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Hello, and welcome to the healthcare facilities network. I’m your host, Peter Martin. As always, thank you for clicking on this network. And thank you to my guest. Steve Carbery who is joining me today, Steve. Welcome.
Morning, Peter. How are you?
I am well, thank you. How are you? Doing great
doing great. Thanks for having me.
Oh, my pleasure. So I had asked Steve, to join us, Steve, as you may know, has a long career. I’m sorry. Steve, on the long has a has a distinguished career in healthcare facilities management. So Steve has worked for some prestigious organizations made his way up to vice president level, Steve now has a consulting business, Steve went to the Maritime Academy. Steve has an interesting background. All things to do with health care facilities management, as we like to do on the network is just to share the stories because every time somebody hears a story, there’s an opportunity that comes out of that. And so I’m very happy that Steve joined us today. It’s a beautiful fall day up here in New England. I’m sure it’s the same town in Connecticut. Steve.
James, hey. Yep. Same Same.
locked into you know, talking about your career. You walked into Greenwich Hospital? Greenwich, Connecticut. 1986. You’re a hospital employee? How have you seen the industry evolve? And what has changed over the years? 86? Doesn’t seem like longer, though. I mean, um, no, people weren’t even born who are listening to this. But, you know, I’m remembering the Mets play in the Red Sox? And it seems like yesterday. Yeah,
yeah. It seems like yesterday for me too. And, yeah, it’s, it’s a different world. You know, I get asked that question a lot. How has it changed? And, you know, I put it in perspective, I said, Well, when I walked in the door, the TV’s only had 13 channels. The thermostats were analog and pneumatic. So, you know, we’ve, the healthcare business has changed quite a bit, the buildings were, you know, a lot older. And, you know, we were back in the plant technology and safety era of, you know, the Joint Commission guidelines back then. And that was probably one of my first tasks was to rewrite, you know, our policy and procedures book, which was a great start, you know, to learn the business coming from the marine industry, and transitioning to health care. You know, it really gave me a good, you know, start and a good footing to learn the healthcare business. When I was hired, you know, my background was, you know, in power generation, you know, in boilers, turbans, generators, air conditioning, electrical systems, and I had to learn the health care business. And so, understanding the Joint Commission and Department of Health process was very helpful in getting the up and running short period of time. What
were you hired in? What role will you hired in for Steve? So
I was I was hired as the assistant director of engineering position that no longer exists, you know, as organizations have become flatter, and flatter and flatter. So very lucky. The gentleman who hired me was also a SUNY Maritime College graduate. So we had a commonality. And, you know, he brought me along. Yeah.
So back in 1986. Now, Greenwich is very well to do area. Still, is it back in 86? Do you recall was Was it A? Did it still have lots of cash behind? It was a prestige? What was it like walking into that environment where expectations are high and your clientele is high? And what was that like for you to learn in a hospital?
So yeah, Greenwich was, you know, pretty unique organization, you know, we were a standalone hospital. You were right, a very prestigious neighborhood, very high end the facilities were all but they early on embraced, you know, patient experience. You know, high patient care. And so, even though the buildings were older, they made sure that the experience of coming to the hospital was terrific from the food, the nursing the care, you know, you name it, it was it was a different experience. I do remember up on six north, they had a little cart for happy hour. And, you know, that was a different time. You know, you don’t have that anymore. But, you know, that was that was one of the things that I remembered was service service service. You know, just as you would expect in a Hilton or a Hyatt. Yeah,
yeah. So what did you just again, thinking back to and I want to ask you a little bit about your Merchant Marine Academy background as well, but it’s What was it about that role in hospital health care that attracted you?
Great question. So previously, I had been working in the in the Merchant Marine business, I had sailed, coming out of college, on a container ship going back and forth to the Far East. That job was a great job, great ship, great ports. But the shipping industry was facing a downturn in the early 80s. And came ashore at a job as a Marine Surveyor going around looking at REC ships for insurance companies basically is similar to an adjuster role. But I learned an awful lot about repair work and negotiations and shipyards dealing with clients and ships crews and shipyard crews. High Value cargo transfer, you know, a very a lot of responsibility for a very young person, you know, 2425 26 and travelled around, you know, all the way up to the North Slope of Alaska. So it’s a great job. But that company faced the downturn in the marine industry and, you know, wound up moving over to Greenwich Hospital, you know, as I said before, so, you know, it, you know, having that having that background, you know, really helped me transition into healthcare.
Was that your first job coming out of college?
Now, my first job was sailing as a third assistant engineering officer on that container ship. Okay. And then the marine surveyor job and then it was actually my third job. Yeah.
So do you know, I’ve always you must know, Paul Cantrell who works? Yes, yeah, yes. I’ve always so Paul has obviously like kind of a similar background to you on ships now. I’ve always wanted to ask him, but since then, I haven’t but since you’re I, as I’ve said before, I love the weather. I love the ocean. We’re close to the ocean. Do you recall? Is there a scary moment from your experience? When you were maybe going over to Alaska or wherever you were, you were on the ocean and, and you’re like, Oh, my God, I just finished reading. I don’t know if you’ve ever read it about the container that broke apart off a Cape Cod in the 1950s. The Finest Hour is the book. It’s about the Coast Guard, Coast Guard 32 footer that went out and see your guys off a container ship
that I’ve seen the movie. I’ve seen them. Yeah, there’s there’s two
Mexican ovens patent on from the Coast Guard to talk about that. But do you recall him obviously, a moment where you were scared witless?
