Leading the way: Scripps Health CEO takes hands-on approach to frontline staff engagement

Chris Van Gorder's rise up the corporate ladder was unconventional to say the least. Once a clerk in a hospital emergency room, he had stints as a hospital security officer, clinical laboratory manager and years as a police officer long before climbing to the ranks of CEO and president of Scripps Health in San Diego.

Perhaps that's why he is such an advocate of frontline leadership, a common-sense approach to engage and interact with employees. Unlike some high-level execs who remain behind closed doors in their corner offices, Van Gorder believes in regular leadership rounds and talking with managers and staff.

During this exclusive interview with FierceHealthcare, Van Gorder, pictured right, discussed his unusual journey and leadership philosophy, which helped Scripps' remarkable financial turnaround from being on the brink of bankruptcy to the $2.6 billion nonprofit integrated healthcare system it is today.

[RELATED: How Scripps Health CEO Chris Van Gorder engages employees every day]

Van Gorder, author of  "The Front-Line Leader: Building a High-Performance Organization from the Group Up," took over the helm of Scripps 15 years ago when the organization was losing $15 million a year and staff turnover hovered close to 20 percent.  

"When I came here, the hospital had no confidence in the previous administration, and relationships were rocky. We were losing money as a healthcare system, doctors were taking patients away, turnover was high. We were losing something like one out of four employees. It was well below the nationwide benchmarks for turnover," he recalls.

But his leadership style is credited with cutting the turnover rate in half and developing the organization's reputation as a top employer with a no layoff policy. Scripps currently has a staff turnover rate of 10.3 percent--and Van Gorder believes it would be even lower if it weren't for the fact that many of the system's 14,000 employees have family members in the military who often must move or transfer locations.

The system was able to knock down turnover by instituting a year-long onboarding process to acclimate new employees to the organization. "If we have turnover in that first six months and year, it's because people don't get comfortable in the organization," he says.

A career that began in the trenches

Much of the system's turnaround is due in part to Van Gorder's own career path, which included almost every level of management and work as a frontline employee. It's a perspective, he says, that perhaps many administrators--who didn't work in the trenches--don't have.

His second career in healthcare took place after he was critically injured as a police officer and spent a year as a patient in and out of hospitals. When the police force "retired" him, one of the hospitals that treated him gave him a job as head of security. He went back to graduate school and worked at several different hospitals, moving up the administration ranks.

"The most difficult management job there is is that of the frontline manager," he says, noting that they must deal with day-to-day operational issues as well as various and sometimes difficult personalities. "I think it's very challenging job and most important job there is. The most important work done at the organization is at the point of service."

As a result, Van Gorder meets with each of the organization's new manager, who take part in a year-long training program, to sets expectations. He also conducts weekly rounds and question and answer sessions on Fridays at one of Scripp's sites, which includes five hospitals and 28 outpatient locations.

Using leadership rounds to build relationships

A recent Friday included a visit to a hospital operating room, which involved Van Gorder donning a "bunny suit" as staff walked him through core metrics, percentages of cases that started on time and turnover times. He also visited the endoscopy lab, where staff discussed procedures and processes to thoroughly clean and sterilize scopes to ensure that they are safe for the next surgical case  He then headed to a monthly birthday luncheon for employees and, in the afternoon, conducted rounds at the Scripps Coastal Medical Center, which he tries to visit at least once a year.

"It's all about relationship building," he says, noting that people feel more comfortable asking questions and expressing concerns with someone they know.

"I explain the bigger picture so I can explain why decisions are being made," he says. "And the managers are there, too. They need to hear questions and answers as well. It's an educational opportunity to recognize the frontlines and build trust and that's the most important thing. For me, it's also a great deal of fun. When I go in the field and talk to patients and the employees doing important work, it's a great motivator for me as well."

Tips for successful leadership rounding

Van Gorder notes that rounding is a serious leadership tool that takes time but is "invaluable if you do it right and do it consistently." The mistakes some executives make is not scheduling the time to do it or letting fear of staff interaction get in the way.

"If you don't schedule it, it won't happen," he says. "My schedule fills up very quickly, months in advance. If you don't block out time to spend time with employees, you could spend the entire day behind a desk."

Van Gorder will spend an entire day interacting with employees, listening to presentations and taking part in question-and-answer sessions so he hears the same messages that employees are told. "I look forward to Fridays where I get to go out where the work is being done and see colleagues across the system. I feel like I'm visiting a friend," he says.

When CEOs first start conducing rounds, it can be intimidating, he admits. "If you do a fly-by and they don't know you, the crowd won't ask you a question and you may feel like, 'I'm wasting my time. I'm afraid of them and they are afraid of me.' It takes time to build a comfort level and sometimes people may ask difficult questions. But my staff are so used to seeing me that it's not uncomfortable."

For those leaders who aren't committed to rounds, Van Gorder warns, "you can't just fake it. Do it all the way or maybe you are better off not doing them at all."

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