Climbing the Rungs via Nursing on Arkansas Medical News Inc.

Climbing the Rungs via Nursing

By: LYNNE JETER

New Howard Memorial Hospital CEO Recalls Being Nudged to "Dream Bigger"

NASHVILLE—When Wadley Regional Medical Center in Texarkana, Texas, a pillar in the community for more than a century, was sold earlier this year by the company she'd worked for 25 years, the last three as chief clinical officer/chief nursing officer, Debra Wright wasn't sure what her next move would be.

"I was at a cross point," admitted Wright, who began her healthcare career as a staff nurse in the hospital's progressive care and cardiac rehabilitation unit. "I initially sought a position as a CNO or CCO. I was very prayerful about it. I knew the Nashville hospital was blessed with a large medical staff that continued to amaze me. I'd worked as a facility liaison and was very aware of the services the hospital provided the community, and the pride the community took in the hospital."

Fiscal Health

For the fiscal year ending Sept. 30, 2008, Howard Memorial Hospital in Nashville, Ark. (population: 5,000), reported a net income of $78,000 on patient revenue of $26.4 million. This summer, the hospital opened a new 63,000-square-foot critical access facility with 20 private patient rooms, two operating rooms, a minor procedure room and full-service emergency, imaging departments and a helipad. The facility replaces an existing hospital and was designed to improve functionality and create operational efficiencies.

Wadley Regional, a 382-bed medical center, which averaged $261 million in gross revenue, more than 7,000 annual admissions, nearly 4,000 surgeries, and roughly 1,500 deliveries every year, had been changed from a not-for-profit to a for-profit hospital during the ownership transition. Staying put wouldn't work for various reasons.

During her time there as CCO/CNO, where she was responsible for all hospital-wide clinical departments except radiology and cardiopulmonary, she led the successful 2006 Joint Commission survey; guided the project team through a lengthy process to become a Primary Stroke Center of Excellence; downsized and combined cost centers in response to a drop in market share and daily census; facilitated the hospital's designation as a Bariatric Center of Excellence to meet eligibility requirements for Medicare and Managed Care coverage for gastric banding procedure, which contributed to doubling the surgery caseload from 20 to 40 per month; and negotiated the lease agreement and contracts for sale of services to Dubuis Longterm Acute Care Hospital.

When Wright was mulling her next move—perhaps a CNO or CCO for a larger hospital system?—a recruiter suggested that she "dream bigger."

On the Short List

On the agenda for Debra Wright in her new role as CEO of Howard Memorial Hospital:

Physician recruitment. "Rural areas in general have difficulty recruiting physicians, but we're blessed in Nashville," she said. "It's a beautiful area to live in, with such picturesque rolling hills, and a wonderful community that showcases small town America at its best. The best form of physician recruitment has been for older physicians to attract younger partners. Once they get in here, they never want to leave."
Relationship-building. "We're working on a plan with administrative teams and other parties to determine needed healthcare services in the community so residents don't have to leave home," said Wright. "It's not part of our management contract to collaborate on this, yet it's a necessary part of a strategic plan to determine short- and long-term objectives. By working together, we can spend dollars more wisely."
Strengthening community ties. "For a critical access hospital to survive, it needs the support of the community," she said. "Sometimes, patients choose to go outside the area to seek services and care that's offered right here at home. I implore them to consider local opportunities, especially for stabilizing treatment or hospitalization for minor illnesses. In turn, that leads to more stability in the community. A more predictive census tremendously helps the health of hospitals."

"I've been told all my life that I exhibited leadership skills," said Wright, the oldest of four children born over a 6-year span to the Lassiter Downs family in Corinth, Miss. Her dad worked for a division of General Motors until his death at the age of 48; her mom, Bobbie Lassiter (now Roberts), was a bookkeeper. "Because Mom worked outside the home, I learned responsibility at an early age, and to do what's necessary to take care of family."

Wright spent a brief part of her childhood—the early elementary school years—in the suburbs of Chicago, Ill.

"Mom and Dad came from a long line of farming families, yet neither inherited farmland and there weren't many opportunities to make a living in anything other than agriculture in Corinth," she recalled. "My dad worked for Fisher Body, a division of GM, in Willow Springs, Illinois, so I spent kindergarten, the first grade, and the fourth grade in Chicago-area schools, which is very different from rural Mississippi where integration took place during junior high school. My mom was one of those true southern ladies who felt out of sorts in urban America, so she returned to Corinth with us, and dad came home every few weeks."

After graduating from Kossuth High School, Wright relocated to Texarkana, Texas, in 1973 and married the next year. She gave birth to a daughter, Autumn McDaniel, in 1975, and a son, Zach McDaniel, in 1979.

"When I went back to college in 1981, I was one of the more mature students," said Wright, who earned an associate's degree in nursing, graduating with honors, from Texarkana Community College in 1984. By 1987, she was the charge nurse in the cardiac rehabilitation unit. A year later, she was the hospital's evening shift director. A year after that, she was the special projects coordinator.

Then tragedy struck in the blink of an eye. Autumn, who was about to turn 16, was flagging down help on a rural highway after a minor accident when a 17-year-old drunk driver lost control of his vehicle and hit Autumn. She was killed instantly by the impact.

"It breaks your heart into a million pieces," said Wright, of losing a child. "I think it makes you love deeper, and look at life through a different set of eyes."

The next year, Wright moved into positions of increasing responsibility and leadership, beginning with executive director of nursing and interim vice president of nursing until she was named chief nurse executive and senior vice president for patient care services in 1993, a post she held for 13 years.

After her daughter's death, she returned to school and earned a business administration degree from East Texas State University, now known as Texas A&M, in 1994, and an MSBA in 1998.

St. Joseph's Mercy System, which has a 3-year management contract with the 25-bed Howard Memorial, conducted the CEO search. Wright was the ideal fit; her post began Nov. 30.

For now, she'll make the 100-mile round trip daily commute traversing the Arkansas/Texas border until the house she shares with her husband, Richard Wright, a contractor, is sold. Already, they're looking for acreage in Howard County on which to build their dream home.

Since her job didn't officially begin until after Thanksgiving, Wright took the opportunity of some free time to indulge her hobbies—gardening, painting, studying the decorative arts, and seeing an exhibition or two—and to get her house in order ("literally, for the realtor," she joked), and most importantly, visit family and friends. Her son, Zach, now 30, is finishing up his fifth year at Fort Campbell, Kentucky in the 101^st Airborne Division; his wife, Natalie, and their three children live in Haughton, La. She has a "bonus" son, Dow Wright, who manages home sales for a developer, and a "bonus" daughter, Robin Wright, a realtor for Avenue One; both of them live in Austin, Texas.

"I'm so excited about the opportunity to lead such a fine institution," she said in mid-November. "I can't wait to get started."