I’m not scared witless. I mean, you know, we had a pretty great crew on on the ship. But I do remember one evening, I would get off watch, I started an eight to 12 Watch. I was good friends with the third mate who stood the 12 to four watch. And so you know, you come off watch your little sweaty, you’re a little wind up and I went up to the bridge, you know, so an engineer goes up to the bridge, have a cup of tea, you know, kind of a little bit of chat before you, you know, go back to your bunk and your state room and relax, because you’re back on watch at eight o’clock the next morning. And we were in a very violent storm coming out of Yokohama heading back across the Pacific, for Oakland, California and a full load of containers. So we’re coming out of the port, and it’s good, you know, 1520 foot seas 25 foot seas. So this is 700 foot container ship. And, you know, it’s rockin pretty well. And I’m standing up on the edge of the bridge and I see a white light in front of us. And I turned to the mate and I go, did you see that? And he goes, see what, and I said, Come over here. And it pops up in front of the boxes again, and he goes Holy crap, they check the radar, and nothing on the radar. But he orders on hard to starboard. And we look down the side of the ship and there’s a Japanese fishing vessel that we almost ran over. And it just he said if you weren’t up here, we would never have seen that we would have run them right over. And we both had chills coming down our spine that night. And I was like, okay, that’s one for the books. And so you know, I think that both was a little bit of pucker time for him in the mate who’s on the wheel. So that’s that was a memorable event. Yeah, very memorable event. Yeah.
Yes,
we got
you visualized that it must be you know, your natural inclination. Like if you’re here on land, you turn a light on and you see what’s in front of you, but you’re out in the ocean and you’re dependent. It must be a strange visual to see it pop
up and you know, they rely very heavily on the radar and why it was not on the radar was you know how Another whole nother question. So it wasn’t a very big boat either. So maybe 100 footer, and they were getting tossed in the storm. That’s for sure. So, yeah, quite lucky.
Yes, quite so Quite so. So I know that you, you know you’re very involved with and you’re passionate about your alma mater, the Marine Academy, Merchant Marine Academy, and the brawny Maritime College in the Bronx. Yes, sir, the Maritime College in the Bronx. And I think you know, you alluded to it a little bit before we started to tape. But how do you see maritime academies playing into help to alleviate this employee shortages that we see and that are going to continue on? How can maritime academies be a solution? They continue to be a solution because they better solution because they’ve supplied a lot of people? What can they do to help?
So we’ve actually had that conversation with some of the folks at SUNY Maritime College and I have, you know, friends of mine, a classmate of mine is in the facilities engineering program. They’ve actually built a new mini steam plant, if you will, in their engineering building. And the whole idea is that it will give students practical shoreside steam knowledge. So they have a small cleaver Brooks boiler that runs on to oil. And that gets fired up. And then we’ll run a small steam turbine, but it also runs some heat exchangers and, you know, pneumatic controls, steam reducing stations, and gives you no real hands on experience of what it’s like to bring up pressure. And, you know, as we say, can you make vacuum, you know, you’d have to make vacuum on the condenser on the ship, in order to get everything to work. And it was always a true test. And so, and the reason it’s important is the shipping industries, now, almost all diesel ships, and so that, you know, steam plant experience is going to go by the wayside. But yet here we are shoreside, and we still rely very heavily on Steam. And so, a lot of the plant operators that you would get were either, you know, merchant, marine or navy, you know, train, you know, steam plant operators. And if you’ve ever been on a steam plant on the ship, it is very, very compact. And so you really have to spend a lot of time as we would say, tracing lines and understanding your systems so that you know, where everything comes from, if you can learn it in that environment, that’s moving, you know, 17 knots up and pitching up and down. And, you know, we, as we say, you’ve got to know how to fix stuff, because there’s no tow tow truck coming to get you have you break down on the side of the canal, you know, you really got to understand how to repair what you operate. And it’s a it’s a very intense environment. So, you know, the schools are going to have to continue to, you know, help put out the right type of folks, that steam experience, they do a great job on controls, and leadership, and maintenance and repair work, you know, that that piece of the equation, they do a phenomenal job. And really, you know, it’s that leadership and experience and that engineering background that we look for, you know, we’ll supplement the steam experience if we need to, but, you know, the, you know, those those young folks come out of those schools and they are ready to go to work. They have actual operating experience going out on that training ship. And the five academies, you know, currently are all getting converted over to diesel, diesel electric ships, highly automated, you know, beautiful, you know, physical plant, but a different operating system than what we’re used to. I mean, they are training merchant marine officers, they’re not training hospital engineers. That’s their mission. Right. But we’ll still we’ll still take them all and, you know, get them some steam experience, and they’ll pick it up. They’re taught it, you know, they understand the theory. But they’ll, you know, they’ll still be my first choice.
Yes, yeah. Well, I’m imagined to you know, as, as I was listening to you speak and I’ve talked a little bit to the folks down at Mass Maritime Academy, in born and they talk about the competition for the students coming out of these academies. Yes, everything that you’ve just mentioned. I’d imagine kind of the demographic and were you like this if you can think you must have wanted to go to did you go there because you wanted to get that engineer Hearing education, but also go to see and maybe see the world a little bit before you settled?
