On Friday June 15, Lillian Montoya will be the first woman named as president and chief executive officer of Christus St. Vincent Regional Medical Center.
Santa Fe's only major hospital has had its share of challenges—lawsuits, complaints from the community about quality of care and a longstanding, negatively tinged nickname that comes up more often than not in conversations about the place.
Montoya has been chair of the hospital's board of directors since 2013, so she's familiar with the problems.
In 2013, SFR wrote about on tense negotiations between the hospital management and District 1199NM, the union that represents its employees. Nurses reported being unable to give proper care for patients because of understaffing, contrary to hospital-made algorithms that showed understaffing wasn't a problem. Management and staff negotiated a contract last summer that included raises and bonuses for some employees and cost-of-living salary adjustments.
The watchdog group Leapfrog gave St. Vincent low marks in 2017 on a number of indicators including rates of infections and other accidents, burnishing the hospital's poor street reputation. The hospital says it's improved detection processes, and purchased a UV light machine to eradicate pathogenic molecules in patients' rooms.
On the eve of her taking the reins at Christus, Montoya sat down with SFR to talk about changes and challenges for the hospital as well as her own background, which includes executive- and director-level stints at the Regional Development Corporation, Los Alamos National Laboratory and the New Mexico Commission on Higher Education over the course of 25 years.
Montoya says real and perceived gaps in the hospital's services are closing due to a better work experience for its 2,100 employees, and that a better work environment will lead to a better patient experience.
Here are some of the highlights of SFR's conversation with Montoya:
SFR: Patient experience and perception were some of the hospital's largest problems since you were elected chair of the board of directors in 2013, and you say it had to do with how the hospital cares for its employees. Can you elaborate?
Montoya: In the first three months of joining the team from the board, I spent 75 percent of my time rounding and visiting hospital staff and clinics. I wanted to talk to our associates and employees and find out what mattered. People want to be seen, they want to know their contribution matters. They want you to help them contribute [at] a higher level.
We hold our leaders accountable for key behaviors they need to engage in with employees and teams. They need to have a sit-down and visit at least once a month or every other month, and it's called a round. Some questions they ask are, do you have the tools and resources to do your job? Are there any questions or concerns you want to raise? Someone you'd like to recognize or compliment?
Please talk a little more about the hospital's procedures for hiring staff, how long they stick around and who you're looking for right now.
We're at 100 percent peer interviewing, with orientations for new employees happening every two weeks. I went to orientation this morning, [there were] 24 new staff members in there. I asked them to raise their hands if they were interviewed by their peers and every hand went up. Our highest performers in the organization hire their peers [workers with equivalent titles]. They fill the vacancies. They can pick people they want to work with. …
Our turnover rate is the second lowest in entire Christus family. We're at 10 percent turnover while national average is at 17 percent turnover. The average tenure for our workforce is seven and a half years, which is good for health care. People have choice in health care [employment].
We're hiring everyone from nurses to technicians to physicians to advanced practice clinicians. We're able to recruit [but] the challenge that we face is the same challenge faced by other businesses and companies in Santa Fe: Housing, transportation, quality childcare, education, and, also very important: Several of our folks who move here ask, "Where's my partner going to work?" And that one we can't do much about.
Is there anything else the state's Legislature could do to give health care facilities what they need?
It's a long list. What has risen to the top is the need for more loan repayment programs for healthcare providers—loan re-service programs. The programs the state has now [which Montoya helped design while deputy director at the New Mexico Commission for Higher Education], focus on shortage areas only, not shortage area professions. We don't get the benefit of bringing people onto our staff because there is a higher need in rural places like Gallup, but if there was an expanded loan repayment program the whole state could recruit more easily than we can now.
Smaller organizations don't have the resources to fill gaps when it comes to [hospital staff] housing. We partner with [Albuquerque Homeownership Center] to provide down payment assistance [and] not every employer in New Mexico can do that. Transportation is a good example: 21 percent of our [full and part time employees] commute from outside Santa Fe. So many come from the Zia Rail Runner that we have people to pick up at Zia and drop them off here.
What is the hospital doing to improve its record of care?
I think it's three things. First, focus on your people—if you focus on people they do their best work and take care of others better. Second is focus on clinical quality of care. … We have physicians and nurses engaged in clinical-driven performance, [who] identify areas where we can do better, track surgical site infections by nurses who work with a team to look at our data … it's a continuous feedback loop. And third is patient experience, how management engages their people and engages their patients, observing our providers in how they talk to patients and their families. A focus on quality, experience, and workplace environment: It's all three.