Jack Bovender: Rebuilding a quality culture at HCA
By Adam Rubenfire | March 14, 2015
Jack Bovender graduated from Duke University with a master's degree in hospital administration in 1969, armed with advanced skills in finance, systems organization and strategic planning. But his mother, Eva, a nurse, reminded him that he would need more than business acumen to become an accomplished leader.
“My mother once told me, when I first went into hospital administration, that if you listen to the nurses and you do what they tell you to do, you'll be successful,” Bovender said. “If you don't listen, you'll make a lot of mistakes.”
He took her advice to heart. Bovender, now 69, said he always made it a habit to talk with the nurses in the critical-care unit, hang out in the doctors' dining room and spend as much time as possible in the halls of the hospitals he led, learning from his staff. It's an approach he used in his early administrative roles and continued through his eight years leading HCA, the nation's largest hospital chain at the time.
Bovender said he always valued and enjoyed getting down in the trenches as a hospital administrator, going back to when he was a Navy lieutenant stationed at the Naval Regional Medical Center in Portsmouth, Va., in the early 1970s, and in his subsequent roles leading Medical Center Hospital in Largo, Fla., and West Florida Regional Medical Center in Pensacola, both HCA hospitals.
“There are people who will sit and listen and agree but never do anything with the information they receive,” Bovender said. “I always tried to react and take the information I had to make life easier for nurses and doctors and other people in the hospital, and tried to solve problems and bring resources to where they were needed.”
That strategy helped him flourish at healthcare giant HCA, where he held several senior-level positions before becoming chief operating officer and executive vice president in 1992 and later CEO, a role he held from 2001 to 2009, in addition to becoming chairman in 2002.
For his lifetime achievements, Bovender was chosen to be inducted into the Health Care Hall of Fame.
Selected career highlights
2002-09: CEO and chairman at HCA
2001: Named CEO at HCA
1997: After short retirement, returns as president and chief operating officer at HCA
1995: Founding member of the Nashville Health Care Council
1985-92: Held several senior-level positions at HCA, including division vice president and finally executive vice president and COO
1969: Begins hospital administration career as a U.S. Navy lieutenant at the Naval Regional Medical Center, Portsmouth, Va.
2012: Distinguished Alumni Award from Duke University
2003, 2004 and 2005: Named “Best CEO in America” by Institutional Investor magazine
2007: Gold Medal winner, the highest honor bestowed by the American College of Healthcare Executives
2007: Woodrow Wilson Award for Corporate Citizenship from the Woodrow Wilson International Center for Scholars
Nashville-based HCA underwent significant expansion during Bovender's time in the C-suite, including its $855 million acquisition of 11-hospital Health Midwest in 2003, which created HCA Midwest Health. He was also COO during HCA's 1994 merger with Columbia Hospital Corp., which led to the company's renaming as Columbia/HCA. The company later dropped the Columbia part of its name in 2000.
HCA's current chairman and CEO, Milton Johnson, said Bovender always strived to be a highly inclusive leader. Regardless of his own conclusions about how company decisions should be carried out, he would go around the boardroom table and hear what each member of his team had to say, Johnson said.
“At the end the day, as the CEO, you have to be decisive, because you have to live with the decisions you make,” he said. “Jack certainly understood that, but at the same time he would also think of you and take your ideas into account.”
Johnson added that Bovender did not necessarily lead his executive team as a democracy. Even if the majority thought one way about something, he would go in another direction if he thought it was the right choice.
Bovender left publicly traded HCA as executive vice president and COO in 1994, shortly after the company merged with Columbia. But in 1997, he was asked to return as president and COO with the support of one of HCA's founders, Dr. Thomas Frist Jr., who had returned to lead the company as chairman and CEO after Rick Scott was ousted as CEO. Scott, currently the governor of Florida, was forced to leave HCA when the company was investigated for fraud by the federal government.
Those fraud investigations ultimately resulted in a historic $1.7 billion settlement with the feds, and Bovender's accumulated leadership and interpersonal skills were put to the test in helping steer the chain through the tumultuous years following its multiple legal challenges.
