Welcome to the Healthcare CEO podcast. Join us as Daniel Fernandez, healthcare leader and patient experience advocate leads dynamic one-on-one discussions with healthcare executives, consultants, and other industry experts. Listen in as they share actionable insights and unique perspectives into the day in the life of a healthcare CEO.
*The following has been adapted from our full-length interview, which can be found here.
Meet Isaac Steg
Isaac is the Founder and CEO of Constellation Health Services, a family-owned, family-centered organization providing a range of community-based health services. Year after year, Constellation is recognized as one of the best places to work in all of healthcare. It is consistently rated in the top 5% of all agencies nationwide by Centers for Medicare and Medicaid Services. The list of awards is both impressive, and numerous successes like these don’t happen without a successful culture in place — and that is exactly what we’re here to talk about today.
Creating an Employee-First Culture
Daniel Fernandez (DF): So, culture means a little bit something different to everybody. What does culture mean to you?
Isaac Steg (IS): To me and to our organization culture is everything. I think early on, when we started this company, we recognized the importance of creating the right culture to be successful in whatever you’re doing. I think sometimes CEOs or leaders tend to sit on top and think they’re really driving success. And as soon as you can recognize that success is directly driven by the employees, and that they really determine the outcome of your organization, only then are you in the driver’s seat. It’s all about employees, it’s all about the people providing care and interacting with the patients and the clients. If you recognize it’s not you, it’s the actual employees that drive your company, I think that’s the first step to have a successful company.
DF: So you’re basically taking the triangular model of hierarchy and turning it upside down. You’re putting the employee first.
DF: Do you have a motto, mantra, or slogan at your organization?
IS: We try to sit back and really figure out how we want our employees to feel. I get up every day and think I have the best job in the world. I wake up in the morning, I’m excited to come to work, I go to sleep at night and I’m excited that I had a successful day or that I’m working in this company and building a successful company. And I’ve always told the leaders and employees that we really need to create a fire so that people get up in the morning, and they feel excited. In order to do that, you really have to make sure your employees feel valued and trusted. And if we can accomplish that, then they’ll get up in the morning and say, “I love my job. I’m happy with what I’m doing.” Because ultimately, if they’re happy or satisfied, it’s going to trickle down to your clients.
And in order to be successful, your clients need to be happy. In order for your clients to be happy, your employees need to be happy. So we go into every meeting, asking, how do we make important employees feel valued to us? I asked my leaders, at the end of the meeting, to think, “Did I make our employees feel valued? How did I make our employees feel valued and trusted?” And if you go in with that mindset, 99.9% of the time they’ll be successful, and your employees will never want to leave, and that’s the ultimate goal because turnover is not only very costly in our business, but also employee retention is key.
DF: When I did some digging, I found out that even on Glassdoor, for instance, you have 100% CEO rating. It’s not a very common thing. Some of the reviews are absolutely outstanding, and they speak very highly about you, and I think that speaks volumes.
IS: I find it very interesting because some of these companies put so much money into different resources, like HR and how to cut costs and they have a director of HR and Operational directors, and I’ve always wondered why don’t companies invest more when it comes to employee engagement and employee satisfaction and building culture. Usually, when you look at a company, it’s the HR director or the HR person or the administrator of the program who works with the culture. And they have to buy into the culture, and it trickles down to the rest of your staff.
But why don’t companies have high-level positions that focus on making sure employees are satisfied? So, about two and a half or three years ago, I made a decision to hire that position, and to have someone go around from location to location and work with employees to find out what’s working — what’s not working — and what we can do better. Making an investment in that in that position was huge for us as a company and really helped us now in terms of culture, setting, and direction,
DF: That leads perfectly into the next question. How large is the company you have today, in terms of employees?
IS: So we’re currently based in the northeast, and we have 600 employees, covering multiple states. Constellation Health Services covers home day services from certified homecare, to hospice care, to personal care. We have a division that focuses on therapy for kids. We also just recently started an ABA which focuses on providing autistic services in the community, in the child’s home. So you kind of cover many different areas of healthcare.
DF: With such a large team that covers many different aspects, how do you make sure that cultural message resonates throughout the team. You briefly spoke about someone who goes around to visit different locations. Is that one of the ways?
IS: That’s definitely one of the ways, but really it starts with myself. I need to give the direction and really show the entire company how important culture and employee satisfaction is. This is something every single meeting we have, we constantly talk about – what can we do better? Are all our employees happy? Especially during COVID. There are definitely challenges, but the message has to stand on top and it has to resonate down. Everyone has to buy into it. So you can talk about culture, but if your leadership team doesn’t buy into it, it’s not going to trickle down. You need to live and breathe culture, and you need to live and breathe that the goal is to make our employees happy.
DF: And speaking of making employees happy, one of the things that I’ve seen echoed across several interviews was people talking about the flexibility that you offer. I would imagine that contributes to better work life balance. Are you seeing that it is helping in the recruitment efforts or retention efforts, just by helping the caregivers have more of that work life balance in place?
