New CEO Michael Garcia hosted a town hall on Tuesday, February 13, 2024. Below is a modified transcription of the event.
ELIUD:
On behalf of the senior leadership team, we want to thank everybody for being here today. Everyone’s pretty familiar with the kind of town hall meetings in our hospital, right? We have three C’s, we want to celebrate, communicate and connect. And so today, we’re actually doing an ad hoc town hall. In April, we’ll be doing a normal town hall. But today, we really want to celebrate our new CEO, Michael Garcia. This is a great opportunity to communicate with Michael and get to know him a little bit better, and ultimately, really connect with him. Now that he’s on board, we also want to celebrate our previous CEO, Chris Siebenaler, who is still with the system in a new role. But now we have the opportunity to welcome Michael, get to learn from him, work with him and have him lead us into the future here, which we all know is really strong. We have a great culture, great organization, great team. So now I’m going to hand things off to Michael.
MICHAEL:
Thank you to the senior leadership team, as well as all of you for the very warm welcome. Thank you for all coming today. I’ve been here now eight days. And I’m looking forward to answering a lot of your questions by taking notes and actually saying I’ll get back to you in April. With that said, I have a number of slides I’m just going to review with you. And then we’re gonna open it up to questions.
MICHAEL:
By now, so many of you have seen this picture, and you can read a lot of details. I think it’s a little bit different than the fun facts about me preferring pancakes versus waffles, where I grew up and all the things about my music selection. I was born in 1972, so I grew up in the 80s. One of the things I want to share is why I went into nursing. That’s not typically the story I get to share, and I want you to understand why I’m in health care. When I was 14 years old, I was involved in motorcycle accident. I got hit head on by a car, and I wasn’t wearing a helmet. And I know like you, it freaked my parents out too. And I woke up three days later, following a coma, and I spent the next month in a hospital. It was not the beautiful private rooms you have here. It was four rooms divided by a curtain, a television hanging off the ceiling, and it was one shared bathroom. When I think about that experience, I didn’t know it then but it shaped who I am. It shaped the notion of customer service, exceptional care and how I want to give back. But what it also shaped was the desire to do something meaningful, and it was in a hospital in the community.
I grew up in New Jersey. The hospital in the community was named Kimble Medical Center. It was about a 200 bed hospital. I didn’t know how great of a care they provided until I then went to other academic medical centers when I worked in New York, Chicago and a few other places. The care that all of you provide here resonates with me because it is the same care I was provided as a patient. And I know when I look at the smiling faces and my interactions with people, the willingness to engage with the patients and the families, to not refer to patients as a diagnosis or a room number, is why I wanted to come to this campus and this organization.
I’ve been licensed as a nurse for 32 years, having worked seven years at the bedside and working my way up. I graduated from nursing school in 1991, and when I graduated, I could not go into a specialty area until I at least did one year of med surg. So I work as a med surg nurse, then I transitioned to ICU, ED, OR and Cath Lab. I wanted to do different things. Nursing is a wonderful, wonderful thing. But during my journey, one of the other things that I have learned is that hospitals are not only staffed by nurses and doctors; there’s respiratory therapists, pharmacists, medical lab scientists, transporters, case managers, social workers. The people represented in this room represent every single profession in health care. So when my kids grow up, they can be anything. And those jobs are likely available in the hospital in some way, shape, or form.
The other thing I want to share is about going to law school. So when I wanted to advance my career, I started business school but ended up leaving because I had a wonderful opportunity to work in the United Kingdom for the National Health System. And I was there for about two years. While I was overseas, I spent a lot of time watching Law and Order. And when I came back, I chose to go to law school instead of finishing business school. I practiced as a lawyer for just about four years. My first year was a judicial clerkship by a mid-sized law firm. And one of the other stories I’ll share with you is how to build connections. When you graduate law school and put your resume together, you have to have your GPA or class rank on the top of your resume. I wasn’t putting my GPA so I put my class rank at the top 30th percentile, which was 29.98. And when I started applying for law jobs, I realized no one was returning my phone calls so I engaged a law placement firm. They put out 400 resumes and cover letters on my behalf. How many interviews did I get? It was two.
