David Feinberg, MD, MBA, serves as associate vice chancellor and CEO at the UCLA Hospital System in Los Angeles, one of the leading hospital system's in the Western United States. In his position, which he's held for just under three years, Dr. Feinberg oversees Ronald Reagan UCLA Medical Center, the No. 3 hospital in the nation in 2009 according to U.S. News & World Report, as well as Santa Monica UCLA Medical Center and Orthopaedic Hospital, Mattel Children's Hospital UCLA and the Resnick Neuropsychiatric Hospital at UCLA, where he previously served as medical director. The health system has a staff of more than 2,000 physicians and patients visit the system's clinics more than one million times annually and enter its hospitals more than 80,000 times a year.
Q: What has been the biggest challenge you've faced as CEO of UCLA Hospital System?
Dr. David Feinberg: The biggest challenge I have is making sure that the very next person that walks through our doors receives safe, compassionate and high-quality care. UCLA has a history of incredible research and innovation, but we weren't always known for providing the most friendly and compassionate care. When I took over three years ago, despite [Ronald Reagan] being one of the top hospitals in the nation by U.S. News & World Report, most patients said that they would not refer us to a friend. We scored in the 38th percentile for that question. I realized that this was something that we needed to focus on, and I have made it my singular concern over the last two and a half years. Now, most of our units score in the 99th percentile for that question. Our goal is to make sure that the next patient we see receives the same compassionate care that we would give to our own family.
Q: How was the transition for you from serving as the medical director of a psychiatric hospital to the CEO of a full-service medical center and health system?
DF: When I was serving as the medical director at [Resnick], we were in a very old building that was very beat up. Nearly 40 percent of the patients we treated were admitted involuntarily. Yet, despite that almost half of our patients were forced to come to us, 90 percent said at discharge they would refer us to a friend. When I came into my new position, I realized that this compassionate care was lacking in other parts of the system. We were the place patients came for incredible medical miracles, but we had missed the boat on connecting emotionally with our patients. At the time, [Ronald Reagan] was also in an old facility, and there was a general consensus that it would all get better at the new facility [editor's note: Ronald Reagan UCLA Medical Center completed its transition to a new facility in June 2008]. But I came from a facility that was old, too, and 90 percent of those patients would still refer us to others. We should be able to do that here. I then tried to take what I had seen to be effective in a 75-bed psychiatric hospital to a much larger hospital system. It's been my singular focus to make that small hospital feel part of this large academic medical center.
Q: What were some of the tactics you used to bring that small-hospital feel to the overall system?
DF: We changed everything. From a senior leadership standpoint it was and is my singular focus. In meetings, we always talk about patients first, not finance, because patients are the most important thing here. The entire senior leadership team has to meet with patients. I spend about half of my time walking the halls and meeting with patients. Even the CFO and non-clinical leaders do this; 250 managers fan out every week. They ask patients questions like, "How is the care you're receiving?" and "Is there anything I can do to make you more comfortable?" I give every patient I see my business card and cell phone number and tell them to call if they ever need anything or if they ever have a friend coming into our emergency department. Now, often I see five or six business cards already in a room because other people have been in to see them. When the frontline staff sees people in suits walking around it helps them see that the most important thing we have here is our patients.
Then, not to use an industry buzzword, but we put in very strong hardwiring to make that idea consistent. We use Talent Plus to help in employee selection. It assesses possible hires to ensure they are service-minded, and we use it on every level of employee from housekeeping to department chairs. Everything here is also scripted — from the valet who greets you with "Welcome to the best hospital" to the nurses who always introduce themselves as they enter a room. The physicians here also have to undergo training on how to enter a patient room, look [patients] in the eye and deliver good or bad news. We've also really made an effort to push care to the bedside. Nurses give patients a direct phone line to reach them so they do not need to be by the nurse's station. Our nurse's station is almost always empty.
Q: When did you realize you were interested in administration?
DF: I studied economics at Berkley and after earning my medical degree I ran a child psychiatry clinic. So I was always doing some form of administration. I started business school [at Pepperdine University] because I thought I could probably leave UCLA and get some dream job. However, I learned two things in business school. One was how to use Excel, and the second was that I already had my dream job. At that time, I was medical director of [Resnick], so I used that as my lab to implement all these things I was learning in business school. The job I had was what I wanted to be doing, I just didn't have the tools and knowledge to realize that at first. I would have been happy running that hospital for the rest of my life if this opportunity hadn't come along.
Q: What is the best piece of advice you received when taking on the role of CEO?
DF: I got some great advice when I took on this role from my good friend Bill Simon Jr., who ran as a Republican candidate for California Governor in 2002. He told me that when I started this job I was going to be faced with a thousand decisions and projects and that no one is going to remember any of it. He told me to pick one or two things and do it really well and focus on that. That advice has been very helpful. At first, I didn't know what that one thing would be, but after a few months of visiting with patients it became very clear to me that the one thing was the culture here. We had to change from "Isn't it a privilege for you to see us?" to "It is a privilege for us to treat you."
Q: With all the uncertainty and concern surrounding health reform, would you like to share any of your thoughts on the issue?