IS: Absolutely. When you look at the home-based services or you look at home care, there’s definitely a lot more flexibility than working a 12 hour, or 24 hour shift in the hospital. There are definitely some flexibilities built into our business. But if you look across the board, there is a lot of competition. There are many, many companies in our space, and the employee pool is shrinking, and flexibility is not enough. Offering flexibility, it’s really about what you do to have employees who want to come to your company and stay with your company. I remember when I started this company 10 years ago, I was walking in one of the offices in New York, and had an employee come over to me and say, “Isaac, this is the best place to work.” And that was probably my biggest compliment that I’ve gotten. That’s when you know you’ve created an environment where people want to be.
Using Internal Communications to Strengthen Culture
DF: Everyone focuses on external communications, but not many are ever focused on internal communications. How important is it and how do you guys go about that?
IS: It goes back to what I said originally. You need to make sure your employees feel valued, trusted, and heard. And in order to do that they have to be in the loop with whatever’s going on in your company. You need to be up front with them when there are challenges, and you need to talk to them about what some of the exciting things are coming down the pipe and what’s happening at the company. If you don’t keep your employees engaged, they’re not going to be brought in. And if you keep them engaged and part of the process, that’s when they start feeling valued, trusted, and heard, and that’s critical and crucial.
There’s so much time, money, and energy spent on external communication and not enough spent on internal communication. Again if you look at it as your employees are really your key to success, then, just like you’re invested in external communication, you need to invest in internal communication. It sounds simple. You want to make sure your employees feel valued, trusted, and heard. If you can accomplish that, and you go in with that mindset, I think you’ll be just fine.
DF: You didn’t start off with 600 employees. I imagine there must have been some challenges along the way. What are some of those challenges and what sort of challenges do you foresee in the future, especially when it comes to maintaining culture?
IS: When you’re smaller you know the name of almost every single one of your employees. I think when we started, I had two employees working for me. And we used to talk multiple times a day. Obviously as you grow, you can’t keep touching base with every single employee, and you’ve got to figure out other ways to build that connection. And it’s a challenge, there’s no question.
As a company grows, it becomes a lot more challenging to keep that culture. But it becomes even more crucial to keep that culture, because your success really hinges on your employees. So you have to make them feel like this is the place they want to be. That’s why you’ve been successful. Without our employees, we would not be here. We invest in marketing and we invest in advertising, but I think if you invest in your employees, you’ll get a bigger bang for your buck than just investing in social media or investing in advertising or whatever else it might be.
DF: That’s a bold statement and I love that. For the person listening right now, who’s looking to improve their own culture, what advice would you give them?
IS: When I come to work every day, I think to myself how I want to be treated and how I want to feel. And I say to myself, the same feeling I have, the same way I want people to treat me. This way I’m going to treat others. So I think you start small and say okay, what would I want my employer to do for me? And how would I want to be treated in the work environment, and then divide it that way and say, is this something that I would want to happen to me? Is this the way I want to be treated? If you do that and have that mindset, you’ll be successful.
So it’s not building these huge programs and investing a ton of money, really It’s the human interaction. It’s feelings. It’s a very simple model of doing to others like you want done to yourself. And really if you live by that — and that’s how I’ve lived my life and built my company — I think you’ll have employees who want to be there for you, and want to work for you,and want to go the extra mile. So you don’t need to invest a ton of money, it’s just having that personal connection and really treating others like you want to be treated.
Using Technology to Create Better In-Home Care
DF: In terms of investing, let’s talk about technology. Are there any technological pieces that you’ve added to the organization that have helped to enhance the caregivers’ perspective or how they interact with patients?
IS: Absolutely. It’s been an extremely challenging year since COVID hit. We pride ourselves as a boutique organization that really customizes our care based on each individual patient seen at Constellation, and technology plays a huge role in what we do. And as we sat back last year thinking about what we want to do, we had these grand plans and how we wanted to utilize technology, and then COVID hit, which accelerated some of the plans we had through technology.
So just to give you a very basic example. Our concept is a complete care at-home approach — which means we want to bring everything the patient needs into their home, to avoid leaving their home, and to avoid going back to the emergency room. And what’s happened with COVID is that patients don’t even want to go see their physician. They don’t even want their physical therapists coming. What we’ve done is really utilized telehealth, video, and we’re doing virtual visits with patients. So if you don’t want anyone coming into your home, we’ll do a virtual visit so you can see your physician. We’ll patch in through a company that we started called Impact Health. We have nurse practitioners and physicians available to video in and put eyes on the patient and assess them.
But in addition to that, we have patients who refuse to go to the physician, so we brought the physician to them. And that’s really our concept of complete care at home — it’s how we utilize technology to bring services that were traditionally provided outside the four walls of patients’ homes into the patient’s home. So now we’re able to bring physician services, therapy services, and a whole host of other services into the comfort of the patient’s home. That’s important regardless because you want patients to be comfortable, but especially during the pandemic, it’s crucial. And then we have some incredible, heartwarming stories through our hospice program where, unfortunately, in the hospital setting or in the nursing home setting, we’re not able to visit patients.
