For nearly seven years, Leslie Marsh, RN, MSN, has served as CEO of Lexington (Neb.) Regional Health Center.
She currently is president of the Nebraska Rural Health Association. In addition, Ms. Marsh, a registered nurse, holds a master's degree in nursing from New Haven, Conn.-based Yale University's Nursing Management, Policy and Leadership program.
On Tuesday, April 18, 2017, Ms. Marsh will speak on a panel at the Becker's Hospital Review 8th Annual Meeting. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place April 17 through April 20 in Chicago.
To learn more about the conference and Ms. Marsh's panel, click here.
Question: The panel you're speaking on at our April conference is titled "Key Thoughts on Improving Quality and Patient Safety." As healthcare keeps evolving, how can hospitals work to improve quality and patient safety?
Leslie Marsh: Quality and safety require intentional efforts that must be a priority for all stakeholders so that safe, quality care becomes a part of the culture. Every process that fails has to be examined in a "just" way and systems must support safety and quality.
Quality and safety are part of the social and operational fabric of Lexington Regional Health Center's mission to deliver excellent care to our community. That foundational underpinning is responsible for several initiatives and tactics at LRHC that were designed to reduce readmissions and improve care post-discharge. One initiative, aimed at reducing readmissions, included the development of a multidisciplinary transition team. Another innovative strategy to keep people healthy involved LRHC working with local providers to design and develop a "Medically Managed Program" that focuses on addressing physical, psychosocial and cultural challenges facing vulnerable, at-risk patients.
Board commitment is paramount — if quality and safety are not as important to your board and to your team as your financial position, then you will not have the cultural transformation necessary to become a highly reliable organization.
Finally, rural providers must find a way to participate in government-driven, values-based, quality programs. We must find ways to participate in a relevant way.
Q: What drew you to a career in healthcare?
LM: Part of a rewarding career involves finding purpose and meaning in what you do. While almost anything we may choose to do has purpose and meaning, the immediacy of the difference you can make in a life or a number of lives provides an obvious and straightforward path to purpose. Healthcare delivery, which considers the person and their life's challenges and opportunities as a whole, can begin to close the gap on inequities.
With an educational background in business and health policy, in addition to being a nurse, holding a leadership role in the healthcare world was a perfect fit. The social component of the business of healthcare appealed to me on several levels, including being able to empower people to act. I like to unharness people's potential and drive change by leveraging the strengths of the people that work in healthcare.
Q: What is unique about the market LRHC serves?
LM: LRHC is located in south central Nebraska and is a community comprised of 13,000 people. Lexington, a rural community, is not typical of most rural communities in Nebraska. Roughly 30 years ago, a meatpacking plant opened and the demographics and social determinants of health changed dramatically. The community saw a large influx of Spanish-speaking individuals initially and the 2015 census still shows Hispanics and Latinos make up the minority majority in Lexington, comprising about 60 percent of the population. Over time, the plant brought in refugees from Sudan and Somalia. Ultimately, the Sudanese moved on and the Somali population remained. According to the 2015 census, Lexington's African American population rests at about 5 percent.
During this time period, the town also doubled in size. Because [the meatpacking] industry employs mostly young people, more than 90 percent of residents are below the age of 65 and 33 percent are below the age of 18.
The community has worked together to embrace diversity. The school offers a bilingual program. At the hospital, we employ about 25 percent minorities, including full-time interpreters 24/7. Community relationships are vitally important; we partnered with the meatpacking plant to deliver on-site care and engage in ongoing communications about the needs of their employee community.
Q: What do you think is the most significant barrier to female leadership, and how can we work to overcome it?
LM: In her book Lean In, Sheryl Sandberg discusses the societal norms for both men and women as well as people's perceptions of women in positions of power compared to men serving in the same role. Men and women, acting identically, are perceived differently. Men and women alike dislike women in positions of authority. They see [women] as self-centered and unlikable while men are seen through the gender bias lens as being decisive and driven.
Since both women and men view women negatively, one solution might be to encourage other women in leadership roles to talk about these stereotypes. As women in positions of power, we can champion the idea that the strengths required of women in executive positions are not signs of feminine failure. We need to mentor and also encourage our colleagues to mentor young women interested in leadership roles.
We have to continue to work nationally to move the needle on inequalities while also addressing this gender dichotomy on a local, academic and professional level.