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Journey from Staff Nurse to CEO

One clinician's path from bedside to corner office

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A desire to inspire, cultivate and facilitate change has always driven me, whether as a nurse at my patient's bedside or as a CEO in the boardroom. The commitment to ensuring every patient, every day received the highest-quality care possible was the driving force in my decision to transition from nursing to administration, and it has been with me every step of my rural health care journey.

Delivering high-quality care and exceptional patient safety is a priority for all nurses but, as we all know, if you do not run a business well, the resources needed to deliver care and reinvest in future services will not be available. That's why understanding how to operate an exceptional business is critical.

It was at my first job that I decided I wanted to be a CEO, because I knew the best way to effect change was to be involved at that high level.

First Opportunities
I began my nursing career at J.C. Blair Memorial Hospital in Huntingdon, Pa. It would become my workplace for 20 years and, due to some exceptional people, I was provided multiple opportunities to grow professionally. I also had the distinct pleasure of working with a superb mentor and colleague, the hospital's CEO, Peter Hofstetter.

Early in my career I was asked to fill an interim role as director of nursing. As I look back now, I realize there was much I did not know at that time, but obviously the CEO had faith in me. I was energized by what I was doing, and I enjoyed the challenge.

Kim MillerUltimately, when the director chose not to return, I was asked to assume the role permanently. That led to an assistant administrator position and later to an associate administrator role.

Peter Hofstetter was an excellent mentor, providing me with opportunities to expand my leadership skills by assigning me duties across multiple service lines. It was great preparation for the challenges ahead.

Forging Ahead in My Career
After completing my diploma in nursing from the Mercy School of Nursing, I earned a dual bachelor's at Juniata College and an MBA from St. Francis University, all of which are in Pennsylvania. I finished college when I was 40, and I felt I was a good role model for my children by balancing work, family and school. If I hadn't had support from my husband, parents, in-laws and mentor, it would have been impossible, and I'm forever indebted to them.

Reaching my goal of becoming a CEO became a reality when I moved to Iowa for a new job and, thanks to my great mentor, I was very prepared. After four years, I accepted a CEO position in North Dakota before becoming CEO of Beaver Dam Community Hospitals, Inc., in 2006.

Some people may wonder why I've forged my career in rural communities. While I've always wanted to work in an urban facility, in rural areas you really get to know the people you work with, as well as the community's residents, and what they think of your organization.

Even though I no longer provide direct patient care, I keep connected by rounding. I look at everything from the patients' perspective and think, "How would they feel about this?"

Commitment and Teamwork
The nursing profession is about caring for people who are placing their lives in our hands. There is nothing more precious than a human life, so we all honor that responsibility. The work we do is so important, we need to function at our highest level and, to do that, exceptional communication and teamwork is vital.

When searching for executive team members, I desire people who have different skills from mine, so we have complementary strengths. That's how we've been able to run the best organization, achieve the best metrics and deliver the best patient care.

At Beaver Dam Community Hospital, our team is proud of our top marks in safety and quality from The Leapfrog Group. We speak with employees regularly about the importance of their roles. When a patient comes in, he or she may touch 50-plus people during one stay. Our job is to make sure all of them - clinicians, housekeepers, dietitians, volunteers and others - provide top-level care and function as one unified team.

Supporting each other and empowering all employees to speak up when they see the potential for error promotes transparency. We post our performance scores and have regular one-hour mandatory employee forums. Together, we review our metrics in quality, satisfaction, performance, people and community.

When we first participated in Leapfrog five years ago, our safety grade was a C.  That's an average score and not where we wanted to be. I asked employees, "If you're the patient, do you want mediocre care or exceptional care?"

All employees agreed the answer is exceptional care. I then asked them to picture the patient as the person who means the most to them personally and to deliver care with that person in mind. 

The next year we earned an A in safety, and we now have earned an 'A' for four consecutive years. We've also earned The Leapfrog Group's Top Rural Hospital award for three years running, becoming and remaining the only Wisconsin hospital to receive that recognition.

Evolution of Healthcare

As health care continues to evolve, so does the role health care providers are expected to perform within the communities they serve.

In addition to delivering safe, quality care, we have a responsibility to serve as leaders in population health. A rural hospital is an important part of the community and needs to promote positive lifestyles. That's why I initiated a community-based Healthy Lives committee, with high involvement from BDCH employees, to help foster healthy choices. This has evolved into a successful journey to bring to our region Blue Zones Project®, which uses evidence-based strategies to help make healthy choices the easy choices.

The hospital of the future is going to have a very different look and feel. It will focus on education, prevention and the support our residents will need on their personal journey to health and wellness. To improve population health, we will be encouraging people to make changes that can be difficult and uncomfortable. We can lead through example by listening, adapting and innovating, proactively addressing the changing health care landscape and turning potential hurdles into opportunities.

Such change can be challenging, but it affords us the opportunity to help people improve their health today and to create a significant impact on generations to come. Those are the kinds of opportunities that originally inspired me to become a CEO.

Kim Miller is President and CEO of Beaver Dam Community Hospitals, Inc. in Beaver Dam, Wisc.

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Honestly, your main concern Ms. Miller is the mighty dollar and what it can do for you, everyone is aware of this. Patient care has become a lesser concern to you, patient's needs being neglected, this hospital has become horrible since you became CEO of this company. You are a horrible woman.

Former PatientJanuary 20, 2017


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