How NCH's Paul Hiltz and Kara Down Built a Healthcare System Employees Actually Trust

0:16 Welcome back to another episode here on the Heart and Hustle Podcast. And today we got two special guests from the NCH
0:21 Health Systems. If you guys can go ahead, Paul, we'll start off with you, man. You're the the big head of the table. you can kind of introduce us and
0:28 then who is this wonderful, beautiful woman that you said possibly looks a little better. No, she looks a lot
0:33 better than you tonight, Paul. And it's a nice fusion outfit. Uh, good morning. Good morning. I'm Paul
0:38 Hiltz. I'm the president and CEO here at NCH in Naples, Florida. And I'm here
0:45 with Cara Down, who's one of my right-hand people here. Carara and I work a lot very closely together. Cara
0:52 runs all of our volunteer services and is very much involved in crafting a
0:57 culture here. Uh that's the key to our future. Having a kind of culture that is
1:03 thrives on excellence and thrives on creating an environment where doctors,
1:08 nurses, and other caregivers actually enjoy taking care of people. So Cara,
1:14 welcome. Thank you. Thanks for having us. Cara, no, I I thank you guys for taking
1:19 your time to do this. I know you guys could be doing so many other things like helping people do what they do best. Uh
1:24 you guys took this time to just have this conversation really to enlighten people and I would I would love to start there when you talk about building that
1:30 culture. Paul just before we got on we talked about some of the restaurants that have been scaling and and that's
1:35 some of the things especially when we talk about raising canes his thing is about culture like he he literally got a co-CEO so he can go and focus more about
1:42 culture and that co-CEO can focus about growth. And I thought that was very interesting that you mentioned that Kira
1:47 like why is that the space that you go into? Like why do you know that it makes sense for culture to be built within a
1:53 location to to really scale? I mean we do this a similar model here. We have COS at each of our locations
2:00 just to create that culture and that way they're focused on that location rather than having to be worried about the entire system. It lets them really know
2:07 and be available for their team for their executives for their direct reports. It lets them have, you know, be
2:12 part of the pulse of that s of that campus. Um, it lets them, you know, be accessible to a a smaller group of
2:19 people. You know, we have over 5,000 employees and you think about one COO for that many employees. If you devest
2:26 and really make them in that local environment, it just allows them to be closer connected to those bodies, which
2:31 creates, you know, a culture of listening, you know, communication, collaboration, and excellence.
2:37 And where did you learn that from, Kira? where where do you like just through your your
2:42 grind and probably different locations realizing wait culture really matters or where did it all come from?
2:48 I think you know Paul has a a mentality to lead by listening and I think when
2:53 you have a leadership style that's like that it's really hard to listen to 5,000 people. So if you shrink the gap and put
3:00 someone in a tighter environment where they have less people to listen to and more people to learn from, it only can,
3:07 you know, work to benefit um our our culture holistically. The other thing that's really unique is that each of our
3:13 campuses have a very different feel. So our downtown campus feels very different than our north campus. And so the people
3:19 that we are placing there, they might need a different leader and they're going to have different things that um
3:25 rise to the top in terms of concerns and opportunities and challenges and then,
3:30 you know, solutions. I love it. I love it. And Paul, what does it what does a good leader mean to you, man? Like I I we've seen bad
3:37 leaders. We've seen good leaders. Clearly, Paul, you're a good leader. Um your right-hand man's just kind of mentioned that right-hand woman is
3:43 mentioning that. So what what does that look like for you? Why does that matter? You know to me a good leader is somebody
3:49 that really can see the potential in a person and help match up that potential
3:54 with an opportunity and we try to do that here. U you know one of the things Ephron is that if you look across the
4:02 country uh the American Medical Association says that physician burnout
4:07 is a crisis in American healthcare. So doctors are really burning out. Nurses
4:13 generally have very high turnover right now. We're trying to reverse all that. So just this morning, a perfect example,
4:19 Cara and I, we have a leadership academy with 20 individuals in the academy.
4:25 Today's uh the sixth session, so the last session for this year. We do it six
4:31 months in a row. And we really try to put a spotlight on mid-level managers to understand what their strengths are,
4:38 what the potential is, and to elevate their profile so that we can promote them the next time an opportunity comes
4:45 up. So to me, going back to your question, the leaders are the ones that can identify people that have the
4:52 potential to go and make a meaningful contribution to an organization like NCH.
4:58 I love that. Paul, how how long have you been um CEO and president? I've been six years CEO here. I've been a CEO in
5:06 various healthcare organizations for the past 20 years if you could believe that. So, it's been been a lot of fun.
5:13 I uh I went to go take a little bit of water and then I realized I had to put my fingers over the uh over the title.
