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ECMC CEO worked his way up to public role at public hospital

In 1979, Richard Cleland had a dream of becoming an FBI agent – but he didn’t have a job. An uncle who worked at Kenmore Mercy Hospital said there was an opening for a linen attendant, working weekend mornings delivering bedding to the floors. Cleland said he’d like to do that, and his uncle agreed to hire him on one condition: “Get a haircut.”

A few years later, when Cleland was working full-time cleaning floors, his boss called him into his office and asked if he would consider taking a shift supervisor job. Cleland wasn’t sure he would like management, until he learned he’d get nearly double what he was making at the time. “I go, ‘Nine bucks an hour? You’ve got your man,’ ” recalled Cleland, who even agreed to wear a tie.

Cleland gave up on law enforcement and stuck with the health-care industry. He continued as a manager in cleaning and environmental services, moved into long-term care and finally took on executive posts overseeing hospital operations.

Following an earlier stint at Erie County Medical Center, he rejoined the hospital in 2006, became chief operating officer in 2012 and was named interim CEO last year, after his predecessor, Jody L. Lomeo, took the top job at Kaleida Health. The ECMC board appointed Cleland permanent CEO in May.

Cleland, 52, is a North Tonawanda native who graduated from SUNY Buffalo State and earned a master’s degree in public administration from Canisius College. He lives in Clarence with his wife, Marsha, a part-time registered nurse at Kenmore Mercy, where they met. One of his three children, Ashley, works at ECMC as an occupational therapist.

Cleland oversaw major projects to build the TerraceView nursing home at ECMC and to consolidate the behavioral health services offered by ECMC and Kaleida Health at the Grider Street hospital.

ECMC employs 3,300 people, brings in $515 million in annual revenue and recently was certified a Level I regional trauma center. Cleland takes over as permanent CEO at a time when hospitals are grappling with federal health care reform and with financial pressures from government and private payers.

Q: What’s the difference between a chief operating officer and a CEO?

A: You can always say COOs make the trains run on time, and CEOs lay the tracks. COO required me to get involved in the integral details of just about every area of the organization, in terms of delivery, efficiency, quality, customer service, budgets, finances and staffing. Really making the vision work, again. I was doing both jobs for a good part of last year, and it was challenging. I went from COO – which I was only in that position a year and a half – to CEO. I was just getting comfortable with the COO position. So the CEO, different competencies, definitely. I’ve always been somewhat private. I realize it’s more public, the face of the franchise. Public speaking – I’ve worked hard on that.

Q: You’re learning the jobs of ECMC employees – or “teammates,” as you call them – through a Walk in My Shoes program, at the suggestion of the chief experience officer you hired. How does that work?

A: I spend about four hours a week in a department, working alongside. I think it’s important to understand and see what others see on their jobs, experience things. You get to learn, you get to really engage the workforce, or our teammates. I spent five hours in the ER on a Saturday morning with the ER attending, which was invaluable, just to see how they run the ER, the trauma. It’s amazing. I was in patient information the other day, and then patient transport. I’m going to work a shift in security, so I’ll get my police work.

Q: ECMC traces its roots to the Buffalo City Hospital a century ago. What is its role today?

A: Back in 2004, it converted from a county-run hospital to a public benefit corporation. That’s very much like an authority, a state authority. The board of directors are the owners of ECMC. And we are a public, safety-net hospital, again. We kept our status. Our mission is to take care of all patients who arrive at our door. Providing services that others don’t. Behavioral health. Trauma. Medical rehab. Long-term care.

Q: ECMC is known as the hospital patients go to when they’ve been shot, burned or otherwise suffered trauma. Is it becoming a hospital of choice?

A: We’ve really focused on cultural change over the last five years, brought in services that we heard our patients wanted. We talked about bariatrics (the treatment of obesity), we talked about renal transplants, which is really a community jewel that we are operating. Oncology’s been an area that we’ve grown. Plastic, reconstructive surgery, those are diversifying our portfolio, along with maxillofacial prosthetics. And if you go on our orthopedic unit and you introduce yourself and you talk to our patients, our family members, when they’re here for the first time they say, “Wow, couldn’t believe this. This is unbelievable. This is great. Love it.”

Q: ECMC earned just $942,000 in operating income last year. That’s a margin of 0.2 percent on your revenues. How much does that concern you?

A: All this work, and we’re barely making a dollar, you know? You look at the margins and, to keep the mission going, we have a responsibility to assure the financial viability of the organization. No money, no mission. Financially speaking, we’re looking at: Are we billing? Are we collecting everything? What is the cost of care? Can we get patients discharged earlier in the day? How is your nursing overtime? Those types of things.

Q: Are you worried about competition from ambulatory surgery centers?

A: We have to be aware of it. We have to really be looking at it extremely closely to ensure that our outpatient volumes, our inpatient, aren’t being impacted. I think competition is always going to be there. I think we need to collaborate and look at other opportunities with our partners, to look at those types of environments as well for us. To see where it makes sense cost-wise. Is it what our surgeons want? Is it what our patients want? You want to be ahead of that. You don’t want to be one day looking at your operating rooms and there’s nobody there. So far, that has not been the case.