Front & Center: Sacred Heart CEO Alex Jackson reflects on changing health care climate

When Alex Jackson was in grade school, a neighbor hired him to help move garden dirt. So he began shoveling the soil into a wheelbarrow a few paces away.

“Alex, what are you doing?” the woman asked.

He replied, “I’m doing exactly what you wanted me to do. I’m moving dirt in the wheelbarrow.”

“I’m not paying you to walk back and forth,” the neighbor said. “You need to have your wheelbarrow next to your job site.”

Thirty-three years later, Jackson still reflects on the lesson he learned that day. As chief executive of Providence Sacred Heart Medical Center and Holy Family Hospital, he’s constantly looking for ways to minimize waste.

“Efficiency is really important in all aspects of health care,” Jackson says – “setting up the workplace and giving people the tools to be successful.”

During a recent interview, Jackson discussed the diverse résumé he built before discovering his true calling; how, despite losing utility power, Sacred Heart stayed open following the recent windstorm devastation; and what about health care he’d change if he could.

S-R: Where did you grow up?

Jackson: In Missoula.

S-R: What were your interests back then?

Jackson: I loved sports. I played a little bit of everything – basketball, track, soccer, debate – but none of them very well.

S-R: Did you have a favorite class?

Jackson: I always liked history – I still do. I also liked political science and numbers, and I was the editor of my high school newspaper.

S-R: Did you envision a particular career?

Jackson: Not really. I went to Indiana University for three of their programs – political science, business and journalism. But after taking a class taught by the administrator of Bloomington Hospital, I began seeing health care as the ultimate industry. And the more I learned, the more I realized that health care needed to change – it needed to apply better business principles and practices while still being compassionate while serving others.

S-R: What jobs did you have before getting into health care?

Jackson: When I was around 10, I began working for neighbors – mowing lawns, housesitting. Later I worked in the food industry, starting out as a dishwasher and working my way up to host at a busy Missoula restaurant. I worked for a car rental agency, a flower shop, a shipping company, and spent a summer on a forest firefighting crew. My freshman year in high school, I sold expensive Oriental rugs. I also worked at the Western Montana Fair.

S-R: What skills learned in those jobs transferred to this one?

Jackson: People skills. When you’re a busboy or a waiter, it’s about being fast and pleasant. If there’s a problem, you have to fix it as quick as you can. When you’re selling something, you have to be able to listen, guide people to what they’re looking for and close the deal. I don’t sell products here, but I sell ideas.

S-R: What was your first job in this industry?

Jackson: After graduating from Indiana, I went to the University of North Carolina and got a master’s in health care administration. And I was really fortunate to get an administrative fellowship at the Cleveland Clinic, which bridged my academic learning with the real world. Since then, I’ve worked at Providence for 18 years, the first 16 in Oregon.

S-R: What impact has the Affordable Care Act had on your industry?

Jackson: That’s one of the biggest changes in health care in the past three decades. We’ve seen a significant drop in the uninsured in Spokane County, as well as an increased demand for services since January 2014. But the Affordable Care Act was largely funded by reducing payments to hospitals, so we’re still trying to balance providing more services and receiving less compensation.

S-R: How has technology affected health care?

Jackson: The big change has been the use of electronic medical records. We went live with a fully electronic medical system in late 2013, and it has impacted every person in our hospitals. For instance, when a doctor enters an order into the system, it automatically goes to the nurse, the respiratory therapist, the pharmacist – everyone involved with that patient’s care.

S-R: Does better communication mean doctors can treat more patients, spend more time with patients, or something else?

Jackson: (laugh) Let’s not go there. But an electronic medical system is like taking all the chapters of someone’s medical care and binding it into a book. One result is that physicians have better access to the latest lab tests and X-rays, which reduces duplication.

S-R: Did the recent windstorm disrupt hospital services?

Jackson: We were on generator power for 16 1/2 hours – the longest time in Sacred Heart history – but our doors remained open.

S-R: What’s your typical workday?

Jackson: Seven a.m. to 6 p.m. Monday through Friday. I often work at night, too. I really try to take Saturday and Sunday off to spend time with my family.

S-R: What do you like most about your job?

Jackson: Health care is the ultimate industry for serving people. And it lets me work with bright, passionate people.

S-R: What do you like least?

Jackson: I still love numbers, but the budget stuff is always tough. It’s a lot of work within a compressed amount of time.

S-R: What’s been your best idea since joining Sacred Heart two years ago?

Jackson: More harm happens in health care than any of us are proud of, and often it’s the result of breakdowns in communication. So soon after I arrived, we started what we call the daily safety huddle. Each morning, we bring department leaders together for about 15 minutes at Sacred Heart and Holy Family, and we identify things that are working, things that are not working, and risks to patients or caregivers. It’s really fun to see how the huddle has evolved. It has created a sense of community and allowed us to fix safety problems more quickly.

S-R: If you could change anything about health care, what would it be?

Jackson: As much as we love to serve people in hospitals, I’d encourage more preventive care. Hospitals are an important part of health care, but they’re only a small part. Health care starts with the decisions we make or don’t make every day – what we eat, how much we exercise, when we go to the doctor or don’t go. If we did a better job at prevention, we could spend a lot less on health care as a country.

S-R: What qualities do you look for in prospective employees?

Jackson: When I meet with new employees during their orientation, I tell them that we hire people for their head, but we want them to work with their heart. And when we survey employees and ask why they work here, one of the top reasons they cite is Providence’s mission.

S-R: What’s Providence’s mission?

Jackson: “As people of Providence, we reveal God’s love for all, especially the poor and vulnerable, through our compassionate service.” That’s our mission.

S-R: How do you get doctors and support staff to embrace that?

Jackson: One thing we do is start every meeting with a reflection – we pause and think about the purpose of the meeting – so that when we make decisions, they’re grounded in our core values.

S-R: What’s the career outlook for this industry?

Jackson: Forecasts suggest there won’t be as many hospitals in 20 years as there are today because of rising costs and falling revenue. If you go back a few years, patients having their gall bladder removed would stay in the hospital for a couple of days. Now they’re discharged in a few hours. But as long as people get sick, there will be jobs in health care. Next month we’ll open our new critical-care expansion unit, so right now we’re hiring people to staff those 12 additional beds.

S-R: Is the prospect of two medical schools here a good thing?

Jackson: Yes, if it means attracting more physicians to Spokane. We don’t have as many physicians per capita – particularly primary care – as other metropolitan areas around the country.

S-R: What sort of person is best suited for hospital administration?

Jackson: Someone who’s focused on results, is passionate about people, and who believes in the organization’s mission and values.

S-R: Is there anything about you that might surprise people who know you?

Jackson: They might be surprised that I raised sheep when I was growing up. I was in 4-H for 10 years and participated in a statewide livestock judging competition.

S-R: How do you relax?

Jackson: My wife and I are best friends, and I really try to be present in my kids’ lives. When they play sports, I’m on the sideline rooting for them and the other kids.

This interview has been condensed. If you’d like to suggest a business or community leader to profile, contact Michael Guilfoil at mguilfoil@comcast.net.