5:18 It says Advent Health on it. I'm like, we we're not promoting these people here today. You know what I mean? Like, we got something else to promote. I'm
5:24 almost scared to drink water now. Yeah, I know. I know. I need I need that cup so we can just stop promoting you guys.
5:30 No, I love it. Paul, so you you've been doing this for 20 years. What gets you into the space? What get you in the space of healthcare, giving back, I feel
5:36 like these spaces of the nonprofit and healthcare, these are very impactful places that people don't really touch a
5:41 lot. Um, and if they do kind of get into it, they forget why they do it, right? They forget the purpose and passion
5:47 behind it. Um, it's not all about the paychecks, but what got you into this baseball? Well, you know, it's interesting you
5:52 asked. What got me into it was when I was a little kid, my my aunt was a hospital administrator in Cincinnati,
5:59 Ohio, and she used to take me through the hospital. And the thing that really got me hooked was seeing the kind of the
6:06 diversity of people from all over the country, from actually all over the world, foreign people, people of all
6:12 different colors and shapes and sizes and backgrounds, but they came together
6:17 as a team to take care of people at Good Samaritan Hospital in Cincinnati. And
6:23 that got me hooked. I always thought, what a great idea to get the smartest people from all over the place, put them
6:30 on a team, and their main concern is to save lives and help people get better.
6:36 And it's I've never lost the enthusiasm for it even today. We we do that here. And teamwork is a key thing here at
6:43 healthcare. And we promote it, we uh highlight it, and we look for teammates
6:49 and team players that have that same passion. So, Kira, in your space of
6:54 healthcare, what how many years have you been doing this and what brings you to the table of healthcare? I actually started my career in
7:00 healthcare um at a for-profit system in Nashville, Tennessee called HCA. They own about 181 for-profit hospitals
7:06 across the United States and um you know, just really I'm I've always been
7:11 that way since I was a kid where I just want to help people and find solutions. And so, that was kind of how I got I
7:18 married those two passions together. Um I I went and did a lot of other things in various industries after that which I
7:24 help which I think has helped bring me into a different kind of perspective as I came back into healthcare about 5
7:30 years ago here at NCH. And I think kind of having that beginning and end journey, you know, has really helped to
7:36 shape and formulate some of the things I'm passionate about. Um and then just being a part of other industries that
7:42 don't have that care, concern, compassion, and empathy for others, it's difficult. And so when you get to go
7:48 back into a space like that and live through your authentic self, there's just something about it that allows you
7:53 to live more fully. Authentic self. I've been seeing this so
7:58 often because I can imagine that you guys know people leaders that are not their authentic self and put on a mask
8:05 and it's like it's bothersome at sometimes like I can I can see it. I can see right through it. How important,
8:11 Paul, is it to be your authentic self as a leader, especially as as big as this organization is?
8:17 You know, I think it's it's critically important because, as you said, you really can't fake it. And these days,
8:23 uh, especially the younger workers are really looking for meaning in their work as much as paid, benefits, and anything
8:31 else. And I believe that the young people are really looking for that authenticity, something that they can
8:36 get into and believe in because in our especially in the healthc care world across the United States and really
8:43 across the globe, people have lost trust in the big established organizations
8:49 like the CDC, HHS, you know, all the vaccination controversy. So, at least at
8:56 the local level, at least where we are here at at NCH, we try to promote this
9:01 idea of transparency and trust and authenticity. And I think it's going to
9:07 attract young people into this profession, this organization. So, we're excited about that.
9:13 I agree. I think another thing that um will really attract people is for them to be able to do more of what they love
9:18 and and less of the things that they hate, right? So, I say that in the sense of AI. I think that it's such a a
9:25 crucial space of where healthcare is going right now. A lot of people are being early adopters. Are you guys in
9:30 the space of actually seeing AI and how is that working out for you guys in the space that you guys are using it?
9:35 We are um real we consider ourselves early adopters of AI. One of the the we've got multiple areas, but one that's
9:42 kind of exciting to me, you just mentioned it. How do we help people do less of what they don't like
9:48 in healthcare? Clinicians don't like documentation. They like to be taking care of patients, not writing in a chart
9:55 or typing into a computer. The AI that we're piloting right now is something called DAX, which allows the doctors and
10:02 nurses to speak to a patient. And this AI application just takes the relevant
10:07 clinical information out of that conversation, puts it right into the medical record. It eliminates that idea
10:13 of doctors turning from the patient and typing. And we think that's just one instance that's really gonna help people
10:21 enjoy their work a lot more. Kira started laughing and smiling a little bit. I could imagine she has
10:27 something to add here. Kira, are you fascinated about this space? Are you excited about what's going on in the AI space?
