Corrections or additions?
This article by Kathleen McGinn Spring was prepared for the February
15, 2006 issue of U.S. 1 Newspaper. All rights reserved.
St. Peter’s Woman Leader
‘A leader is different from a manager,” says Sheryl Slonim, CEO
of St. Peter’s University Hospital in New Brunswick. She says this in
such an off-hand way that it is easy to glide over it. But wait, what
exactly does that mean?
“Leadership is the ability to think strategically, to think
critically, to gain the respect of the community,” she says. “It means
that you create a model that people will follow.” A leader is not task
oriented, she says, but rather makes sure that managers under her
become leaders in their own areas of responsibility.
Slonim is charged with leading a 422-bed city hospital, which is about
to celebrate its 100th birthday, through the booby-trapped maze that
is the delivery of healthcare services in New Jersey in the 21st
century. “This is a uniquely challenging time,” she says. “It’s not
just St. Peter’s or New Jersey, it’s national. We’re all in the same
challenging bucket.” The issues range from the need to invest in
wildly expensive technology to the soaring cost of malpractice
insurance.
After an extensive search, St. Peter’s choose Slonim to lead it
through the toughest environment healthcare it has ever experienced.
She was named CEO in 2003 after serving as interim president and CEO
since 2001. She oversees 2,800 staff employees and 900 doctors and
dentists in a hospital that serves 30,000 inpatients and 200,000
outpatients every year. Her hospital, with a specialty in obstetrics,
also delivers 6,400 babies annually. Its neonatal intensive care unit
was the first in New Jersey, remains the state’s largest, and is the
reason that Slonim first came to St. Peter’s.
Slonim’s route to a healthcare CEO began before she entered third
grade. “I was in a hospital visiting a relative, hand-in-hand with my
mom,” she recounts. “I was at most eight years old, but I knew that I
wanted to work at a hospital. True story.”
Her mother was a homemaker and her father a systems analyst at
American Cyanamid, “back when computers were the size of this room.”
She grew up in Fairfield, and, when she was a junior or senior in high
school, decided that the healthcare career she would pursue was
nursing. Like many high school students, she didn’t necessarily go
over all of her career options in detail, and certainly didn’t plot a
path to top management. “It was a happenstance,” she says.
She attended Fairleigh Dickinson, where she earned a bachelor’s degree
in nursing in 1976. Her first job was in the neo-natal department of
the Children’s Hospital of New Jersey in Newark. She isn’t sure
exactly why she chose her nursing specialty, but says that one reason
is that care of pre-mature babies was “cutting edge” when she entered
the field. “Treatment of respiratory distress syndrome, which is very
common in pre-mature babies, didn’t begin until John F. Kennedy’s son
was born pre-maturely,” she says. (The president’s son, Patrick, born
five weeks pre-maturely in 1963, died two days later.)
Slonim remained at Children’s Hospital for 10 years, eventually moving
into a teaching role. When she relocated to central New Jersey in 1985
she accepted a similar position at St. Peter’s. After a brief stint as
a nurse educator, she became divisional director of maternal child
health, and then, in 1988, was promoted to assistant vice president of
nursing. She held that position for 10 years, and then left to become
vice president of patient care services at Clara Maass Medical Center
in Belleville.
It was difficult to move away from a job she enjoyed, but Slonim says
that, after so many years as an assistant at St. Peter’s, “I needed to
move to a place I could call my own. It was a career advantage.” She
says that she would encourage other executives to take a similar path.
“It’s easy to get comfortable,” she says. If a job that will advance a
career comes along, “by all means, go,” is her advice.
It turns out that Slonim was not away for too long. Just a year after
she left St. Peter’s, the hospital’s vice president of patient care
services departed, and she was asked to take that job. Despite the
quick return, she thinks that her time away turned out to be a good
thing. “It’s better to move in than to move up,” she says. “It sets a
different tone.”
From that position, she was just one job move away from the hospital’s
top position, and it was soon hers. She is one of a trio of central
New Jersey hospital CEOs who began their careers as nurses. Robert
Wood Johnson Hamilton’s Christy Stephenson is a nurse, as is Judy
Persichilli, who served as CEO at St. Francis in Trenton before being
promoted to a job in which she oversees a number of hospitals for
Catholic Health East.
Despite this central New Jersey cluster, Slonim says that it is
unusual for a nurse to rise to the top management position. But she is
proof that it is possible for a nurse to end up doing much more than
carrying out a doctor’s orders. She uses her career success as an
example when she speaks to her hospital’s nurses about the range of
possibilities open to them.
