Gothenburg Memorial Hospital: John H. Johnson, CEO

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It’s easy for healthcare organizations to be overwhelmed by the many requirements the federal government has enacted in recent years, especially if the organization happens to be smaller and possibly, rural.

However, John H. Johnson, CEO of the 12-bed Gothenburg Memorial Hospital in the town of Gothenburg, Neb. (population 3700), does not let the changing climate affect his leadership, and he applies an age-old technique to cutting through all of the panicked chatter—common sense.

This approach seems to have worked. In 2011, the University of North Carolina did a study through the National Office of Rural Health and found that for the past three years, Gothenburg ranked in the top 32 critical-access hospitals in the United States.

Steady as she goes

Johnson’s approach to leadership over his 13 years as CEO is even, both in temperament and handling.  On one side, he employs common sense and logic, and on the other side, he practices honesty and trust.

“Whenever difficult, tough decisions need to be made, and in many people’s books they may think of this as kind of a corny outlook, I really honestly do look at what’s in the best interests of the patients,” he said. “What can we do to meet their needs? That’s why they come to hospitals and healthcare facilities.”

He described Gothenburg as fluid in what they do, trying to stay ahead of the curve, such as when they decided to eliminate the 37-bed nursing home that was attached to the hospital. This was both an acknowledgment that there were other long-term health facilities in the community and a recognition of the gradual decline of long-term care.

To replace it, Gothenburg demolished part of the structure to build an 18,000-sq.-ft. physician clinic onto the hospital as a way of preparing for the future when many of the primary-care physicians may fall under the same net or bundling / payment process. This project is scheduled to be completed around Dec. 30, 2011.

Gothenburg also houses one of only six certified cardiac-rehab units in the state of Nebraska. It was also one of the first hospitals to put in a 16-slice CAT scan and one of the first to have high-definition equipment in the OR both in the orthopedics and general-surgery areas.

Another feature of Johnson’s leadership is the hospital’s ability to make swift decisions. A few years ago one of the major hospitals in the region was doing a study about adopting an interstim-transplant program through urology. They were told it would take about six weeks of study to determine whether they could do it. Gothenburg was interested in adopting a similar program and took all of one day to realize that they could do it and thus became one of only two hospitals that offers these procedures in the state of Nebraska.

Clouds of reform

For all of his clarity, recent federal measures can get in the way of Johnson’s approach. He described deciphering healthcare reform as being akin to wandering through a cloud.

“We’re at a time right now with the electronic health record where everybody on the planet is pushing it and meeting the meaningful use standard,” Johnson said. “I’m going probably a lot slower than most people simply because there are 500 companies out there trying to sell you 500 different products, none of which will communicate with each other.”

Johnson said he knows quite a few people who have spent a ton of money on systems that have ended up being failures. Common sense, he says, means not rushing into a decision. So right now, he and Gothenburg are examining systems carefully, waiting to decide on the right one for their hospital and not worrying about meaningful use’s deadlines.

“The timelines for meaningful use, honestly, really don’t mean much to me because being in a small community, we may not have all of the funds available that a lot of other places do,” he said. “We’ve been very successful here, but we certainly don’t make a practice of just going out and flushing money down the toilet, so to speak, just so we can meet a mysterious deadline that the federal government has put in place.

“Probably one of the biggest oxymorons that exist in this point in time, and you read it all the time from CMS, they come out with things that they call their interim final rules. Never heard of an interim final rule. So it’s kind of a silly season for a lot of those politically governmental-group programs.”

In the last year, Gothenburg has purchased a new hologic digital mammography system, funding this project  through the Helmsley Charitable Trust foundation. They’ve also renovated the HVA systems throughout the facility and installed a new rehab center that offers physical, occupational, and speech therapy in their wellness building.

“When you live in a rural area, if you have good facilities, good equipment, and good people, it certainly makes recruitment of trained professionals a lot easier also,” Johnson said. “And we strive for those things. I do. That’s my work ethic. People want to be part of a successful organization, and it’s probably been our strongest asset.”

Remembering the patient

As Gothenburg goes into the future, Johnson’s rallying cry could be described as, “The patient always comes first.” At all times, he returns to this theme.

Perhaps that is why he doesn’t get rattled  when the government produces its latest standards and reforms. Most of those changes, he asserts, don’t even begin where new programs should start—at the patient’s bedside.

“If the federal government ever wants to do something right, instead of dealing with a bunch of actuaries and geniuses and academics and things like that,” Johnson said, “someday maybe they’ll speak with some of the people that actually do healthcare for a living and are closely in touch with it, and they might do something to change some of the tort reforms to eliminate frivolous lawsuits.”

-by Pete Fernbaugh

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