Strong leadership brings positive change for hospital

Fosdick is president and CEO of The Nebraska Medical Center, a 624-bed teaching hospital affiliated with the University of Nebraska with 6,000 employees, including more than 1,000 physicians.

When he first came to Nebraska in 2001, after senior management positions at Hurley Medical Center in Michigan and Buffalo General Hospital, the center was facing significant challenges. They had only eight days of cash reserves on hand and were third in market share for the area.

Ten years later, the hospital has improved to first in market share and its bond rating is Aa3, the best in the state. Fosdick led the way.

“The job of the CEO is to define the vision and then get the organization to go there,” Fosdick says. “At Nebraska Medical Center, we decided to focus on what we do best, and do those things very well, with the highest level of safety and quality.”

The hospital focused on four specialty areas, in addition to general health services: heart and vascular care, neurological sciences, transplantation and cancer treatment. The hospital is the only transplant center in Nebraska, and has performed more pediatric small bowel transplants than any hospital in the world. It also is nationally recognized for lymphoma care.

Fosdick is a firm believer in the Six Sigma management philosophy of quality improvement and control. The hospital has conducted hundreds of Six Sigma projects, seeking ways to make processes better, quicker and more cost-effective, with outstanding results.

For example, the hospital no longer mass-produces meals. “We now use a room-service process that provides a meal to a room, on average, in 23 minutes,” Fosdick says. “People can order what they want and it is prepared especially for them. And that is 24 hours a day, seven days a week.” This approach saves time and money, eliminates waste and increases patient satisfaction.

Fosdick is not afraid to look outside the industry for best practices. He instigated “crew resource management” training for surgical teams, a process first developed by the FAA to decrease errors caused by breakdowns in communication between pilot and crew. “There are checklists that must be followed and the last thing the surgeon says before beginning a procedure is, ‘If anything is wrong, it is your responsibility to tell me now,’” Fosdick says. Nearly 1,400 people have been trained in the system. “The staff is now dramatically more comfortable in voicing their concerns.”

He is proud to say that through 10 years and hundreds of Six Sigma projects, there has been no reduction in the work force, despite the fact that they have cut a minimum of $15 million in expenses.

“In the short term, you save money when you cut staff, but in the long term it negatively affects the quality of the organization,” Fosdick says.

Another source of pride is his regular communication with employees, including an address given every morning and evening. “That was important to implement when the economy went south,” he says. “People were concerned about job security.” The addresses are also available through a podcast.

The hospital even has its own YouTube channel that features videos of “the great things our employees do,” such as throwing a baby shower for a couple who unexpectedly found themselves 35 weeks pregnant after 17 years of marriage.

“I’m most proud of our employees,” Fosdick says. “Our people use their incredible skills every day to help make lives better.”

Written by Cathy Wilde