It’s yeah, I definitely, you know, pick the school because it was a unique opportunity. Even back, you know, when I entered there in 1976. The they were offering 100% guaranteed employment. And so that is still pretty much the case today, you know, that everybody comes out of there has a job waiting for them, at least within four months of graduation. Very few schools get to say that other than medical schools. But yeah, the whole idea of coming out, going to see, and the money was great back then, I mean, you know, we made a lot of money, they still do do quite well. And even 10 years after graduation, they are still setting record salaries, you know, right up there with the Harvard’s, and the MIT’s Believe it or not, the state maritime academies are very well thought of. So that was the exciting part. But then you come out. And you realize that with that experience, in that degree, the world is your oyster. And I always tell people, you know, you’re coming school, you’re like this, but then you get out and you realize I can do anything I want with that background. And we constantly mentor students and graduates that, you know, there are plenty of possibilities. And certainly healthcare is one of them. Like, I didn’t even think I would work in a hospital when I was in school. I mean, they were full of sick patients, and they smelled Well, Greenwich was not that case. It didn’t smell. And I said, I really, really enjoyed it. And one of the attractions for me was, you know, I got to fix my own stuff. And I love to fix stuff. I mean, that’s what gets me going and, you know, then I caught the bug, hey, not only do you get to fix it, you get to build stuff. Yeah. And then, you know, when I got involved in some construction projects, you know, my whole career kind of turned into the, you know, the project side of the equation. And, you know, I, I tell, you know, folks that I mentor all the time, I learned a lot more about operating facilities, after you’re learned how to build them, and why you build them a certain way, you have a much greater appreciation for why the operation has to be the way it is. And so, you know, it all comes together in that, you know, sort of equation, did
you end up? Did you end up enjoying the design construction element of the role more than the facility management? Part of the role?
Well, yeah, you know, to a certain degree, if I look back, you know, the operational piece is very, you know, cyclic, you know, you go through your year and heating season cooling season, shoveling snow, you know, you know, maintenance and repair, very cyclic, but they design and construction stuff, you know, you’re always doing a new project, there’s always a beginning and middle and end to those projects. And you move on to bigger and better things. You know, my first project was working on a 550 car parking garage, great way to, you know, learn, it’s not very complicated, not a lot of risks, right, a lot of great architects and contractors and engineers that I still talk to today. And, you know, we got that done. And I built a cancer center, which was about 28,000 square feet with an underground parking garage. And then I wound up, you know, building two hospitals on that site, you know, over, you know, 13 year period. And so, you know, your progress your way up. And, you know, I’m very thankful that I had a lot of great folks that taught me a lot of stuff along the way and gave me opportunity along the way. Right. So you didn’t learn it all on the first day, that’s for sure. No,
no, you did it. It’s amazing how much parking you build. You never build enough. Yeah, it’s never enough. Yep. So I wanted to you you were kind enough to respond to the survey that we had placed out in the fall. And you had a lot of insightful comments on there. But one of the ones you wrote, and it speaks to kind of what we’re talking about relative to a lack of employees coming in and the need that we have, but you wrote, We have flattened our organizational structures to the point where the career ladder was eliminated when we lost positions, such as the Assistant Director of Engineering, right, but yours, right, lost our succession planning and pipeline available pipeline ability. We talk about that a lot, Steve, that elimination and how it’s just killing us. Right now. What What do you get? Is that ever coming back? What are your thoughts?
I mean, do I see it ever coming back? The way it was? No, I think we have to think differently about it. I, you know, there are different, you know, terms that are used today, you know, what might have been in the system, the director might be a manager or a coordinator today, but, you know, having those layers, I mean, I was lucky enough to be an assistant director of engineering. And when my boss left, who was the director, you know, I got moved right up. You know, it was a conversation in the office that said, are you ready to take over on Monday? And I was like, Yeah, I know, the plan. was, I
had done everything. How long? Were you the assistant director for?
About three years? Okay. Yeah. So I became a director, you know, about 31 years of age, you know, I had a great boss, great mentors, you know, trusted me, and I worked hard, I put the hours in and, but, you know, I really enjoyed it, and, you know, learn learn quite a bit. So, you know, the challenge for me is, you know, I was the vice president was, whereas, you know, where’s my next replacement going to come from, and, you know, I had a unique ability at Greenwich, which are transferred up to Yale New Haven of, you know, having the engineering background, but having the project background, which is normally handled by a, you know, an art, somebody with an architectural background. But I also developed a really great real estate team, over a period of time, so I sort of had the three main pillars of facilities management under my belt, by the time I, you know, run my course at Greenwich, and, you know, we came became part of Yale New Haven, and they said, Okay, guess what, you’re going up to New Haven to start a corporate facilities group, you know, which I ran for about 12 years, and, you know, we’ve accomplished quite a bit, I think one of the things that was a challenge is it was still siloed, underneath me, we, you know, we needed to grow to the next level to make that next level of leaders really work for a system that large, you know, we were still very specialized. But I think, you know, that’s, you know, when you get to that VP, Senior VP level, you’ve got to have a lot of those experiences under your belt. And with siloed structures, and very flat structures, you know, it gets to be tough, there was no assistant vice president under me that oversaw my stuff. You know, maybe when I wasn’t there, you know, everybody was very specialized. And I think, you know, how to, how do you get that experience, and I tried to, you know, give some of my subordinates different experiences might my head of engineering, you know, we had a, fired a nursing home, and I put him in charge of that renovation, to get that project management experience. You know, it was, you know, a little bit of a risk, but you know, I had a project manager from FD and C underneath it. So, you know, but it gave him that experience and made sure that the, FD and C folks were involved in commissioning, so that they understood the engineering side of what they were turning over to the operating engineers at the end of the day, so that there was that crossover that happened, and the real estate folks would be very much involved with the design of, you know, new office building, so that, you know, they got to appreciate what they were delivering to the next team. So, and they all worked great together. I mean, we had such a terrific bunch that met together. You know, I hear a lot of different organizations will maybe have real estate reporting off the finance because is, real estate is a financial transaction, you know, it’s at the end of the day, you’ve your previous session, you got to talk CFO, well, your real estate guys really got to talk CFO, and that was it was a great session. But that’s that’s where we started to try and build that cross pollination so that, you know, any one of them could take over.
