Sally A. Hurt-Deitch’s official office sits in a glass building that overlooks the Dallas downtown skyline, where she, as chief nursing officer and vice president of patient care services for Tenet Healthcare, oversees much of the quality improvement initiatives for the system’s hospitals stretching from coast to coast.
But her ties, along with her time, are still rooted deeply in El Paso. Before taking on her current role with the Tenet system, Hurt-Deitch oversaw the El Paso market's Hospitals of Providence campuses and Valley Baptist Health System’s group of hospitals in the Rio Grande Valley, as the El Paso and Rio Grande Valley Groupmarket CEO, following a long history of leadership roles.
For those who know her, it’s hard to separate Hurt-Deitch as a hospital leader from the culture and family of the city she calls home. Today, she splits her time between Dallas and El Paso, where her parents, her husband Greg and their five boys still reside. But the effects of her leadership are felt around the state and beyond, both in the reach of her current role through a fleet of her former mentees – “her kids,” as she refers to them – who have gone on to their own successes in hospitals across the country.
She credits the openness and accepting nature of the city – along with her family — for instilling in her a pragmatic, frank approach that has been key in her success as a hospital leader.
“Sally has the unique ability to engage people no matter who’s sitting across the table from her, whether it’s a housekeeper or board chair,” said Tim Adams, president/ CEO of Saint Thomas Health, ministry market executive for Ascension Tennessee, a close friend since their early days as young hospital directors.
Her ability to engage will be critical as she takes on the role of chair of the board of trustees of the Texas Hospital Association in January and shepherds the industry through the 86th Texas Legislature.
As a young girl, Hurt-Deitch’s first experience being in and around hospitals stemmed from her mother’s experience with an autoimmune disease. Her father brought her, along with her brother and sister, into the hospital to visit over the course of six months as her mother’s doctors worked to get her mother's illness under control. But when asked if that was the moment Hurt-Deitch wanted to be a nurse, she laughed and said, “Nope!”
That revelation would come later, but for those who know her as a hospital leader today, her father’s role in helping her mom fully recover once she came home may have made the bigger impression.
“My father is a coach. He will teach you a lot, but one of his biggest lessons is you always get up,” said Hurt-Deitch. A high school football coach with two state titles, her dad is something of a legend even beyond Hurt-Deitch’s hometown of El Paso. She recalled the experience of seeing her dad challenge and support her mom to complete the grueling physical therapy exercises during recovery.
Her father’s ability to encourage her mom’s strength even when she couldn’t is mirrored in how Hurt-Deitch’s own mentees describe her ability to build teams today.
“When I think about her leadership style — she’s a real coach, and I think she gets that from her father,” said Monica Vargas-Mahar, CEO at The Hospitals of Providence East Campus and Market Chief Operating Officer for The Hospitals of Providence, El Paso. “She’s all about developing people. She’s grounded with incredible humility to be able to see the best in people.”
Hurt-Deitch took her first job as a nurse in endoscopy for the operating room at Sun Towers Hospital in El Paso at the age of 22 after graduating from The University of Texas at El Paso. Her boss was close to retirement and was quick to pull in Hurt-Deitch to help with tasks, which in retrospect, Hurt-Deitch recalled, laughing, were well above her pay grade.
“I swear I hadn’t been there more than three months. She would come in and she’d say, ‘Come here. You’re young. You just got out of school. You should know how to do this,’” said Hurt-Deitch. “And I remember looking at my preceptors, like ‘What do I do?' and they would say, ‘Just go do it! Just go do it!'”
Within her first year, she had gained experience with policies and procedures, scheduling, payroll, developing an operating and capital budget, and even doing the lion’s share of work on a Joint Commission survey.
“I didn’t know! No one said, ‘You need to ask for more money’! They said, ‘Go do it!’ So I did. It was cool. It was fun. I mean, I figured it out,” Hurt-Deitch said.
The added responsibility made her the top choice to succeed her boss, who retired not long after Hurt-Deitch’s first year.