Jack Bovender began his hospital administration career as a Navy lieutenant assigned to the Naval Regional Medical Center in Portsmouth, Va..
Frist said he needed Bovender to help him get HCA back on track. “I knew the very best person to do that with me, and to help rebuild what we had before Columbia, and put an appropriate culture in place was Jack Bovender,” Frist said. “He had very high standards and he led by example.”
Outsiders agree. Bovender put a strong focus on improving corporate culture following HCA's legal crises, said Wayne Smith, chairman and CEO of Community Health Systems in Franklin, Tenn. “Jack brought integrity and stability, and returned HCA to the outstanding organization with the great reputation it has today,” Smith said.
But Bovender did more than restore order at HCA. After he was named CEO in 2001, he launched several programs in workforce development, patient safety and administrative efficiency that leaders both in and outside of HCA say have left a lasting impact on the company and the industry.
Realizing that many HCA division heads and senior executives were nearing retirement, Bovender decided shortly after he took the helm that the company needed to find better ways to more swiftly develop young talent. In 2001, he launched HCA's COO Development Program, which recruited individuals from graduate programs in healthcare administration and business, paired them with mentors and offered them hospital as well as corporate-level experiences to prepare them for becoming chief operating officers.
“We were very committed at HCA—and continue to be committed—to promoting from within,” Bovender said. “We see it as somewhat of a problem when we have to go outside of the company.”
At the 2012 annual joint meeting of the Japan-U.S. Southeast Association and the Southeast U.S./Japan Association in Tokyo, Bovender, then chairman of SEUS/Japan, participates in ceremonies with Hiromasa Yonekura, chairman of the Japanese association. The groups work to foster closer business and cultural ties.
That program, now called the Executive Development Program, was eventually expanded to a wider variety of healthcare leadership positions. Bovender also named himself the company's chief diversity officer, and emphasized that the development program must focus on hiring more women and minorities to fill the system's ranks, which at the time, were overwhelmingly male and white, mirroring most of the industry.
Bovender wanted HCA to lead the healthcare field toward a more diverse executive workforce and a safer environment for patients. He pledged that HCA wouldn't compete on matters of safety and would instead share its best practices with all organizations. Bovender said every hospital should have its own patient-safety staff, not just at the corporate level, noting that HCA needed a unified effort across all locations to improve its safety record. He worked with Jane Englebright, then the company's vice president of patient safety, to bring together HCA's thought leaders to share best practices in patient safety across the company on an ongoing basis.
Under Bovender and Englebright's leadership, HCA became one of the first systems to use bar-code verification technology to avoid medication errors. The hospital chain went beyond the Veterans Health Administration's pioneering use of the technology, expanding its use beyond medications and broadening its user base to include respiratory therapists, in addition to nurses.
“Jack was a tremendous supporter of that,” Englebright said. “I think it just made sense—we scan our groceries, we should scan our drugs.” Englebright is currently a senior vice president at HCA, as well as its chief nursing officer and patient safety officer.
Although it was relatively easy for Bovender to achieve company consensus around growing leadership talent and improving patient safety, not every project he spearheaded was popular. Toward the end of his career, he led an effort to centralize HCA hospitals' back-office services such as patient accounts, supply chain, credentialing and payroll, in an effort to improve efficiency and lower costs.
The project created friction between the corporate team and hospital administrators, as Frist remembers it. But he notes that Bovender's hands-on leadership approach also helped calm administrators who were concerned about the welfare of their staff and the quality of their back-office services.
“It took not just salesmanship but actually getting out there with the people and articulating the strategy of why this was good for everyone and why this was effective,” Frist said.
Regardless of the decision to be made, Bovender brought the smartest people he knew into the room and then went with his gut instincts to forge ahead, said William Carpenter III, chairman and CEO of Brentwood, Tenn.-based LifePoint Hospitals, which was spun off from HCA in 1999.
“When I think about Jack and his leadership style particularly, I think of a decisive leader who makes decisions based on fundamental beliefs about what is right,” Carpenter said. “He's very focused on doing the right thing ... for patients, for physicians and for his company.”
Follow Adam Rubenfire on Twitter: @arubenfire