So I guess I never really thought about that. Before. You know, we you just mentioned it, you got rid of the assistant director role is gone. We don’t often think of kind of like at the vice president level where you were, but so you didn’t have that barrier. Did you have all your directors report in your various areas reporting right up to you directly?
Yes, yeah, I had a layer of executive directors and directors reporting to me And there was there is about five, six folks that, you know, were my direct reports and, you know, kept them all working together, we’d meet together as a team. So that we had that cross pollination and you know, they got to hear what everybody else was working on. And, you know, but then I’d meet with them individually as well. So
how did you go about Steve eliminating silos that existed when you took over? What did you do?
Well, a lot of it was was meeting in person, you know, so that everybody knew we were on the same team. And, you know, they knew they had to come to my office and face each other at least once a month, if not twice a month, so there was no finger pointing. And, you know, you just create that culture that we’re all on this together. And I would draw the map of, you know, a typical project where you know, real estate’s the pointy end of the spear, they got to do a deal, but they have to hand it off to the ambulatory design team. And the ambulatory design team then has to hand that off, to the facilities engineers to operate it if it’s a licensed facility. And so I said, you’re all in this together, and I don’t want to hear you guys designed a piece of junk and handed it over to me. You know, the engineering guys, you got to be at the table with the design guys to get what you want. I’ll support you, but you got to speak up. You can’t, you know, you can’t sit there and go you, you know, you gave me crap. No, no, no, I’m not gonna give you everything, you may not get a Cadillac, you might get an Oldsmobile. But, you know, I really worked hard to make sure that, that that conversation took place, because I’d been in all of those seats. And I wanted to make sure, at the end of the day, we were delivering a quality product that everybody was proud of. Yep. So that those conversations were very, very critical.
You know, going back to your education, and going back to, you know, the maritime academies and pumping out and pumping out graduates with that engineering background, we’re seeing less of that, in today’s world, with folks coming out with that engineering background, what’s the impact of what’s the impact of that? Skill set loss or education, base loss, today’s facilities world?
You know, it’s really making it tougher, we’re all scratching for the same small pool of talent. You know, I compete with architecture and engineering folks, I, you know, compete with the, you know, the CMOS and the GCS of the world. You know, I’m competing with universities, across the street, you know, I lose people too, because they pay more. Yeah. You know, so that’s a challenge. And, you know, then, you know, there are other industries, you know, that are out there, you know, you know, hedge funds that are looking for somebody to run a data center that they’re paying gobs of money to, and, you know, it just, it just gets tougher and tougher and tougher now, you know, but we tried to create an environment where it was, let’s say, fun to come to where it was always high pressure. But we had a great environment. And I think one of the things that, you know, people knew, my team, our team, you know, at Yale New Haven, you know, we had our stuff together, we worked hard, we had high standards. But we all got along, and we were very professional. And I think that was attractive to a lot of folks, and you were home every night, you knew where you were going to go every day, folks that left the construction management firms knew I could go to work there. And, you know, I know where I’m going to be every day, you know, which was, which was, you know, very helpful for them in their family life. And, you know, we made sure that, you know, family first, you know, work works, there will be there. You know, we’ve always had, we’ve had a few folks that have had a tough go of it. I made the investment and say you take the time now, because I’m gonna get it back later on. And they really appreciated that. So that’s the culture that you have to build.
You know, I was, I’m wondering if, as you were hiring, and we’ve done a couple of shows where we talked to the millennial group, because I love to hear their perspective, because it’s a little bit different than what ours was. But one of the things and I’m wondering if you saw this or you’ve seen this, relative to the younger generations, they are much less they don’t put up with as much inefficiency or as much chaos is I know that I did and probably you did, too. They’re much more demanding and I say that their expectations in a good way like they’re, they don’t want to work in a chaotic environment, they want to know you’re going in a straight line, they can deal with some. Yeah, a little bit of static on the edge. What are you going the right way? Did you find what do you find that amongst younger generations, that’s different than ours? Yeah, I’ve
seen that. I think probably one of the most surprising thing, you know, that I saw was, you know, they’re on the job, six, nine months, and they want to know when their next promotion is going to be. But you’re, you’re right, they don’t deal with a lot of static, they’re not used to large organizations that take a long time to effect change, or create new positions or, you know, salary adjustments that happen midstream. You know, it is, I think, a bit of a shock to them, but that’s where their patients gets a little thin, like, why can’t I get a promotion or a raise nine months into whatever I’m doing? Well, you know, we have a fiscal year, and we have a cycle. And, you know, you have to review 26,000 employees. So we have a process that everybody does, you know, online, and, you know, we meet individually, but that’s done in a certain cycle time. You know, that that can be challenging. And, you know, they may like the freedom of a smaller firm that can read and react quicker. So, you know, you sign on to, you know, a large academic, you know, health care system. I said, you know, the right is like being on a supertanker, it doesn’t stop quickly, it doesn’t change course, quickly. But it keeps moving. And, you know, I said the advantages are, you know, we did great work on not only on the facility side, but on the healthcare side, you know, the healthcare successes were truly, truly amazing at the academic level, I mean, it is the highest level, and it’s great to be able to support that work, and build, you know, some of the coolest stuff to support some of the greatest physicians in the world. That was, that was truly gratifying. And so, you know, that’s, you know, you have to sort of get them away from what they’re worried about, to what they’re really doing in the mission and say, this is the important stuff, the other stuff will solve it stuff. Stay focused on the mission. And, you know, I used to say all the time, you know, go to the ribbon cutting, and enjoy it, because it’s the best part of that project, because humans take over that space tomorrow, and it’s never going to be the same. But enjoy what you build. And I actually stopped going to ribbon cuttings, and I made sure my project managers went and were in the picture so that, you know, they got the picture in the high praise. And, you know, and enjoy that moment, I actually said the night before, it was always the best, best day before everything happened. So and I, you know, I think that’s, it’s their creative juices going, you know, keeps on going.
