Carl Cline: Hospital Administrator
This summer, VANA spoke to Carl Cline, Hospital Administrator for Carilion Franklin Memorial Hospital. Learn more about his journey to leadership:
Can you tell us a bit about yourself, your role, and your history with Carilion Franklin Memorial
Hospital?
I’m a nurse by background. I received my associate’s degree in nursing in 1989 and began working as a nurse in the emergency department at Roanoke Memorial Hospital for around three years. From there I became a helicopter flight nurse within a program that I worked and managed for twenty years. Once my children were a bit older, I decided to go back to school. I earned my bachelor’s and master’s degrees from Jefferson College in Roanoke. I’ve been in leadership almost entirely ever since. I returned to Franklin Memorial Hospital as the Director of Nursing, but the administrator at the time had just retired and I moved into that role, where I’ve been for the past four years. COVID presented itself just as I was settling into the role of Hospital Administrator. Needless to say, my introduction into hospital administration was quite challenging. We’ve done a lot of renovation work – our hospital was built in 1952. In September we’ll be finishing a complete operating room renovation. We’re going from two 300 sq. foot operating rooms to two 600 sq. ft. operating rooms and two procedure rooms. Our PAC-U has increased from eight beds to 15 beds, and we’ve increased the number of surgeons using our facilities from four to up to 22.
We’ve had MD Anesthesiologists in the past but recently we’ve managed all our care through CRNAs.
As someone in leadership, what challenges do you face in your role and how do you continue to push yourself while serving at a leadership level on a daily basis?
This is a small hospital in a more rural setting, although we aren’t considered to be a “rural” hospital. We’re close to a “home-base” hospital and it’s important to take advantage of that. One of the things I’ve been focusing on during my time here is providing our patients all the same opportunities and resources here at Franklin Memorial that they would find anywhere else. We do that through a process of systemization. By systemizing each department with one another and with our partner regional hospitals, patients who may previously have chosen to travel to other community hospitals for testing, sick or well-visits, or any of their necessary procedures might choose instead to see one of our practitioners. Just as importantly for our medical practitioners, systemization allows for the opportunity to travel between hospital campuses without losing any quality or missing any resources. They will find what they need here, just as they will in Roanoke or anywhere else. These systems provide the best care for our patients and their families.
We have a college down the road and as an administrator, one of my biggest challenges is convincing CRNAs to come practice with us. We have a busy emergency department where we do everything, so there are a lot of opportunities for newer CRNAs. Supply acquisition has also proven to be a challenge at times because we are smaller, but we’re solving that through our standardization process.
Let’s talk about the role that CRNA’s play at your hospital and within Virginia’s healthcare system in general:
CRNAs are critical for us. Our facility relies heavily on CRNAs and will continue to – in fact, because we’ve chosen to prioritize systemization, we’ve created an environment for CRNAs to flourish. We’ve had CRNAs retire after long careers within our hospital system and have been able to bring in new CRNAs from Roanoke that we are actually able to share with hospitals in Roanoke! If we’ve completed our cases early in the day, we’ve had CRNAs choose to run down the road and finish their day at another facility, or be requested as an additional set of hands, because we maintain the same competencies and skills.
What are the big issues facing health systems like Carilion Franklin Memorial in Virginia today?
Like every other industry, we’ve gone through some staffing issues over the years. One thing that sets us apart is our ability to work with our partner facilities to both be supported and help support through our systemization model. We’ve certainly sent CRNAs to other facilities if they’re having a busy day and we’re having a light day or vice versa. That wouldn’t be possible if not for our system, which strengthens regional medical care for our patients overall.
VANA supported legislation this year that would have removed physician supervision from the Virginia regulatory code. It would change “supervision” to “consultation,” allowing the CRNAs to work independently. Is this something your team supports?
As someone who is aware of just how qualified the CRNAs on my team are, it’s important to me that CRNAs, and all medical professionals, are supported in practicing to the fullest extent of their education and training to best allow for patient healthcare access. The best outcomes happen for patients when health professionals work in partnership, supporting one another, to achieve greater success.
As you’ve grown in your role over the years, what role have mentors played in helping you achieve your goals and how do you work to mentor the people around you?
The biggest mentor for me over my time in healthcare has actually been a past medical director, Dr. Carol Gilbert. She’s now retired but she was a trauma surgeon and a flight crew medical director. She was always wonderful to work with. More recently, both Steve Arner, my boss, and Nancy Agee, our CEO, have helped me immensely and been hugely influential. I also rely very heavily on my peers throughout the system, particularly my fellow regional hospital administrators. I also rely greatly on my leadership team right here at Carilion Franklin Memorial Hospital. I am very fortunate to have leaders with many years of experience. My team here is the most supportive team I have ever worked with.
I firmly believe in giving everyone the same equal chance that I’ve been given, so I try to mentor people as often as I have the opportunity. When a student calls me and says they’re considering a future in healthcare, I set them up with a job shadow so they can make the best decision possible. I’m just hoping they’ll come back and work for us!