10:32 I I love it actually. I I think it's one of those key things that provides lift to those doctors. You know, Paul
10:38 mentioned burnout being a huge factor with our clinicians today. And so if we can make this tiny thing work for them
10:45 and you know able to kind of collaborate together and all they're having to do is really check and make sure AI got it
10:51 right. Um you know gosh can you imagine how much more time they get with their patients um and much more time they get
10:58 back to themselves to be able to kind of pull into that wellness and stay healthier and happier um and longer in
11:03 their in their job and in their life. I love it. Yeah. I think AI is we're definitely in a space where there's so
11:10 much potential. Um, obviously you have to be very mindful of what's out there cuz everyone's in the space and you
11:16 don't know what's who's the real one and who's not at this point, right? We talked about being authentic and um I I
11:22 love it. I think that when you talk about as well as going into your doctor and having that conversation the last
11:28 and I say this all the time I I speak to someone in healthcare because it was just so I didn't I didn't notice it until now when I'm 30 some years old on
11:35 how bad it is that you go and for experience and your experience you've no you don't even know what this person looks like face to face right because
11:41 they're not looking at you nor do they know what you look like so I walked into um one of my yearly appointments right
11:48 and and I went in there and the wife my wife is the one that set it up for me cuz that's what wives do Right. Shout out to all the ladies that do all the
11:54 men work. Paul, has someone set up your appointment suit, Paul? Of course. Right. That's it. Shout out to my wife.
12:00 She says, "Yeah, it's my doctor." I go in there. I'm talking. I'm a very talkative person. So, I'm talking to the lady like, "Yeah, you just took care of my my wife the other day." And she's
12:07 like, "Yeah, yeah, yeah." Then I go and I tell my wife about the experience I had. And she's like, "That's not my
12:12 doctor." I'm like, "So, the lady just sat here and lied to me all just to kind of get through whatever she was doing the whole time just looking. Never
12:18 looked at me. I'm just sitting there just talking." And it's the experience. It's like when we go to a restaurant, it's like when we go to an amusement park, we pay really
12:25 for the experience. And when people don't get that good experience, it is so hard for them to come back. When they don't, as you mentioned, trust a little
12:31 bit. When you mentioned being authentic, like those are the things that allow people to be feel comfortable and
12:36 wanting to come back and realize that you actually cared. And I think now more than ever, we are looking for people
12:41 that care. So you guys doing what you're doing is really going to continue to, you know, uplift what you guys are
12:46 doing. But you know, two, two quick things on that. I I love what you just said. Two quick examples. You
12:52 know, we have a simulation center here where we actually train people on how to
12:57 do the eye contact, the physical touch, and that way doctors and nurses can get
13:02 video feedback on how they look when they're interacting with a patient. That's been one thing that's really
13:08 helped. A second thing that we were just talking about, Cara and I, before we got on with you, we just recently hired a
13:15 hotel executive who's been 15 years in the hospitality industry. He just joined
13:21 our team from a national hotel chain to help us learn hospitality. We we know
13:28 customer service. We know patient care, but the things that happen in a hotel to make you feel welcomed and cared for, we
13:36 want to bring that same feeling into the hospital to the extent that we can. And
13:42 uh a third thing that Cara is working on is a big initiative to expand our
13:48 volunteer program here so that we have volunteer ambassadors from the community
13:53 to come in here and really add to the culture and expand that feeling throughout this whole Southwest Florida
14:00 community. So that topic you just brought up is something very near and dear to our heart, something we're going
14:06 to spend a lot of time on to make people feel, heard, cared about, listened to,
14:12 and we'll continue to work on that in this year ahead. And I think just to feedback on that really quick is that, you know, in
14:19 bringing in the a, you know, a hotel executive to come into a hospital room,
14:24 they may not know all the ins and outs, right? but they're able to what they do know is the human experience. And so as
14:31 we think about patients, their guests, their families, their kids, our team,
14:37 you know, it's about enhancing the human experience regardless of who you are within these walls and making sure it's
14:42 just the best it can possibly be at every touch point possible. Not just from your bill to your bill, but from
14:48 the time you are greeted to the time you have to make a follow-up appointment and everything in between.