Well, that’s the nice thing about project work. I mean, they’re, you know, what you go through to get to that ribbon, cut your you got all the stories, but it’s just a tremendous sense of accomplishment when you’re finally there. As like, you say, the next day is probably when all those to do lists begin again, once it’s occupied, but for that one day, enjoy
it, enjoy it. You know, we had some successes on the operation side, I mean, we had some awards from Ashi. On, you know, our digital optimization of our department was nationally recognized, you know, and that was a long cycle. But, you know, we have a lot of folks that, you know, we took our department out of the dark ages and Excel spreadsheets into a highly sophisticated automated system that was, you know, really changed the way we operated. You know, it was really something to see at the end of the day.
It’s you, Steven, I was going to ask you kind of at the very end, but you mentioned working in an academic medical center, and, you know, some of the benefits that you worked for a long year, and in a long time in an academic medical center, what are some of the practices? How do you survive, and it’s a very competitive environment. What are some, you know, tips tricks that you would offer to folks who are maybe considering kind of that academic medical center, how just five all those years.
So it was very interesting when I was at Greenwich, and I had a executive coach down there, and he said, Boy, you think you’re busy. Now, this is right. When I was making the transition, he was sort of prepping me because you think you’re in fourth gear right now and you’re moving pretty quickly. He goes, I got news for you. It’s an eight speed transmission and you’re about to move into fifth, sixth, seventh and eighth gear. And I kind of looked at him I was like, Man, I’m pretty busy. Now. I don’t think I could be much busier. But yeah, you find that within you too. I’m moving at a higher pace. You have to prioritize what’s important, and what you need to be working on, and delegate what you don’t need to be working on and rely on your folks to do it. So that’s probably the, you know, one of the most important things and I think, you know, some of the folks struggle with that delegation. You don’t need to be doing that you need to have your folks do it. And they were like, oh, yeah, I said, it’s, you know, hard to, you know, move in that direction. I had some, you know, other executives say, you’re great at fighting fires, you’re the guy who shows up, you’ve got to be more strategic. And, and so I had to change the way I thought, and I had to continue to step back, and delegate, and delegate, but then think about stuff strategically, you know, to help the organization move forward. You know, and so, that’s important. And then how do you think strategically, well, then you have to spend time meeting with the right folks that have that vision? And, you know, say, Okay, where do you want to go? And what do I need to do to get you there? And I had some executives that were really visionary thinkers. And, you know, we come and say, Listen, I, you know, I got a bed problem, you know, you got to help me solve that. And then, you know, well, is that building more beds? Or is that, you know, do we need to change other things to get improved throughput? And so, you know, you start to say, Okay, let’s bring in some folks that have helped us with throughput, and learn in that direction. You know, your CFO chat the other day, you know, understand the business model, you know, where do you make money in the organization? Where do you not make money in an organization? Where do you spend dollar one of very scarce capital? Yeah, and I had a lot of conversations with our CFOs and our senior VPs, of finance, about making that prioritization, because there’s never enough money to solve all your problems. And so, you know, you’ve got to develop a way to think through and prioritize capital. And, you know, when you’re running 12 million square feet, there’s a lot of asks, so you know, now you what got you here is not going to get you there. So we had to rethink how we prioritize capital, and develop a system to do that. Which was a grading matrix, to say what, you know, what rose to the top? And where would you spend your money? If that’s all you had? And, you know, that was a sea change for everybody to learn. So you continually had to evolve? Yeah. I always said, I learned something new every day on the job. There wasn’t a day that I, you know, didn’t go through that something, you know, was an aha moment. And, you know, that’s, that’s saying a lot, you know, right. Never stop learning. You never stop learning. If you think you know, it all, forget it. You know, nobody knows at all.
