Bill Klaproth (Host): Welcome to the Healthcare Executive Podcast, providing you with insightful commentary and developments in the world of healthcare leadership. To learn more, visit ACHE.org. I'm your host, Bill Klaproth. In this podcast episode, we're going to talk about how you improve as a healthcare leader. Our guest today is Dr. David Schreiner, Author and President, CEO at Katherine Shaw Bethea Hospital in Dixon, Illinois.

 Dr. Schreiner will be the featured speaker during a C-Suite networking breakfast, be the best part of their day supercharging communication with values driven leadership during ACHE's 2024 Congress on Healthcare Leadership, March 25th through the 28th in Chicago.

Register for Congress today at ache.org/congress. Dr. Schreiner, thank you so much for your time. It's a pleasure to have you here.

David Schreiner, PhD: Bill, thanks for having me. I'm excited to spend some time with you.

Host: Absolutely. Me too. Anytime that we can learn how to become better, more effective healthcare leaders, I'm always in on that. So we're excited to talk to you today. So Dr. Schreiner, can you start off by telling us a little bit about your career journey and your path to becoming a healthcare leader?

David Schreiner, PhD: Sure, Bill. My story begins with playing in a pickup basketball game in the gym of a community college in Kansas. And I had finished my undergraduate degree in health education and was perfectly unemployable. And another person that was playing in this game was the director of the... radiologic technology program, and they had a person that had withdrawn from the program the Friday before, and so I filled that slot.

I immediately fell in love with it. I loved everything about being an x-ray tech. My first position was at the University of Kansas Medical Center, and then I went to a hospital in Missouri, Golden Valley Memorial Hospital. And then in 1989, I interviewed at a position in Dixon, Illinois at Katherine Shaw Bethea Hospital, and I'm still here today.

So that role here at KSB Hospital, as we call it, started on the clinical side and then became a vice president, became chief operating officer. And now almost 13 years ago, I became CEO.

Host: What a story. That's great. Who would have thought a pickup basketball game would be so instrumental in your career?

David Schreiner, PhD: And I didn't even shoot well, so I must have said it to the right person.

Host: You didn't shoot well, but you won the game.

David Schreiner, PhD: I think I won the battle, right? If

Host: You won the battle. That's for sure. So you certainly have a passion for executive engagement and communication. So what drew you to that and why is effective communication such a key trait for healthcare leaders?

David Schreiner, PhD: Bill, the time that I really started focusing on this was in 2018, 2019, and I mention those years because in all of our lives, that was pre pandemic. And I had been in my position as CEO for six or seven years and things were going great. I mean, we're an independent rural hospital and that's certainly a challenging place to be for an organization.

But all of our metrics, the KPIs that any CEO would look at were moving along just fine. And yet I was unfulfilled. I believed that I was not performing at the level that our community and our hospital and our board of directors deserved, and I couldn't really put my finger on it. And I ended up going to lunch with a friend of mine who did some HR consulting for us, and he told me about a doctoral program in values driven leadership.

And through that program, I learned about something called appreciative inquiry. And the 10 seconds on Appreciative Inquiries around that idea of what was the environment, what was going on when either us personally or our organization was performing at its best. We were just knocking it out of the park.

And Bill, this completely changed my perspective on the world. And one of the things that I found is that we have an opportunity to really make a valuable difference in people's day. And as executives, I think that opportunity is magnified. And so that became a real passion for me and the focus of my doctoral research.

Host: Wow. That's really fascinating. So appreciative inquiry.

David Schreiner, PhD: The original AI, right? Before we knew what uh, what AI was. Appreciative inquiry was, it originated at Case Western University and it quickly spread throughout the leadership space and it's getting, it continues to gain a lot of traction in all fields, not necessarily just specific to healthcare, but I have found that it leads to some wonderful conversations.

Host: So it came around right at the right time, because you said you were rather unfulfilled at the time, and this just happened in your lap at this lunch. Who knew a lunch would be so instrumental in your career?

David Schreiner, PhD: Exactly, it's those moments that we reach a bit of a fork in the road, right, and we didn't even know the fork was ahead of us, but it ends up being a beautiful thing. That's part of the thing that makes life so wonderful.

Host: Yeah, that is so true. So is that what led you to write the book, Be the Best Part of Their Day? Which you can pre order now and is available widespread on Amazon on January 16th, 2024.

David Schreiner, PhD: It is, Bill, and I was encouraged as I wrote my dissertation, I was encouraged by my committee. They said, I think there's a book in there. And so I took what is inarguably a very boring dissertation and hopefully made that a bit more colorful in a book that describes some of the experiences that I had in my research. I had the chance to go out, well, virtually because it was then during the pandemic, but I had the inter, I had the chance to interview 26 individuals from five different health systems around the country.

And they were five of the best performing rural hospitals in the United States. And I found some themes. I found some commonality, in all 26 of those people, and most importantly, all five of those organizations, and that really became the genesis and the content of the book.

Host: So in the book, you identify 15 ways to help executives improve their leadership skills. So without giving them all away, can you share what you found? You said you found traits that ran through or themes that ran through all of these. Can you share a few of those?