“Right after I turned 23, (my boss) retired. There was a group of surgeons and gastroenterologists who went to the CEO and said, ‘We want Sally to be the next director,’” said Hurt-Deitch. “Kevin Hicks, who I think the world of — he’s a phenomenal CEO — called me to his office. He looked at me and he said, ‘How old are you?’ He was also very young at the time. He was probably in his mid-30s and he said, ‘We’ll give you a shot. I’ll give you six months.’”
A Young CEO
It was during that first experience as a director, she explained, that she realized she wanted her career path to include bigger, larger leadership roles within hospitals. “People ask, ‘When did you fall in love with this or when did you realize you wanted more?” she said. Understanding the workings of the hospital — how the parts fit together — quickly became her passion.
“You get this picture of the facility. You watch. You have to ask, when do I call in the ICU? When do I call in the OR teams and what’s happening to the ER? How are you moving patients? And how does this whole thing work? It’s like a whole city. And you’re in charge of that city,” she explained.
“So? When the pipes burst at 2:00 a.m. or when you’ve got a Jane Do who comes in through the E.R. needing neurosurgery, what do you do? It’s all of those things. Watching how the teams worked together — that was the most fascinating thing to me.”
During those years, she went on to earn her master's degree in nursing administration from UTEP, as well as her master's in health care administration from Trinity University.
Adams became a close friend during those years at Sun Towers. The two found common ground as young, driven directors.
“Being a CEO — being successful as a CEO — is so much about establishing trusting, credible relationships with your medical staff,” Adams said. “I think people saw that in her early on. She could influence not just the associates within an organization but the physicians within an organization and move an organization forward.”
Quickly rising in the ranks, Hurt-Deitch took on roles as chief nursing officer and chief operating officer, before becoming one of the Hospital Corporation of America’s CEOs at the age of 34 for the Oklahoma University Medical Center Edmond.
She recalls her first year as CEO as one of her most difficult.
“My first year as a CEO was horrible. I always tell people; the hardest transition was the one from chief operating officer to CEO. Hardest transition. Hardest year. You go from being an operator and understanding how this works to having to look at things from a 30,000 feet view,” she said. “But then, as the saying goes, it gets better.”
It did get better as she found success in her role in Oklahoma. In 2007, she was recruited to open Tenet’s greenfield hospital Sierra Providence East Medical Center in El Paso. Thrilled at the opportunity to return home and raise her family in her hometown, she accepted her first role with Tenet Healthcare, the first of many that have led her to Dallas and to THA's 2019 board chair position.
Drawing on Strengths to Navigate a Tough Political Climate
As she steps into her role as board chair and one of the industry’s most prominent voices, Hurt-Deitch acknowledges a highly polarized political climate that has lost a commitment to civil discourse. But the need to find a unified voice as an industry is critical, she explained, to stay out in front of other forces that seek to define the terms of public debate around health care.
“I think as an industry in general, we have done a poor job of consolidating our message because we have so many different stakeholders or we have so many different people who see it through multiple prisms,” she said. “Whether it’s being futurist, if we don’t look at the reality of what we (hospitals) theoretically look like in five years and 10 years and are defining that, then it will be defined for us,” she warned. “And we’ll be in the same position, complaining about where we are, like we do today.”
Tough issues like addressing the future needs of hospitals’ workforce or the challenges to serve patients in a state with the highest uninsured rate in the country call for solutions that require a unified industry voice to define the path forward. In her view, the key to get there is honing the ability to listen and remembering the need to be civil.
“I understand being steadfast in what you believe and standing on principles and standing on your values. But too often today, there doesn’t seem to be any willingness to listen. And I think the greatest trait of a great leader is the ability to listen. I mean truly listen,” said Hurt-Deitch.
For Hurt-Deitch, her own ability to listen and pull together people to form a common team will be familiar territory.
“Her ability to assemble teams and develop individuals is one of her key strengths. When I was young and first began working with Sally, I observed the way she was able to connect and develop relationships. That truly is what we do as health care leaders is work on our relationships. We help bring people together to problem solve. I do believe that that is one of the factors why Sally’s incredibly successful,” said Monica Vargas-Mahar, recalling watching and learning from her during Vargas-Mahar's own early days as a hospital leader.