How do you ever thought about this before? But you know, you mentioned how do you so you’re at the VP level? How do you continue to, like, evolve and push forward? What do you ever have in the a little bit of doubt, and you’re the guy so you’re moving them forward? How do you continue to push forward, evolve and learn? And navigate away from fear, doubt, uncertainty,
go out and steal ideas? That’s it. Yeah. So, you know, when I was one of the things I tell people get outside the four walls of the organization and go learn. I, you know, early on, you know, I said, Go to actually go to PDC, go to a conference, go to, you know, New England health care’s engineers, and meet with people, you know, and, you know, the great ideas are out there. And, you know, there’s a couple of conferences that I continue to go to, you know, the the healthcare design conference down the beach in Santa Fe, New Orleans this year, in November, probably one of the best conferences I’ve ever gone to. Through going to that conference. I joined the Center for Healthcare design and the built environment network. I got to be in a room with other facilities VPs and senior VPs from some of the largest healthcare systems in the country, Kaiser Permanente MetroHealth University of Wisconsin, ascension, med XL. I mean, these are all the first round draft picks. And you know, I’m there representing em and Avon. So, you know, not not too much of a slouch. But we, we talked a lot about the symbol Other challenges we all had, we also had some very great corporate sponsors that were part of the group. You know, Mazetti engineering out of the west coast really thought leaders in health care engineering. I mean, Walt Murnane, you know, you’re in the room with Walt Vernon, you know? Yep, get your pen and paper out, because there’s going to be a lot of ideas flying your way. And, you know, Doug Erickson from FGI was part of our group. And so, you know, being exposed to folks like that really helped keep me fresh, getting new ideas, and then my job is to bring that back, and bring it to our organization. And that’s what you have to do. You know, if you think you’re gonna sit in your chair and read a magazine and come up with all the ideas, you know, yeah, that’s great. But, you know, getting out and touring other facilities, see what they’re building, see what they’re designing, what’s the new idea that they got? You know, I always said, If I went to those conferences, I came away with one aha moment, it was worth it. Yeah, you know, it’s expensive to go. But you know, it’s cheaper than college tuition.
Yeah, true. Very true. So how do you go back to one of the comments that you had made on our on the survey that we had done, and this is relative to the emissions and health system should set targets to reduce their emissions by half by 2030, compared with the baseline from 2008, and to achieve net zero emissions by 2050? On our survey, which is I said you responded to 76% of respondents said that they are concerned, very concerned about being in the 2030 day, we obviously didn’t even ask about 2050, because that’s Yeah, right. But so aside from the political factors that are that are in play with decarbonisation, you wrote, because we’re not concerned with that here, but you wrote Electric is not the answer. There’s not enough electric service capability to do this on a large scale. If natural gas is no longer involved, than a substitute fuels, such as hydrogen needs to be commercially viable, quickly and cost effectively. It’s a lot, Steve, how do you see this? And now that you are, you’re you’re out of that seat at Yale New Haven, and you’re into your own consulting firm, you’re still vested? How do you see this playing out by 2031? That’s six years away? That’s not far. Yeah, it’s,
you know, it’s a real challenge. You know, everybody says, Okay, you’re going to stop, you know, burn and stuff, you know, New York City, no more natural gas permits being, you know, issued, even for health care. You know, so I’m, I’m very concerned about, you know, the practical side, the engineering side of this, you know, my mind immediately goes to that, and I look at the size of some of the air handlers we have on the roofs of these buildings. And, you know, these are 3050 100,000, CFM, air handlers, we’re moving a lot of air, okay. And steam is what heats it, you know, that’s, that’s a high BTUs transfer there. That’s a lot of air moving through there, if you’re going to come in and go, Okay, I don’t have steam, so I don’t have natural gas or to oil to burn, what do I do, because an electric toaster in that air handler is not going to get it done. And there is not enough incoming power into that facility today. Nevermind, you know, seven years from now, and there isn’t enough power in the street, in the town, in the city, in the county in the state to do that. Okay, so it’s great to say, Oh, you’re gonna convert to electric, but how do you do it? You know, it’s the same thing with electric charging vehicles, if everybody owns an electric vehicle, we don’t have enough power to charge. Right, right now. So you know, we really have to think about the infrastructure that is needed to make this vision happen. So, you know, I looked at it, and I was like, well, listen, if I could burn hydrogen in the existing boilers, I have, I can generate enough steam to meet that and it would truly be zero emission. So you know, you know, in my mind, and I’ve talked to a lot of engineers or design engineers around the country, you know, that’s probably going to be one of the solutions. I mean, hydrogen is non economical today. But, you know, we need to mass produce it and come up with a way to make green hydrogen and get that to these facilities. And it may be a new storage tank I have to buy, okay, you know, that’s fine. So we’ll have to have something backing that up. You know, and so, you know, until we figure all of that we made a lot of investments in fuel cells. You know, we have fuel cells installed out at Lawrence Memorial Hospital, park at Medical Center, and brick Milford hospital, with designs for Bridgeport Hospital on the ways and, you know, that’s great to power the facility, but it’s still not heating the facility. And so, you know, we’ll partially meet those goals by doing that, but, and I’ve challenged, you know, our dean of engineering at, you know, my college to say, You better be figuring out how to just start doing some research on this, because it’s going to come up pretty quick, and everybody’s thinking about it. But, you know, we really need to accelerate that thinking and that supply line to help us in the future.
What do you think? And perhaps this is an unfair question, what is a realistic? What is a realistic timeframe? If you’re going to do it correctly?
