struggling at home,
and we're able to help them right coach them, I'll
(43:51):
provide assistance even financial.
Speaker 4 (43:53):
So that's something that we're very product seric. Yeah. Part
of that we call here for you, We love the
here for you, care for you approach. That there are
many employees who during a workwaker, while they're on shift,
may see a little would die that they're caring for,
(44:14):
may think they made mistake and have a panic attack.
We actually had what was it? Outside of our hospital.
There is police action. People are threatened and scared about that,
so we consider it almost like an emergency response for
these employees. We have other employees who are trained to
be there for them. That's what we call it care,
(44:37):
So they see that employee on that shift and talk
things through them. Well.
Speaker 2 (44:42):
More innovative programs and solutions to very common outcomes and
challenges that I imagine healthcare workforce sees. And with that,
you know, the SANATOI Regional Hospital teams have been shining recently,
achieving a four star Medicare ranking and hospital also was
recognized as a top fifty cardiology hospital in renovation. What
(45:08):
does that mean for Sanato Regional Hospital and his patients.
Speaker 4 (45:11):
Well, I think it's just validation to the community with
these types of awards. US News and World Report just
gave us a specialty hospital to five percent in the
US for art bypass, but we're really proud of as
well as the same thing US News and World Report
(45:33):
recognizing US as a top maternity hospital. He was using
World Report recognizing US as a top orthopedic joint replace
in hospital. These are all specialties that we spend a
lot of time and to make sure their quality and
efficient and meets the needs of the community. So these
(45:57):
service lines, we'd love to see those awards right right,
It just tells the community you're.
Speaker 2 (46:03):
Going to the red place, right, doctor Jacob, What does
that tell you when you're leading human resources, to see
the accumulation of so many awards, including as I mentioned,
Top fifty Cardiology in the nation and for Star medicare
making well, I'm very proud.
Speaker 5 (46:20):
Of this organization and what we have achieved, you know,
I think you know, I'm very proud of our place.
I mean, I think that's our the most important assets
any corporation or in the industry, and you know, being
able to value our employees and make sure that they're
(46:40):
taken care of, I think that's really important and really.
Speaker 4 (46:44):
Shows and shines all these accolades that we see. And
you know, tying that back to your original question about unions,
we're giving you the type of things that we do
that unions after coming in other places that aren't doing so,
I said, places where unions are eat it. They're trying
to do the same things we're doing, except we're doing
(47:05):
it without our employees having to pay you dues to
have an outside and do what we as leaders should
be doing and hard.
Speaker 3 (47:15):
Well, that's exceptional. And you know, recently, through the ability
to invest and innovate and.
Speaker 2 (47:22):
Grow the footprint of the hospital, there was a recent
launch of the ACGNY accredited residency programs. What impact has
that had on the Star community internally and externally?
Speaker 4 (47:36):
Oh all right, you got another program, right.
Speaker 3 (47:40):
Right, I mean we're just scratching the surface. So and
we're coming to the end of the hour, but just
wanted to throw this next.
Speaker 4 (47:46):
So I mentioned that in Leanland Empire, it is the
lowest county in California for a number of primary care
Family of Medicine tree hundred thousand populations. Right, we want
to close the gap in zan burgagain county. No one
else is doing it. Fifty three percent of hospitals are
(48:06):
losing money. They're not investing in these things. We're investing
in growing training for a residency program, getting more important,
keeping these physicians in our community, representing San Antonio and
treating our patient population. That's the external. Intern Well, when
(48:27):
you're dealing with the tending doctors, the tending doctors are
seeing their patients and clinics all the time. Right, if
you have a loved one who you've spent an in patient,
what's the first thing you are always looking for? When
is that doctor going to visit? I have questions and
let's be honest now for those who have experienced it,
we're lucky revires to one hospital where you have to
(48:48):
see a physician once or twice to give of you
what's the update on your you or your loveless condition residents,
when you've have thirty residents running around representing those doctors. Oh,
the families love it because they can talk and find
out five, six, seven times a day and answer to
questions because that those residents are internal in the hospital.
(49:13):
We're seeing a big improvement on our physician communication scores
on our national averages for how we're doing with in
patience duey like us, they scores ten out of ten
on every category. Well, one of them has always been
for every hospital physician communication and soaring internally with the residency.
Speaker 3 (49:37):
That's exciting.
Speaker 2 (49:38):
So last questions of both of you and all, starting
with doctor Jacua, what is your visions for the teacher
of sanch on your origional hospital as a beacon of
care innovation and community partnership.
Speaker 4 (49:51):
I think it's in terms of you know my area,
which is you know, the employees.
Speaker 5 (49:57):
I think it's continued to be you know, the top
employer in our region by offering good you know, wages
and benefits keep employees engaged. And I think as long
as we do that well, we continue to bring being
the kind of sort of the beacon for for and
(50:17):
what other possibles in our region will strive.
Speaker 4 (50:20):
To be great. And to JOm, I'm going to get
this right because a vision you get to close it
out right. You know, our our vision is to prove
the heleph of the community. And that's measuring right. How
do we measure that? We measure what is the how
(50:44):
how long are people living? We mentioned zip codes? Are
the conditions that we're tackling by zip code improving over
the years?
Speaker 5 (50:54):
Uh?
Speaker 4 (50:55):
You mentioned innovation? Are we bringing the type of services
that most people would have to travel to an academic
medical center forty miles away, like bringing City of Hope
next doore to have all their cancer care right here
in this community instead of getting in their car and
(51:16):
going and driving those thirty miles to where' support right,
I've had a mom who's had chemotherapy. It's not easy
just to get up and let alone have to travel.
So our goal is to find those cunning edge technologies,
(51:37):
find those community partners, make this hossible, incredibly known for
its quality and care, and keep this care in the
community and share with the community. Yeah, we are making
a difference, and here's the metrics that prove it.
Speaker 2 (51:56):
And your team and you on your leadership are a
definitely making that difference and moving the needle in healthcare.
And it's exciting to see the growth and transformation in
real time. So thank you both so much for your time,
for your expertise, and for just doing what you do
to continue to serve our communities.
Speaker 4 (52:15):
Weaken.
Speaker 3 (52:16):
Thank you for letting you share our story all right
for everybody listening.
Speaker 2 (52:20):
Don't forget to find us on Facebook, YouTube, LinkedIn, and Instagram.
Don't forget to check us out on SCBR talk dot com.
And don't miss my conversation with Randal Lewis, executive vice
president and principal at Lewis Operating for his visionary leadership
and unwielding commitment to community has transformed the landscape of
California and Nevada.
Speaker 3 (52:42):
Next week We will have Janice.
Speaker 2 (52:44):
Rutherford, from leading Girl Scout watershed cleanups to shaping California
public policy. Jane's lifelong devotion to service is woven through
every chapter of her life.
Speaker 3 (52:55):
You do not want to miss it, and we will
see you all next week.
Speaker 4 (53:11):
The sip the E stat
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