David Schreiner, PhD: Sure. I'm happy to do that. I found three major themes. The first is engage and connect. The second is engage with intent. And the third is be mission focused. So if we think about engage and connect, there are five subcategories or subheadings under that. And one of those is ask great questions. And generate positivity.

So one of the people that I interviewed, one of the CEOs that I interviewed from the state of Washington was describing a situation where she worked for a county hospital and they needed a new facility. Their facility was older and it was a replacement. They needed to have a replacement. And the people that were on her board who were elected officials; two of those people had committed to no new taxes and they needed to have taxes in order to generate enough funds to start a new hospital. And so she built a presentation and then she had her marketing director deliver that presentation to her. And then she asked as many questions as she could think of.

And her goal through all of that is by asking questions, not only do we learn more about the person that we're engaging with, but we also show a higher level of respect and we get away from that idea about when you're telling me something, I'm thinking about my response. And instead, we listen deeply to what you're sharing, and then we follow that up with a great question.

So I really admire the way that she handled that. And I use that every single day in my personal and professional life. The idea of asking great questions to engage and connect at a more meaningful level.

Host: It is a great way to show that you care and it is a great opportunity to listen, as you say. And I think most executives, no matter what the industry, think listening is on the short end. They want to do a lot more talking, where listening is so crucial. So I think that's really something great. So the first one is engage and connect. And can you share more on the second one as well?

David Schreiner, PhD: Sure. The second is around engaging with intent. And one of the five in that category is being transparent with high frequency. One of the CEOs that I interviewed from the state of Missouri talked about being one of the very first hospitals in the state to have a COVID patient. And so what happened is that the narrative in that community became, stay away from there.

We don't know what it is, but you don't want it. And you do not want to go to that hospital. And so what he took on is he made the decision very early that I'm going to communicate at a very high level with a very reliable level of frequency. So his method of doing that is he would send out a video every day to all of his employees.

And sometimes as they moved through the pandemic, that video would say, I don't have anything new to share with you today. And he'd tell them how much he loved them and how grateful he was for the work that they were doing. And that was the message for the day. But as you can imagine, early on, there were several times where he would say something at 9 o'clock based on the best information that he could get from the Center for Disease Control or the Missouri Department of Public Health, and then that would change at 2 o'clock that afternoon.

And he'd come back and he'd share the new information. But by having that level of transparency and that reliability around the frequency, he was engaging with intent and he was showing the people that he was working with, how important they were to him and how important they were to the mission of the hospital.

Host: Absolutely. So engaging with intent, being transparent. I could see again how that would be very valuable. So we had engage and connect, engaging with intent. And then the third one you mentioned was mission focused. Can you tell us about that?

David Schreiner, PhD: Working in the hospital space is a great opportunity. It's so important in the impact that we have on our communities. And one of the things I heard from the CEOs that I worked with was that focus on the mission. And part of that is knowing the audience and being prepared. I spoke with a CEO in Vermont and he told me about making sure every opportunity that he had to interact with either the community or his internal audience, meaning from within the hospital, he always wanted to make sure that he included two things around his mission and why their community hospital existed.

And then he realized that he had to know that audience because that presentation that he gave to Rotary was different than the one he gave to the medical staff, was different than the one that he gave to his housekeeping department team members. And all of them had that commonality of coming back to why are we here and how does our organization support and enhance our community.

Host: Really interesting. And you said and these are things that you use have used throughout, your career since you came upon these things.

David Schreiner, PhD: And here's what I found, Bill, through my research, is that of the three major areas and the five subheadings underneath each of these, we have to do our best to try to understand and use all 15 of them. And that sounds like a monumental task, but it's that, how do you eat an elephant concept, right?

It's the idea of picking one and hardwiring that into your personal and professional life and then moving on. So you can begin with the idea of asking great questions. And you can keep doing that until you build that muscle and you learn how to use it in an effective way. And then we move on to that high transparency.

And if you look at these 15, all of us at leaders would look at a number of those and say, maybe eight of them, or maybe 10 of them. I'm pretty good at that. I'm already doing those. What my research shows is that if we go from 10 to 12 to 14 to 15, our engagement with the people that matter the most to us becomes more meaningful.

Host: That's when you really hit your stride as a healthcare executive, I would imagine, if after you really hone in and add those skills on, like you said, up to the 15.

David Schreiner, PhD: Yeah, my fear is I'll reach that about an hour before retirement, but it could be determined.

Host: You know, that's a good point. This is a journey, too, right? I mean, and we always have the capacity to learn and get better no matter what age or what stage of our career that we're in. Is that right?

David Schreiner, PhD: It's absolutely right, Bill, and what I found with this is when I'm sitting out in the car after I park to come into the hospital, I'm excited to come into work. And I know for me that having these areas to focus on and just having that idea that there's something that I can do to be the best part of someone's day; that's very motivating for me.

And it's exciting to know that we don't really know where in our schedule or where throughout our day that that opportunity is going to come up. But as we move higher in the organizational chart, the more impact we have on the people that we interact with. And we only have a thousand people, employees, at KSB Hospital, but I still might have a situation where I only get to have a conversation with a person maybe once or twice a year.