Well, you know, I think any great idea takes at least 10 years, yeah, you know, go from, you know, theory to, you know, the truck pulling up unloading hydrogen at my hydrogen tank. You know, I think we could do it, but I think it’s got to be a priority. You know, we’ve got too many other challenges in this country, we’ve got crumbling infrastructure, you know, we’ve got all sorts of, you know, the country has got the same capital problems we have in hospitals, you know, that a lot of problems, not enough money going around to fix them all. So
yeah, exactly. I mean, that’s obviously an issue you’re just talking about, think of a director or VP of facilities with everything they have on this is a full time job without that other stuff. Yeah, you put that on top of the plate, something’s gonna I mean, it’s impossible. You can’t keep them on Well,
hey, you know, on the, you know, the CFO side? Yeah, we have a mandate now to go, you know, carbonless rates aren’t going up to reflect that. Nobody’s given us more money to go do that. Now, you can probably go out and get some grant money to do it, but it’s not going to fund it. 100%, there’s no way. Yeah. So, you know, that’s, that’s a challenge. And where do I put my scarce time and resources into managing my capital plan that I have, or, you know, filling out grant applications, it was like, we don’t have the expertise in that, you know, we might maybe in the development office, folks, we could pull in, but you know, that was always a challenge. And then the money’s not really free at the end of the day, what you have to go through to prove that you spent it correctly, and the audits and before you get the check is can be challenging. Right. Right.
So now, you are the president of carbury facility solutions. What are you doing? What are you? What are you involved with? Are we talking about all these issues that are on the plate? Right, and everything you’ve right, well, your career? What’s carbury facility solutions?
Well, you know, we were trying to get the plane off the ground, we’re having a lot of conversations about some high level strategic planning, you know, helping other organizations that may or may not have done big projects, you know, maybe have a, you know, lack of talent, maybe need some help and guidance. So we’re talking to, you know, some other consulting firms that have seen this, and, you know, need to bring somebody in from the owner side, that can speak CFO and CIO and CEO, you know, to help with those, you know, strategic conversation. So, that’s, that’s what I’ve been working on. You know, that’s my desire. Having that conversation with a few folks. And, you know, we, as we said, We got to get the plane off the ground, though. So, you know, it’s only been a couple of months. And, you know, that takes a while to get going. But I’m very excited about the ability to help share what I’ve gained over, you know, 37 years, you know, organizational development, and, you know, a lot of folks out there still haven’t leveraged, you know, the possibilities of creating a corporate facilities group and all the advantages that come with that, you know, from contracting, to purchasing power to setting design standards, to look to save money, how to digitally optimize the department so that you can actually demonstrate that you’re saving money by giving money back to the capital committee. You’ve got to be able to track your projects in such a way that you know, what your spend is and what you have available to get back. And I learned an awful lot, you know, making the investment in some of these, you know, software systems, you know, pays dividends within the first year the payback is extremely short. But you’ve got to put the time into Make sure they are up and running. And same thing with maintenance management systems and making sure that they’re easy to get to. And we installed the system that was like using Amazon, you know, you’ve put your work order in, you got a receipt to say it was accepted. When it was assigned to a mechanic, you got another receipt that said, it’s been assigned to so and so. And when your job was complete, you got another email that said, your your job is now complete. And then you got a satisfaction survey at the end. Wow. And, and, you know, we were in the high 90s Yeah, tire time since we’ve installed it to say this, this works great. Yeah, I said, you know, I wanted to have an Amazon like experience or, you know, hospital mate at some, you know, the Corrective maintenance side, obviously did the same thing on the preventative maintenance side. You
know, you had mentioned and I didn’t bring it up only because it’s a completely different topic area. And I kind of wrote it for the something in the future, but I was you talking about the you phrased it bringing you out of the dark ages and kind of into the the data ages. And then we have mutual friend Jim Hogle. From Barnabas, who spoke well of the program that you guys developed at Yale New Haven, can you talk about we don’t have a ton of time left. I do want to ask one last question. But can you talk about a little bit, Steve, kind of the data angle and and using information to make informed decisions? And I know, you could go on and on, but how long did it take? And What’s that process like?
So you know that that story goes back to when I was saying, you know, attending conferences? Yep. And I met Jordan Kram from installa, at a conference, and he was talking way over my head about installing these data systems at hospital and I knew he had been down at New York Presbyterian. I brought him up to Yale, I said, Here’s what I have today, I have nothing. Let’s put together a program where, you know, we can track capital projects better. We can put in a central I had seven different maintenance management programs across, you know, the health care system, all antiquated, none of them updated. And when we looked at them, they go, Well, these were never installed right in the first place. So I’m like, Okay, well scrap them all. Let’s start from ground zero. Hello, Steve. So this is back in 2016. We started the analysis. We got it funded in 2018. It took a while, you know, few of those fiscal cycles to get it funded correctly. It was about a $6 million investment in software time and resources. But it paid for itself very quickly. The first year we gave that we were full year, we were tracking capital projects. I think we gave back $8 million in latent capital. And when I started this project, I didn’t know what latent capital was, well, it was unspent capital locked in projects that never went back to be redeployed for other uses. So what we would call quick hitters at the end of the year, 8
million was sitting out there for a lab. Wow. And