So there I am, I’m working Friday, Saturday, Sunday, to pay for my law school degree. I owe several hundred thousand dollars from law school and I’m trying to figure out how to pay for it, so I’m working as a nurse. And one of the things that happened was I took care of a patient in the emergency room who was showing signs and symptoms of a heart attack. And as a hospital supervisor, my job was to start their IV. Patients are anxious, patients want to know a little bit of what’s going on. And one of the things that happened was, for those of you that know how to distract patients, you distract them, you provide the best care. And then you move on because you’re successful. I said a prayer and I got an IV started. And that was a Friday night. On Saturday night, I then went to go see that patient and their wife who was in a room with them and we started having a conversation. That’s where Eliud talks about meaningful connections. As it turns out, the person says ‘well, you’re very good. Thank you for following up with us. We appreciate it. Tell us how long you’ve been a nurse?’ I answered him then said I had also graduated law school and was in the process of looking for a job. The patient turned out to be a federal judge who introduced me to someone else who I ended up clerking for in Cook County. Value connections in the value of doing what we do on a day to day basis. So fast forward a year later, he introduced me to three people he went to law school with. I ended up working for their law firm – talk about valuable connections.
MICHAEL:
This is an important slide for me to share, because when you think about pictures of my family, I think of all of your families. And my responsibility to you, along with the senior leadership team here, is to make sure you have your family and your priorities. How to find work life balance, or work life harmony. Our responsibility is to make sure that you have what you need so you can come back here and be the most effective. When I look at pictures of my family, it makes me smile. Our responsibility is to make sure you find work life balance, and our job is to continue to support you, so you come back and you find meaning in your work. We want you to be happy. We want you to find purpose. And we want you to also know that we are part of your family.
MICHAEL:
I got asked about this a lot with the fun facts you may have seen – I have an identical twin brother, who also worked at Houston Methodist. I’m embarrassed to share this with you, but on your left hand side is a picture of my brother and I, along with our older brother, and we are in leisure suits. And some of the best stories I’ll tell you about my brother, for those of you that have twins or know twins. Maya Angelou once said that people will forget what you said or what you did, but they won’t forget how you made them feel. So one of the benefits of working with my identical twin brother is that when we worked on the same campus for four years, I went to Saudi Arabia. Janet was actually with me for a short period of time. My brother was on the main campus and people would stop him and tell them what their problem was, whatever it may be. And then he would actually tell me who said what. And then she would say you got it like this? Yes. When I think about the Maya Angelou quote, our goal was never to embarrass anyone, our goal was to always be supportive. And that resonates with me with how best to support all of you, and not to embarrass anyone. But how best to take care of the things that you need, and how to listen attentively.
But I also now look at this photo. There’s a picture of my twin brother and I in the middle, and my older brother that actually took that picture. And the joke in my family is that if you look at the tuxedo picture on your far right, no one in my family can tell if it is me or my brother. I’m more impressed that I shared the picture with you, so you actually know I had hair.
MICHAEL:
Here in my first few months, my commitment is to actually fully round on this campus, get to meet as many people as possible. I apologize profusely if I forget your name. The third time I have some sort of interaction, that naturally gets fostered into my brain because of the fact that there’s so many people on this campus and everyone’s smiling. And people change clothes and wear masks and then they change their hats. But my commitment is to get to know as many people as possible, and thank you for those of you that I have met and introduced me to other people.
One of the other commitments that I have is trying to get integrated into the Sugar Land community. You have a very active board here. And I’m very appreciative of that, along with the support of the SLT team. We want to make sure that our board represents the community that we live in, that we serve. And I also want to continue to support the strategic plans that have already been put in place by the senior leadership team when I came on board. I know Chris is very supportive. And now, along with the senior leadership team, we’re all looking at how best we can foster growth in the community. And candidly, how do we actually keep people in the community here versus going anywhere else.
And then the last bullet point is that we’ll have another town hall in April. So I can take my first 90 days lessons learned, and come back to you and share what I’ve learned and the things I want to work on. I’ll share the priorities and ask all of you tell me if I’m wrong. When I was with the SLT group at a recent medical executive committee meeting, my commitment to them and all of us that I will have a level of transparency that all of you will understand the decisions we are making. Admittedly, you may not agree with it, but you are welcome to ask us why we’re doing the things that we do, because it’s important for you to understand some of the thought process. Again, you may not agree. But we want that level of transparency. And then my commitment also to the senior leadership team and all of you, there should be no surprises.
