'Fail fast and fail forward': BJC HealthCare's CEO on learning from mistakes

As president and CEO of St. Louis-based BJC HealthCare, Rich Liekweg is facing the same challenges as other leaders in the industry, including inflation and workforce shortages. But he said there are opportunities for his organization amid these difficult circumstances. 

Mr. Liekweg joined BJC HealthCare in 2009 as president of Barnes-Jewish Hospital and group president for the health system. In 2015, he was promoted to executive vice president and subsequently president of BJC HealthCare. He has served as the health system's president and CEO for the past five years.

Mr. Liekweg told Becker's he's looking forward to BJC HealthCare celebrating three decades as a system as well as initiatives such as a new campaign focused on what patients "deserve" and a flexible staffing and scheduling app for nurses. He shared his top priorities, discussed a few of the top challenges facing hospital CEOs and offered some advice for his peers.

Editor's note: Responses were lightly edited for length and clarity.

Question: What has you most excited about your role at BJC HealthCare?

Rich Liekweg: While admittedly it is a challenging time for the industry, I am excited about the opportunities for BJC HealthCare as an integrated academic health system. We have a long history in St. Louis and across the region — some of our facilities have been serving our communities for over a century — and this year we're celebrating 30 years as a system. BJC HealthCare is one of this country's first healthcare systems formed via a joinder agreement between a few hospitals and provider organizations. 

I'm particularly excited about this milestone, because earlier this year we launched a new campaign: "You deserve extraordinary care." While the campaign is new, the promise is not. Everything we do is about the people in our communities and beyond who look to BJC for care. Healthcare is a basic human right.

By infusing this promise into everything we do, we're creating that extraordinary experience in all our touch points. We're creating more cohesion among our employees and across our sites of care, which will raise the bar on the quality of care and the experiences we create for our patients. And it positions us well to continue making advances in achieving health equity in our region.

I'm also excited about how our affiliation with Washington University and its school of medicine continues to redefine the frontiers of medicine and expand access to the innovation incubator on our academic medical campus. Our collaboration spans more than a century and has improved patient care and enhanced discovery. This unique collaboration supports the work and passions of our physicians, scientists and employees; it helps us to reduce the cost of care we deliver and improve the value of that care; it enhances our efforts to attract the best talent locally, regionally and from around the world and — perhaps most importantly — it provides greater, more equitable access to healthcare throughout our region.

Equitable access to quality care is the key to creating and sustaining healthy communities, in every sense of the word. Physical health, emotional health, economic health — all of it is intertwined. And we're committed to making health equity a reality in the St. Louis region and beyond. 

Q: What keeps you up at night the most right now?

RL: We're challenged with many things in the industry right now — labor shortages, inflation, increasing healthcare costs, reimbursement, digital and AI advances, the continued inequities and disparities in healthcare and the political agendas threatening the special relationship that exists between an individual and their physicians and providers. All of these challenges keep me awake many nights. Yet, I see a lot of opportunity for innovation coming from some of these challenges and that also keeps me awake — but with a drive toward and excitement about what we can and will accomplish. 

One of those things is the promise I mentioned earlier — our promise to deliver extraordinary care to anyone who connects with us. Our patients, families and employees deserve that. That means being forward-looking and understanding our headwinds while ensuring we have a strong strategy in place to keep moving forward and innovating. It means reflecting on what we've done well and keeping the momentum going to build on those accomplishments. It means thinking differently about what our patients, our employees, our providers and our communities need in this ever-evolving industry and then implementing strategies to make those things happen. 

I feel hopeful because I know we have the talent, the creativity, the systems and the culture in place to thrive. 

Q: What are a few of your top priorities for the rest of 2023?

RL: To ensure we're keeping the promise of delivering extraordinary care, we're focused on three top priorities this year: People, which includes our patients, our caregivers (our employees), our physicians and providers, and our community; growth, which allows us to expand access to our care, fuel more jobs in the region, and serve more people within and beyond our region; and value, which is all about holding ourselves to the highest standard related to the care we're providing and its value to our customers.

When we think about people, we're thinking about ways to attract and retain the best talent so we can, in turn, deliver the best care. We're thinking about what work looks like in this new post-pandemic world and how we can adapt to give our employees more flexibility and support our providers. And we're thinking about how we can provide even more support to our community through our community health improvement efforts, which range from working with local businesses and institutions that provide housing, educational opportunities and jobs to address racial and economic disparities; participating in novel programs to improve access to healthy foods to address disparities in diabetes outcomes; and creating positive social impact through local banking. 

BJC was the first anchor institution in the region to become an impact banking depositor at two financial institutions — Midwest BankCentre and St. Louis Community Credit Union, which are committed to investing more in economically distressed areas to create opportunities for residents through access to capital. This helps create healthier, more vibrant communities by intentionally leveraging their balance sheets toward neighborhoods that have experienced historic disinvestment. These are the types of community efforts that have great reach, and we're committed to expanding efforts like these. 