that’s not uncommon. Yeah, that, you know, all I’m gonna, project manager is hanging on to his contingency, you may have a million dollar contingency, you know, in a $50 million project, and he’s toward the end, but he’s still hanging on. Like, I’ll let you hang on to 100,000. Yeah, but I want the 900,000 back and be like, Oh, okay, I can live with that. But I had a dashboard that I could see who’s hanging on to what. And so, you know, that was really one of the big aha moments. But then, you know, we did it on the maintenance side. And where we really, you know, got into it was when we digitized every building in Revit and CAD, by scanning them and be coming up with accurate floor plans, building plans in 3d and, you know, tagging who was using what so now, you know, I used to get asked all the time, how many ADA patient bathrooms do we have? Be like, I have no clue. But now I can have somebody go do that research. And we’ll come back with the answer in an hour and run that query. You know, how many exam rooms do I have? And so and the real scary part for us was, when we started the interview process on space, we interviewed departments, and I go, how many of you are using space data to run your business? And we had 44 departments come back and go, I’m using space data that I got from my boss 20 years ago, and I go, that can’t be accurate. He goes, but that’s what I have, and I have no way to get anything better. And I said Well, if we don’t give it to you who will. And so we started this journey and, you know, put those queries in for them, that now they, you know, it’s just about automated, they can go in and look at their floor plans and pull those reports, because everything is tied to a database, and, you know, they can generate it. And so, you know, and then, you know, disaster recovery, emergency preparedness, you know, they couldn’t believe the capabilities that they inherited, and the safety and security guys, you know, they were like, hey, you know, if we ever have an active shooter situation, and we can go online and show the police on the SWAT team, what the building actually looks like, and what’s where that’s invaluable. And so that, you know, my hair still stands up when I think about that, because I was like, what we were going to do pull a roll of drawings out on the sidewalk for them. Right, right. Well, you know, now we can show it to him on an iPad and blue beam. Oh,
it was funny and not funny, like, like, they say in Goodfellas, not funny in a hallway, was when you were talking about, I was thinking of an active shooter and you’re trying to find plans, you know, and nobody knows where they are. Where are they? And then you might pull it out. But it’s from a set that was 20 years ago, and nobody’s got a few years
ago. Yeah. Yeah. And it doesn’t look like that. That was what architect gonna look like back then. So, you know, that’s, you know, how do you live without that? You know, that’s, that’s, that’s employee safety, right there patient safety.
So I imagine this experience is all part and parcel with carbury facility solutions that you’re looking to get up and offer to organizations, because certainly that type of expertise doesn’t exist everywhere.
Yeah, so you know, like I said, I want to share and give back. You know, I’m not everybody says, you’re retired, I go, No, I’m on sabbatical. I’m just looking right, the next chapter in the book. And, you know, I’ve, I’ve had a long, long career given back, I volunteer a lot, probably too much, my wife says, But, you know, I enjoy that. And they think this is the opportunity that, you know, I can go not gonna volunteer at this, though. So, you know, I still want to make a bit of a living.
Yeah, we got to make that your, your service. But I
think, you know, having spoken to quite a few folks, you know, there’s still a need for this. And, you know, I’m certainly not unique in this position. But, you know, certainly have, you know, my experience to bring to the table, and I think we can help some folks. And it sounds like there’s a need out there. So we just got to bring it together. Yeah,
I think that that’s only going to increase if one final question for my guest, Steve Carberry and, Steve, it’s kind of along those lines, you haven’t retired? But have you now that you’ve stepped away from the day to day for a large organization, academic magazine? Because Have you decompressed and Have you have you come to any realization as anything kind of surprised you as you’ve stepped away from the day to day of busy academic medical center?
I think, you know, the first realization, you know, when you, you stop working, and you know, all of a sudden, you know, emails are down 95%, my calendar opened up 95% and availability, you realize how fast you run. And, you know, that, that was definitely an aha moment for me to, you know, step back and go, I’m starting pretty hard and fast there for a while. And I, you know, started to feel the fraying around the edges. And, you know, I was very much aware, you know, because we talked about stress, and we talked about burnout. And, you know, you start to say it was am I approaching that. And, you know, I was gonna be I was a grandfather, you know, on September 11, my daughter had her first grandchild, I was, you know, very much aware that I want to be in the moment for that event, and I was, and but you really do take perspective and go, Okay, you know, I think I’ve given enough here at the office and time to step away. And I think everybody should really, really be aware of that, because it’s a tough time in healthcare, I’ll be honest with you, it was a lot easier to be in healthcare, when we were making a lot of money and we’re able to do a lot of stuff. It’s a pressure cooker right now. And everybody needs to be very much aware of their surroundings and what’s going on. And as, you know, positions don’t get filled or can’t get filled. People are taking on more and more and more. And, you know, we came out of COVID Everybody was, you know, drop everything and shift gears and move into a different world. You know, that stopped. Now we come back out. And you know, we’re in these very tough financial times. And, you know, so you’ve gone from one major price life changing crisis. Let’s not underestimate what we went through to now have very severe financial difficulty. And so you can’t you can’t run the engine in the red line forever. So, you know, and I don’t know what the answer is I, you know, the CEO, CEOs CFOs they’ve got a tough task in front of them. And the answers aren’t there, there’s very few levers they can move to solve the problem. I mean, you think about, you know, contracts with insurance contracts with the government, they’re not going to pay you more. And so, rising costs for operating expenses, goods and services, salaries. What are the levers do you have to solve that imbalance, that equation? Right, right income, you know, expense have to balance. So they don’t have a lot of levers left to pull. And I think that’s really the challenge. And it just creates this pressure cooker that everybody just needs to be aware of. Keep your head straight. You know, take some time off when you need it.
That’s great. That’s great advice. Great advice. Steve Carberry Carver facility solutions. Thank you so much for appearing. I appreciate your time, great conversation and good luck in getting that up and off the ground. How do they get there? Or I can put it into the description if folks want to reach out to you. Is there a mechanism to do so? Yeah, there’s
a I have an email set up for the company. It’s Steven Carberry. Carberry FSX llc.com.
Nice. And I will put that into the description as well. Steve, thank you so much for your time. Have a great day. Peter, great