Our staff was able to go in through video visits, and we even did a virtual birthday party with a terminal patient with the entire family on the virtual visit with the tablet. But at least the patient who was dying was able to have that connection and was able to see their family. And they were able to sing Happy Birthday for the last time. So, that technology if utilized properly, really has had an incredible effect during the pandemic, and even post-pandemic, it will really affect how we provide care.
DF: Because of COVID, the pandemic has accelerated the implementation timeline for a lot of technology. Do you think that, because patient behaviors have changed, that they’ll go back to the way it was before? Or do you think some of these things are here to stay because people now have become accustomed to things like telehealth?
IS: Absolutely. I think some of these things are definitely here to stay — especially during recovery. For instance, if you go into the hospital for hip replacement, now you go straight home. You need therapy at home. At Constellation, we come in and we provide therapy in the comfort of your own house. You can’t make it to the grocery store, and it’s hard to make to the doctor. So what’s happened is patients and clients now see that there are companies out there that can come to me and I don’t need to be in the waiting room and wait in long lines. That’s not going anywhere. It’s all about comfort, it’s all about customer service, and it’s all about patient experience, so I think technology enhances all of that.
DF: To some extent, it’s almost like healthcare’s come full circle. I remember the doctor with the briefcase showing up at people’s front door. Then it evolved to where we’re all going to clinics and offices. But now there’s a way to deliver all of those services back at home again
IS: It’s amazing how technology has evolved, and what the capabilities are. And it keeps on changing so rapidly and so quickly. I looked at a device the other day that’s a contactless device that sits on the patient’s wall and monitors heart rate and respiratory rate. The patient doesn’t have to wear a device. It’s incredible to think about what you’re able to accomplish through technology, and it’s only going to get better.
DF: Are there any other technologies that you are excited about?
IS: Well when you look at technology, you need to be careful, because sometimes you get wowed by the fancy car. So we want to make sure patients are safely at home. If a patient has congestive heart failure, we want to be able to monitor their weight and their heart rates. Sometimes it’s just as simple as having a patient go on a scale and having a bluetooth device connected to a monitor that’s able to transmit data. You don’t want to make it too complicated. But at the same time, it’s difficult because when you see all these shiny new tools, you want to figure out a way to implement them.
DF: Here’s a fun question, Isaac. We’re jumping in a DeLorean time machine, and we’re bouncing five years into the future. What does Constellation look like?
IS: That’s a great question. My goal is to continue to grow, perfect, and bring a complete care solution to our clients and our patients. So if I have to fast forward five years, I’m hoping that regardless of what a patient needs, we’re able to provide that in the comfort of their own home. With some of the programs that are coming out even today, there’s no reason why the patient has to go to the emergency room when they have an episode. What can we continue to bring, so we can bring services, so patients don’t have to go to [an on-site clinic]? So, you know, I’m hoping that the patient continues to be at the center, and we can continue to add tools and resources to make sure the patient stays in the center, and the patient receives the best possible care in the comfort of their own home. So if I had a crystal ball, I just hope that employees continue to feel valued, trusted, and heard. I hope that this is a company that everyone wants to work for, and I hope that anytime anyone needs care or thinks about care, they think about Constellation.
DF: I imagine that a lot of people want to continue to work there, so kudos to you on your leadership and the culture you’ve created. I have a few closing questions. If you could recommend one great book that our listeners should read, which book would it be?
IS: There are so many books focused on civic culture and techniques on how to build a culture, but it really is very simple — treat your employees the way you’d want to be treated. I like to read biographies on inspirational leaders and how they treat others — not necessarily the ones directed at culture. But it just shows you there are so many good people in the world and helps you think about how you make other people feel. And those are the books that really inspire me and inspire me with my employees.
DF: Do you have a favorite quote?
IS: Treat others like you want to be treated yourself.
DF: It’s clear that last year was challenging for almost everyone in different ways. What has the last year taught you, personally?
IS: The last year has taught me that we don’t often recognize greatness in our employees until we’re faced with a challenge. Our employees have stepped up to the plate in ways that I could never have imagined. They’ve done things that I could have never dreamed of. Every single one of my employees have put our patients or clients first and have gone out of their way to make them feel comfortable, even if they put themselves in danger. I was incredibly taken aback in a positive way. How they stepped up to the plate and have really taken COVID head on. They’ve gone into the fire, essentially. Even with some of the innovations we’ve done over the last year, without them, none of this would have been possible. I am blessed to have them work and be part of this Constellation family because without them, I don’t know where we would be. So that’s really the biggest lesson, that people really step up to the plate.
DF: And that speaks volumes to the culture that you’ve created as well. Final closing thoughts to the listener, healthcare executive, or physician who’s leading their own organization — What advice would you give them?
IS: You need to stay passionate. If you, as a leader, stay passionate and believe in what you do, it will trickle down to your employees and trickle down to your culture. But you have to believe. People can see if you’re bluffing. They see right through it. If you want your employees to buy into it, you truly have to buy into it. Understand what you want, understand what you want the culture to be like, and understand what you want your employees to feel like. And then believe in that.
Learn More about How Isaac and Other Healthcare Leaders Are Shaping the Future of Healthcare
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