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A Blueprint for Success: CEO Requirements for Critical Access Hospitals in Small Communities

Written by Ryan Bouda. Based on interview from October 22nd, 2023 with Dr. David Bouda.


In the realm of healthcare administration, the role of a CEO in a Critical Access Hospital (CAH) comes with its unique challenges and responsibilities. Dr. David Bouda, an experienced healthcare executive, has outlined a comprehensive set of guidelines to ensure the success and community integration of such healthcare facilities. This article delves into these CEO requirements, emphasizing the importance of presence, communication, and community engagement.


1. Establish a Visible Presence


Dr. Bouda recommends a simple yet powerful gesture – park in the same place each day. This small act serves to affirm the CEO's consistent presence, offering reassurance to both staff and the community. Additionally, for CEOs with offices in remote locations, regular walks through the hospital, greeting individuals twice per day, contribute to a visible and approachable leadership style.


2. Foster Connections Through Lunch


To strengthen ties with hospital staff, Dr. Bouda suggests spending 50% of lunch breaks in the cafeteria. This time can be utilized not only for sustenance but also as an opportunity to engage with and listen to the concerns and ideas of the hospital team.


3. Engage Night Shift Staff


Recognizing the often-overlooked night shift, CEOs are advised to make unannounced visits twice a month, bringing treats and engaging in conversations. This demonstrates a commitment to understanding and appreciating all aspects of hospital operations.


4. Regular Walk-Arounds and Observations


Dr. Bouda underscores the importance of regular walk-arounds, emphasizing visits to the admission area, observation of public bathrooms, and checking for dust on top of door jams. This hands-on approach ensures a CEO's familiarity with every facet of the hospital and promotes a culture of accountability.


5. Effective Communication


Monthly staff meetings with exceptional communication skills are deemed crucial by Dr. Bouda. All meetings should follow a structured agenda, and a "parking lot" approach ensures that important topics are addressed even if not initially on the agenda.


6. Stay Informed


To stay connected with the day-to-day operations, CEOs are advised to call the hospital weekly from an outside line. Engaging with the operator allows the CEO to understand what may be unknown or overlooked, reinforcing a commitment to a well-informed leadership approach.


7. Mystery Patient Engagement


Implementing a secret shopper approach, attempting to make appointments as new patients weekly, provides valuable insights into the patient experience. This ensures that the hospital is consistently delivering quality care and identifies areas for improvement.


8. Community Involvement


Dr. Bouda stresses the importance of being seen in the community. CEOs are encouraged to join local service clubs and be visible about town. This not only strengthens community relations but also reinforces the vital role of the hospital in the town's fabric.


9. Data-Driven Decision-Making


To stay on top of hospital performance, CEOs should be aware of the daily number of ER visits, admissions, and clinic visits for each provider. Regular staff meetings should include a review of these metrics, fostering a culture of accountability and continuous improvement.


10. Expectations and Targets


Dr. Bouda sets clear expectations, suggesting an minimum patient goal of 8 patients per day from MD/NP/PA, 4 days per week. This target ensures an equitable distribution of responsibilities and maintains a focus on efficient and effective patient care.


11. Patient-Centered Approach


Above all, CEOs are reminded to enroll every patient and family every day. Dr. Bouda emphasizes the importance of patients sharing positive experiences, highlighting the hospital's role in providing essential care to the community.


Dr. David Bouda's comprehensive set of CEO requirements offers a roadmap for success in managing Critical Access Hospitals in small communities. By prioritizing visibility, communication, community engagement, and data-driven decision-making, healthcare leaders can navigate the unique challenges of these healthcare settings and contribute to the well-being of both staff and the communities they serve.


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