MICHAEL:
I believe the last slide that I have is a wonderful picture of Chris and I. I know many of you already know Chris, because of the fact that he spent 17 years of his career here. He spoke well of this place and it’s one of the things that resonated with me. When I came on board full time last Monday, I won’t share the entire contents of a very nice note that Chris left me, but one of the things that resonated with me is he said the people here are exceptional. Take care of them and they will take care of you.
MICHAEL:
The focus is on weekly, Monday communications and updates. I want to be able to communicate with you some of the things that are going on. Again, so there’s no surprises and so there’s a level of transparency. Email me, ask any question that you may have, and we’ll answer it for you. Some of the answers may be we don’t know it yet, but we’ll get back to you.
And then rounding. Janet was kind enough to round with me earlier today in the OR Cath Lab. It’s helping put all the pieces together, because I like jigsaw puzzles. This is one large jigsaw puzzle for me right now, as to location and faces and names, but I will be rounding a lot more. And also, we’ll set up some time with individual departments, attend huddles, and also meet with you, your leadership, your staff. It is my goal to meet and introduce myself to all of you and your staff. My goal is just to make sure that they know that we support them, and then understand what’s going on day to day.
And then, before I turn it over to questions and answers, one of the things that I got asked routinely during my interview process was, what am I going to do to preserve the culture here? And what my answer has consistently been is continue to foster support for all of you. Having come from the Medical Center, where I’ve been for 11 years, there’s this stigma or fear or concern that I’m going to take everything I learned there and apply it here. In fact, I think a lot more of what you do here needs to be applied to the Medical Center and not the other way around. The best thing that I’m going to take from the Med Center is my phonebook. I have every Chairman’s contact information, every division chief, every resident. Many of you also know the same people that I’ve worked with that have also come from the Med Center. This is a great place. There’s no reason to change things here just for the sake of change. In fact, the focus should be how do we build upon the successes that you already have. And this is a shout out to Chris. The reason Chris elevated into his current role is he needs to take every best practice that was started here and apply it everywhere else. You shouldn’t be concerned, but I appreciate you asking the question. And I hope you heard my answer. I want to build upon the success you have and I will share some best practices. The goal is to learn from each other. And foster, not just the I CARE values on this campus, but the culture on this campus.
ELIUD QUESTION:
Michael, thanks for sharing all that informative, helpful context. I love that you’re a lifelong learner and that you’ve tried different things and you take from your experiences. How have your experiences as a nurse and a lawyer helped shape how you approach problem solving in an operator’s role in a hospital environment?
MICHAEL ANSWER:
Great question. For the longest time, I couldn’t reconcile being a nurse and a lawyer. But when you think about being a nurse, you just think about how best to care for patients, how to use evidence-based practice, and how to effectively communicate well with others with a goal of caring for the patient. When you look at all the skills you require as an attorney, it’s how to effectively represent your client. But one of the things that I learned from being an attorney that I’m going to apply routinely is deference to subject matter experts. When you think about what Eliud just said, I’m not an expert on any one thing. I have working knowledge of a lot of things. So when you talk about how to problem solve, and how to actually combine the skills of being a lawyer as well as being a nurse, it’s deference to subject matter expertise, pharmacists, PCAs. And I know that that’s especially prevalent here, because of all the things that you’ve already done with performance excellence.
JANET QUESTION:
Sometimes things don’t always go as hoped. So with that in mind, what do you do when things aren’t going exactly the way that you hoped. How do you stay calm?
MICHAEL ANSWER:
The easiest answer I’m going to give you is called box breathing. Box breathing is where you breathe in, hold your breath for four seconds, and then you exhale slowly for four seconds, and then repeat it. The more complicated answer is understanding what went wrong and how you can adjust. And for me in my role, the question that goes in my head immediately is, when making any decision, do you have to make it now or can it wait, and who do you need to consult with? And all of these things occur in fractions of seconds. But when things don’t go well, call a friend. Pause. Think about it for a moment. Take a deep breath, then make a decision. And the most important thing that I’ve learned over the years, if you make a decision and you carry out an action that doesn’t work, then make another decision. Because I think it’s important for you to learn from all your mistakes.
STAFF QUESTION:
Do you have a moment where you’ve felt like a failure or have been worried about failure, or where a road bump has served you in your career?
MICHAEL ANSWER:
The reason I’m in my role is that I have all the elements, so many different things. I have made so many bad decisions that I have learned from it. Because I have learned from it. I know not to repeat it again. I think to your comment, we will learn more from our failures than some of our successes. For some of our successes, you’re like I need that, I got it. You just got lucky. Failures? You beat yourself up over and then you go How do I do that? Never. That’s your failure.