14:53 Hey, real quick. Have you enjoyed the podcast? We first want to say thank you and we also just want to give you a
14:58 little insight of what we're up to at Francis. Some they'll even realize that we're working with organizations to help
15:04 them use AI to create that real human communication experiences where that's
15:09 actually supporting your your families, those patients or the entire community. We're actually creating tech that
15:16 connects. Check it out. Francis.ai. Very good. I don't know how you guys
15:22 ended up thinking hospitality manager or someone in that space, but it's so smart and I'll tell you why. Because I think
15:27 hospitality, especially when done well, they win time and time again. Recently, I was going to Boston and the first time
15:34 I went to Boston, I had an opportunity of a lifetime. So, I didn't book a hotel. I just had to get to Boston. So,
15:39 when I went there, I stayed at a horrible hotel. Hospitality was horrible. Wouldn't go back. Wouldn't recommend it. However, when I from that
15:46 hotel, I had to go drive to conduct an interview in person. And it was just I
15:51 think she was a supervisor of like food and beverage or something like that. But she was so kind from the time that I
15:57 walked in. Everyone I was only in the lobby just conducting this interview, but everyone was just so kind. She was
16:02 so kind. Um I left there thinking to myself, next time I come back to Boston, I'm staying here. I came to Boston two
16:09 weeks ago, two weeks after and I stayed at that same hotel because of those people. When in reality down the street
16:15 there was it was a Hyatt. I think it was between Hyatt and and Hilton. There was a Hilton down the street, a little less,
16:20 you know, expensive, but I remembered how I felt and how I was treated. So, I went back to that place and I was so
16:26 excited cuz when I went back, they like, "Oh my god, you're back." And I was only there for a couple hours. So, yes, it
16:31 matters so much when you can get that. You're always going to choose where that experience and where you felt cared for
16:38 and they were they were just nice to you, right? And and it's clean and all the other good stuff. So, as you mentioned, we have everything already
16:44 done. We just want that that care, that person to feel like, oh, I I want to recommend them. I want to come back next
16:50 week because I had so much fun. That is really really We're convinced. We're convinced the same way you are that that is the
16:56 winning formula. And actually, Mace, I say this a lot, but we we say this a lot is that to attract the best doctors to
17:03 come and practice here. We have to make the doctor feel welcome because doctors
17:09 have felt somewhat disenfranchised from the health care system. And that's why we've been so uh focused on keeping
17:17 ourselves locally owned, locally governed so that we can deliver first
17:22 class interpersonal relationships to physicians, nurses,
17:27 other technicians. Everybody that comes to work here needs to feel a great relationship and we're going to continue
17:33 to emphasize that. Paul, I see why you're the man to run the team. I mean, I'm pretty sure it's also good people around you, but these
17:40 ideas that you're saying doesn't happen often. I speak to a lot of people in this space and and you're really ahead
17:46 of the game. I mean, from the hospitality part to the AI part. Is there anything else that really separates you guys from the rest of the
17:53 individuals? Well, you can talk about we have a a meeting that Cara has organized as
17:59 quarterly and we call it culture cultivators and it's our mid-level management, but you might talk about how
18:05 we do that. Sure. So, it's C2 for short or culture cultivators. And we really wanted it to be an a beginning point or
18:13 a starting point for our culture. One thing we know in healthcare and I think that it's pretty much across the board
18:18 nationally that our frontline staff, they trust their manager, but they don't trust administration. So, the gap is
18:26 really big from administration to someone who's actually giving the care. And so as a way to try to reduce that
18:31 gap, we created a quarterly meeting with the middle management team and we have the administration talk to that middle
18:38 management team and they share this is what's happening in my organization transparently. This is what we're making
18:44 and losing as a as a hospital system. Here's what I'm doing that's making your experience great to be at work. Here's
18:51 an idea we heard from you that we're implementing because of something that you said and showing them that we're
18:56 listening and implementing all those things. And then they're able to take that information from that meeting and tell their frontline staff, guess what?
19:02 I heard from the CEO today. I heard from his leadership team. They gave me this to give to you. And so they have team
19:08 huddles and they share that information. And so we've seen that gap shrink tremendously. So much so that
19:14 year-over-year our employee engagement scores grew by 57%. And I know it's not
19:20 just that meeting. It's all these other things we've been talking about a friend. It's, you know, the the engagement, it's the leadershipmies,
19:27 it's the president's forum, it's these other opportunities that we're providing, but being able to shrink that gap and let middle managers know that we
19:34 had their back and we're communicating with them truthfully and honestly and that we're listening to their feedback
19:39 and incorporating it into what we do every single quarter. It really made a huge, huge difference. And so those
19:45 meetings now are just they're places of fun. Um they're places of engagement. People look forward to them. they feel
19:52 left out if they can't come and they want to join virtually even if they're off on PTO. Um, and then as a as a
19:58 secondary matter of that, we've created a speaker series as a kind of an off cycle meeting. And so we'll bring in
20:05 executives from various industries. We've had executives from aeronautics, from IBM, from Navy Seals. Um we've had
20:13 former um shopping executives and sausage manufacturer executives come and
20:19 talk to this group of healthcare middle managers and directors. But the thing that we really try to get
20:24 across is what does it take to be a leader? What does it take to build a great team? What does it take to provide
20:31 a sustainable culture to build trust, authenticity, to deal with change in a
20:37 transformative environment? because if you've been in the same job for 20 years and something's being done differently, you may not want to do it that way.
