DEL.ICIO.USCEO tries to remake ‘Grady culture’
Young’s layoffs have rankled some, who say cuts could hamper patient care
The Atlanta Journal-Constitution
Monday, March 30, 2009
When Grady Memorial Hospital announced earlier this month that it was laying off 140 employees, CEO Michael Young said the hospital needed to save money.
But a drop in government funding and an increase in uninsured patients were just two reasons for the layoffs.
Ben Gray/bgray@ajc.com
Michael Young says he wants ‘bring new ways of doing things and new ways of thinking’ to Grady.
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The pink slips were Young’s first major move in remaking the so-called “Grady culture,” which critics say tolerates inefficiency and hampers patient care.
“It’s an old and unsuccessful way to run a hospital,” Young said in an interview last week. “We need to bring new ways of doing things and new ways of thinking.”
Young’s actions, which include ousting several top managers and directors, have created controversy at Atlanta’s top trauma hospital and safety net for the poor.
Young, Grady’s sixth CEO in three years, was hired in the wake of threats to close the downtown Atlanta hospital. When he arrived six months ago, he found a hospital drowning in debt, struggling with antiquated equipment and dwindling government aid. His mission was nothing less than resurrecting the storied institution.
The layoffs will save $6.8 million, he said. The hospital has a budget of about $690 million.
More than 15 directors, managers and supervisors, including the vice president in charge of the cancer and cardiac centers, were laid off. The department that advocated for patients was gutted.
The cancer center and the cardiac unit were not attracting enough new patients, particularly paying patients, Young said. Some cardiac equipment was old and nobody was leading the cry to replace it. Philip Lamson, a hospital vice president in charge of both, is gone.
Lamson did not respond to several phone messages left at his home. A person who answered the door at Lamson’s home took a reporter’s phone number, but Lamson did not respond.
Some of Grady’s top physician managers criticized Young for not discussing the layoffs with them before dropping the axe.
“It would have been nice to consult the leadership on this,” said Dr. Carlos del Rio, chief of Emory Medical Services at Grady. “It creates a situation not conducive to collaboration and cooperation.”
Young said sharing and discussing the layoff list would have slowed what needed to be a fast process.
The majority of staff cuts involved people behind the scenes, not associated with direct patient care. They included clerks, a groundskeeper, training coordinators and interpreters.
Some managers and staff worry that other personnel cuts may hamper patient care, since the losses include social workers, nursing managers and pharmacy workers.
Young said he believed the patient advocates were middlemen, so he eliminated the department. Now when a patient has a complaint, it will go directly to a department supervisor, who will be held accountable, he said.
But many Grady patients are low-income people who won’t feel comfortable taking their complaint to someone they view as an authority figure, said state Sen. Vincent Fort (D-Atlanta), whose district includes Grady.
“Many of the patients depend on these employees,” Fort said.
Young said quality managers in the nursing department were also redundant. Department leaders should take responsibility for quality themselves, he said.
Fort is among those who take offense at the portrait of the so-called “Grady culture” as lax and inefficient.
“There are a lot of people who take a lot of pride in what they’re doing at Grady,” he said.
In an Oct. 24 memo, Young called out an inefficiency and bluntly expressed his frustration. The deadline for a lab installation had been moved from December to April.
“This is an example of the dysfunctional operations of the Purchasing Department, lack of leadership and the failure to meet Grady’s goals and targets,” Young wrote. “The three month away install will cost us $2 to $3 million in revenue that can never be captured.”
“This lack of response is the old Grady way, making Grady a laughing stock,” he wrote.
Fort said that some workers have told him that Young’s management style creates friction.
“They don’t think he respects them,” Fort said. Workers who could have gone elsewhere stayed to help Grady stay afloat, he said.
Other Grady advocates praised Young’s moves.
“Grady does have a culture where there are some bad employees, and some of those who were released wanted to continue that culture,” said the Rev. Tim McDonald, head of the Grady Coalition. “The old Grady is slowly but surely going away.”
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