'Tough, dirty, demanding work:' 5 keys to effective leadership, says Centura CEO

Peter D. Banko serves as president and CEO at Centennial, Colo.-based Centura Health. 

Mr. Banko will serve on the keynote panel "The Next Competition for Physicians, Referrals and Healthcare Dollars" at Becker's 10th Annual CEO + CFO Roundtable. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the roundtable, which will take place in Chicago from Nov. 7-10, 2022.

To learn more about the conference and Mr. Banko's session, click here.

Becker's Healthcare aims to foster peer-to-peer conversation between healthcare's brightest leaders and thinkers. In that vein, responses to our Speaker Series are published straight from interviewees. Here is what our speakers had to say.

 

Question: What is the smartest thing you've done in the last year to set your system up for success?

Mr. Banko: Investing in our 21,000 incredible people. That process started with listening more intently and, most important, following up with meaningful and timely actions. We have leveraged our associate and physician engagement survey feedback like never before, hosted staffing summits focused on nursing where we met with more than 2,500 caregivers and our market-based diversity and inclusion councils to name just a few mechanisms.

We changed how we looked at and timed our market and merit increases as well as implemented a nursing retention bonus, a living wage program, and several benefit enhancements, including tuition reimbursement, loan forgiveness, childcare support, housing stipends and paid time off buy back. Those investments in our workforce represented more than $230 million over 18 months to help respond to engagement, retention and recruiting opportunities identified by our co-workers. The result of all this intentional people-focused work has been impactful. Our associate engagement has moved to the top quartile of all health systems with similar significant engagement improvement with nursing and physicians. We have witnessed measurable declines in turnover (including RNs) and vacancy rates. Like all health systems and major employers right now, we are challenged by The Great Resignation and historically low unemployment rates. However, our commitment to our people and our Mission is furthering whole person care and the communities we serve.

Q: What are you most excited about right now and what makes you nervous?

PDB: I am most excited about advancing the most prolific growth period in the 140-year history of our healing ministry. We have the unique opportunity to create world-class outcomes and value-based affordability by innovating cancer, heart and vascular, neurosciences and orthopedics care across the Front Range of Colorado. We have plans to expand in our existing geographies in Denver and Colorado Springs. We have designed new consumer-driven processes and systems for our physician group, ambulatory network, emergency departments, acute care facilities and our digital footprint to improve access and better coordinate care transition for our existing patients.

I am most nervous about the macro-economic environment in our country. In my 30 years of health care leadership, I have never experienced a time when the economy had so much impact on our business. Inflation is at its highest rate since 1981. Unemployment is at its lowest rate since 1969. We are experiencing the largest interest rate hikes in 28 years. A bear stock market. The longest period in American history without a recession. Delayed care and changing utilization patterns with consumers struggling with affordability and access. Health systems are going to have to find all new skills in resiliency with talent, efficiency, our balance sheets, and growth. In particular, that will mean quickly adapting to demand shifts, finally using all our economies of scale, keeping our costs lean, and building short- and long-term operational and financial discipline.

Q: How are you thinking about growth and investments for the next year or two?

PDB: We believe health care and health are truly better where Centura is. We have steadily built that growth mindset where we take on challenges, learn from them, increase our capabilities and deliver on our results. We think about growth in the very same way that successful S&P 500 companies have thought about and executed on growth over the past three decades and more. Flawless execution only represents four percent of historical S&P growth. In fact, no organization has ever beaten disruption just by trying to do what they currently do better. 

However, nearly two-thirds of healthy revenue growth should be driven by competing in the right place at the right time. That translates to growing, divesting and creating new opportunities in geographies, services, programs and segments. Most “where to win” companies are also active acquirers (which accounts for 31 percent of healthy revenue growth on the S&P). In the last six months, we have added two acquisitions with St. Catherine Hospital in Dodge City, Kans., and St. Elizabeth Hospital in Fort Morgan, Colo. In less than a year, we will open our 20 hospitals with St. Francis at Interquest in Colorado Springs. Going forward, we would like to aggressively expand into new geographies in northern Colorado, western Kansas, in the Mountain Region and northern New Mexico as well as partnership in the health plan and Medicare Advantage space. As we accelerate out of the pandemic, acquisitions and alliances have never been more important to our growth planning.

Q: What will health care executives need to be effective leaders for the next five years?

PDB: The Turnaround. S&P and Kaufman Hall reported that the first quarter of 2022 marked the toughest performance quarter on record for U.S. non-profit hospitals and health systems with no immediate end or relief in sight. We are also in the midst of the longest period without a recession in U.S. history: 13 years. With the average healthcare CEO turnover of three to four years, we have executives in key C-suite seats today that have never worked into and out of a major recessionary business period.

Leaders are going to have to be resilient with talent, financial discipline, re-prioritizing capital and rationalizing the portfolio. This is tough, dirty and demanding work. Work that no one likes to do. So, it takes a special kind of leadership to be effective over the next five years. You have to have the courage to make the tough decisions. You have to have decisiveness to make the decisions when they must be made. You have to have a results orientation (i.e. not confusing activities with actions with results). You have to hold people accountable. Accountability requires great clarity with expectations, measurement, capability and consequences. And, at the same time, keeping your true north toward a strategic perspective, with positivity, and in a growth mindset.

Q: How are you building resilient and diverse teams?

PDB: We have a clearly communicated diversity, equity and inclusion framework in our health system. It is the first agenda item for our board meetings. Every senior leader has their long-term compensation tied to making it a reality. That framework is built firmly on recognition, support, education, development, structural changes in our people and workforce systems, eliminating health disparities and having a direct impact on the communities that we serve. To help build resiliency, our senior leadership has committed to spending even more time together in both personal and professional settings. We have developed formal leadership expectations and rules of engagement to live into those shared expectations. We engage in focused team and individual development three days every six months (including one of those “advances” with our families). We have fostered opportunities for connection, leading with transparency, acting with personal ownership, creating bridges, providing support and enabling teams to partner and manage through both successes and challenges. All these intentional steps together have helped us to deal in the moment today and not really worry about the past.

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