Leslie Paul Luke has spent his entire career in healthcare administration, but it wasn’t until he took over as President and Chief Executive Officer at St. Joseph’s Health that he felt he no longer had to separate his spiritual beliefs from his job.
“With St. Joseph’s, I’m able to merge my values, my spiritual beliefs, and my professional skillset all into one. I don’t have to bifurcate them anymore,” Luke said. “That’s really important to me because to operate a healthcare system well, you have to come from the perspective of values, instead of, ‘This is just a business.’ St. Joseph’s really allowed me to do that.”
Luke earned a Masters of Health Administration from Brigham Young University in 1986 and went on to work for a variety of health care companies, most of them for-profit. He gained a reputation as someone who could come into a facility in poor financial straits or struggling to meet quality standards and turn it around. The first hospital he ran was a 50-bed facility in rural Kentucky in 1992. “I learned a lot about continuous improvement, and was able to turn that first hospital around by using those principles.”
Luke then became a Vice President of Quality at a larger teaching hospital to transform it to a quality-centered culture. Through that experience he learned that, in order to truly make a difference in an organization, he would have to hold the top job.
“You have to be a CEO,” he said. “Being a vice president of quality, you can say what you want, you can train everybody, but without the leader leading, it won’t work.”
Luke was CEO of three other hospitals before moving to Nashville, Tennessee, to join Community Health Systems (CHS) in 2005 where he was a corporate Vice President managing physician practices in four states. After eight years, CHS then assigned him to be Interim CEO for its struggling hospitals or health systems. During those assignments he would stay at the helm and help the facilities address their quality or financial issues, and then find a permanent CEO before moving to the next assignment.
In order to do such a job, Luke said it’s important to have a full understanding of how to provide quality health care. Doing so will lead to good financial results, he said, as will efficient management of the physicians who work at the Hospital.
But most importantly, he said, good leaders — even interim CEOs — have to think long-term.
“[The thing that] I learned from my interim experience was being able to quickly assess areas that can be improved and knowing how to make those improvements to the benefit of the organization,” Luke said. “Some people come in, they make changes, but instead of benefiting the organization in the end, they’re such short-term thinkers and can make a mess of things.”
A historic institution
Luke brought his experience to St. Joseph’s Health in February of 2017. Last year, the hospital on Prospect Hill celebrated its 150th anniversary. It was founded by the Sisters of St. Francis, including Saint Marianne Cope, as the first hospital open to the public in the city of Syracuse and one of the first 50 general hospitals in the U.S. The facility served the sick and injured without regard for ethnicity or religion. It thrived under the leadership of Saint Marianne who was known for her kindness, innovation in hospital management and her exceptional treatment of patients, particularly those who could not get care anywhere else.
Luke said St. Joseph’s strives to continue to uphold those values today.
“Our mission and values are our driving force to do what we do today,” he said. “When we look at the programs and services we offer, our biggest concern is if they are going to meet the needs of our patients and community, particularly the underserved.”
Luke said the hospital gives more than $50 million per year into the greater Syracuse area in community benefit. That’s accomplished through providing healthcare for the poor and underserved as well as partnerships with local nonprofits like the Northside Urban Partnership (Northside UP) as well as others.
“We had an area adjacent to the hospital that was really run down,” Luke recalled. “We partnered up with a developer and Northside UP, and we were able to build some really nice affordable housing that improved the neighborhood.”
That housing not only helps the community at large, but it helps St. Joseph’s larger goals of making a healthier community.
“There are influencers of health like the need for affordable housing. With projects like this we’re able to meet our mission objectives,” Luke said.
Community health care
St. Joseph’s has also worked to meet those objectives by expanding its influence. In addition to the hospital on the city’s North Side, St. Joseph’s Health has satellite primary care locations throughout Central New York including two other locations in Syracuse (James and Gifford streets), as well as in Cazenovia, Fayetteville, Liverpool, and most recently Camillus.
“Gone is the day in which people have to come to a hospital to get their health care,” Luke said. “Health providers need to learn to get into the communities that they serve.”
Luke said the hospital’s leadership felt that reaching out into those communities was imperative.
“There are some communities out there that have difficulty, for instance, getting good cardiac care,” he said. “We’re able to rotate our cardiologists through clinics in those communities. But then if a patient needs more advanced cardiac care, they’re now within our network and we’re able to provide care here at the hospital.”
St. Joseph’s is also a member of Trinity Health, a network of Catholic health systems operating 93 hospitals in 22 states. Those connections allow the organization to share services with other, often smaller hospitals that might not be able to offer the same specialties.
“It doesn’t mean that rural hospitals are not a great place to receive care,” Luke said. “It really just comes down to the fact that many specialists tend to want to live in more urban environments, but they’re more than willing to go out to these rural partners to assist.”
