Q: What attracted you to Mission Hospital?
Peter Bastone: I came from Daniel Freeman Memorial in South Central Los Angeles. I saw with Mission an opportunity to be part of what was at the time a new Catholic healthcare ministry. [Editor’s note: Mission Hospital was acquired by St. Joseph Health System in 1994]. There had not been a Catholic hospital in this region of the county, and I saw an opportunity and a challenge to take my previous experience working in Catholic healthcare and bring it to a new ministry.
Q: What accomplishment are you most proud of during your time at Mission?
PB: I really see myself as a servant leader in the sense that the hospital’s success is not mine. I don’t want to take credit for it alone. I work in partnership with our physicians, staff and benefactors. That said, the thing I’m most proud of is that the clinical expertise and clinical outcomes that are occurring here are some of the best in nation, if not the rest of the world. Protocols developed here by our physicians and nurses, such as our traumatic brain injury protocol, are now used by hospitals from the Mayo Clinic to John Hopkins. Our rapid response team, which is comprised of nurses who work to reduce death associated with non-ICU cardiac/respiratory arrests, have reduced the mortality rate for patients with cardiac or respiratory arrests outside the ICU by 40 percent.
The staff here also understands the challenge of being in healthcare and is committed to vigilant stewardship of the gifts this hospital receives. The gifts we receive for our programs are truly a gift for the community and help us in caring for our dear neighbors.
Q: What is the most important lesson you’ve learned over the course of your career?
PB: The biggest lesson for me is it’s not what you do, it’s how you do it. The days of being a hospital operator who is completely focused on cost is gone. You can’t have a knee-jerk reaction of cutting 10 percent across the board when you need to make cuts. You have to be very strategic about what you do when the house is on fire or when you’re managing growth. It takes a great deal of strategy to deal with a business model that doesn’t really work. You have to continually reinvent the organization and be a constant learner; think outside the box. With the explosion of the Internet, there is this response to be tied to the computer, but I’m an old-school kind of guy. I’m originally from Chicago, and I think back to growing up there and of the Daley political machine. You have to get out of your office and be seen. You have to be active.
Nearly 50 percent of my job is dedicated to philanthropy. With this, you have to be out in the community and let the benefactors see you. Go out in the community and talk to neighbors and try to get a feel for what the expectations are for a true community hospital and shortcomings of healthcare in the community. You have to pull away from operations a bit to really maintain the type of vision put forth for the hospital. Don’t get too big for you britches, and don’t think you’re more important than the person that accesses your hospital. You have to value people and really step into their shoes. Have conversations with both your top neurosurgeons and your environmental service workers. You have to validate people’s work and their commitment to what they do. Being a bit of a cheerleader is certainly part of my job.
Q: What has been the biggest challenge in your career?
PB: When I started at Daniel Freeman, we needed a $30 million turnaround. The hospital had lost $30 million from operations in a year, and the challenge was reinventing the hospital. We had to close some vitally needed services for the area, but if we didn’t close them it would challenge the very life blood of the ministry. We closed a trauma center that was losing $1 million a month. That great of a loss would have closed the doors of the entire hospital, and we couldn’t have the hospital close in South Central where our services were vitally needed. We kept our ER open, and it is still the busiest private ER in LA, but we couldn’t continue to provide the trauma services. The worst thing a hospital administrator can do in this day and age is close a program, but that’s what a lot of hospitals have to take a look at. Hospitals within a community should really just put their clinical outcomes on the table and whoever has the best outcomes should get the best reimbursement so that we’re not duplicating services.
We also had to freeze salaries and lay off some employees. That’s a though thing to do, but we tried to be upfront about it. We tried to be the Lee Iacocca of healthcare by saying we’re in trouble and here’s what we have to do about it and why. The staff was resilient and they definitely came through for us, and we were able to turn the hospital around. At Mission, the difficulty is not cutting programs but managing growth, assessing the needs of the community and making sure that how we do grow aligns with the strategic plan of the hospital.
Q: What advice would you give to other hospital administrators for managing a successful hospital?
PB: Active listening is really something that most of us need to work on. Beginning upfront, you really need to try to read the organization. CEOs make the mistake that they can be seen as a peer. If a CEO seems to like an idea, staff won’t go in the other direction. I also like the idea of an executive having some exposure that if you make a mistake you need to step up and go back. Admit your mistakes. There’s an executive vulnerability that promotes loyalty and provides an environment where people feel they can take a chance and be wrong. You don’t want them to be too wrong, of course, but people need to take chances and go in another direction sometimes to bring innovation.
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