She also thinks that it makes a great deal of sense to choose a nurse
to lead a hospital.
“Clinical and managerial experience is a good combination,” she says.
What’s more, she adds, “trust is such a critical factor.” A nurse
rising through the ranks is likely to have earned it both from those
above her and from those she supervises. A nurse is also likely to be
very good at working with physicians – a key job for a hospital CEO.
“I’ve interacted with physicians all through my career,” says Slonim.
“When you do that you know what they need. You can anticipate their
requests.”
Attracting staff and physicians – and keeping them happy – is always
on Slonim’s mind. Not only is there a “huge” labor shortage in
healthcare in the United States, particularly for nurses, pharmacists,
and many types of technicians, but the situation, she says, is even
more difficult in New Jersey. Tight supply combined with high living
costs adds up to a big problem for the bottom line.
“Salaries are more of a challenge in New Jersey,” she says. “That is
why there are shrinking margins in New Jersey versus other parts of
the country. Other parts of the country have 5 percent margins, but
here we’re doing well if we can have 2 percent margins.” The reason,
she is convinced, is the higher wages that New Jersey hospitals must
pay.
Nurses, technicians, and orderlies need to make more money to afford
New Jersey’s housing, tax, and insurance costs, but doctors need to
deal with those expenses and also make enough to cover their
malpractice insurance premiums.
“Malpractice is a huge crisis, especially in New Jersey,” says Slonim.
The insurance is a direct drain on her hospital’s resources, and also
affects its ability to keep some of its biggest specialties staffed.
Obstetrics is an important specialty for St. Peter’s and is one of the
areas hardest hit by malpractice insurance rates.
Slonim is also focusing on the new issues of technology – which she
sees as both a blessing and a burden. “It’s crucial to maintain
cutting edge technology,” she says, pointing to her hospital’s
electronic documentation system, which goes live in May, as an
example.
The documentation system will replace pen and paper as the main method
of recording and transmitting all kinds of patient data. “It’s
important from a safety point of view,” says Slonim. “There will not
be a whole lot of interpretation.” In other words, a nurse or
pharmacist will no longer have to guess at what doctors, with their
famously erratic penmanship, have written. The downside is that the
price tag for this one system alone is $42 million.
Money is an issue for St. Peter’s. As a city hospital, St. Peter’s
cares for a number of charity patients. “It’s part of our mission,”
says Slonim, and her hospital doesn’t shrink from it. Yet it does have
to come up with services that do pay.
Slonim has had success in generating revenue through physician
partnerships. St. Peter’s ambulatory surgical program is an example of
how this works. It is a for-profit center in which the hospital
provides the space, and the doctors provide the services. Profits are
split 50/50. “This kind of joint venture helps us,” says Slonim.
There could well be more such partnerships in the hospital’s future,
and Slonim shows interest in another money maker, the
hospital-affiliated fitness and wellness center. Both Princeton and
Robert Wood Johnson Hamilton hospitals have turned to these souped-up
gyms for revenue. She says that St. Peter’s does not yet have a
fitness and wellness center in the works, but that it is looking at
the phenomenon.
What Slonim’s hospital does have is a new strategic plan due to be
unveiled soon. It has occupied much of Slonim’s time for months. She
says that she spends about 70 hours a week at the hospital when major
initiatives like this plan are in the works. She commutes from
Middletown, where she lives with her husband, Robert, a musician who
“plays all of the woodwinds, but especially the sax,” and who also
teaches music to junior high school students. She uses her commute to
unwind, but it easily adds an hour to her day – and sometimes as much
as two-and-a-half-hours. Her leisure time, what there is of it, is
spent on their power boat.
She remains connected to work via laptop and cell phone during weekend
boating outings, and says that her position makes it hard for her to
get away for much more than a long weekend.
On the job, Slonim says that she spends a lot of time with city
officials and with politicians at other levels of government. “A
hospital may appear to be a fortress,” she explains, “but it’s not.
It’s part of the community, and needs community support.” She also
devotes a part of her day to talking with patients and “being visible
to the staff.” The rest of the day, which begins with a one-on-one
talk with her COO, is “meetings, meetings, and more meetings.”
Slonim knows that she has to develop and inspire confidence in a
complex vision if she is keep her hospital healthy. She needs to
adhere to its traditional mission as a teaching hospital and regional
care center, while at the same time moving it into new, profitable
niches. As she well knows, that is what leaders do.
Corrections or additions?
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