20:43 Yeah. So, helping leaders get, you know, okay with that or their team. Um, and so that's been a really fun component that
20:49 we've added on too. This has created kind of a cross functional awareness um education and then just a culture
20:55 bolster. This is so good. Like you guys, this is this just to hear where you guys are at.
21:00 It's so different than anybody else that I I'm seeing. Um, Paul, were you always in Naples or is did NCA
21:07 I've been I I spent my whole career really in Ohio? Um, up until six years
21:12 ago, I was recruited to come here because of a change in leadership, but I was in Cincinnati and up near Dayton and
21:19 then near Cleveland. And I was uh happy to come to a warmer climate.
21:25 So, I I really enjoyed the sun of Florida even though I still I love Ohio,
21:31 love Ohio State football. Uh, but it's fun to be in Florida where there's a lot of growth and a lot of opportunity. We
21:39 we're having some great innovations here and the population's growing. It's a
21:44 great environment for health care, I think. And so, it's a great place to be and it's a great time time to be in
21:50 healthcare too with so many innovations and so many things we can do for
21:55 patients that we couldn't do as recently as 10 years ago. Yeah. You you mentioned what does it
22:01 take to for a leader right what does it take to be a good leader what does it take first of all I want to go back to
22:06 the fun part I have on the board that I said one of my board members always says ephra is not fun it's not going to get
22:11 done right so bringing that fun into what you guys are doing allows people to really get engaged and now it's getting
22:17 done the things that you guys want is getting done because you brought fun to it so I actually love that I love that you guys thought beyond just the seauite
22:25 level right you guys truly thought about at the bottom line because you remember what it looked Like when we first got
22:30 started, I I say we, I didn't get started. Healthcare, by the way, is not my thing. Want to know why? I'll pass out by see blood. That's why.
22:38 Not my thing. Okay. When my wife gave birth, they almost needed two doctors in there. One for her, one for me.
22:45 What does it take? Back to that leader question. What does it take to to have a good leader? You guys been in this space
22:51 for so many years and probably worked with some that may not have been so good, but what does it take? Well, I'll
22:56 tell you when we we we spend a lot of time interviewing when we have a new teammate and we look for things like
23:03 inquisitiveness. Is a person curious? Are they interactive? Do they listen?
23:09 Because we believe in health care listening and listening to the patients is just so critically important. So, we
23:16 look for people like that. We look for people that uh come in with a problem-solving mentality. People that
23:22 can work well in teams because in health care very difficult to do anything on
23:28 your own including the CEO. CEO can do very little. It's really healthc care we
23:33 believe is a team sport. So you're looking for people that have demonstrated they can work on a team. We
23:40 look for uh athletes because people that have played on uh high school or
23:45 collegiate teams is a good background. People that have solved problems and they don't necessarily have to come from
23:51 healthcare. They can come from other industries. In fact, we think that's really important right now to have a
23:58 diversity of background. Uh so those are the qualities that we look for and we we
24:04 have a an interview process that includes multiple stakeholders here so that we look at a person from all
24:09 angles, right Cara? Yeah. And we we try to kind of take them around. It's not just a one-time interview. It's multiple days. It's
24:16 multiple types of situations and scenarios just to make sure it's a good fit because if you don't fit the
24:21 culture, you're ultimately not going to be successful. And so then it's our loss and theirs. And so we want it to be, you
24:26 know, easy from the the time they walk in to the time, you know, they get started and and feel imshed. The other
24:32 thing I think that's important, while we do try to look at talent from outside our pool, the other thing that Paul's
24:38 done a really great job at is really promoting a culture of promoting from within. And so, you know, the the
24:43 leadership forum he was talking about, it's called President's Forum of Excellence. It's one avenue to help our team do that. Another one is our
24:50 physician leadership academy. And while they're not being promoted necessarily, they're growing their skills and they're
24:55 getting crossf functional teamwork um with physicians from other areas within the hospital. And so, and then we do the
25:02 same thing on our nursing capacity, too. We have learning and skills training for them, you know, their first year of nursing all the way through to the time
25:08 they've been here for 20 years. And so, just helping those nurses and those team members really get acclimated to knowing
25:14 how and what it takes to become that next level leader. We're trying to share that information with them. And we're in
25:20 the process too because of this culture of creating a leadership boot camp. So when you go from being just a frontline
25:25 leader to all of a sudden now you have to manage a team and all of the downstream impacts that come with that. learning how to manage a budget or, you
