Hospice of Acadiana recently named Keith Everett as its new CEO following a nationwide search. Everett recently sat down with Hospice News to discuss how organizational culture is key to maneuvering through the changing hospice environment.

Based in Lafayette, La., the nonprofit Hospice of Acadiana was established in 1983 and has served more than 20,000 patients and their families across the region since its inception. Prior to taking the reins, Everett previously served as the chief performance, cultural operations and compliance officer at Capital Caring Health in Virginia. 

Why was it time to make this leadership transition at Hospice of Acadiana?

Hospice of Acadiana has made some truly significant strides over the last several years. They’ve increased their census, they’ve added a palliative care service line [Palliative Medicine of Acadiana], and there was a new inpatient facility that they opened, which was the Calcutta Hospice House. Anytime there’s a change in leadership, it’s an opportunity to reassess, set a strategic vision and develop a plan on how to move forward. Given my experience at Capital, it was perfect timing of the transition of their former CEO for me to come in and to develop a long-term plan for continued success.

What do you see as the most significant areas of focus for Hospice of Acadiana as you take the helm?

Focusing on our people, our staff within the organization who are doing great work with our patients, and then really working on setting our strategic vision and building that out., There’s no perfect strategy, but there are steps to take in developing a successful strategy. First, would be to reach out to community leaders and organizations and start having some open conversations and open dialogue around what is needed in the community? From there, really try to figure out as an organization, how we can meet that need. It’s about creating relationships, and it’s a grassroots effort that you’ve got to build from the bottom up, and really work hard at it.

We have an identity in this community, but I think it’s about asking the critical question of who we are now and who we want to be in the future; understanding and redefining that identity and ascension. My goal is to work with the employees, volunteers and board members to try to create an advanced illness health system for this community, because it is one that is needed not only here, but across the United States.

What do you see as the largest challenges in the industry that hospice leaders are facing? How will your hospice be tackling these?

Hospice care is changing, but at the core of hospice — the day to day of how we provide care to our patients and the communities we serve — I don’t feel like that changes a lot. What is going to change is related to new payment models and the regulatory environment, and how all of those things present themselves.

The regulatory space, especially with the fiscal intermediaries, is going to be a competitive environment, and so organizational relationships are significant. For example, with outside stakeholders, vendors and other collaborators that you’re using to provide this end-of-life care, they are getting more scrutinized as well. Think of your [durable medical equipment (DME)] vendors, pharmacy vendors and [electronic medical record (EMR)] vendors — there is increased scrutiny from every level, which makes things challenging for their space and means that for us, as a hospice, it could makes things difficult for us, as well. We have to understand it and manage through it.

Can you tell me how Hospice of Acadiana has fared in terms of the workforce pressures facing the industry? How are you addressing that issue?

Hospice of Acadiana, like other health care systems and organizations, always faces the same thing: We’re facing nursing shortages across the board throughout the United States. The way to face those shortages — especially around nursing — is finding innovative ways to not only attract, but to also retain staff.

There’s been a major uptick in the number of nurses who are going to contract work and working for agencies because they’re getting paid at a higher rate. It’s another thing about the external environment that’s causing a trickle-down effect. We have to figure out how to attract qualified nurses, and retain the excellent staff we already have.

That’s going to ride on your organizational culture, focusing on the internal aspects of our organization and determining what we can do with our current staff. How do we use our current staff to attract their colleagues who may be nurses or other specialties to come into the organization as well?

One of the critical issues facing the industry is the matter of diversity, equity and inclusion. What initiatives or strategies will you employ when it comes to reaching underserved populations?

First, I want to understand any gaps and barriers to care. We’ve already started pulling data from the last three years to look at where the gaps are as they relate to serving the underserved population, not only in our community, but even in those outside communities.

To build anything externally in support of equity, inclusion and diversity, you have to also identify your own gaps internally within the organization. You can do both of those things simultaneously, but it’s important for you to take that lens and work within first to get a better understanding of yourself before you roll out anything externally.

A lot of organizations have started talking about developing an equity, inclusion and diversity program. For me, I struggle with that a little bit, because from my perspective we’re not developing a program, we are developing a culture. That is what it’s going to take to truly meet this need of serving the underserved population, and meeting disparities up front. It can’t be a program, because programs tend to end. We have to instill a true culture change that gets embedded within your culture in your organization.

Hospice of Acadiana, which has been around for 39 years, has a great framework. To imagine how serving the underserved population now becomes part of its culture, can be part of the organization for the next 40 years.