In The Name of Public Health

Antonio Martins and crew

By the time Antonio D. Martin left Kings County Hospital Center as executive director to lead the restructuring of the $6.7 billion New York City Health and Hospitals Corp., no one called the hospital by its old nickname, ?Killer County.??

?Even police officers now say they want to be taken to Kings County when they are shot,? Martin once told The Network Journal

The country?s largest public health system, New York City Health and Hospitals Corp., or HHC, operates New York City Kings County Hospital as part of its Central Brooklyn Family Healthcare Network. ?I?ve seen a lot of administrators going through that place. Antonio Martin gets things done. He?s not this nine-to-five person. He?s there on Sundays and I know he?s been there at three in the morning. He?s willing to put himself out to get things done. He knows how to work behind the scenes,? says a specialist Martin hired 15 years ago at the Central Brooklyn Network, who asked to remain anonymous.

Those attributes, plus his long and successful administrative experience within the HHC system, make Martin, 59, one of the individuals HHC President and Chief Executive Officer Alan D. Aviles turns to when there?s tough work to be done. When Aviles invited him to join HHC?s C-suite as executive vice president and chief operating officer, Martin had been simultaneously senior vice president of the Central Brooklyn Network and executive director of Kings County for less than three years. Aviles had named him to those positions during a period of? reform following the death in June 2008 of a 49-year-old local woman on the floor in the hospital?s psychiatric emergency room. A security video showing employees walking past the woman as she lay dying went viral on the Internet. It was also to Martin who Aviles turned to coordinate HHC?s corporatewide relief efforts after the catastrophic earthquake in Haiti two years ago.

Martin oversaw the opening of Kings County?s $153 million Behavioral Health Center Pavilion and the redesign of its services, as well as the opening of its 15,000 square-feet Cancer Care Center that brought under one roof oncology, chemotherapy, surgery, medicine, pharmacy, nutrition and social services. ?My job is to work to improve the quality and culture of the organization. It?s important that the staff feel that the leadership is very visible,? he said as he took Network Journal executives on a tour of the cancer center.

He was just as visible as chief operating officer and subsequently executive director of the massive Queens Hospital Center, where he was known for roaming the halls and talking to the staff and patients. He presided over the completion of Queens Hospital?s transformation into a state-of-the-art medical facility, with a new Ambulatory Care Pavilion; Centers of Excellence for Cancer Care, Women?s Health, Diabetes and Behavioral Health; and four affiliate family health centers in the hospital?s neighboring communities. Before heading to Queens in 1999, he was executive director of East New York Diagnostic & Treatment Center, part of the Central Brooklyn Network, and deputy executive director for the network?s Behavioral Health Services.

In an interview in December at his corporate office overlooking Foley Square, the Green space in Lower Manhattan?s Civic Center, he described his tenure at Kings County as a high point of his 25-year career with HHC. ?My proudest accomplishment is the cultural change I perceive that occurred at Kings County. Kings County offers superior service but the manner in which we delivered it left a lot to be desired,? he said. ?During my tenure there, we took up the matter of respect. We saw steady progress. We used to measure respect. We had town hall meetings where we would anonymously poll staff to get their feedback on where we were on the respect meter. When I got there we were about sixty on a scale of zero to one hundred, our goal was ninety; when I left we were around eighty. So we didn?t get to ninety, but we saw steady progress.?

Kings County may have needed Martin, but Aviles needed him more. ?HHC is at a crossroads, where we simultaneously face many daunting fiscal challenges but also have important opportunities to restructure our own health care delivery system,? Aviles said in reporting Martin?s latest appointment to HHC?s board of directors. ?Antonio Martin ? will be leading our restructuring efforts as well as overseeing broad operational areas, such as IT, operations, professional services and affiliations, contract administration and control, corporate support services, internal audits and materials management.?

The appointment initially gave Martin pause. ?I came here because I liked working with Al Aviles,? he said. ?One of the things you look for in a leader is integrity. When he suggested I come here, I had some pause because many of these jobs are determined by the term of the mayor. Mayor Bloomberg has two years left and I said to myself ?you may be looking at [no job] in two years.??

But he attacked the job with trademark enthusiasm. ?We have been faced with a tremendous budget deficit as most hospitals have. Nearly a third of our patients are uninsured, which means they come to us with no ability to pay for the services we provide them. We have a $300 million deficit this past year and that?s after being subsidized by the city, as well as federal funding,? he said. ?We have a restructuring plan and it?s my responsibility to ensure that a number of these things are achieved so that we can meet that $300 million shortfall. We can?t fail. We?re too big to fail. We have too many people who depend on us.?

One strategy involves continuously deploying the organization?s process improvement system, termed ?Breakthrough,? to help the staff solve problems, make operations more efficient and reduce waste, Martin said. ?It is effective because it empowers our employees who do the work to make decisions about how to change and improve it. To date, Breakthrough teams have helped find more than $200 million in new revenues and savings from increased efficiencies,? he said.

Martin has a master?s degree in health service administration and policy from the New School for Social Research in New York City. Always immaculately groomed and outfitted, with a ready smile, he has worn a diamond earring in his left ear since a girlfriend in college told him that men of nobility wore a diamond that way. ?I don?t know where she got that, but I liked the idea. One day, she lined us up ?? me and my friends, there were five of us ? slapped on the ice and pierced our left ear, one by one. I?ve been wearing it ever since,? he explained.

His leadership style is understated but rooted in teamwork and respect. ?I came here with the knowledge that there were a number of talented people here. I came in with the goal of having folks in the field and folks in the central office work more effectively for the benefit of our patients,? he said. ?I truly believe great leaders motivate, they don?t dictate. To the extent that my enthusiasm rubs off on people, I?m happy. I like to be able to inspire people.?

With the good looks to help make it happen, he once saw himself as the next [Oscar-winning actor] Sidney Poitier, but financial demands led him to a job in health care. He smiled, ?My passion is directed to the work I do right now. Working with this corporation is a labor of love. The senior leaders here are able to make much more outside. The mission of our corporation resonated with me ? [providing service] for all who come to our doors regardless of their ability to pay.? Service is a family trait. ?My mom was a nurse, my sister is a nurse-attorney, my father was a chiropractor. Many people in my family, not just my immediate family but also cousins and others, have gravitated toward service. I feel privileged to do the work I do. I get jazzed behind that ? creating healthy communities.?

To the specialist he hired 15 years ago, Martin may have ?made a big investment in his attire? but he gives his work his all. ?Those promotions are well earned,? she says.