When David Entwistle became chief executive officer of University of Utah Hospitals and Clinics in February 2007, he had plenty of goals—but three in particular. “Our No. 1 goal is patient satisfaction. Two, quality-of-care. Three fiscal responsibility,” he rattles off. “Our focus is on those three things, and how do we get those fundamentals down?”
Patient-care scores on Press Ganey surveys have risen from the “low teens, now pushing toward the 50th percentile,” says Entwistle, with a goal of reaching the 90th percentile by next year. He has worked department by department to set goals.
Among the satisfiers have been reductions in average inpatient length of stay, from 6.2 days to 5.8 days, and in average wait time in the emergency room, from nine to three hours—battleship-sized turnarounds in a four-hospital system with 5,500 employees, 23,000 inpatient admissions and 1.2 million outpatient clinic visits annually.
Entwistle, 39, has brought fiscal discipline to the Salt Lake City system despite the CMS’ changes to upper payment limit calculations that produced a $36 million hit on its $603 million annual budget. “We have been able to maintain our budget, despite shortfalls in those areas,” he says. “We have to be able to produce capital to grow and meet our needs. We like to say, our budget is a plan—not a wish.”
Another significant change during Entwistle’s tenure has been on the capital improvement side, where the system is undertaking a 250,000-square-foot expansion that will convert all inpatient rooms to private ones in the main hospital while also doubling the size of the cancer hospital; the system also has separate orthopedic and psychiatric facilities.
“He’s an individual who thinks out of the box, creates a vision that is compelling, and gains the support of those who work in the hospitals and clinics,” says A. Lorris Betz, senior vice president for health sciences and CEO of University Health Care. “The relationship of trust that he’s built with the physician leadership has been tremendous.”
Entwistle gets similar raves for his performance as senior vice president and chief operating officer at the University of Wisconsin Hospital and Clinics in Madison, where he worked for six years before taking the helm in Utah.
Donna Sollenberger, former CEO at University of Wisconsin Hospital and Clinics who’s now CEO of Baylor Clinic and Hospital in Houston, says that he helped drive an increase in patient satisfaction to the 95th percentile from the 37th on Press Ganey surveys while lowering employee turnover to nearly 10% per year from 20%. “A lot of what he put into place … really solidified and became ingrained as a practice,” she says. “There’s a real calming consistency about David and his leadership that make people want to perform better.”