Behavioral health services were not a central priority at St. Dominic-Jackson Memorial Hospital in Jackson, Miss., when Trace Swartzfager became vice president of the division in 1996. Located across the street from the main facility, the
division was a "status quo, laissez-faire" program, Swartzfager says.
felt like (St. Dominic was) a real diamond in the rough," he recalls of his previous stint as associate administrator of behavioral health services for Forrest General Hospital in Hattiesburg, Miss., a competitor located 90 miles away.
Based on his belief that "There's no real separation between the mind and body element in terms of healthcare," Swartz-fager, 39, worked to make behavioral health more central to the mission of 571-bed St. Dominic. In the eight years since, the average daily census in the 118-bed division has risen from about 60 to the upper 80s or low 90s and customer-satisfaction scores have risen from about the 50th percentile to the 99th percentile in 2004, he says.
In part Swartzfager and his staff achieved these results by decentralizing, opening seven outreach offices in rural parts of Mississippi that, by early September, had accounted for 47% of inpatient admissions.
At the main building, Swartz-fager cleared a vending area at the front entrance to make way for an intake assessment office. "Before I came, you had to have a psychiatrist call to you get admitted. That's sort of a 1965 way of doing things," he says.
For Claude Harbarger, president of St. Dominic, Swartzfager brings a blend of assets. "He brings a good balance of people skills and being able to get operational tasks accomplished," Harbarger says.
A 1987 University of Mississippi graduate, Swartzfager was candid about his aspirations with the CEO of Charter Behavioral Health System of Mississippi, where he worked from 1989-95. At age 23, he made an appointment with his boss and told him: "My goal is to be a hospital CEO. I know I'm young, I know I don't have all the exposure and experience, but I wanted to tell you that in hopes that maybe I can get there."
"He took that very seriously to the point where he said, `One of the first things we're going to need to do is have you go get your master's degree,' " Swartzfager recalls. Charter paid for him to obtain his MBA, and he subsequently received a promotion to assistant administrator.
Swartzfager later had the chance to become CEO of a hospital Charter had just bought in Lafayette, La., but decided it wasn't the best opportunity.
"The first thing I was going to have to do was fire 40 people," he says. "You don't expect to fire 40 people and then stay for very long because you're never going to have the trust of the people who are left."
Although that CEO goal remains unfulfilled for now, Swartzfager says he has enjoyed CEO-like responsibilities within his division. "The buck stops with me," he says.