What COOs actually do: A day in the life of a NewYork-Presbyterian operations leader

A chief financial officer deals with the hospital's finances; a chief nursing officer manages its nurses. But from one enterprise to another, one role tends to vary more than most: the chief operating officer.

Becker's is touching base with healthcare COOs to illustrate what the job means to different health systems — starting with Juan Mejia, senior vice president and chief operating officer of NewYork-Presbyterian Lower Manhattan Hospital in New York City.

"At NewYork-Presbyterian hospitals, the COO role is charged with setting the campus strategy and ensuring our clinical and nonclinical teams are in line with the goals," Mr. Mejia told Becker's. "So we have the responsibility of leading the entire team together to make sure that we're moving in the right direction."

The COO is also the external-facing leader within the system, Mr. Mejia said; he frequently meets with elected officials or other community-based organizations to "ensure that our hospital is aligned with our local communities."

Here's what that looks like in action on a typical day for Mr. Mejia:

Morning meetings

The first thing Mr. Mejia does each day is watch the local news with a cup of coffee. As chief operating officer, it is important for him to understand any trending developments in New York City that could affect the hospital.

When he gets into the hospital, Mr. Mejia meets with his executive business associate to review the day's agenda and ensure they are on the same page.

Next is a "tiered huddle," a quick daily huddle with the hospital's leadership team. In less than 15 minutes, leaders from all departments identify any barriers, and discuss solutions, to address patient safety, employee or operational concerns for the day — from staffing to supply related items. These huddles occur seven days a week, and Mr. Mejia attends them as often as possible when he is in the hospital.

More meetings…

Throughout the day, Mr. Mejia has numerous other meetings both at the Lower Manhattan Hospital and with the larger NewYork-Presbyterian executive team. Oftentimes, those meetings focus on finance, patient quality and safety, operational efficiency, employee engagement and "any initiative that impacts [the hospital]," according to Mr. Mejia.

NewYork-Presbyterian has locations across New York City, Hudson Valley and Westchester, N.Y.; as an enterprise, it sets very specific goals for each hospital campus, from finance to employee engagement. It is Mr. Mejia's job to "trickle those down to the Lower Manhattan Hospital" and its individual leadership team, he said. By this time of year, in June, the hospital's leadership team is evaluating its progress on goals set for 2023.

Throughout the week, Mr. Mejia rounds with hospital staff in different departments: directors, physicians, nurses, housekeepers.

"The reason I round with staff is to ensure that I am connected to what's happening on the floors," Mr. Mejia said. "What I don't want to do is just sit in the executive office, sit in meetings throughout the day and not have a connection to the front-line staff."

Sometimes the staff rounds are specific to patient safety or quality initiatives; other times, he does environmental rounds with support and facilities staff to see where there is opportunity for improvement. Mr. Mejia is currently concerned with the high turnover and burnout rates facing hospital staff, so in the past year, the hospital has introduced employee retention initiatives to provide feedback on what is working and what needs changing in employees' environments.

"My primary goal as a COO is to ensure we have systems in place to provide high-quality care to our patients and to ensure that we're supporting our amazing employees who are caring for patients around the clock," Mr. Mejia said.

The day's end

At the day's close, Mr. Mejia often attends meetings outside of the health system, where he represents the hospital in numerous community initiatives. As a community hospital in lower Manhattan, partnerships with local external organizations are important to ensure the entities are connected.

Mr. Mejia is sure to go to the gym often, a habit that allows him to listen to music, spend time by himself and piece together his thoughts about different happenings inside and outside the hospital.

A side-role centered in LGBTQ+ equity

In addition to his primary role as COO, Mr. Mejia serves as the executive lead on the health system's LGBTQ+ task force — a subcommittee of the larger diversity, equity and inclusion steering committee across the enterprise.

His team takes on various initiatives to improve circumstances for LGBTQ+ employees and patients across the enterprise. For example, they have modified, improved and implemented policies to ensure NewYork-Presbyterian is inclusive of the LGBTQ+ population; partnered with the talent development team to create staff e-training modules that address best practices in caring for LGBTQ+ patients; and collaborated with IT partners to modify the electronic medical record to ensure that fields and data collection are inclusive and appropriate for LGBTQ+ patients and families.

"The balance of it is easy," Mr. Mejia said of juggling both roles. "As a leader, the work that we lead  influences the culture we have amongst our teams. The work for our LGBTQ+ staff, community and patients is really a subset of the greater compilation of the staff that we have, so it really fits in well with the culture we want to create across NewYork-Presbyterian."

"Although it's an additional task force I oversee, it's important work," Mr. Mejia said. "For me personally, as a gay man, I lead it with pride and it's an important pillar of a lot of the work we do here at the hospital."

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