'Accelerating Change': CEO Katrina Keefer Reflects On First Year At DCH Health System

TUSCALOOSA, AL — It's been roughly a year since Katrina Keefer took the reins at DCH Health System as its chief executive officer and she appears to be delivering on her promise of a culture reset for the better.

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As Patch previously reported, the Monroeville native was hired by the area's second-largest employer after serving as CEO of Augusta University Health in Georgia and executive vice president of health affairs at Augusta University.

Just in her first few days on the job last August, Keefer made no secret about her desire to implement a new leadership culture for DCH Health System that would then transform every aspect of the organization.

"The relationship building has been what I’ve been most proud of, with our medical staff, community leaders, the Chamber of Commerce, the appointing authorities and with our caregivers," Keefer told Patch on Friday in an interview looking back on her first year on the job. "We've also been working hard to be transparent and visible. The community has been so welcoming and I’m very confident we’re taking better care of patients today in Tuscaloosa than we were this time last year."

Perhaps one of the most impactful changes implemented during Keefer's first year is the long list of new hires, described by hospital leaders as an elite "recruiting class" — a nod to college football recruiting in Tuscaloosa. These new hires range from high-level administrators including the CEO to a long list of new nurse managers and physicians hired after Keefer was brought on board.

Other director positions include new hires for the following DCH Health System departments: Emergency Department; Imaging; Cancer Center; Chief Clinical Informatics Office; Service Excellence; Women’s Services; Revenue Cycle; Finance; Medical Staff Services; Strategy Execution and a new manager of the Diabetes Center.

"I think that new leaders at all levels of the organization is going to be very key as we have very many new caregivers overall," Keefer explained. "Having new leaders with fresh approaches is important to us. I think that DCH had the reputation in the past of doing things the same way and I think our new leaders are bringing new tools to educate our caregivers and help them take better care of patients."

Keefer then spoke to having an open-door policy not just for hospital leaders, but also for other community leaders and stakeholders as the hospital system eyes the future.

"Collaboration, innovation, those are all buzzwords, but they really are things we’re practicing each day," she said, before mentioning discussions over new models of care. "That’s just rhetoric unless you’re really going to do the hard work of reorganizing yourself to ensure your quality metrics, for example, are improved."

And, as is the case with so much in the health care sector, those highly anticipated improvements are dependent on mostly on funding.

"With our continued partnerships, we’ve got to ensure improvement in the financial situation," Keefer said of the west Alabama health care provider, before going on to allude to pay raises for DCH staffers implemented this spring. "We have invested in our people and now we are asking our people to help us through margin improvement efforts so that financially we can rebound.

"And we’ll continue to talk to other partners," she added. "We are currently talking with the UAB Health System and saying how can we accelerate change if we were to work with UAB. We’ll continue to talk to our leaders internally how can we accelerate change if we are thinking about our care delivery model."

Also related to finances have been the impact on indigent care at DCH Health System due in part to struggling rural health care providers in the counties surrounding Tuscaloosa, most of which are in the service area for DCH Health System.

In an effort to open the lines of communication to those communities, Keefer said she has visited places like Eutaw and York to speak with hospital leaders on the ground to learn more about the patient population and staff resources for physicians and nurses.

"When we’re thinking about what the next 10 years looks like for DCH, we can build for a right-sized operation," she said of the conversation. "Some of those little hospitals might have a daily census of four patients or eight patients, so a lot of the acute care is already coming here [to DCH Health System]. They have assets, they have hospitals, they have geography so how do we think about rotating our specialists through to get care to them?"

Apart from bigger-picture operating changes, Keefer also spoke to partnerships and discussions in the Tuscaloosa community, such as working with emergency agencies in the Tuscaloosa metropolitan area to improve services and response times.

Outside of the walls of the hospital, these are the relationships Keefer truly hopes to build upon so the overall health of the community can improve.

"We’re hopeful we can work together to best utilize resources," Keefer said. "For example, if we had a triage nurse in a 911 call center so it can prevent an ambulance having to go all the way across the county to get a patient. Those kind of things really are super exciting so we can best utilize precious resources. We all need to be working together in addressing the challenges that present themselves."

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