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


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


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


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


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.

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