Written by Caitlyn Canby, San Diego North Economic Development Council
Rarely have I met someone as tenacious and as passionate about her work as Palomar Health CAO Stephanie Baker, who when asked what her favorite pastime is, said she has run over 65 marathons on all seven continents. Yes, that includes Antarctica, for which she had to win a lottery and ride on a Russian War ship across 40-foot seas to attend.
Baker has had a lot of practice overcoming obstacles. She moved to San Diego with her family as a young girl, as she suffered from severe asthma and was a frequent emergency department patient due to the extremely wet climate of her hometown of Lexington, KY.
“Probably the reason why I went into emergency medicine is that I was in the [emergency department] a lot as a kid,” said Baker. The weather service suggested either Phoenix or San Diego as a better climate for her condition, and her family chose San Diego. Her asthma cleared up within 6 months, and they’ve been here ever since.
“There’s just a lot of great opportunities to be outdoors and do fun things, up-and-coming restaurants, just a good community that we can grow,” said Baker. “There’s a great opportunity to have a balanced life because you put a lot into your work, so you need to maximize those hours outside of work to be balanced.”
The Patient-Centered Experience
One thing that makes Baker so uniquely qualified for her position is her background in nursing. As a new graduate, she started as a staff nurse and rose through the ranks to chief nurse. But for the last 16 years, Baker worked as a consultant to help organizations across the country. “It’s given me a really broad range of different experiences, organizations, and areas across the country, seeing how those things work, clinical and non-clinical,” she said.
Now as an executive for Palomar Health, Baker focuses on ensuring the organization’s strategic plan is driving into operations and being well executed. “Most organizations have a lovely strategic plan, but does it sit on the walls, or does it work in the halls?”
To determine ways to improve and implement processes, Baker said that “going to the end user is a really good way to find that out. A staff nurse knows what’s getting in the way of their work.”
“I believe it is important for [executives] to be visible and stay connected to frontline staff and patient experience,” said Baker. “I try to spend 30-50% of my time each week out in [patient] areas, rounding, seeing what’s happening, watching workflows, and seeing what the patients experience.”
Baker said that improving patient experience isn’t its own process, however; it is built into everything staff does, every day. Ensuring that every patient has a reliable experience requires executives, directors, and managers to watch, validate, observe, coach, and provide resources to the staff daily.
“Everything we do should be patient-centered,” Baker said. “Many times, organizations design processes for our own efficiency, but we sometimes forget, ‘What is that going to look like for the patient?’ We must think like our customers, driving an experience that will be helpful and meaningful to them.”
Employee Engagement & Development
Beyond providing quality healthcare, Baker cited being a large healthcare employer as one of the benefits Palomar brings to North County. “We’re a large employer, and we take that seriously,” she said. “We want to be the employer of choice. To be a good community resource, a safe place for people to have attractive employment at a competitive rate so that they can afford to live and work here.”
Baker said it is a privilege for her to work for Palomar Health. “I’ve got a lot of great leaders who report to me, and my job is to develop them, help them scale the services, and help grow the next generation of leaders.”
Baker tries to keep it fun but purposeful. “You have to have fun at work. Research shows that. I’m on a one-woman mission across America to bring joy back to healthcare. But you also have to have a purpose. That’s what keeps us connected to the work because you know, the work is hard.”
The COVID-19 Impact
“Never let a good disruption go to waste,” Baker always likes to say. “Covid disrupted a lot the ways we were doing things in our lives, but it helped us to stand up processes and services in alternative ways as well. There’s a lot of opportunity and great things that we learned – a lot of good things can come out of a disruption.”
One great thing that Baker said came out of the Covid disruption was the accelerated advancement of telehealth, which would have otherwise taken many years to implement. “The urgency and the need weren’t there. [Covid] got us out of the traditional thinking that you have to come in for a visit and caused us to have to improve our access.”
“There was some [telemedicine before Covid], but it exploded during that time,” said Baker. “I was still on the consulting side at that time, and my company helped a lot of organizations get up and running really quickly.”
Now providers and staff have more efficiency during the workday, and customers have more ease of access. Patients don’t necessarily need to take a half-day off to go see a doctor and come back. They can take a virtual call with a doctor as one of their meetings. Or they don’t have to leave the comfort of home and risk exposure to themselves or others.
On the other hand, the Covid disruption has been hard on everyone, especially to frontline medical staff, and Palomar Health is continuing to implement strategies to support the workforce.
New Behavioral Health Hospital
“I’ve been a nurse 35 years, and this is probably the hardest 2 years with the isolation, the difference in a patient not having as much support family- or friend-wise in the hospital,” said Baker. “We had to stand in the gap for that. It’s a big responsibility, and the caregivers have been through a lot, but we’ve got a really dedicated team.”
“We have seen people needing more therapy, needing more follow-up,” said Baker. “The loneliness, the isolation, the depression… It was a toll on everyone.”
In response to the rising need for mental health care services, Palomar Health (in a joint venture with Kindred) will be breaking ground early next year on a new behavioral health acute care hospital.
“We are seeing as we really help drive mental wellness and take the stigma off of it… The more that we normalize it and make it ok that your emotional and mental health is just as important as your spiritual or physical care, the needs will absolutely increase over the next 10 years. We want to be a leader out front. We are committed to behavioral health and a comprehensive continuum of care,” said Baker.
Caring for Vulnerable Communities
When asked about the biggest community issues that weigh heavily on her mind, Baker said “homelessness” without a second’s pause.
“Homelessness is one of our top issues as a healthcare organization. We’ll see many unhoused patients – or those who don’t have a safe place to go after discharge – back in our emergency department,” said Baker. “I think as a community that’s our responsibility. We have to work as a team to make sure that we are looking at affordable housing, ways to help the unhoused community, and finding community resources and safe places where people can go.”
Palomar Health tries to keep costs low and partners with organizations to help the most vulnerable communities stay healthier and not come to extreme illness.
“There are a lot of people in the gap we need to care for to ensure that vulnerable populations stay above the fray and have the access to healthcare that they need, not just in emergency situations,” said Baker. “We are always asking, ‘How do we drive quality and reduce costs to keep healthcare affordable and ensure that people have access?’”
However, one organization can’t fix the region’s most pressing issues alone. “We as business owners and organizations – have to lead, not follow,” she said. “This must be considered our problem, our opportunity to make the change. We’ve got the resources to do it, and the more we combine our resources as businesses that are committed to this area, we have an opportunity to make real change.”