The lessons learned by business leaders struggling with today’s economic uncertainties are likely preparing them for a similarly volatile future, suggests #b#Deborah Zastocki#/b#, president and chief executive officer of Chilton Memorial Hospital in Pompton Plains.

More flexible and creative management models must be put in place to adapt to the changing landscape, healthcare or otherwise, Zastocki says. “The challenge is creating conditions that foster innovation. We are not going to be able to meet those needs using prior models of management behavior.”

Zastocki will be part of a panel on “Leading in Challenging Times,” on Tuesday, May 4, at 6 p.m., at the Dolce Basking Ridge Hotel, for the New Jersey Chapter of the Association for Corporate Growth. Joan Verplanck, president of the New Jersey Chamber of Commerce, will join Zastocki, as will Patricia Lizarraga, managing partner of Hypatia Capital Group; Madeleine Robinson, CEO of LPS Industries; and Hope Vaughn, director of Corinthian Capital Group. Cost: $95. Call Jo-Ann Maude at 877-224-6667 ext. 20, or E-mail

Zastocki speaks about how she has tried to adjust her community hospital to an uncertain future:

#b#Stretching how people conceive of problems and their solutions#/b#. Innovation begins when the different stakeholders — employees, patients, families, physicians, and other providers — have opportunities to come together, develop relationships, and start having conversations that have never occurred before.

Zastocki shares an example of how Chilton Memorial responded to the issue of growing stress in the community. As part of a community needs assessment, the hospital developed a coalition targeting adult and adolescent stress and consequent depression, and addressed the question of what resources the hospital could provide.

One suggestion was to offer a series of educational sessions on the signs of stress and depression and how to deal with them. Holding classes is a standard response to a problem, but Zastocki wanted to push participants to think about how the hospital could reach more people under stress. To get this discussion going, Zastocki asked different kinds of questions: “Who do most people tell their stressful events to, and who do people have relationships with over time?”

#b#Hair#/b#. One group that came to mind was clergy, and indeed the hospital had a program to help clergy connect people with resources for stress management. Eventually the group came up with an unusual but totally sensible idea — reaching out to the “hair people,” like barbers and salons. The hospital provided beauty salons with small cards listing community resources that provide short-term support for people under stress.

When Zastocki meets with people in hair salons that have these cards, they can’t thank her enough. Having the cards in an accessible spot in the beauty salon allows owners to feel more connected to clients they otherwise could do little for, psychologically. “Instead of reaching only people who would come to educational sessions,” says Zastocki, “we have a cascading event where more can be reached. This is how we are starting to change the conversations we have and the way we think about and approach situations.”

This solution has also been effective from an economic perspective, with the only costs being the business cards and staff time for introducing them at salons. “Often people imagine that innovation is high-cost, but it doesn’t need to be,” says Zastocki.

#b#Creating a context of trust through modeling#/b#. Cultural transformation is one of the key items in the hospital’s strategic plan, with the goal of creating an environment characterized by collaboration, willingness to follow through, accountability, showing compassion for each other, and being focused and decisive.

To create such a culture requires building trust through relationships, and leaders need to model the behaviors they expect from their staffs. “We need to become more aware of the shadow we cast as leaders and how we can work more effectively ourselves before we ask our staff to work more effectively,” says Zastocki. Leaders must be open and direct and curious about how to work more effectively together.

#b#Reaching widely for the best models#/b#. To practice the best evidence-based medicine requires knowing what is happening throughout the world. “The earth really is flat, and anything we do has to be based on what is shown and proven to be the best international practice,” says Zastocki.

The next step is to incorporate these standards into the hospital’s internal processes and, wherever possible, to become nationally certified in particular areas.

#b#Focusing on strengths#/b#. “You have to focus on those things you do extraordinarily well,” says Zastocki. “If you are not meeting the needs of the community or not doing something well, you should stop doing it.”

Chilton Memorial had to make a tough decision about its in-patient behavioral health unit, which it ended up closing, while maintaining its outpatient program and its crisis program for the emergency room. Sometimes the unit had as few as two patients. This created two issues. First, the hospital had to keep staff available, whatever the patient count. Second, it was tough to run group therapy with tiny groups, especially when the patients’ ages and needs were often drastically different. Without a critical mass of patients, it became clear that the unit was not serving the community’s needs, and the hospital decided it had to close.

#b#Being more flexible with staffing#/b#. Chilton Memorial, like most hospitals, has seen fewer patients. People, Zastocki says, worry about taking too much time off from work and appearing expendable, not to mention the financial costs of recovery.

At the same time, the hospital must maintain its infrastructure, purchase new equipment, and have emergency room staff ready and able to treat any sudden increases in patients.

In response, Chilton looks to improve efficiency. More flexible schedules is one avenue — having people take off when less is going on, such as during a holiday week. Reducing overtime is another. As a result, the hospital has not only avoided a reduction in force but managed to increase pay across the board.

Zastocki, the first person in her family to go to college, grew up in Millstone Borough, where her father was an auto body worker. Zastocki’s parents were strong role models for her. Her mother had a severe stroke during pregnancy that left her partially paralyzed. “One of the things that drew me into nursing was her compassion, and not letting physical disabilities stand in her way,” says Zastocki.

In high school Zastocki volunteered in medical practices and was a member of the Future Nurses Club. She earned her bachelor’s in nursing from the University of Rhode Island in 1974 and started her career as a staff nurse at community hospitals.

Zastocki earned a master’s in nursing and another in community health at Columbia. She then got a job at Beth Israel Hospital in Passaic, where she taught nurses how to be better caregivers. She also taught in the undergraduate nursing program at Kean College and later in the graduate nursing programs at Fairleigh-Dickinson and William Patterson.

Zastocki became director of specialty nursing at St. Clare’s Hospital in Denville and then vice president of patient care at Newton Memorial. In 1990 she became vice president of patient care services at Chilton Memorial Hospital, a 260-bed, acute-care, non-profit community hospital with approximately 1,300 employees.

In 2000 she became the COO and chief nurse executive. In 2004 she was appointed president and CEO.

Even as a hospital administrator, Zastocki maintains her interest in nursing. In 2008 she received a doctorate in nursing practice from UMDNJ. “Nursing is such a holistic profession,” she says. “Such a great opportunity for thinking about how you keep people well, and helping people recover. I believe that’s where healthcare reform is going — how do we keep people and the population well — and I think nursing will have a lot to offer.”

Zastocki likes to use a kayaking analogy she once heard from a Wharton professor to explain how to handle uncertainty. A good kayaker knows that at some point the kayak will overturn, says Zastocki. “But the overturning of the kayak is not the issue,” she continues. “The important issue is that you know how to right yourself quickly, safely, and effectively and get on with your journey.”

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