25:32 know, deal with someone that needs FMLA or, you know, manage up for a very difficult um personnel issue um or learn
25:40 how to do lead a one-on-one, you know, anything like that from very simple to a little bit more robust. Trying to really
25:45 equip those leaders so they feel prepared to step into that leadership role. Not just because they've outgrown
25:51 the role they're in, but because we're helping them become that next level leader and coach. Yeah, it's so important to invest into
25:58 your leaders. Like I come from various industries and the one thing that I
26:03 couldn't stand is people put people in positions and never invest into them and expect them to get it right and then
26:10 when they fail it they look bad but it's like what what did you do to actually invest and because I do a lot of
26:15 coaching I was actually talking to um um it was a franchise owner from Firehouse
26:21 and one of my friends works there and he's like hey friend what can we do to build build sales you know he's like
26:27 our stores are down I'm Well, what are you doing to help your managers? Because to me, I always feel is at the manager
26:32 level. If you're not leading, if you're not pouring into that leader, that leader is not pouring into the people
26:38 under him, then how are you really growing? You know, because I've seen I've been in the, you know, the sandwich
26:43 shop or the sub shop industry. And whatever store that I went to was successful. Why? Because I understood how to lead and I found people that
26:49 would willing to be a part of my team because that matters so much that when
26:54 you walk away, you know, it's still running like if you're there. And that's the most important part is pouring into your staff. And I love that. I love that
27:01 you guys can. This whole conversation has been how do we pour into our people that work for us because it's not about
27:07 us when you're at that level. It's not about you, okay? It's about everybody else that's doing the actual work that
27:13 people don't realize. Um, so I I totally appreciate that you guys continue to
27:18 talk about pouring into someone and and hiring from within, right? Allowing them to know their value. Okay, we see your
27:25 value. Now, we want you to see your own value and let let's kind of walk through that. Um, this is just amazing. How long
27:31 have you been been working with each other? The whole five years, Paul and K. I came about a year and a half after he
27:36 he arrived. Cuz I only say that because the way that you guys, we were just talking. Paul
27:42 said something. And the way that you guys are transition, you can tell you do this often. And I'm like, wait a minute. This is a good duo right here. This is
27:48 unstoppable. You know, it's funny you said it often happens. I have an idea and that sometimes I mean we even talk sometimes
27:54 on the weekends and Carol will say you know I've been thinking about the same idea and here's my thoughts on that and
28:00 then we immediately kind of get get to that. So part of that that culture that
28:05 we have is trying to create people that are always sort of thinking about how can we get better and Cara is a a
28:11 perfect example of that and just trying to interject uh innovation ideas into
28:17 this culture thing. You know, one of the things we're thought and again Cara's
28:22 doing a lot with volunteers. We really think Ephrain that one of the next big areas is going to be to dip down into
28:28 the high schools now and start getting younger and younger people interested in healthcare in either a volunteer
28:36 capacity or whether we can train high schoolers to take on roles here in in
28:41 the hospital. Right, Cara? So, we have a six week program in the summer that's specifically for volunteer
28:49 here for about 6 weeks and you can do any number of jobs. But I just kind of asked the question, why couldn't they
28:55 just stay on? You know, as you know, being in Florida, Bright Futures is a is a great um program that requires you to
29:00 have a certain number of volunteer hours, but also it's allowed a lot of students in high school to dual enroll,
29:06 which means they have a lot of flexibility in their day-to-day work life, whereas some other locations in, you know, in the US don't have that. So,
29:13 my son is a great example. He doesn't have to go to school Monday, Wednesday, or Friday. So, he's able to volunteer
29:18 that entire day somewhere. And so being able to kind of tap those young, bright, energetic minds and get them invested in
29:26 something and show them them that there's capability, there's growth opportunity, that there's things they can do that aren't a nurse or a PA or a
29:33 doctor, that they could be a healthcare executive, um or be an HR person that knows everything about healthcare. Um
29:39 it's been really really exciting to see every orientation class since this summer, we've had an exceptional number
29:46 of teens coming in and wanting to work in healthcare. and not only just healthcare, but work at NCH because they
29:51 know that we're doing something different. So, it's been really great and I'm I'm grateful to the leadership team here to support initiatives like
29:57 that to help us do things like that. I love that. I think these are the conversations we should be having in high schools is having real authentic
30:03 conversations. Um, and becoming the president of my old high school, it is that it's talking about the nonprofits.
