One of Gus Valdespino's first jobs in healthcare involved a major expansion of a hospital. Now he's doing just the opposite.
During his tenure as chief operating officer at Los Alamitos (Calif.) Medical Center from 1987 to 1990, Valdespino oversaw a $12 million 28,000-square-foot expansion, which included a new lab and a new emergency room.
Then, last year, Valdespino put the finishing touches on consolidating three hospitals' top management staffs into one.
"No one enjoys downsizing, but in terms of putting a puzzle together, it's one of my strengths," Valdespino says.
Valdespino, 38, now chief executive officer at Tenet Healthcare Corp.'s Long Beach, Calif., campus, admits it wasn't easy, and in fact, he made some mistakes. But in the end the consolidation was needed to reduce duplication of tasks and services and to make three neighboring hospitals more efficient, says Neil Sorrentino, Tenet's senior vice president and CEO for Southern California.
Santa Barbara, Calif.-based Tenet's Long Beach campus consists of 148-bed Lakewood (Calif.) Regional Medical Center, 130-bed Suburban Medical Center in Paramount, Calif., and three additional regional health centers. The consolidation resulted in a top-level staff reduction of 3%, to 52, and a salary savings of about $2 million. Now the management of the three hospitals is under one roof and is led by Valdespino.
Even though the hospitals are all within about a 15-mile radius, they have distinct personalities, the main reason Valdespino took his time with the consolidation, he says. Lakewood serves an eclectic group of ethnic communities, while Los Alamitos serves mostly upper-middle-class families.
Meanwhile, Suburban serves a high Medi-Cal (California's Medicaid program) population. The hospital has presented a special challenge because its employees have suffered through three ownership changes in the past few years.
The first round of consolidation involved the Lakewood and Los Alamitos facilities and took about 18 months to complete, starting in 1994. Last year, it took Valdespino and his team about six months to add Suburban to the fold.
Because of each hospital's distinct culture, a cookie-cutter approach to the consolidation wouldn't have worked, Valdespino says.
"I don't think it's a good idea to come in and do wholesale changes," he says. "You need to decide who would fit better in each situation. And you have to allow time for (a manager's style) to develop."
Sorrentino added it was a "no-brainer" to put Valdespino in charge of the consolidations, not just because Valdespino had been CEO at Los Alamitos since 1994 and chief operating officer for four years before that, but because he has a "great gut for understanding issues.
"He has great instincts for people and situations and at the same time has a focused sensitivity for how he approaches his job," Sorrentino says. "To be successful, you have to have a broad view of what you're trying to do . .. and you have to assess what those changes mean as you progress. Gus is able to make that general assessment and make changes where change is needed."
During each consolidation, Valdespino's objective was to put one manager in charge of a specific area at all the facilities. In one example, a single manager covering medical records, case management and performance improvement wasn't working out, mostly because of each hospital's individuality, Valdespino says. For Los Alamitos, it was more important to have two managers, but Lakewood and Suburban shared one.
"Here we pushed the consolidation too hard and too fast," Valdespino says. "We identified the error, and I think built credibility in the end."
Sorrentino says it's important to have people like Valdespino who are able to look at things differently and to regroup when things are not working out as planned.
"We don't want `yes men,' " he says. "Gus is a very focused guy, and he's got a lot of street smarts."