STAFF QUESTION:
What’s your favorite dessert?
MICHAEL ANSWER:
Perhaps the better question is, “what don’t I like?” It’s a little bit dangerous. I was fortunate enough to have limoncello cake last night. I like every sweet and I stress eat. So ice cream, cookies, you name it.
SALLY QUESTION:
Since you have legal experience, can you give us a specific example of how your legal training has enhanced your leadership effectiveness as a COO?
MICHAEL ANSWER:
When I think about my legal training, it taught me everything to do and think methodically. In law school, you would be prepared to go in as a plaintiff or a defendant. But when you went into class, the professor would say “You’re no longer the plaintiff, you’re now the defendant,” so you have to actually think of almost every scenario and try to think of what could go wrong. So how do you plan for mistakes? You account for it and then you think, “if this, then what; if that, then this.” And this is where I also look at all of you in this room. You have all the training as experts in your field. You can adjust accordingly and then communicate. The other answer is, apart from trying to problem solve every single scenario, communicate well and communicate often.
SALLY QUESTION:
Moving forward as our CEO, how will your legal training make a difference?
MICHAEL ANSWER:
My legal training has actually served me well on the administrative side. I know how to review all the contracts. I know how to handle supply chain. I am keeping the executive sponsor for the system for Gen Med, which means I chair the committee that approves all the supplies. So, if you have a new product, I can easily review some of that quickly. I also know how best to navigate some of the loopholes required. The challenge is that my law license is inactive, so the question is, how do I apply it more on a diminished creative side? And then building upon my previous answer, I need to communicate it and actually problem solve, figuring out how to go into difficult situations being as prepared as possible.
DR. DESAI QUESTION:
How do you motivate your staff and teams?
MICHAEL ANSWER:
In order to actually motivate teams, you have to know what the goals are. We have to work together; we have to better understand what we’re working to accomplish and why. The other part of it is how do we all celebrate small wins? It’s worth celebrating a lot of things every day. But it’s also equally important to celebrate the small wins on every project. I’ve had to do this over the years, and I’m going to ask that all of you hold me accountable. When I was working as a lawyer, as soon as you finish a case, there’s another case. In this room, I want you to hold me accountable and tell me when we need to celebrate. And on the flip side, I want us to all learn from the mistakes we made and ask how do we not repeat it? To go back to motivating teams, make sure you are well informed. Make sure you understand what we’re doing and why.
STAFF QUESTION:
Which resonates to you most among Dr. Boom’s five priorities?
MICHAEL ANSWER:
I’m just thinking of the six words of unparalleled safety, quality, service and innovation. This is where I don’t have a perfect answer because they’re all related to each other. If you hear Marc’s story about how he did it – Marc took time to actually think through ‘How do you put those six words in the right order to focus on it?’ I don’t think we can actually focus on any one thing specifically, because they’re all related. But if forced to really choose one I would think service, because when you think of service, you have to listen to whoever it is – our patients or each other. Only from there can you provide a level of high quality service, innovation and so forth.
STAFF QUESTION:
As a father of three boys, and two young kids still at home, how we how do you practice a good work life balance? Because that seems to be for me, that’s a challenge of having two kids.
MICHAEL ANSWER:
That’s a great question. And the answer is for me is balance is not 50/50. I’m going to have a perfect home life or a perfect work life. In fact, balance for me, and you have to find balance for you, is what I’m comfortable working and recognizing how it impacts my family. So for me, there are certain times that I know I must be there to attend a non-negotiable family event. I have attended dads and donuts, because it is important to my kids to have me there. The tip I will give – you do not need powdered sugar donuts. The other thing I would say is how to find that balance. My family went on a cruise last year. I bought Wi-Fi because I can work when everyone is asleep at night and before they wake up. But my family accepts that of me because they know that I’m comfortable doing that, and I will get anxious if I don’t try. But that’s why work life balance for me might look different from you. You have to find what actually works for each and every one of you.
MICHAEL WRAPS UP:
You’re welcome to email me, call me, stop me in the hall. I will commit that I will respond to all your emails within a timely fashion, typically 24 hours. I’m also committed to coming back in April for another town hall. I was telling you all the things that I’m thinking about, but haven’t fully committed to because I think it’s important again, that there’s a level of transparency, you understand what the priorities are, and then how do we work together.
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