30:08 Let's talk about doing things that you have passion for. Um, things that are purposeful, right? Because a lot of the
30:14 times we're in schools, we're told to really chase the paychecks. And it's like that's not really what feels fills
30:20 my cup. And it doesn't fill a lot of people's cup. You can make all the money in the world and you're still not happy. But what happens when you're doing
30:25 something that is actually, you know, purposeful that really fills your cup at night when you go home like, man, I'm so
30:31 glad that I was able to help this woman or this man overcome whatever the situation was. So, no, it it definitely
30:37 does matter. And I love that you guys are in the space of just getting our our young ones in here um and helping with that work ethic. you know, no shade to
30:43 them, but the work ethic is a little different. So, I can imagine that you guys, you know, are pouring the good stuff into them. So, if they stay there,
30:49 great. If they actually spread their wings, that they've actually been taught well as well because of the good leadership. What does it look like
30:55 though? Volunteering. I think that's really fascinating that you guys mentioned that. If we can kind of talk about what does a dayto-day look like if
31:00 someone wants to go volunteer for the organization? Goodness. So, we have any number of positions available from the golf cart
31:07 driver that takes you to your car after you parked and brings you to the front door to a greeter that walks you to your
31:12 admitting appointment to someone who's managing the surgical waiting room to being embedded into our floors. So, we
31:19 we're getting ready to pilot a program here where we're embedding volunteers into our units to serve as additional
31:25 support for our nursing teams and to provide access to patients. So if a
31:30 patient needs a glass of water or needs an extra blanket, that volunteer can go and help provide lift not only to the
31:37 patient but to that nursing unit. As you know in healthcare, if you've been to the hospital or known anyone that has,
31:43 it's not always an easy time and there's times when you're bored and you may just want someone to talk to. So can we just
31:48 make that availability? Can someone just pop in and say, "Hey, I have a magazine. Is there anything else I can get you?"
31:54 And just to listen because sometimes they just they've been here for a couple days and they just need someone to talk to. So just finding ways I mean that's
32:00 the thing that you know is so great about the leadership is that we're just going to try it and see what happens and
32:05 so if someone has an idea we're going to say yes and then if it doesn't work we'll figure out a way to make it you know repurposed into something else. So
32:12 all kinds of volunteer opportunities available and I'm always excited and looking for more. What are some of the values you guys
32:18 live by? I mean I always feel that there's values that we live by as an organization. Um not only do we say it,
32:24 we actually live it. What are some of those values you guys have? Well, you know, you your the podcast
32:31 Heart and Hustle I guess are two I think really we we I think live by this idea
32:36 we're passionate about what we do and we don't uh sit back and let things happen.
32:42 We try to be a little bit faster than the average bear, faster than the average organization. Uh so those are
32:50 clearly two I think if you're in health care these days you have to have a certain energy level and um you know I
32:57 think the two of us both we talk about this because we both are fitness people. We like to be fit and keep our energy
33:04 level up to a point that we can be effective as leaders in a space that's
33:09 dynamic and we bring our best selves to this place every day and we have a team
33:15 of people around us that do the same thing. I think I think one thing that continues to be a theme for for us internally and as we
33:22 talk to our community is quality. So we're really focused on that, you hear that lingo quite a bit if you walk the
33:28 halls of NCH. And then excellence, you know, doing everything you can with excellence. So in almost, you know, I
33:34 like I like to say let's be superlative, not just let's be excellent, let's be better than excellent. Um learned that
33:39 from a from a dear friend of the hospital, Mr. Ralph Ster, and he just kind of challenged us. Can you be better than excellent? Can you provide better
33:46 service? you know, so what's that superlative nature look like? And I think in healthcare too, it's underlying
33:52 themes of compassion and empathy. They're always going to be there, but just making sure we never stray far away
33:57 from those things because even though we're hustling really hard, we still have to be compassionate, empathetic, cuz not every you just don't have it
34:03 every day. And so if we're willing to be empathetic and to and provide compassion on the days we don't have it, it lets
34:09 the others of us that do have it hustle harder for those that don't. I love it, Paul. I think you're you're going to be in trouble when people see
34:15 this and how good Kira is and they might try to actually her. So be very careful.
34:22 I can imagine. I'm just talking to her like, "Wait a minute. Can we duplicate her and and add her into other healthc
34:28 carees?" There's only one of her. They threw away the mold after they made Cara.
34:33 I love it. No. Um, I ask you Paul, when we talk about other CEOs that are not
34:38 talking about culture, if you can actually sit across from another CEO in America for just one minute, what would
34:44 you actually say about culture right now? Culture to me is more important now than
34:49 it ever has been because again going back to this idea that so many people are burned out. Number one, the other
34:56 thing is there's just this uh lack of trust across the United States,
35:02 especially with the young people. If they can't find a culture that they feel good about joining and that they trust
35:09 that, I just don't see how organizations are going to be able to fill the jobs because people are voting with their
35:15 feet right now. they'll they'll pass up a paycheck if if it's just not living in
35:21 alignment with their values and and with the way they want to live. So, I believe we're going to double down on trust here
35:28 and I believe over time it will be the winning strategy and we'll make our jobs
35:33 and our lives just enriched because we'll be living our true values.