Rarely has there been a better time to bring together key hospital leaders and their legislators to address major health care issues. While not all of the opportunities coalesce around bipartisanship, 2019 is showing signs of being a less divisive environment. At the same time, legislators are recognizing health care needs in their districts. For example, being able to address those issues without the negative discourse means being able to use legislator initiatives to address behavioral health, an area rising to the attention of many Republican and Democratic legislators alike.
Similarly, identifying ways to better leverage technology like telehealth could mean taking redundancy out of the system without affecting hospital reimbursement when done properly.
Always a Nurse
“Quite honestly, I don’t really care what role you put me in. I’m always going to think like a nurse. Whether it’s as CEO, COO, CNO, it doesn’t matter. I’m still going to approach it the same way,” said Hurt-Deitch.
Her current role as CNO and vice president of patient care services at Tenet Healthcare has put her at the center of the system’s initiatives to improve quality and patient experience. She’s brought her roots as a nurse and a refreshing pragmatism to the task.
“One of the things that I really appreciate most about Sally is how connected she is to the patients. She’s a clinician first and always — she’s Nurse Sally. She is not afraid ever to roll up her sleeves and go out and do the work. That is the business of what we do — we heal, right? We are in the business of touching patients and she is not ever shy to get out there and do that work,” said Vargas-Mahar.
A key strength of Hurt-Deitch is her ability to translate larger organizational objectives into the on-the-floor realities of how clinical and medical teams would need to execute those changes. Vargas-Maher explained the challenge of getting implementation right.
“We sometimes take broad concepts and when we translate them down to the person at the bedside or what we’re asking of the nurse at the bedside, it may not be all that practical,” said Vargas-Mahar.
Vargas-Mahar admires Hurt-Deitch’s willingness to keep open dialogue. “It can be something as small as a documentation challenge that she then steps back and says, ‘Is this really making sense?’ We’re able to talk a change through. Does this paperwork approach make sense? Or does this extra task that we’re giving to nursing — does it ensure that our nursing staff is functioning at top of license?”
Hurt-Deitch credits her insistence on real-world approaches to quality improvement and her wariness of becoming too separated from the hands-on work of the hospital to a teaching moment from her early years at Sun Towers. Hurt-Deitch recalled her first CNO, Nancy Rout, interrupting a policy and procedures meeting.
“I remember Nancy walking in and she said, ‘You think it’s so easy, you go do it.’ And I thought, damn right!” Hurt-Deitch said, laughing. “It’s so easy to say, ‘go do X, Y and Z!’ when you have no idea what it takes to actually get that done. So I’ve always approached decision-making that way. Why are we making this so hard on our hospitals? Why are we making it so hard to just provide care? Because we mandate so much. It’s always been this kind of fight. How do you declutter? How do you take the bureaucracy out of it? How do you take it to its simplest form and let them actually provide care4?” explained Hurt-Deitch.
A Strong Advocate for Hospitals
While the year likely won't prove to be an easy one, those who know both THA and Hurt-Deitch well are confident she will prove to be an adept board of trustees chair. From a deep well of experience of leadership to a clinical perspective, Hurt-Deitch's pragmatic approach lends itself to real-world problem solving for the Texas hospital industry.
“In every role, Sally brings a thoughtful, compassionate perspective, always keeping focus on what course of action is best for hospitals in their pursuit of the highest quality of care for patients,” said Ted Shaw, THA’s president/ CEO. “Texas hospitals are a varied bunch, and it is no easy task to create an environment where every member feels their voice can be heard, but because of Sally’s commitment to fairness, equality and respect, even the most contentious of policy issues can be discussed openly and productively.”
Tim Adams echoed that confidence in Hurt-Deitch’s ability to navigate the challenges of the board chair role in the coming year. “I think she'll represent THA very well. She is a proven,
experienced leader. She is a clinician. She is passionate about quality, patient experience and always puts the patient first in what she's looking to accomplish,” he said. “She is someone who can sit down with legislators and try to influence the decisions they're going to make.”