Brian Gragnolati believes in staying out of the way of his staff. "When you give your team broad parameters and you just let people go –– it's amazing the innovation that I've seen at the bedside," he told Becker's.
Mr. Gragnolati has served as president and CEO of Atlantic Health System since 2015. The Morristown, N.J.-based network comprises six hospitals and serves 11 counties throughout the state. He previously served as the chairman of the board of trustees for the American Hospital Association.
In December, the health system cemented a co-membership agreement with CentraState Healthcare System. Atlantic now owns 51 percent of the Freehold Township, N.J.-based network in a partnership that will provide resources to CentraState while helping Atlantic achieve its goal of providing more value-based care.
He spoke to Becker's about the benefits of this partnership and his priorities for the coming year.
Q: What outcomes do you hope to see from this partnership with CentraState, and why do you think it's a great model for other health systems?
Brian Gragnolati: No. 1, this isn't the typical member substitution. And so consequently, we think that from a regulatory standpoint, it's something that is easier to achieve. It took us less time than some of the other agreements that have been going on. We also think that this really tailors these specific investments that need to be made in those markets, and it does so by working through the entity that's already there. It helps them help their communities, and at the same time, they have significant control there. We think that that works fine.
As it relates to us, we're able to expand our footprint and our network. As it relates to our strategy of rolling out more value-based care, it gives us a chance to work with a partner that we think is really compatible. It's for folks that aren't really interested or ready to go into a traditional member substitution. That's why we think it's different.
Q: Did your experience chairing the American Hospital Association change the way you approach leadership?
BG: The opportunity to chair the American Hospital Association was something that I think opened my eyes to the diversity of care that we have in the country, whether it's from tiny rural hospitals to densely urban settings, whether it's for-profit healthcare systems or safety net organizations. Criss-crossing the country and engaging in those conversations was incredibly valuable, but to me. What it did is reaffirm the principles that I think most healthcare executives have or should have, and that's making sure that we're always putting our patients first and our communities first, making sure that we continue to understand that we're a business of human beings taking care of human beings.
Our team members, our doctors, our nurses, our technicians and our scientists have to be front and center in all of the decisions that we make, and we have to do everything in our power to empower them to do the right thing.
It also reinforced that we are in a business that has some challenging economic models, and we've got to make sure that we have the very best talent to help us on that journey.
Did it change my approach to leadership? Probably not. But it did warn me about the differences in this country and the importance of staying true to our core values.
Q: What are your two top priorities as CEO for Atlantic Health System this year?
BG: Obviously we're still in a pandemic. If CEOs don't have 'coexisting with COVID' on the top of their list, let me know. It would be a good place to live. The pandemic is still at the top of our list and right now we're in another surge here in the greater New York and New Jersey markets. We've just peaked and are starting to come down. That's a good sign.
The other priority that we have is to make sure that we have this pipeline of team members coming in because this Great Resignation has affected healthcare in a pretty significant way, and we need to do everything as healthcare organizations to make sure we have the right environment for people so that they can continue to practice and serve their communities, but also that we continue our efforts to innovative when it comes to the recruitment and retention of team members. Over the last two-plus years of this pandemic, we've seen a lot of people exit healthcare organizations because of the overwhelming burden that it's placed on them. I still believe that healthcare is the greatest profession in the world, and we just need to double down on our efforts –– not just here at Atlantic, but throughout the country –– to replenish our ranks.
Q: Describe the most challenging decision you've had to make as CEO and why was it so challenging.
BG: I've been a CEO for a long time and there are hundreds of super challenging decisions you have to make. What I've tried to do my entire career when faced with a complicated or difficult decision is ask three questions: How does this affect our patient? How does this affect our team members? How does it affect our numbers? And I ask those questions in that order. Consequently, whenever I'm faced with a difficult decision, I run it through that screen.
I'll use the pandemic as an example. At the beginning of this pandemic, we were that hotspot. We were that location in the New York and New Jersey areas where it started, and we were seeing our cases doubling every two to three days. What we said to our team members at that point was, 'we're going to focus on two things and two things only –– never closing our doors to our community and doing everything possible to protect our team members –– And if we do that, we figure out the third thing, the financial impact, later.' And that has really guided us through what I believe to be the two most challenging years of my career.
Q: What has been the most pivotal lesson you have learned as CEO during this pandemic?
BG: The single biggest lesson that has been reinforced to me is to trust your team, because, I have to tell you, when you give your team broad parameters and you just let people go –– it's amazing the innovation that I've seen at the bedside.
I'll give you an example. When we received ventilators from the federal stockpile, some of the plastic tubing, because it had been stored for so long, was rotted, and the connectors were rotted, and the supply chain wasn't working at that time. Our biomedical engineers used 3D printers to manufacture the coupling mechanisms that we needed to get those ventilators to work. That's just one example. I can give you hundreds, but again, if you allow people who know what they're doing to do what they do best and not get in their way, I think that's when the magic gets created, particularly during times of crisis like this — and I couldn't be more proud of our team here at Atlantic.