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April 2002
Executive TLC
By Nan Bauroth
     Suzanne Freeman’s first job out of UNC College of Nursing in 1975 was in a cardiac unit of Carolinas Medical Center (CMC). Today, Freeman is still applying her TLC skills, now as president of CMC, which ranks as one of the best healthcare facilities in the Carolinas. 
     “I see being a hospital administrator a calling,” asserts the soft-spoken Freeman, who assumed her post in 2000. “This is an exciting time in health care. We have increasingly limited financial resources relative to the significant advances in medical science and technology being made. And many people can no longer afford the full extent of medical care possible. But this challenges us to figure out humanely and scientifically what is the best and most appropriate care to provide at each point in the disease process.”
     With the compassion of a true nurse, Freeman is able to see healthcare in terms of patient care. Unlike those who are negative on the prognosis for the industry, Freeman emanates optimism. “You see health care providers at their best, thinking and redesigning the health care delivery model, and to me that is thrilling.”
     Freeman maintains that CMC’s cost efficiency efforts helped produce a record year in 2001 in terms of market share and volume. “We looked at everything in our system, from the supply and pharmaceutical side to the processes which support care, to see what we could do better and more efficiently. As a result, we have been able to reduce costs.” 
    For instance, instead of warehousing a plethora of similar drugs, CMC has confined its supply to those proven most effective, or most valued, not only from a cost standpoint, but from achieving the desired outcome. 
     Freeman and her management team have also reorganized the administrative team on a service line approach. “We have one person who operates the radiology and imaging system for our Mecklenburg hospital facilities, so we can optimize use of our radiology resources, which are very expensive, high-end technology. We want to operate them as efficiently and close to capacity as possible, while providing patients access at a convenient site.”
     Another case in point: CMC has devised a new approach for patients suffering lung disease. “It’s exciting,” says Freeman. “Preliminary studies show we have improved morbidity and cut in half the amount of time patients spend on ventilators.”
     CMC’s pulmonary team accomplished this leap through a scientific study of how patients respond best in early weaning from ventilators helping them breathe. As Freeman explains, it’s critical to wean people as early in their recovery as possible so their body doesn’t become dependent upon the mechanical ventilation. 
     The bottom-line benefits are twofold: “It reduces the time the patient is in intensive care which in turn reduces the time the pateint is in the hospital. That reduces the costs to patients, their providers and employers. It is a win win.”
    Freeman credits a combination of intensive care physicians, nurses and respiratory therapists, who began the initiative. “One of the beauties of CMC is that ideas travel vertically and horizontally. And, if it’s a great idea and resources are required, then CMC will get them what they need.” 

Business Benefits Accrue

    Freeman is equally upbeat about the prognosis of healthcare coverage from a business perspective. “I can reassure businesses that the dollars they’re expending on the health of their workers are making a huge impact on how we deliver care. Even though new technologies are more expensive, we are able to get employees well and back to work more quickly.”
     She cites an acute gall bladder condition. Thanks to technology, doctors now have two options: A huge incision requiring six weeks of recovery, or laparoscopy, in which a few tiny incisions are made, reducing recovery time to a few days. 
    “Healthcare is rapidly progressing toward minimally invasive procedures,” Freeman declares. “As their availability increases, recovery and timeout from work should rapidly decrease.”
     Dr. Harry Nurkin, president and CEO of Carolinas HealthCare System, feels Freeman is the perfect person for the job. “In my judgment, she has become one of the best decision makers around. She approaches everything from an interest in and in relation to sick human beings. She approaches care from a scientific and technical basis, but with the patient constantly at center.”
    Nurkin well remembers the first time he heard about Freeman: “When I arrived 21 years ago, physicians described her as one of the best nurses in North Carolina.” 
    Shortly thereafter, Nurkin was asked by a physician to meet with nurses concerned about the quality of patient care. “Suzanne was one of those nurses who talked in terms of quality care, not how hard the job of nursing is. Her deep abiding concern was about the level of care patients deserve when entering our institution.”
    Freeman believes one of her gifts is her ability to lead and manage others. “I love to see people develop and grow, and get in an area where they can shine. I always try to enable people to win.”
     In 1997, Freeman left CMC for several years to manage Specialty Facilities within parent Carolinas Healthcare.This provided valuable preparation for top management.
     “The balance sheet responsibility and different sets of regulations gave me an appreciation for a broader base of health care.”
     But Freeman is happy to be back home. “When I came back to acute care, which is my first love, I had all of those experiences to draw from. I think I understand the health care system as well as anyone does.”

