From Nurse to CEO: Q&A With Marina Del Rey CEO Fred Hunter

Fred Hunter, RN, president and CEO of Marina Del Rey (Calif.) Hospital, has an interesting perspective as a hospital leader because he began his career as a nurse. Mr. Hunter's first nursing job was as a vocational nurse, after which he returned to school to earn his RN and bachelor's degree in nursing. He worked at the bedside and entered into middle management, where he worked in the emergency department and critical care. In 2003, he graduated with a master's in business administration. Below, he discusses how his experience as a nurse has helped shape his leadership style and decisions as CEO of a hospital.

Q: How has your experience as a nurse affected your leadership style?

Fred Hunter: I think the most important thing is that it actually helped me be more process-oriented and outcomes driven, as well as understand that nothing can be achieved without a team. [This perspective] works well for the vision for a hospital as a whole.

So, when I'm looking at patient satisfaction, I'm looking at all the processes involved to achieve those metrics as outlined by value-based purchasing and understanding that there are several steps, [such as] how you introduce yourself to patients.

Q: How does your nursing background influence the decisions you make as a hospital CEO?

FH: What drives me is the patient. It's [all] about patient care. I model initiatives around the fact that this is about a patient, and no matter what the strategy might be, it's really about the patient.

When I was working as a director, I would be the one to receive patient complaints. [I learned to understand] that when you listen to patients about their experience it may be right or wrong, but their perception is really what you're dealing with. You have to create an environment so their perception is a positive experience.

Q: How has your experience influenced how you interact with nurses and employees at the hospital?

FH: Even to this day, I'm able to put myself in the nurses' place or employees' position, understand what they [may be] experiencing at a point in time and explain my vision. I'm able to empathize with them [regarding] the challenges they're going to experience and put in safeguards to address those concerns that they may experience. They may not always tell you [their concerns]. I'm able to draw it out of them because I can say "I remember when…" I have been in situations in the past where an idea is a great idea, but the process implemented is not the best process. So, you want to drive it back to people who have their hands with the patient: "What do you think is the best process to achieve this goal?"  They have to be involved, committed. If the hospital CEO doesn't involve them, I do believe chances of failure will increase markedly.

Q: How do you involve employees in the hospital's vision?

FH: It is important that the CEO is visible to employees and the medical staff. Unfortunately, it's not an easy task to achieve; it requires time by the CEO to make [him or herself] visible in spite of all the responsibilities the CEO might have. I do believe that the employees want to see me. I do believe that rounding in all the departments periodically is valuable; it gives that individual, whoever may be on duty at that time, an opportunity to talk to me about their successes, to talk to me about concerns. Employees almost always have great ideas. I believe that they care about the hospital and want to make it better. So that's one mechanism I do utilize.

Another method I incorporate is employee forums. I will try to set up several over a period of a week [on a] quarterly [basis]. Anybody can come as they are able to come, and that gives me and the employees an opportunity to, as a group, interact and dialogue on certain activities within the hospital. I share what I'm thinking, then they can share with me their thoughts on those ideas. They always have an opportunity to give me thoughts on what else we can do for their own agenda. You always need to handle that very delicately. Sometimes, I don't like what I hear, but it's the truth and I need to listen.

Another method that I use, also on a monthly basis, is I have a breakfast with night staff and lunch with day shift staff. All this is really attempting to improve communication. The more opportunity that I have to interact with everyone and for them to interact with me, the better communication is. The breakfasts and lunches are by invitation, and my director of human resources works with me to select random folks from different areas of the hospital. That's actually turned out quite beneficial because now everybody knows each other. People are more comfortable sharing personal aspects of who they are, which is extremely valuable in building trust in the relationships that they have with me.

Q: Is your strategy for engagement different for physicians compared to nurses and other employees?

FH: Medical staff is a bit more formal. I attempt to visit with physicians when I do my rounds. I also try to keep an open door policy at all times. If the medical staff wants to talk to me about anything, I always try to make my time available to them, because their schedules are so strict — there are several hospitals they visit in a day. While they're here at my hospital and want to stop in, it's very important that I allow that audience.

I attend medical staff committee meetings, where I try to update them on activities within the hospital. We [also] have a biannual medical staff meeting. If they have not been able to attend one of the department meetings, they can come to the medical staff meeting where I have an opportunity to speak with them, hear what's happening, share what we're doing and how they can assist and how it impacts them. [In addition,] hallway discussions are always spontaneous and always very useful.

Related Articles on Hospital Leadership:

Leading Change With Vigor: 6 Questions and Answers for Hospital CEOs
A Relationship Checklist for Hospital CEOs: 7 Behaviors to Ace

10 Traits of Top Healthcare Leaders

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