Living like a leader: A day with University of Iowa Hospitals & Clinics CEO Suresh Gunasekaran

Gunasekaran_Suresh 2018 1a.jpg"I'm a big believer in management by wandering, so I will often leave my office a bit early and pop into different departments on my way to a meeting. I'll often round for 15 to 20 minutes on my way to meetings, because there is always a lot to see, a lot to learn and a great chance to refine my thinking by observing what happens on the front line by talking to patients and staff."

Between driving growth, meeting clinical objectives and navigating complex payer dynamics, there don't seem to be enough hours in the day for healthcare executives.

Leaders succeed despite these challenges, each with their own habits, hacks, styles and methods — and Suresh Gunasekaran, the CEO of University of Iowa Hospitals & Clinics and associate vice president for the University of Iowa Health Care, is no exception.

Mr. Gunasekaran, a seasoned healthcare leader with more than 20 years of experience, joined the Iowa City-based academic medical center as CEO in November 2018. In his CEO role, he oversees operational strategic and financial performance for the UI Hospitals & Clinics, an 811-bed hospital with more than 37,000 inpatient visits and 58,000 emergency department visits annually. As associate vice president Mr. Gunasekaran works to advance the organization's three-part mission of excellence in biomedical research, medical education and training and patient care.

Prior to UI Hospitals & Clinics, he served at the University of Texas Southwestern Health System in Dallas as assistant vice president and CIO for 10 years and COO for five years.

Here, Mr. Gunasekaran speaks with Becker's Hospital Review for our "Living like a leader" series, which examines the daily routines of influential decision-makers to offer readers an idea of how they manage their energy, teams and time.

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

Question: What is the first thing you do when you wake up?

Suresh Gunasekaran: I get up, get ready and get out the door as fast as I can. I have two reasons. First, I like my sleep. Second, I like to do most of my work at work. Usually on the way to work I will talk to my wife or my mother on the phone. My commute is about 20 minutes. I arrive to the hospital between 7 a.m. to 7:30 a.m.

Q: What's the first thing you do when you arrive at work?

SG: On a normal morning, I will walk through the front door like a patient. This allows me to start my day off by speaking with patients. It's great to understand how our patients see us when they walk in, and it reminds me of why we are here. When I get to my office, I usually walk the hallway where the executive team is located. I like to touch base with the team in the morning, see what's on their minds and connect on major things they're working on. It's a great way to gauge what's going on with the team, but it's also a great way for me to start my day with a lot of energy and feel the pulse of what's going on.

Q: Is there anything that makes your office setup unique?

SG: My office has a lot of room to walk and pace. I like to walk, and when I'm at work, I walk about five to six miles a day traveling between buildings and pacing when I am on the phone. I also have a big electronic smart board. I like writing things out on this because it allows me to think about things in a different way and share those thoughts with team members.

Q: What does your routine look like in the morning versus afternoon?

SG: While there isn't one set pattern, the mornings are more likely to be collaborations with the community or other health systems. I try to make sure I always end my day in the office so I can respond to emails or complete document reviews. However, there are always exceptions.

Q: How often do you round or meet with clinical staff?

SG: I schedule rounds once a month. However, functionally, I round weekly. I'm a big believer in management by wandering, so I will often leave my office a bit early and pop into different departments on my way to a meeting. I'll often round for 15 to 20 minutes on my way to meetings, because there is always a lot to see, a lot to learn and a great chance to refine my thinking by observing what happens on the front line by talking to patients and staff. The structured, scheduled rounds are when I round with the leadership teams. But informally I pop into different areas of the hospital quite often.

Q: How much time do you spend with your direct reports?

SG: I have one-on-one meetings with my direct reports scheduled in advance. Those meetings would probably comprise about 10 percent of my time. However, I collaborate with them on a lot of efforts, which would make it closer to about 40 percent of my time spent with them. My style is to partner with my direct reports on various initiatives and programs we are developing for the institution. We spend a lot of time together working with others to implement them.

Q: How do you think your routine differs from that of other healthcare executive?

SG: Healthcare is a team sport in every hospital, but successful academic medical centers really rely on a high level of collaboration and synergy between the faculty physicians and the hospital system. So I think the main difference in my routine is that I spend a significant amount of time working with the leadership of the medical school and the individual department chairs on developing a shared vision for excellence and making plans for how we can reach ever higher levels by working together to implement different initiatives in our own spheres. I think that we partner on the full life cycle of management — not just strategy, not just operations, not just finance, not just quality. We know we are only going to be successful across all domains if we really work together on all the initiatives.

Q: What is the hardest part of your day?

SG: We hold ourselves to a very high standard at UI Hospitals & Clinics and sometimes, very rarely, we don't hit that standard. Rarely are setbacks the result of staff not doing a good job; instead they are related to not having the right processes and systems in place to support our staff or patients. I take a lot of personal responsibility for those failures, and I think that's probably the hardest part.

Q: What would you consider the most rewarding?

SG: I think one of the most rewarding things is that we serve patients from all 99 counties of Iowa and are the only academic medical center in the state. Having the ability to serve the entire state, across all services, regardless of ability to pay, is a tremendously rewarding opportunity for us. Additionally, being a leader in this kind of environment is really an honor.

Q: What is the last thing you do before you leave your office?

SG: I really focus on responding to all emails before I leave. I also try to connect with key members of the organization by the end of the day. I like leaving knowing I've done my best to touch base and communicate with the key leaders around the organization. That way, we close every day with a level of clarity around where we are and what we are trying to do, and hopefully we make achieving our future goals a little more possible.

Q: Do you work at home?

SG: This is probably a bit unusual for a hospital executive, but the answer is pretty much no — I don't work at home. I think my wife would be the first to say that I consistently scan my email. But I won't respond to emails unless they are pressing. We have processes in place to contact me if something urgent is happening. A big part of my professional success and my personal wellbeing is having a good work-life balance. I spend a lot of time with my family, my wife, my kids, our friends and the community outside of work. I really like to leave work at work, so I am highly focused on work when I am there. It is also mentally satisfying to think about other things that enrich my life when I am not at work. Occasionally I will work from home on major projects where having some dedicated private thinking and reflection time is useful.

Q: How do you unwind at the end of the day?

SG: Usually with my wife, talking about the family, the world and everything that's not work-related. We have a lot of activities with our kids and other families, too. We also travel a lot. If I am lucky and there is time left during my evenings, I play tennis or I might catch a concert.

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