He pointed to relationships St. Joseph’s Health has with Rome Memorial Hospital and Our Lady of Lourdes Hospital in Binghamton as examples.
“We work together to make sure that we’re complementing each other’s care,” Luke said. “We may work together to establish a clinic using both of our resources, and then again, both of our hospitals and health systems can put various specialists into communities that otherwise wouldn’t have them.”
Value-based care
In order to ensure that patients are receiving the best care, Luke recently traveled with Trinity Health President and CEO Michael Slubowski among others to Washington, D.C.. There they met with 24th District Rep. John Katko (R-Camillus) and Senate Minority Leader Chuck Schumer (D-NY) to advocate for value-based policy. A value-based reimbursement structure, whether it’s through Medicare or private insurers, focuses on the level of service and quality of care provided by physicians and health care professionals, offering incentives to provide the best care at the lowest cost. Luke said it’s a much more effective way to provide care to patients.
“We don’t look at our community members just as people who come in for episodic care,” Luke said. “We feel like they are people with whom we interact all the time. We want to be a part of their lives and keep them healthy so they don’t actually need to come into a hospital for serious episodic care.”
Not only will value-based policy change the way health care is provided, but it fits into St. Joseph’s larger mission of collaborative, community-based care of the whole patient.
“It makes healthcare providers look at all of the influencers of health,” Luke said. “Just as I talked about affordable housing, improving community health and well-being is critical such as tobacco cessation, reduction of diabetes and obesity. So as an example, to improve community health we need to look at the kinds of foods that are out there and their nutritional value. We once again partner up with other community resources to improve nutrition, or we can do some of this directly through education, or through outpatient programs. This helps people better manage the healthcare within their lives. By doing that, we not only improve the quality of their life but, as we reduce episodic high expense care, we drive down the cost of care to the government and to insurers.”
He said value-based care encourages practitioners to look at the whole patient instead of the particular problem they’re being seen for.
“We’re not just saying, ‘Hey, you need a valve replacement,’” he said. “Instead, we’re saying, ‘Okay, before you even came into the hospital, how well were we helping you manage the contributing factors that lead to your heart failure?’
In using this approach, Luke said, St. Joseph’s is providing better quality care at a lower cost.
“We’re trying to deliver a high-value product, and last time I looked, we’re the highest value system in Central New York because we offer great quality at reasonable costs,” he said.
Mission and values
Quality of care, Luke said, draws physicians and staff to St. Joseph’s Health.
“They come here because they really want to help people to be healthy, or to help them to get better,” he said. “Moreso, I think people are coming because of our mission and values.”
Luke said the hospital leadership does all it can to instill those values in its staff.
“We try to tie a lot of our decisions and how we communicate with our colleagues back to the values. We ask them, ‘Do we have integrity in what we are doing?’” he said. “’Are we considering reverence? Are we valuing the individual?’ By asking these questions and honoring our values, our colleagues are better able to understand how they fit and how they can contribute, not only to the values, but also to the job that they’re doing.” And those values shine through in the treatment patients receive.
“I get a lot of thank you notes from patients and families,” Luke said. “The majority of those letters acknowledge the great clinical care the patient received. And then they tend to go on and say, ‘So-and-so did a great job helping me feel better, even though it was a really tough time for me.’ ‘So-and-so went out of her way and got me a blanket or food when I didn’t even ask for it. They anticipated my needs.’ What those letters are reflecting is that our colleagues are not just looking at patient care as the clinical care, they’re looking at it as healing the whole person, the spirit, the body, emotionally, et cetera.”
Once again, Luke said, this demonstrates St. Joseph’s commitment to the patient as a whole person, not just a list of symptoms to be addressed.
“Our colleagues and doctors look beyond whatever that diagnosis is and can find things that will help the patient get better that may not be directly related to that diagnosis,” he said. “They may discover that these patients can’t access healthy food. So, we find a way to provide that to them. Again, we’re looking at the care of the person throughout the whole system of their life, which is not just the episodic event.”
In the coming years, Luke said he hopes to continue to expand that mission into other communities so that it can provide the best outpatient and primary care to people closest to their homes. He aims to bring financial stability to St. Joseph’s Health to make it the largest, most comprehensive health system in Central New York while providing the highest quality care at the lowest cost. And he hopes to continue to be what he calls a “servant leader.”
“If we are humble, and we come from the orientation of, ‘I am serving you,’ that makes you an effective leader, versus individuals saying, ‘Well, you’re here to serve me,’” Luke said. “If an organization is based on an individual’s charisma, or an individual’s own leadership style and not on the mission and values, the organization will not be able to stand for a very long time. I really believe the best leaders are very civil people. They care about others. They’re polite, they’re kind, and they’re able to lead by example so that people want to follow. They are not compelled to follow.”
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