Virtua hospital CEO on the frontline: Messes and a bullet-proof vest

Not all CEOs can go undercover the way Forman Mills CEO Rick Forman did on the TV show, but many chief executives actively try to spend time on the front lines with their employees. (Anything beats getting out of the office, right?) At Virtua, CEO Richard Miller's front line experiences including helping to clean up a patient who "messed herself," donning a bullet-proof vest at a shooting scene and entering an abandoned house in Camden with an emergency crew looking to help someone who had overdosed.

"I've actually done shifts," Miller told me during our Leadership Agenda interview published in Monday's Philadelphia Inquirer. "I've done a 12-hour nursing shift."

Question: How was that?

Answer:  It was a great experience, because I actually started with report out between the nurses going on and off the shift and I ended it with report out.

"It was really a fascinating experience watching how you care for patients.

"We had a patient -- I'll never forget this. The poor soul had dementia. She was an older woman in her 90s and, first of all, my legal counsel says, `Don't touch any of the patients. You can't touch any of the patients.' But I can't help myself.

"So we went into a room and I'm with a nurse and the [patient] had messed herself, this poor soul. So I'm just helping [the nurse] with the patient and the woman's daughter walks in the room and I hear her say, `Rich, what are you doing?' I had known this woman for years. I knew the daughter. [I said,] `I'm assisting the nurse.' She broke out laughing because I was helping with her Mom. She never forgot that.

"I loved the shift work because I learned a lot about nursing care, about medications."

Q: You've worked with other employees too, right?

A: The other experience I had was in the mobile intensive care unit. So, I spent a night in Camden with my mobile intensive, with my paramedics.

And the first thing I got was, the medic said, `Put the bulletproof vest on.' And I go, `What are you talking about?' He said, `Put it on."

"The first call we had was shooting, so I'm in the back of the vehicle and you never stay in the vehicle so, here I am with all the yellow tape around the shooting scene.

"I'll never forget. I get back in the rig and we're transporting a guy who was shot. We're in the rig and the guy's is in the ambulance. So the guy has a bullet hole in his thigh and the paramedic is getting the IV ready for the guy. This guy must have been 6 foot 5,  250 pounds. And the guy is [asking] the paramedic, `Is this going to hurt?' What? You just got shot in the leg.

"Then, they took me -- this is no lie, this is as scared as I've ever been. They get a call for a drug overdose at this abandoned apartment building in Camden, in the north end of Camden. We pull up, I'm in the back seat and I say, `Listen, I'm going to wait here.'

"The medic said, `You're not waiting for us in this rig. The tires will be gone and you'll be gone.'

"It's like in the movies. We're going up this stair case in an abandoned apartment building. It's pitch black and she goes to me,  `You stay right on my hip.' I go, `Sharon, I am surgically attached to your hip. I can't get any closer.'

"It was quite an experience to be on this rig. and seeing what our paramedics deal with on an ongoing basis -- I saw people who weren't taking their insulin, who were diabetics, going into diabetic shock and the work the paramedics do.

"I took a helicopter ride one time. We actually had a patient trapped between a boat and a pier. We had to go on the beach and get this person. The work these people do, God bless them."

Q: Who do you want to follow next?

A: Home health. I've been invited by one of my staff to do home visits, to see how that works.

Q: Is there a CEO entourage or are you alone with the worker?

A: Yes. When you spend 12 hours with a nurse, or an eight-hour shift with the medics, you are talking all the time. You become part of their team. The nurse wants me back. She says, `When are you coming back? You were great. I had another set of hands.' They enjoy it. They aren't afraid to have me on a shift. They want me on a shift. I think it's great to find out how people work, what their day is like, how they work through a day.

Q: Do you ever find out a little detail that you can fix that makes a difference? (Readers. keep in mind as you read this that Virtua went through a Six Sigma program with a lot of attention to process mapping and continuous improvement. What I wanted to know was whether real life experience by a CEO can augment that knowledge.)

A: When you see it live, it's all different. It's really a different experience. One thing, I found out when I did the 12-hour shift with our nurse, she would tell me to go get the pulse oximeter, which is a piece of technology to measure the oxygen in the blood.

"I'm out in the hallway looking for the pulse oximeter and it's all the way at the other end of the hallway so I said why do we only have one pulse ox on the whole floor. That said to me, `This poor nurse has to run from one end of the hallway to the other to get the pulse oximeter and we should have two of them on the hallway.' So I said, `Let's get another pulse ox.' She was happy about that. You could see it live what we weren't doing and what we needed to do.

Q: Yes, you might have the right ratio of patients per pulse ox, but you didn't have the right ratio...

A: for the number of feet she had to walk. In this hospital, every piece of technology is tagged with an RFID system, so we tag everything and we can find it quickly, so this hospital is so efficient in that regard.