A Scientific Thinker

     Freeman’s decision to move into hospital administration was a conscious choice. Only six months after she first set her nursing cap inside CMC, she rapidly ascended the nursing management ladder: assistant nurse manager, nurse manager,  RN supervisor, nursing director, and in 1986, vice president and nurse executive of CMC. 
     At that point, Freeman went back to school and obtained her MBA from Queens College, which altered her perspective. “We learned so much about financial and organizational management and accounting, and I found that it takes every piece to make a good decision. You can’t base every decision on whether it is right for patient care. I always had this altruistic view that if it was needed, you had to do it.”
    This is the most important thing learned in getting from her MBA: “To understand that in any decision there are not only the numbers and target you’re shooting for, but knowing how the decision will impact people. So you have to make a balanced decision about what you want to accomplish.”
     In her opinion, “I am a somewhat scientific thinker. I like to have quantitative information, as well as qualitative information, to make a decision.”           
That scientific mentality, coupled with her newfound approach to decision making, influenced her thinking about a problem she faced at CMC at the time: a nursing shortage. “It became clear to me that to have a steady supply of nurses over the long haul, we needed to have a school of nursing at CMC in addition to the existing schools in Charlotte.”
     Freeman says that although her proposal wasn’t popular or enthusiastically received by some groups, she held her ground. “I knew what having a qualified ready work force would mean to this hospital and our community. Despite quantitative information which was not overly convincing, the qualitative outcome and needs of the hospital and community prevailed.”
      Nurkin says Freeman’s leadership style, evidenced by her resolute stance on the school, and the way she stood up to hospital architects years ago, sets her apart. “She will sort of teach, but also tell us this is the way it should be. That kind of decision-making characterizes Suzanne. It’s never a fist on table. It’s, let’s look at what we’ve got here and see if we can improve it.” 

Water and Snow Skier

     Freeman’s calling as a nurse is rooted in her childhood. “I was very blessed,” she observes. “I had a maternal great grandmother who was diabetic. I loved taking care of her and entertaining her when she was bedfast. On my Dad’s side, my grandmother owned a restaurant. So I got business and nursing from two different sides of my family.”
     Today, she feels equally blessed with her own family – husband John and three children. They recently moved to Lake Norman, a natural fit for a family of sports buffs. Freeman loves to snow and water ski.
      Although she keeps a fairly low profile, Freeman is devoted to church and community activities. 
      Her early experience tending for her grandmother makes her a champion of the junior volunteer program at CMC. “It gives kids an opportunity to give back. They interface with patients and see the opportunities in healthcare firsthand.”
     Asked if CMC sponsors any programs in the lower schools to encourage careers in healthcare, Freeman replies, “We plan this summer to have a project designed by nursing called ‘Experience Nursing.’”
    CMC will give high school juniors and seniors who are thinking of a career in nursing, a very structured view of nursing from the inside out. CMC also sponsors a group of Explorer Scouts interested in healthcare careers. 
     Freeman notes that unlike many of her friends who have had a midlife crisis and decided to change careers, “I didn’t have to suffer through that because I already knew I made a difference in someone’s life every day in my job.”
    Her love of her profession speaks for itself: “I don’t think you could be in hospital administration without a true love of human life. The ability to champion and have an impact on the health and comfort of those who are diseased — that is the most fulfilling thing you can do.”



Nan Bauroth is a Charlotte-based freelance writer.
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