"This is a long, crazy story," chuckled Cynthia Moore-Hardy, embarking on a narration of her career path.
Indeed, the chief operating officer at Lake Hospital System in northeast Ohio didn't take a direct route into administration. First, she spent nine years in nursing.
Moore-Hardy's first job was in intensive care at Saint Luke's Medical Center in her hometown of Cleveland. She advanced to become a director of nursing, but those years convinced her that key decisions affecting patient care and services were made not in nursing but in the corridors of administration. She decided to learn the language of business.
Her part-time pursuit of an MBA at Cleveland State University wasn't entirely smooth. Other nurses wondered why she wasn't getting a master's of science in nursing, which would lead to a clinical leadership role. "At the time," she said, "I was considered a little bit of a traitor."
In 1988, she made the leap to Painesville, Ohio-based Lake Hospital System, which recruited her to revamp its unprofitable Lake County, now has two hospitals, three urgent-care centers, an ambulatory-care center, and a rehabilitation and wellness center. It has a staff of 2,000.
At Lake, Moore-Hardy, 39, has earned a reputation as smart and unrelenting. Ralph Sorrell, president and chief executive officer, called her "tenacious as a bulldog."
Moore-Hardy brought the cardiac catheterization lab to profitability, mainly by changing the pricing structure and renegotiating and streamlining key supply items. Then she turned her attention to other departments. One of her biggest challenges was women's services.
In the early 1990s, Lake's market share in women's services was declining. The average age of its obstetricians was 57, and those doctors had lost interest in doing deliveries, Moore-Hardy said. "A dogfight" is how Sorrell described efforts to change attitudes.
Under Moore-Hardy's direction, the system is developing a comprehensive women's services program. It recruited five new obstetricians and opened a level-two nursery for sick babies at LakeEast Hospital in Painesville. Patient satisfaction with obstetrics services has increased significantly since 1991, Sorrell said.
Recently, Moore-Hardy persuaded the system's trustees to build and equip an obstetrics floor at LakeWest Hospital in Willoughby, Ohio. The facility is expected to open in the second half of 1998.
It took more than two years and 15 meetings to win the board's approval, said Paula Bell, a trustee who met Moore-Hardy at a leadership training program in 1993.
"She brought in facts and figures, the concept of the building, the percentage of the population we'd be driving toward," Bell said. "I give Cynthia a lot of credit because if she ever became defeated, I never saw it."
Moore-Hardy told board members the estimated $7.6 million expenditure would ensure a future stream of patients. "OB is a critical entryway into the healthcare system. It is there you create many of your family relationships," Moore-Hardy said.
Since 1988, the Lake system has battled unsuccessfully for a certificate of need to do open-heart surgery. It's been Moore-Hardy's job to coordinate the effort, which has included multiple applications and court proceedings. "At times it's very frustrating, but our belief is it's a service we need to bring to the community," Moore-Hardy said. "It's also our belief that open-heart surgery is not just a tertiary service anymore."
Moore-Hardy said her clinical experience helps her relate management goals to employees and physicians. She's not big on setting policies and procedures but rather establishing goals. "When you're making changes it's important to share what you visualize at the end and how it will benefit the organization," she said.
Outside her job, Moore-Hardy is secretary of the Make-A-Wish Foundation of Northeast Ohio, which benefits children with potentially life-threatening illnesses, and participates in the teen ministry at her church. Her idea of a vacation is a bicycle tour with her husband, Jeffrey.
Moore-Hardy thinks about becoming a hospital CEO some day but for now enjoys her COO role, which she assumed last year. She said: "Probably my greatest personal goal is to maintain my sense of humor."