Our growth efforts are aimed at making an even greater impact within the community, expanding access to our services, and advancing our efforts to achieve greater health equity and creating more jobs. As the largest employer in the region, we have a responsibility to create jobs for those most under-resourced as well as to use our spending and purchasing power to support local minority and diverse communities and begin to bridge the gap that has divided us for so long. 

And when we think about value, it's all about how we can improve our care delivery efforts to ensure we're continually providing the extraordinary care people deserve, in a way that lowers the total cost, while still prioritizing innovation, research and education, and improvements in areas like technology and facility upgrades. 

Q: BJC HealthCare recently released four new commercials focused on patient experiences. The campaign features the tagline "You deserve extraordinary care," which reiterates the concept that patients deserve the best hospitals, latest treatments and expert advice. What does this concept look like on the ground?

RL: We believe access to quality care is a fundamental right. We believe everyone in our region — and beyond — should have the chance to live their healthiest life. And most importantly, we believe everyone deserves extraordinary care.

For most of its 30-year history, BJC HealthCare's hospitals have operated under unique identities based on the needs of their local patient populations. The healthcare needs of St. Louis and the region have continued to evolve and become more complex, which requires new approaches to the delivery of extraordinary care. As we move into the next 30 years, BJC will continue to evolve and adapt. We've seen firsthand through the experiences of the pandemic what happens when we come together more intentionally. We learned so much about the pace of change. We can move faster than we ever thought we could. We learned how to be agile, how to try a lot of things quickly and use that feedback to course-correct, if needed. Now, we are committed to taking what we learned, building from those learnings and driving greater change. We needed to do things in a new way and we did — and now it's important we keep moving forward. 

BJC serves communities in Missouri and Southern Illinois — urban, suburban and rural — with a wide range of services, from primary care to surgical procedures not offered anywhere else in our region. We have nationally-recognized academic hospitals affiliated with Washington University School of Medicine, and we have exceptional community hospitals — and when we bring all those entities together, we're able to deliver personalized, accessible care that is unique to our system. Our hospitals and health services are working together in new ways to coordinate care for our patients. This means that no matter where you start your relationship with BJC — whether it's in an emergency room in St. Louis or a physician's office in Alton, Ill. — we're going to work together as a health system to ensure you receive the right level of care, at the right location, at the right time.

Q: BJC HealthCare also recently piloted its new flexible staffing and scheduling app for nurses. How has this affected recruitment?

RL: Our workforce is always our top priority. The reason BJC is able to deliver the extraordinary care our community expects from us is our 30,000 caregivers — employees, who give their all to providing that care. The pandemic years have been hard on our staff. That's not unique to us. And the mental health of our employees is very important to us. So we've listened to our employees about new ways they want to work and the types of flexibilities they are looking for. And we've started to innovate on how to better meet their needs. 

As a result of that work, BJC is piloting an app at Missouri Baptist Medical Center and Christian Hospital that allows nurses to select available shifts on their phones. Being innovative and meeting the staff where they are to achieve work-life balance and job satisfaction is extremely important to retention and satisfaction. 

We're looking forward to rolling this app out across all of BJC in May during National Nurses Week. We believe this will continue to aid in our recruitment and high retention rates, and give our nurses the flexibility they need so they continue to bring their best selves to our patients every day. 

Q: What is one pandemic lesson that will stick with you in 2023 and beyond?

RL: Sometimes it takes a real crisis to show what we're made of, and the pandemic presented such an opportunity. At the height of the crisis, our ability to quickly and efficiently mobilize and organize resources, set up a command center and orchestrate all of the critical pieces coming together was the key to saving lives. We stepped up and made it happen. Our 30,000 employees — the real heroes of the past few years — made that possible. In the past, these changes would have required extensive planning and deliberation, which take time. The urgency of the situation forced us into being innovative, partnering with others, taking more risks on the spot and course-correcting in the moment. And it worked. We found we could move much faster than we thought we could. Perfection was not our goal, interacting along the way to continually improve was, and I don't want us to lose that learning. We have to build from there and make that our standard mindset. 

Q: If you could pass along a piece of advice to other hospital CEOs, what would it be?

RL: I talk a lot about the incredible, diverse talent we are fortunate to have at BJC. And one thing I've learned, especially over the past few years, is that empowering a diverse and inclusive group of leaders will help move the organization forward. We have to show them that we will be there for them, that we'll support them and guide them when needed, but we have to let them lead. Giving leaders autonomy over decisions and allowing them to demonstrate their talents helps accelerate and drive accountability and results. When they know and feel they're valued, supported and heard, they bring their best to their teams and patients every day. 

I would also add that we have to get comfortable with not always getting it right and making mistakes. As CEOs, we must create a learning environment and culture that embraces innovation and learns from mistakes. And the faster we can do that, the better — we can learn, iterate, and move forward. Waiting for everything to be perfect before acting means we're going to be waiting for a very long time. Fail fast and fail forward. What we don't get right the first time will turn into invaluable learnings and even better outcomes.

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