Tulare Regional Medical Center: Shawn Bolouki, CEO

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Construction on the original Tulare Hospital began in 1949 and more than half a century later, the organization is breaking ground for an expansion project that will position them to continue meeting the needs of their region.

Shawn Bolouki took over as CEO of Tulare Regional Medical Center two years ago. Said Shawn,  “When I arrived at Tulare Regional Medical Center there wasn’t a permanent management team.  The first six months I hired a Vice President of Business Development, a Vice President of Human Resources, a Chief Clinical Officer, a combined position of Chief Operations/Chief Financial Officer (COO/CFO) and created the position of Chief Compliance/Quality Officer.”

The 112-inpatient bed facility was projected to lose more than a million dollars the year Bolouki arrived. “The first year I was here, we turned it around and the hospital had a positive operating margin of $2.8 Million. We are now focusing on the expansion project.”

Items of No Compromise

“My management philosophy is really very simple,” said Bolouki. “The keys to success are; no compromise on quality of patient care, and no compromise on compliance requirements with regulatory agencies.  In addition, focused customer service is paramount.  For any organization to be successful, it has to be financially viable and fiscally disciplined.”

Bolouki believes in open dialogue. “Considering all the pending changes in healthcare, there is no such thing as over-communicating. Keep everybody informed of what the challenges are, then when we make difficult decisions, they will understand the reason behind our decisions,” he says.

“Tulare Regional Medical Center has many long-term employees,” he said. “They have their culture and values. When I came into the organization and needed to make changes, I had to look at how to make changes within the context of the existing culture. If it seems that everything has been working fine for the past 20 years, you really have to build a compelling reason for employees to understand why changes are needed.”

Bolouki says the constant challenge in his job is that he has to clearly explain to the employee’s the current status of the hospital and how it is performing.   If Tulare Regional Medical Center continued on the same path, it was not going to be a successful organization and I needed to change the way we do business.

“Change is difficult because we are human beings. We are afraid of the unknown. If the organization is going through this process and I do not communicate, there will be a lot of unknowns for our employees and they will become anxious. They can not really stay focused on implementations necessary for change.  That’s why you communicate and communicate.  There is no such thing as over communicating.”

He also believes in deadlines and accountability. “I tell my colleagues that accountability starts with me,” he says. “In order to build any organization, you need a lot of good and dedicated people. I think the role of CEO is to act more like a coach and assemble a team with the specific expertise the organization needs and then through direction the team works together to produce the result.”


The expansion project is expected to be completed in 2012. It will include a 115,000 square foot medical tower. Additions will include a 26-bed emergency department (400% increase in capacity), six new surgery suites, 16 private birthing rooms, a new nursery and a new NICU, 27 private medical surgical rooms, and a state-of-the-art imaging center. Bolouki has already been able to reduce the cost of construction by more than $5 Million by consolidating purchases of high end equipment from a single vendor.

The new facility will be energy efficient, to meet the standards set by the State of California and we are also looking at possibilities such as solar power. “But my goal is a true operational efficiency,” says Bolouki.

Staying Prepared

“I cannot predict the future, and that keeps me on my toes,” Bolouki says. “I am constantly looking at so many different areas. Right now, I am building this facility. I’m constantly thinking about what is happening with the construction or what trends will impact the cost of the raw materials. I am following the changes in healthcare and the impact of the healthcare reform and I worry about the final product and how this is going to impact Tulare Regional Medical Center’s reimbursement.”

The state of California has more than a $19 Billion shortfall in their budget; Bolouki can’t help but wonder how this is going to affect the hospital’s ability to get paid by the state government. Last year reimbursement was cut by 10%, which had a net impact of $1.5 million to Tulare Regional Medical Center’s bottom line. Then the County decided to close some of their primary care clinics, so Bolouki had to assume operation of those clinics to make sure community members have access to quality care and the population served in those clinics didn’t end up in Tulare Regional Medical Center’s Emergency Room.

“The number of the patients coming to our emergency room has grown by 12% in the past year. When I look at the trends in healthcare, I wonder, what is going to happen next?” Bolouki says. “Tulare Regional Medical Center’s mission here is focusing on quality patient care, demonstrated in our core measures and customer service; we are doing very well, better than the hospitals in surrounding areas. Tulare Regional Medical Center is the only hospital in the Central Valley with 2 national accreditations, The Joint Commission and Det Norske Viritas (DNV).  Quality counts.”

-by T.M. Simmons

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