Leadership Corner: Ken Zeri
Interviewed by Catherine E. Toth
Advertiser Staff Writer
Name: Ken Zeri, RN, MS
Age: 47
Title: President and chief professional officer
Organization: Hospice Hawai'i
High school: Highlands High School in Sacramento, Calif.
College: Bachelor of science in nursing, California State University at Chico; master of science in nursing administration, University of Maryland.
Breakthrough job: Zeri considers his first supervisory position at San Diego Hospice in 1987 as his breakthrough job. As a staff nurse, he took care of 10 patients at once. But as a supervisor, he supported the care of 60 patients. "It really opened my eyes to running healthcare as a business," Zeri said.
Little-known fact: He loves to cook for his family and sing tenor in his church choir. He's also worked as a firefighter and emergency medical technician in California, a job he thought at the time would become his career.
Major challenge: "Balancing the mission of Hospice Hawai'i with the business of Hospice Hawai'i," Zeri said. "I think it's one of my most important jobs to make sure Hospice Hawai'i has enough resources — meaning, have enough people, enough knowledge, enough money to carry out our mission. It's about being proactively responsive to the ever-changing and ever-increasing needs for timely hospice care."
Q. What is one major change in recent years in hospice care?
A. For the last five years, we've seen a decline in the length of stay. People are referred to hospice care later than they used to. The average stay is about 40 days, but the median stay — which is the more important number — is about three weeks.
Q. Is the reason for the decline because people don't know what hospice care is?
A. That's still the recurring problem, simply that people don't hear about hospice care. ... The No. 1 complaint we get is "Gee, I wish I knew about you sooner." That hospice care is for only when you're dying, only when you've got a couple of days left, is a misconception. ... The reality is hospice care provides palliative care and support for the last several months of life.
Q. Is part of that because people are apprehensive about discussing death?
A. Discussing end-of-life care is difficult to do and that's never changed. To have a conversation with someone you love about the end of your life or the end of theirs isn't easy. But we see that it's becoming more frequent that people are having these conversations. ... (Caring for someone in the last months of life) can be a very spiritually and emotionally powerful time. It can be awesome. There can be tremendous growth and gifts of love that are shown and shared. That's the rewarding part.
Q. When you took over the role of president in 2002, Hospice Hawai'i was facing some financial challenges. But last year you were able to post higher net assets — $1.2 million — than the year before. How did you turn it around?
A. The cost of providing care had gone too high. It had gotten to be too much for the organization. For a couple of years, we were actually losing money. As a nonprofit you're not in it to make money, but you still need to run a sound business. In November 2002 the board of directors and I simply decided we needed to run a business that wasn't geared toward aggressive growth but rather toward quality and competency. That's what we've focused on — where we're spending our money and what we're spending it on. We've spent the last couple of years working on that. ... Part of being a leader is not being satisfied with where we're at.
Q. Where do most of your donations come from?
A. I want to say maybe half of our income we get comes from people whose lives Hospice Hawai'i has touched. ... Sometimes families will ask that in lieu of flowers, please donate to Hospice Hawai'i. We'll get checks from all over the country.
Q. How difficult is it to rely on so heavily on donations?
A. You have to have faith, faith in God, faith in the mission, faith in the community. You run a nonprofit on a wing and a prayer. That's the community support. You tell people, "This is important work and we know you value this. Please help us." ... People donate as they see fit, as they're able to. The reality is the $5 donation is just as valuable and just as important as the $5,000 donation in the spirit in which it's given.
Q. How important is streamlining the operation of any nonprofit to reduce extraneous costs?
A. You're doing more with less, every single day, and that includes less time. One way to run a nonprofit is to not have superfluous people running around. Of the 70 employees we have, only 12 are not engaged in providing or supervising patient care. Every single resource we can scrape up we use to provide and support the mission.
Q. What are in your long-range plans?
A. What we really want to do is fundamentally change the way Hawai'i people care for their dying. People want to be at home, families want to be able to take care of them at home. It's tremendous pressure on families. We know there's a whole lot of care that's intensely delivered at the last moment that doesn't seem to improve their quality of life. What's quality of life when you're in ICU hooked up to machines? ... Our long-range goal is to ensure our survival as an organization, making sure that next year and 10 years from now we're going to be there to give care.
