JPS Gets Healthier
Under CEO Robert Earley, the hospital system put its recent troubled past behind it.
Robert Earley’s office on the main campus of JPS Health network in Fort Worth is surprisingly small for the chief executive of a $650 million, tax-supported hospital system with 4,500 employees.
One arm of the L-shaped configuration at John Peter Smith Hospital features what Earley calls a workstation. There’s a basic table in front of an average-looking office chair. Papers and a few personal items cover the table. A small, hand-drawn sign reads, “Bryce’s dad.” (Bryce is Earley’s daughter.)
A sitting area occupies the other part of the office. A well-maintained but obviously old rocking chair stands out near three cloth-covered wingbacks. Earley says he finds comfort in the rocker, which has been in his family for many years.
When he’s seated there, an antique mantel clock—wound every Friday morning—is in Earley’s line of sight. If he’s uneasy for some reason or other, he sits and looks at the clock, often recalling a summer internship he had with a South Texas judge. The same clock sat behind the judge’s desk.
The clock’s deep chime—it sounds every 15 minutes—strikes people in one of two ways. It startles those who can’t forget they’re in Earley’s office. On the other hand, visitors who have sunk into the easiness of the sitting area take the chime as a natural element of the surroundings.
It’s that ease and comfort that Earley wants for everyone who enters his office—and his health system’s 44 facilities. “We realize that when you come into a healthcare organization, this one or any other one, you’re not going to the day spa,” Earley says. “You’re not going to take the half-day off and go fishing and relax. You’re going to be in a situation that, oftentimes, just by its nature, is going to make you feel uncomfortable.”
JPS, which has been guided by Earley since he was appointed its interim CEO in 2008, has three rules for everyone who works in the health network—including vendors and physicians who work at, but not for, the system:
No. 1: You own it. No. 2: You must seek joy. No. 3: Don’t be a jerk.
Each rule is equally weighted, but No. 2 has an infectious, physical manifestation. Earley smiles easily. So does his head of operations, the staff at the information desk, and Raymond Tucker, who helps maintain the main campus’ facilities.
“If you work in healthcare and you can’t smile, go to another profession; don’t work here,” says Earley, who dropped the interim title in 2009. “We had 1.1 million ‘patient encounters’ last year. Of those 1.1 million people, I venture to say very few of them wanted to be here. We’re not the Hyatt Regency; we’re not the Omni Hotel; we’re not the day spa. Nobody is getting out of their car in our parking lot, going, ‘Oh man, I’ve waited for this day.’
“It’s a tough time,” Earley continues. “Even sometimes in the greatest of situations—of bringing life into the world—there is trepidation to that. So we need to make sure that when people come in that front door, we smile.
“We don’t have to be hokey. We don’t have to be singing songs. We don’t have to have jazz hands. But I want them to smile because I want our patients to feel better even walking in that door.”
Earley acknowledges that rules No. 2 and No. 3 haven’t always been the law of the land at JPS. Not long ago, critics say, there was a get-them-in, get-them-out approach to patient service. Earley and his team set out to change that.
“We want to create a level of pride in the people who come here, and we want to create a level of pride in this community,” he says. “I want to create a pride in people that don’t even use our services. I want them to say, ‘You know what, I’m really proud that we have a public hospital in Tarrant County that has this reputation.’ ”
Prior to Earley’s appointment as interim CEO, the Fort Worth Star-Telegram reported on a consultant’s findings, based on visits to JPS in 2007, that were critical of the hospital under then-CEO David Cecero, who would announce his retirement the following year. According to the newspaper, the consultant cited “filth, ineptitude, and callousness” at JPS, including delays in treatment, broken or missing equipment and medical records, and a dehumanizing environment in general.
Scott Fisher, chairman of the network’s appointed board of managers, says that there was poor communication and distrust between Cecero’s administration and hospital physicians, and between that administration and elected officials in Tarrant County.
“Pre-Robert, there was a sense taken that we’re providing healthcare for the poor and indigent, [that] they should be content with the services they received because they were getting it for free or highly discounted,” Fisher says. “Our approach since Robert took over as CEO has been that every person that walks in the door should be treated with respect and dignity and compassion and genuine care, so when they leave our hospital or one of our clinics, they feel that they have really been cared for.”
Earley notes that in addition to its role as a public hospital—it’s the sixth-largest hospital facility in North Texas, with 537 licensed beds—JPS is Tarrant County’s Level 1 trauma center. That means that even people with more healthcare choices could end up at JPS if they’re involved in a serious wreck or some other emergency.
Earley says the pride that his team is building goes along with the trust that the network must continually earn and maintain as it spends taxpayer dollars.
During the recent tough economic times, JPS has operated at a very thin margin of positive revenue, negating the need for tax increases, Fisher says.
“It has built a sense of confidence in the community that we are a very efficient operation. I went through the loss of confidence and now
have been here for the regaining of confidence. [Community and civic leaders] attribute that to Robert. I certainly attribute that to Robert.”
Making the Rounds
If it’s Thursday morning, don’t bother going down the long, nondescript hall at John Peter Smith Hospital toward Earley’s office. He won’t be there. The system’s VPs, CFO, COO, and general counsel also won’t be in their offices or in the modest administrative suite.
Instead, you’ll find them somewhere in the hospital doing rounds. The best bet will be to look where you would not expect them.
As part of rule No. 1, Earley and his administrative team do weekly rounds outside of their core areas of responsibility and expertise. Earley says it’s important for everyone to take an interest in all areas of the system, and for employees to see the CEO. He also says rounding outside of one’s reporting areas creates ties across the system, allows administrators to see how their departments touch others, and makes open questions about processes and services a normal part of the environment.
“Not having the background that some others might have is an advantage,” says Earley, who earned a B.A. in political science from the University of North Texas and a master’s in healthcare administration from the University of Texas at Arlington. “It allows me to ask questions [that people with medical training] might be embarrassed to ask.”
Dr. Ron Anderson, who served as CEO of Parkland Health and Hospital System in Dallas for 30 years, recalls talking with Earley before Earley took over as JPS’ chief executive.
“He was concerned with not being a hospital administrator or a physician,” says Anderson, who recently became senior adviser to the CEO at Dallas’ public health system. “He and I talked about the characteristics and the qualities you have to have. I encouraged him to take the job.”
Anderson, who grappled with his own thorny, high-profile problems at the Parkland system, says Earley’s personal and listening skills—as well as his ability to surround himself with smart people—made him a good fit for the CEO position at JPS. Anderson has since recommended Earley for several industry leadership roles, including the Health Industry Council and Teaching Hospitals of Texas, where Earley now serves as chairman.