Chris Van Gorder, CEO, Scripps Health: Building Healthy Relationships

work hard can come in at entry level and after two years be managing a small group of people, then five years later be managing 50 people. That’s how we get our leaders. They learn the business from the ground up and love the culture. They’ve learned the ropes and are now responsible for teaching the next generation.

This way of managing also ensures consistency. With such a strong network of homegrown talent, it is easy to trust that our core business philosophies are being followed anywhere in the world.

Encourage Evolution We try to run TransPerfect as a very flat organization. Because my partner and I spend so much time talking with employees at all levels and around the world, we help create an open environment where people can speak their minds and offer suggestions for change. I think it is easiest to embrace change when the positive results are visible, and having a flat organizational structure makes them much more easily noticed.

People realize they can make an impact. I tell people that the worst thing is staying exactly where we are. Complacency is not going to get us to the next level; we need to always improve.

Tell Employees to “Own It” We do not want “yes” people. We do not want people to sit in a room and listen; we want back-and-forth discussion. We want people who give opinions and have no problem challenging or bringing things up. The more of that, the better the answer we arrive at.

One of our most important values, if not the most important, is “run it like you own it.” The same thing goes whether you’re managing two people or a 20-person department, whether you’re in IT, HR, or sales. We want employees, no matter what their positions, to act as if they own the company. In that way, people will not worry about whether they will get in trouble, but will do what is in the best interest of the company.

CHRIS VAN GORDER, SCRIPPS HEALTH BUILDING HEALTHY RELATIONSHIPS

When Chris Van Gorder was named CEO of Scripps Health in 2000, the organization had big problems. “There had been a vote of no confidence in my predecessor, we were losing $15 million a year, we had 55 days of cash on hand, and everybody was angry,” Van Gorder says. Fast forward to 2014, and Scripps Health, a San Diego–based $2.6 billion private, nonprofit, integrated health system is in the black and has been recognized by Truven Health Analytics as one of the country’s top five large health systems. Moreover, from 2011 through 2014, Scripps Health will have eliminated $300 million in operating costs by cutting inefficiencies—all without layoffs. Van Gorder’s achievements are, of course, all the more remarkable given the immensely complicated and fast-changing healthcare landscape. Here he tells how he got employee buy-in—and why he likes email so much.

Fill the Information Gap When I came to Scripps, we had become super-centralized and people felt completely disconnected from decisions that were being made. I had learned from my

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years of experience, beginning when I was a police officer, that trouble often springs from a lack of knowledge. If people do not have information, they will make it up or believe every rumor.

So I created structures designed to fill the information gap. I started a Physician Leadership Cabinet with the idea that we would run the company together. They would give me the clinical information I needed, and I would give them business information. Smart people, given the same data, will generally agree. We have accepted 100 percent of the recommendations coming from that group. We also created a Leadership Academy, in which a small group of middle managers spends one full day each month with me and the members of the executive team. The first few hours of the day are a wide-open Q&A with just me. I tell them I will not violate HIPAA privacy laws, and will not violate labor laws by talking about personnel issues, but other than that they can ask me anything. If they don’t ask me tough questions, I chide them.

Eventually people get comfortable, and you build a relationship. When they graduate, I tell them, “You’re my agents of change. Now go out and demand more from, and deliver more to, the people who work for you.” We have now had 300 managers go through the course.

Trust Can Lead to a Turnaround When I realized we needed to cut costs by taking out inefficiency and non-valueadded variation, I went to my front-line employees and middle managers even before I went to senior management. After all, who is in a better position to see where waste is? I told them I wasn’t going to attempt to make these changes unless they could support the effort. And both groups said they absolutely would.

I use email as a teaching tool.

--CHRIS VAN GORDER

I also told them we would have a policy against layoffs. People have told me I'm extraordinarily naïve to say that, but human nature is human nature. Why would people help me change if it was going to cost them their jobs? We also developed a Career Resource Center to re-train and redeploy people within Scripps, if needed. In this way, we have taken out $300 million worth of costs in the past three years. To have a no-layoff policy, you have to have contingency plans and do a lot of forward thinking. Ultimately, though, it makes my job easier. I don’t know any chief executive who enjoys layoffs. And an engaged workforce helps you change when you need to change.

VAN GORDER AND TEAM AT A PHYSICIAN LEADERSHIP CABINET MEETING

Email Does Not Have to Be a Burden The secret to email is, for me, very simple: Do not fall behind. For me, email is a way of conveniently conversing with people. I carry my phone with me and I set it on vibrate. If I am home watching the news or a TV program and it vibrates with a new message, I pick it up and answer.

I meet with every new manager and tell him or her to feel free to email me. I will usually answer within 12 to 18 hours. The best emails I get are from front-line staff with suggestions or questions. I can tell them, “Here is who you might want to talk to,” or “This is what we are already doing.” I get great joy from this. I also use email as a teaching tool. Every day of the year, including Christmas, I get up at 5 am and check a number of different sites—local and national newspapers, healthcare management journals, and more.

Then I summarize key articles and send an email to hundreds of people, inside and outside my organization. I call it Market News. It takes 45 minutes to an hour to do this. Since I need to do the research anyway, I figure I might as well share it. It gives me a personal connection to all these people. And every person that receives those emails knows that’s what I believe is important information.