CEO Tonya Darner: Charting a New Course for Marquette's Hospital

The Latest from Marquette, MI by Brian Cabell

TONYA DARNER HAS a big job ahead of her. The newly appointed CEO of UPHS-Marquette is charged with eliminating the dysfunction that has plagued Marquette’s hospital and, almost as important, changing the public’s generally unfavorable perception of the hospital. A daunting task.

She seems well equipped for the job: 25 years in medical care and hospital administration, 20 years in the Air Force. A resident of Marquette for the last 14 years—she wasn’t some hotshot outsider hired by Duke LifePoint to jump in and fix one of their troubled hospitals. She actually lives here and wants to stay here.

The 52-year-old Darner is the mother of two adult children, and now the proud grandmother of a six-year-old boy. A hiker, a mountain biker. An everyday kind of woman, except that she’s got a ton of responsibility on her shoulders, what with 1600 employees under her, and a payroll of $160 million a year.

She’s personable, unpretentious, and not overly defensive when faced with criticism that has often targeted her hospital. The fact that she was willing to sit down for a 90-minute interview with one of the hospital’s harshest critics tells you a lot about who she is and what she wants to accomplish. She answered a wide range of questions, many of them uncomfortable, with a seemingly straight-forward honesty.

TRUST IN THE HOSPITAL

“My biggest problem has been building back trust with employees,” she says. “Once we get there, I think the community piece will follow.” In other words, she is, first and foremost, focused on stabilizing the staff and operations inside the hospital.

She says this without a hint of criticism toward her predecessors. It’s simply an unfortunate fact of life, caused by a variety of factors.

The hospital’s relationship with its patients—past, present, and future—is also paramount if the hospital is to succeed in its mission. “I have reached out privately to some patients when I’ve read their criticism on Facebook,” she says. “I want to answer their questions and see where we went wrong. I want to right this ship. All the patients we see at the hospital are contacted afterwards to get their opinions on their treatment. We read all the criticism, and then we create action plans to correct them.”

RECRUITMENT AND RETENTION

It’s been a problem for all hospitals nationwide. Medical care is stressful work, especially in the wake of the Covid pandemic. Burnout is common, early retirement seems alluring.

Darner says her staff is constantly talking to nursing schools, and UPHS has a longtime, highly effective recruiter, Teresa Stewart. But convincing doctors, nurses, and techs—and their spouses—to relocate to the frigid, northern frontier of this nation can sometimes be a challenge.

“What we’re seeing is a trend in young, dual family providers who want to live here,” Darner explains hopefully . “Pitching both a husband and wife together is easier and more effective.”

A point of pride: “We now have the fewest travelers (transient doctors and nurses) we’ve had at the hospital since Covid,” she says. “And we’ve decided not to keep some of the travelers because they haven’t fit the bill.”

“Retention is a priority,” she continues. “We’re having continuous conversations with our staff for retention, and to avoid burnout.”

She admits disappointment when some of the specialists, highly trusted by patients, have chosen to leave, but she attributes some of those departures to the desire of the specialists to have more patients. “The volumes here simply didn’t feed their hunger,” she says, so they left for bigger hospitals.

Yes, she concedes there are gaps in some specialties—gastroenterology, for one. They’re now out recruiting gastroenterologists. And the Heart and Vascular department, often criticized, has been undergoing major changes, to benefit both the employees and the patients.

And finally, this encouraging fact: UPHS-Marquette has 40 new providers (doctors, physician assistants, and nurse practitioners) starting at the hospital this year.

PSYCHIATRY PROBLEMS

This came up just a few weeks ago. Three staff psychiatrists announced they were resigning which would have saddled the hospital with a huge problem. Turns out, one of them did leave, but hospital officials sat down with the two others and convinced them to stay.

“We had conversations with them,” Darner says. “They felt they didn’t have a voice. We listened to them, and they were heard.” So, the problem was averted through a very simple process—listening to your employees, and following through on their concerns and their recommendations.

A third psychiatrist, who is currently a resident, will also be joining the staff soon.

EMERGENCY DEPARTMENT CRITICISM

It’s been a chronic problem with disgruntled, overworked doctors, burned-out nurses, heavy turnover, and unhappy patients. That’s not to say most patients have had bad experiences in the ER, not at all. Most, in fact, have been treated well and in a timely manner. But too many have waited too long in the ER for less-than-optimal care.

Darner acknowledges this but voices optimism. “The Emergency Department is fully staffed for the first time in three years,” she tells you proudly. “We’re turning the corner. But we’re never satisfied, never complacent.”

She claims the ER has a triage nurse most of the time—someone to determine who’s in greatest need of immediate care—but concedes that sometimes there’s no one to fill that position because all the nurses on duty might be busy tending to patients already in beds.

