The budget area this Louisiana system CEO won't touch

E.J. Kuiper, with two decades of experience in Catholic healthcare leadership, began serving as president and CEO of Baton Rouge, La.-based Franciscan Missionaries of Our Lady Health System in May.

Before joining Franciscan Missionaries of Our Lady, Mr. Kuiper served as CEO of the Midwest Division of Chicago-based CommonSpirit Health. His other previous roles include CEO of the Illinois Division of Springfield, Ill.-based Hospital Sisters Health System, president and CEO of Alton, Ill.-based OSF Saint Anthony's Health Center and COO of Fort Myers-based Southwest Florida Regional Medical Center.

Mr. Kuiper told Becker's that looking back on his career, there is one budget area he avoids cutting. He discussed that area, shared the hardest day of his career and offered his perspective on the industry he believes healthcare can learn from.

Editor's note: This is a regular series of conversations with CEOs of the nation's health systems. Responses were lightly edited for length and clarity.

Question: What's an industry or business outside of healthcare that you think people could take notes from? 

E.J. Kuiper: The industry that comes to mind for me is the banking industry. And the reason I'm bringing it up is for those of us that are old enough, we probably remember that at one point, not all the debit cards when you went to an ATM were speaking to one another, so you had to go to certain banks to pull some money out of the ATM. And at one point, the banking industry decided to unify with one system. And really, the system that you have right now is all banks throughout the world almost fully connected. We could fly to Europe tonight and tomorrow morning in London or Paris or Rome, wherever we might be going, we're going to be able to look at our account balances, our checking and savings account balances. 

The reason I was thinking about that is in healthcare, we still need to do a much better job connecting our electronic health records. There's still too much of a disconnect for a patient. It shouldn't matter where you live, which facility you seek your care from, there should be an electronic health record that you carry with you. And we as an industry have not figured it out yet. Now, we as a healthcare system, obviously, within our $4 billion system, have figured it out. We also have a lot of satellite facilities, hospitals and clinics that are on our version of Epic. But I think if you zoom out and you look at it at a national level, I think as an industry, we need to do better.

Q: What's the most difficult choice you've had to make for your organization this year? 

EJK: Generally speaking, the most difficult decisions are when there's a financial downturn, and you have to lay off parts of the workforce. I believe the reason we are very careful in our growth plans, and the amount of people that we invite into our FMOLHS family is because we want to make sure that we never get to the point that we grow too fast, or when the economic environment changes, that we have to sit across the desk from somebody and tell them that we no longer have a job for them. 

You know that sometimes you have to do it to protect the mission, to make sure that we can sustain the mission well into the future. But it doesn't take away the fact that you're dealing with human beings, people that show up every day for work, but have a big heart, a passion for our mission. No matter how much you can rationalize the decision and know that it's the right thing to do, it doesn't take away the heartbreak associated with it.

Q: What was the hardest day of your career? How did you get through it?

EJK: The most challenging day was probably going back to my years with Nashville, Tenn.-based HCA Healthcare. I was a chief operating officer in the Fort Myers market, and one of the hurricanes that tends to pop up in the Gulf from time to time this time of the year directly hit the Fort Myers area. HCA had two hospitals at the time: Southwest Florida Regional Medical Center and Gulf Coast Hospital. I was based at the largest of the two facilities. As the hurricane started making a turn and crossed Sanibel Island, right into Lee County and Fort Myers, we knew that both our hospitals were going to get hit pretty hard, and they did. It just happened to be the facility where I was not based. I was in the command center at Southwest Florida Regional Medical Center, but we sustained significant damage at Gulf Coast Hospital. So the county was without electricity for close to a week. We had to, with the help of the National Guard, move from Southwest to Gulf Coast to assess the damage there, and we had to shut down that hospital overnight because there were significant roof leaks and water damage. And so we had to transfer all the patients, with the help of EMS and other volunteers, back to our larger facility. 

That was a very difficult day. It was a very difficult week. But I will say that I do look back on that week also with great pride of the team that did whatever it took to take care of the patients that we had in our care. That was the most difficult time during my career, but also the one that I feel we accomplished the most as a team to take care of our community. 

Q: If you could go back in time 10 years, what would you tell yourself to start doing, or start learning about? What ended up being a bigger deal than it might have seemed at one point? 

EJK: I've always been people-centric and always understood the power of a highly engaged workforce. But I believe if I could go back 10 years in time, I would tell myself to never cut the budget for leadership development. At the end of the day, whether you have 18,000 team members like we have in our system, or you have 1,800 or 180,000 people, it's really the leadership team, the managers, the directors, that drive your success. Sometimes during economic downturns, you tend to want to or you have the need to cut the budget, and leadership development sometimes is high on that list. And really it should, at all times, be protected. Without a highly engaged, highly educated, highly mission-centric leadership team, we wouldn't be successful here at FMOLHS. So I would tell myself, no matter how big the need might be or the temptation to cut dollars there, I would advise myself to never do so.

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