DF: I really think that if you take great care of the patient — not only treating them with respect but with high-quality care that's low cost or cost-effective — it won't matter what happens in healthcare reform. Every hospital belongs to its community. It's a resource, much like the police or fire department. Our friends trust our lives to us at their most vulnerable times, and I think that if we do right to them they will make sure they take care of us. If we care for them with compassion and high-quality care, I think they will reciprocate that to us regardless of what happens in healthcare reform.
Learn more about UCLA Hospital System.
Q: What has been the biggest challenge you've faced as CEO of UCLA Hospital System?Dr. David Feinberg: The biggest challenge I have is making sure that the very next person that walks through our doors receives safe, compassionate and high-quality care. UCLA has a history of incredible research and innovation, but we weren't always known for providing the most friendly and compassionate care. When I took over three years ago, despite [Ronald Reagan] being one of the top hospitals in the nation by U.S. News & World Report, most patients said that they would not refer us to a friend. We scored in the 38th percentile for that question. I realized that this was something that we needed to focus on, and I have made it my singular concern over the last two and a half years. Now, most of our units score in the 99th percentile for that question. Our goal is to make sure that the next patient we see receives the same compassionate care that we would give to our own family.
Q: How was the transition for you from serving as the medical director of a psychiatric hospital to the CEO of a full-service medical center and health system?
DF: When I was serving as the medical director at [Resnick], we were in a very old building that was very beat up. Nearly 40 percent of the patients we treated were admitted involuntarily. Yet, despite that almost half of our patients were forced to come to us, 90 percent said at discharge they would refer us to a friend. When I came into my new position, I realized that this compassionate care was lacking in other parts of the system. We were the place patients came for incredible medical miracles, but we had missed the boat on connecting emotionally with our patients. At the time, [Ronald Reagan] was also in an old facility, and there was a general consensus that it would all get better at the new facility [editor's note: Ronald Reagan UCLA Medical Center completed its transition to a new facility in June 2008]. But I came from a facility that was old, too, and 90 percent of those patients would still refer us to others. We should be able to do that here. I then tried to take what I had seen to be effective in a 75-bed psychiatric hospital to a much larger hospital system. It's been my singular focus to make that small hospital feel part of this large academic medical center.
Q: What were some of the tactics you used to bring that small-hospital feel to the overall system?
DF: We changed everything. From a senior leadership standpoint it was and is my singular focus. In meetings, we always talk about patients first, not finance, because patients are the most important thing here. The entire senior leadership team has to meet with patients. I spend about half of my time walking the halls and meeting with patients. Even the CFO and non-clinical leaders do this; 250 managers fan out every week. They ask patients questions like, "How is the care you're receiving?" and "Is there anything I can do to make you more comfortable?" I give every patient I see my business card and cell phone number and tell them to call if they ever need anything or if they ever have a friend coming into our emergency department. Now, often I see five or six business cards already in a room because other people have been in to see them. When the frontline staff sees people in suits walking around it helps them see that the most important thing we have here is our patients.
Then, not to use an industry buzzword, but we put in very strong hardwiring to make that idea consistent. We use Talent Plus to help in employee selection. It assesses possible hires to ensure they are service-minded, and we use it on every level of employee from housekeeping to department chairs. Everything here is also scripted — from the valet who greets you with "Welcome to the best hospital" to the nurses who always introduce themselves as they enter a room. The physicians here also have to undergo training on how to enter a patient room, look [patients] in the eye and deliver good or bad news. We've also really made an effort to push care to the bedside. Nurses give patients a direct phone line to reach them so they do not need to be by the nurse's station. Our nurse's station is almost always empty.
Q: When did you realize you were interested in administration?
DF: I studied economics at Berkley and after earning my medical degree I ran a child psychiatry clinic. So I was always doing some form of administration. I started business school [at Pepperdine University] because I thought I could probably leave UCLA and get some dream job. However, I learned two things in business school. One was how to use Excel, and the second was that I already had my dream job. At that time, I was medical director of [Resnick], so I used that as my lab to implement all these things I was learning in business school. The job I had was what I wanted to be doing, I just didn't have the tools and knowledge to realize that at first. I would have been happy running that hospital for the rest of my life if this opportunity hadn't come along.
Q: What is the best piece of advice you received when taking on the role of CEO?
DF: I got some great advice when I took on this role from my good friend Bill Simon Jr., who ran as a Republican candidate for California Governor in 2002. He told me that when I started this job I was going to be faced with a thousand decisions and projects and that no one is going to remember any of it. He told me to pick one or two things and do it really well and focus on that. That advice has been very helpful. At first, I didn't know what that one thing would be, but after a few months of visiting with patients it became very clear to me that the one thing was the culture here. We had to change from "Isn't it a privilege for you to see us?" to "It is a privilege for us to treat you."
Q: With all the uncertainty and concern surrounding health reform, would you like to share any of your thoughts on the issue?
DF: I really think that if you take great care of the patient — not only treating them with respect but with high-quality care that's low cost or cost-effective — it won't matter what happens in healthcare reform. Every hospital belongs to its community. It's a resource, much like the police or fire department. Our friends trust our lives to us at their most vulnerable times, and I think that if we do right to them they will make sure they take care of us. If we care for them with compassion and high-quality care, I think they will reciprocate that to us regardless of what happens in healthcare reform.
Learn more about UCLA Hospital System.