'Handing off a treasure': Inside Rady Children's seamless CEO transition

When done properly, a handoff — from shift to shift, for example — creates continuity and consistency in a hospital setting, ensuring no balls are dropped when it comes to patient care.  

So when Donald Kearns, MD, decided (with some gentle nudging from his wife) it was time for him to step down as president and CEO of Rady Children’s Hospital-San Diego, he knew he would be instrumental in the handoff. 

After all, Rady had been his "baby" for 35 years, first as an otolaryngologist in 1987, then as president and chief medical officer starting in 2013 and then as president and CEO as of 2015. He had no intention of handing the baton off to just anybody.

In fact, though a thorough search for his replacement was conducted by the hospital, Dr. Kearns found the person he wanted to take his place on his own, courting Patrick Frias, MD, who at the time was COO of Children's Healthcare of Atlanta. Dr. Frias was reluctant to leave the hospital where he had spent his entire career, first as a pediatric cardiologist/electrophysiologist before advancing to a senior administrative role.

The retiring CEO finally won him over and Dr. Frias officially became president and CEO at Rady on Dec. 31, 2018 — the same day Dr. Kearns' quasi-retirement began. 

Dr. Kearns, who now holds the title of president emeritus, was instrumental in bringing in Dr. Frias in a way that ensured he would fit with Rady leadership and employees. And more than four years after stepping down, Dr. Kearns still comes to the hospital a couple of days a week and talks with Dr. Frias to offer advice, be a  Rady history book and support him as he walks his own walk in the hospital's top spot.

"I got up every day and thought about this organization that I've had the privilege of leading. I wanted to find someone who was in lockstep" with Rady's mission, Dr. Kearns said. "It's important to know he has his own way of managing people and his way of relating to people. But it was fairly easy early on for me to know that Patrick was going to be a perfect fit and that the organization was going to fall in love with him.

The goal was to make sure there was no change in the quality of patient care. "I knew I was handing off a community treasure and, together, we worked to ensure a seamless transition in leadership," Dr. Kearns said.

For the first six months of Dr. Frias' tenure, Dr. Kearns was a go-to resource for the new CEO. With Dr. Kearns by his side, Dr. Frias networked with benefactors, the senior staff and the entire employee base at Rady. As proof of the alignment between the two, Dr. Kearns said together they raised $250 million in donations in 2019, including "a landmark $200 million gift from our main benefactor for a new tower. We were able to do that because we were aligned and our transition reflected that this organization wasn't going to skip a beat" despite the change in leadership.

Dr. Frias agreed, recalling a question from one of his initial interviews. "Someone asked me, 'What's in your heart? What's your purpose? What's your true north?' When I answered, they saw that Dr. Kearns and I are pretty similar," he said. "I like to think that helped when I spent 20 percent of my time during my first year here going to every department in the hospital and organization in the city. I spent time with them in a way that really helped the transition."

Of course, at the time, in 2019, neither man knew what was in store in March 2020. 

"Taking the time to get to know people across the system — from environmental services to our urgent cares and everyone in between — really helped us when the pandemic hit and life changed for everybody," Dr. Frias said.

When he took over at Rady, Dr. Frias started a blog and wrote about initiatives happening throughout the hospital. When he met with the supply chain team, he wrote about it and posted photos. He did the same when he met with the environmental services team — and for meeting after meeting after those.

"I've been in healthcare my whole career, but every institution does things a bit differently," Dr. Frias said. "You really learn the fabric in the DNA of a hospital when you come with fresh eyes. I saw the passion that people here have for the kids we care for. I learned about Rady's mission and how things had always been done."

He added that having Dr. Kearns often only a phone call away allowed him to infuse his own ideas and style with the status quo — for the better.

The important takeaway, both doctors agreed, is the transition was never meant to fix something that was broken.

"I'm just somebody passing through this role. It's not about me. It's how the person in this role serves our institution and our community," Dr. Frias said. "The real question was, 'How do we evolve to serve the next generation?' That's what I came to do."

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