35:39 Okay. How many locations do you guys have? I think there was one when I was looking up you guys have another one maybe opened up in the fall. Has it
35:45 opened up already? Yeah, we've got three hospitals now and we're we uh have uh over 200 other
35:52 locations throughout Southwest Florida with outpatient uh physician offices, diagnostic
35:59 centers, and then we've recently begun talking about a fourth hospital now out
36:04 in a Maria, which is north and east of Naples. Uh so our footprint will expand
36:10 a little bit here over the next couple of years. We're we're excited about that. Was that a goal of yours, Paul,
36:16 taking the seat? Yes. Not so much expansion for expansion's sake, but but we're big
36:21 believers here is that people want health care as close to their home as they can get it. And so when the
36:28 population begins to shift out to the north and the east, we want to be near people's homes so that they don't have
36:35 to drive to access healthcare. And we'll try to be in each of the neighborhoods here in Southwest Florida.
36:41 All right. Listen, I leave you guys with this blind question. This is the last question just to kind of get you guys thinking. You guys made coach your
36:48 cornerstone, but but leadership can be very lonely. What's one moment in the last few years that maybe have broke you
36:53 guys and how do you put yourself back together? I think it's always fascinating to figure that out because
36:58 we look great on the outside. Okay, you guys mentioned I look great. Sometimes though in the inside we're questioning
37:03 ourselves syndrome is running 100 miles per hour. So tell us if we want to start
37:09 off with Kira ladies first. I, you know, I there's a couple options I could I could go here, but I think for
37:15 for me in thinking back over the last few years, Hurricane Ian was probably um
37:20 one of the one of the hardest times for me personally, I'd not really ever been through that devastating of a hurricane
37:27 before. And so to have waters literally at the door of our hospital and not getting in and to know that we were, you
37:33 know, able to care for people who had lost their entire homes where they had lived for most of their, you know, most
37:38 of their lives, you know, just a couple blocks from here, water was 8 ft in people's homes. And so just seeing the
37:45 vast devastation of both the land and then the the people um was it was really
37:51 really tough. You know, that was that was a tough time. But there was a bright spot and that you know again the water
37:58 made it to the door but didn't come in. And for me that just was this it was this bolster that we are here for the
38:03 community by the community and so we're always going to be there no matter what even if a hurricane waters do get
38:09 through the door. And so the resilience of this team during that time was really what I think just kept us all going. Um
38:15 I know for me personally and just continue to see that time time after time whether it's a small or a large um
38:22 catastrophe. Yeah, that's a good one. I appreciate you sharing that, Paul. And that was that is a great example.
38:28 And to me, another one was in the early days of CO when you just really didn't know there wasn't enough data. Uh, you
38:35 know, we just we just had to make the best of a tough situation. And again, listen to our doctors, listen to the
38:42 experts at Mayo, and do the best we could to reassure the community, reassure our employees, and just not
38:49 lose focus in those early days of CO. So, but that's the challenge of healthcare. That's why we really like
38:55 health care and we love solving problems and working as a team and making a
39:00 difference here in Naples and in Southwest Florida. So, it's great to share these ideas with you. Uh, Ephrame
39:08 really is fun to do this. Yeah. Yeah. Not just share with me though, share with everyone that's listening. I think there's so much
39:13 things when we talk about leaders right now. We're in a space where government funding has really shaken everyone's
39:18 foundation and everyone's trying to figure out how do we pivot? How do we communi u move forward in these times?
39:24 And Paul, it doesn't look like you are worried at all. Like the both of you guys are sitting here very comfortable
39:29 understanding where you guys are at. And if I almost feel like if we can overcome the pandemic, oh, this is nothing to us.
39:35 It's just kind of the the the looks you guys got sometimes. Yes.
39:41 I appreciate you guys so much. What is the website? If someone wants to go volunteer, find out more about the hospital. To find out more about NCH, you can go
39:47 to www.nchmdmedical. nchmdmedicaldocctor.org and just to find volunteers, you would
39:54 do just do a back slashvolunteer on that. Love it. Are you guys on socials? Can they see you guys on socials or anything like that?
40:00 Social. Social media. Yep. So, um, our Instagram is NCH Florida. We're also on LinkedIn
40:05 as Naples Comprehensive Health-N. And we're on Facebook as the same.
40:11 Love it. Well guys, another amazing conversation with other great leaders into the space of just heart and hustle,
40:16 of giving back, of understanding what impact looks like in our community and just never giving up even when times get
40:22 hard. This is Paul Kira. I'm Era. We'll catch you guys on the next one. Latest.

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