One other contributing factor to the occasional dysfunction and lengthy wait times: Some patients arriving at the ER don’t truly need emergency care, Darner explains. They’d be better served at an urgent care clinic, thus reducing the wait times in the ER.

BOARDING TIMES

How long does it take before a patient first admitted to the ER is sent upstairs to an inpatient bed where the care is more specialized? That’s what boarding time is, and Emergency Department doctors and nurses at UPHS-Marquette have reported in the past that the boarding time was exceedingly high, and the patients were left waiting, often without proper care.

Progress on that front, it appears. According to the hospital, the average boarding time at UPHS from November 2022 to January 2023 was 4.6 hours…The average boarding time from November 2023 to January 2024 had been reduced to 3.8 hours. It’s generally accepted that, to protect patient safety, boarding times should not exceed four hours. So, UPHS-Marquette has improved, but it’s far from ideal.

HIGH PROFIT SURGERIES

Some critics have claimed that UPHS-Marquette prioritizes high profit surgeries at the expense of equally serious surgeries that produce less profit for the hospital. Darner disputes this. “Some service lines do produce more revenue,” she says, “but every service line needs access because we are a Level Two Trauma Center. We treat everybody that we can.”

UPHS-Marquette performs 900 surgeries a month.

THE NEGATIVE IMAGE OF FOR-PROFITS

“I came from a nonprofit hospital, and I can tell you there’s not much difference between nonprofits and for-profits,” she says. “We all have to pay our bills, we all have to be good fiscal stewards.

“If we feel there’s a need to spend money, we have to justify those requests. We have to be fiscally responsible, and we believe that we are.”

CORPORATE INVOLVEMENT

A persistent belief of the hospital’s critics is that Duke LifePoint’s headquarters in Brentwood, Tennessee, is actually running the hospital, not Darner and her staff in Marquette.

She disputes that. “If it’s true, then my position is unnecessary,” she says, “and I would be working fewer hours.” She and her staff work long hours, she says, and they make the crucial decisions, but of course, with corporate oversight.

UNION REPRESENTATION

UPHS now has three unions representing employees at the hospital—the nurses, the techs, and most recently, the Steelworkers union which represents a wide variety of workers at the hospital, not actual steelworkers.

Some employers aren’t thrilled when their employees vote to a join a union, but Darner, at least in this interview, takes a neutral stance. “There are pros and cons to it,” she says. “It’s not a problem for us.”

COMMUNITY CRITICISM

“What bothers me most is when I hear people criticize the employees here at the hospital, especially when the criticism is not fair,” Darner says. “And again, if we do hear a valid criticism about a department, a floor, or a staff member, then we create an action plan to correct it.”

And then there’s this problem—potential patients deliberately avoiding UPHS-Marquette, which is something we’ve heard all too frequently. “When people bypass this hospital for another because of what they’ve read or heard, that bothers me,” Darner says. It’s not good for the patients, she says, and it’s not good for the hospital which, after all, is the largest, best equipped hospital in the Upper Peninsula.

COMMUNICATION

This is a point of emphasis for Darner. She can’t be a stand-offish CEO, issuing orders and expecting her employees to just fall in line. “I meet with leaders here at the hospital monthly, and we’re going to be having quarterly town halls for the entire staff,” she says. “We’ll be open to all questions.”

As for the broader community, she’s been meeting with NMU officials, school superintendents, the City Manager, the Ambassadors, the Lake Superior Community Partnership, the Economics Club, and soon, the civic clubs. And toward the end of this year, the hospital is planning on town halls and coffee get-togethers, where everyone in the community will be invited to meet and ask questions of Darner and her staff.

It’s a start. And let’s be honest, this is still the honeymoon period for the new CEO. When her appointment was announced, it was greeted enthusiastically because she was a local, she had experience with the hospital…and yes, because she was a woman—the first female CEO of Marquette’s hospital, ever.

But, as they say, the proof is in the pudding. Progress will have to be made, real and perceived. Vacant positions will need to be filled, doctors, nurses and techs will have to stay, and operations will need to be made more efficient.

And regardless, for better of worse in this age of social media, we will continue to read about every glitch, every failure at the hospital—the misdiagnosis, the botched surgery, the maddening wait, the delayed callback, the uncommunicative or unavailable doctor, the brusque nurse, the rude ER receptionist, and more.

It’ll be up to CEO Tonya Darner to significantly reduce those criticisms, and change the depressing narrative that we’ve heard for the last several years about UPHS-Marquette. It certainly won’t happen overnight.

Will it happen at all? The skeptics, suspicious of anything that happens on LifePoint’s watch, say No.

Darner’s out to prove them wrong.

HAIKU OF THE WEEK

Dark skies, stormy seas

Foundering ship, anxious crew

Watching the Captain

—Anonymous

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