And so it's important for me to show up in a way that tells them how much we respect them and how much we love them and how grateful we are for the work that they do, because every single one of those people impact our patients every day.

Host: Yeah. It's the moments that matter and every moment counts. Every interaction counts. That's a great point.

David Schreiner, PhD: The other side of that too, Bill, is when that doesn't happen the way we want it to, and that's going to be part of our life too, right? It takes a long time to recover from that. If I pass someone in the hallway and I don't say hello to them, if I do that very many times, that impacts the way that they think about their leadership.

Host: Such a good point. Yeah, the opposite can have a negative effect. So, again, a really good point, Dr. Schreiner, and thank you for that. And I love how you say in 2018, 2019, you were unfulfilled and you were searching and still trying to get better, even already as an accomplished health care leader. And that leads me to you earned your doctorate in 2022, so you're continually trying to learn and get better.

How did you balance your doctoral studies with your role leading KSB hospital? I mean, that's a big role. And how has your leadership style evolved based on what you learned?

David Schreiner, PhD: Well, Bill, first of all, if I knew a pandemic was coming, I would have never signed up for that program. So, you know, looking in the rearview mirror, that's pretty clear, but it wasn't so much through the windshield that I was looking through at the time. What I found is that when I went away to class, and the program that I was in was a weekend format, so I would leave every month on a Friday, Saturday, Sunday.

One of the first things that I told myself was I was not going to come back on Monday and try to install in our organization, everything that I learned that weekend. I was going to be more intentional than that because I didn't want the flavor of the week or the flavor of the month. But what I did find is that as I learned more about appreciative inquiry and I understood more of the literature, I was able to take pieces and incorporate that into my practice.

And that's what's so important to me is to try to be able to continue to sharpen that saw. And it's most of it is aspirational, right? I want to do it. And like anyone else, I fail from time to time. I think that I have developed a better sense of understanding when I fail, and then hopefully being able to correct that.

Host: I like how you say you came back and tried to install things with intention, not just, Hey, here's what I learned this weekend. This is what we're doing. Not that program of the month thing, which drives everybody crazy, but it sounds like you took what you learned and said, you know what, I can apply this and here's when I'm going to apply it. Is that right?

David Schreiner, PhD: It's exactly right. And one example that I would give of that is finding ways to express gratitude. That's one of the components under Engage and Connect. How can that go wrong? As long as I'm authentic and I express gratitude because I really mean it, and it's coming from deep in my heart, then that can only be a positive for the people that I'm telling how much I appreciate them.

Host: That is so good. When I engage and connect, if I do it with authenticity, how can that go wrong? That's really profound. I really like that. This is fascinating, Dr. Schreiner. I could talk to you forever. I do have a few other questions, though. Finally, can you tell us about your FACHE credential? And what that means to you and how ACHE has helped you in your career?

David Schreiner, PhD: Bill, I have so many ways that I could tell you about how ACHE has benefited me, but if I begin with the fellow, one of the things that was very surprising to me is after I went through that process, at the very next medical staff meeting, we had a cardiologist on our medical staff make a point of saying that Mr. Schreiner is now Board Certified in Healthcare Administration. And especially when we think about that from the perspective of our physician colleagues, that certification, that board certification is a really big deal. And it is within ACHE as well. And so when we have that partnership with the members of our organization, I think it presents some level of credibility that is especially meaningful in segments.

But it shows people that you care about your career enough to excel and be recognized to meet those standards. And ACHE provides us that opportunity to do so and to be board certified. And I'm extremely thankful for that.

Host: Absolutely. Very well said. Well, as we wrap up, Dr. Schreiner, I just want to ask you, is there anything else you want to add as we talk about executive engagement and the vital role of communication and healthcare leadership?

David Schreiner, PhD: I would just encourage people to give that thought to how do I become that best part of someone's day? What is it that I can do to try to make a difference to those people that mean the most to me? And that can be in your professional life as well as your personal life. And what my experience has been is I'm more effective in doing so for others, that fills up my cup.

And that's part of why I think we're here, is in order to make a difference for our patients and their families and the communities that we serve. And in doing so, we know how important the people that we're fortunate enough to work with are in making those types of things happen. And so gIve it a shot, see how it feels.

You may or may not do one or 15 of the things that I talk about. But if you just try to make that difference, I think we can have a positive impact.

Host: What a great message, not just for healthcare leaders, but for everybody in everyday life. How do I become a part of someone's best day? I love that. Dr. Schreiner, thank you so much for your time today. I've really enjoyed talking with you.

David Schreiner, PhD: Thank you, Bill.

Host: And once again, that's Dr. David Schreiner. Hear more from Dr. Schreiner during ACHE's 2024 Congress on Healthcare Leadership, March 25th through the 28th in Chicago. To learn more and to register, visit ache.org/congress. And if you enjoyed this podcast, please share it on your social channels and please consider rating and reviewing on Apple podcasts or your podcasting app of choice. Thanks for listening.