Meet Diane Blake, CEO of Cascade Medical

As CEO of Cascade Medical, Diane Blake brings a servant-leadership approach, a focus on community-centered care, and a commitment to fostering a strong workplace culture in a rural healthcare setting.

A native of Eastern Washington, Blake’s path to hospital leadership wasn’t planned—starting with a temporary role at Cascade Medical after years at home raising her children, she gradually took on increasing responsibilities in materials management, accounting, and finance before stepping into the CEO role in 2013.

Since taking the helm, she has led efforts to expand services, invest in workforce development, and strengthen the hospital’s connection to the Leavenworth community. In this Q&A, Blake shares insights on her professional journey, leadership philosophy, and the challenges and opportunities facing rural hospitals today.

Please tell our readers a little bit about yourself.

I grew up in Eastern Washington, on a wheat farm in Douglas County. After graduating from Bridgeport High School, I went on to Spokane to attend Gonzaga University, graduating with a degree in finance and a minor in philosophy. After living in Southern California and then St. Louis, MO, I was glad to return to my home state. My husband and I have two adult children and one grandchild. I enjoy many things and currently make time for recreational activities like tennis, kayaking, biking and hiking. I also carve out time for gardening, cooking, reading and some traveling.

Can you share a bit about your professional journey and what led you to become CEO of Cascade Medical?  

I did not set out to become CEO. I took a temp job at Cascade Medical to dip my toe back into the workforce, after staying home with my kids for a handful of years. Right away I was interested in and curious about how Cascade operated, and a chance conversation with the CEO at the time resulted in my being offered a full-time position as Director of Materials Management. I continued to deliver supplies and sterilize equipment, but I had the opportunity to learn purchasing and lean into leadership. Not long after that, the Accounting Director job opened up and I was asked to take on that role as well. Later I was offered the role of Controller, then CFO, and, eventually, in early 2013, the job of CEO.  

Prior to becoming CEO a mentor encouraged me to think about that role, telling me I’d be perfect for it because I “wasn’t ambitious.” I was a little bit offended until I realized he was giving me what I think of now as a compliment; he understood that my motivation to say yes to opportunities was to contribute to an effort rather than for personal gain. That has always been my driving force, a willingness to say yes when people ask for help, from taking on additional responsibilities at Cascade to contributing as a leader on boards and committees. That yes is often a little scary, because it has a tendency to push me out of my comfort zone, but it’s a great way to grow while also contributing to something much bigger than myself.

How would you describe your leadership style? What values guide you in your role as CEO?

I am most drawn to the servant leader style, and I aspire to be that every day. The values that guide me are the same seven that provide the cultural foundation for our organization (Commitment, Community, Empowerment, Integrity, Quality, Respect, and Transparency). These values are all deeply meaningful to me, both personally and professionally. If pressed to pick the most essential of the list, and recognizing this is different for everyone, I would choose Integrity. For me, that question of what is right, of doing what is right, is the foundation for everything else.

What’s one lesson you’ve learned in your career that you think every executive should understand?

There are so many lessons, and hopefully I continue to grow and learn throughout my life. One I’m still working on that took me a while to figure out is that sometimes silence can be taken as agreement or condoning something. Sometimes this doesn’t matter, but for everything of importance, I think it does. As leaders I believe we have an obligation to be clear and to respectfully speak up for what is right, to respectfully educate when we hold important facts that can be shared. This can be uncomfortable, but I think it’s an important duty. I would balance this with the inverse lesson that when the team is brainstorming or I am seeking feedback, I would like to be the last person to give my opinion, to avoid my thoughts dampening someone else’s different ideas. We set a better course as a team when we can really noodle on things together in an open and safe environment.  

What makes Cascade Medical unique compared to other rural hospitals in the state?

There’s a saying in healthcare that when you’ve seen one rural hospital, you’ve seen one rural hospital. That’s because most rural hospitals are centered on the convergence of what the community needs and what resources are available to meet those needs; often the range of services can be quite different. I think I know nearly every other hospital CEO in the state, and I can say our organizations are all the same in that we are deeply committed to our communities.  

That said, I would identify our culture as the thing that most defines us. We conducted a number of employee listening sessions in May and the most common theme, strongly present in every session, is how much people love being a part of the Cascade team. They love who they work with, that the environment is supportive, that the work is meaningful, that the patients are wonderful, that it feels like family. That culture isn’t by accident; it takes concerted focus and effort and is the product of every single Cascade team member’s work. This is a factor in our relatively low turnover rates and that we have no to very few open nursing positions and typically utilize minimal travelling staff. Of course, I am knocking wood as I type this!

What are some recent accomplishments or milestones that you and your team are most proud of?

There are so many! This is a team that knows how to get a lot done, and a team that is driven to continuously improve our work environment and the services we offer to the community. We’ve been regularly expanding services in the past year or two, adding outpatient ultrasound, wound care, mobile integrated health, additional clinic procedures, mobile MRI, hospitalists, cardiac rehab (supported by our Foundation), and telestroke services. This growth is exciting for all of us and particularly for our care team, who have more tools at hand than ever before to care for patients, providing more opportunities for that warm, convenient, high-quality care close to people’s homes.

We’ve also invested in our team and provided opportunities for growth. We now operate a medical assistant apprenticeship program and, in partnership with Mountain Meadows, a certified nursing assistant training program, including being a state-certified testing site. We also invest in leadership development for newer and emerging leaders. This strategy of team investment is a win all around; it helps ensure we have the expertise to take best care of our community while creating opportunities for advancement and career development within our local community.

How do you see the hospital’s role in supporting the overall health and well-being of the Leavenworth area?

We are vital to the health and well-being of our local communities. For one thing, when a person sustains a life-threatening injury or health condition, having our ambulances and emergency department here locally means life-saving treatment is quickly available when minutes can make the difference between life and death. That close proximity matters for many other services as well; we know many of our patients are more likely to see their care provider or have a mammogram or colonoscopy or participate in cardiac rehab because it is conveniently located close to home.  

We also offer a Community Financial Assistance Program which provides free or sliding scale care for people who qualify, based on income, whether or not they have insurance, for care provided in the hospital, clinic, and/or ambulance. And we partner with Upper Valley MEND who operates the Monday night Free Clinic at Cascade. We work with the school district to help meet needs there, and we get out into the community, meeting patients where they’re at with both our mobile clinic and mobile integrated health programs. We offer wraparound services in the clinic, including behavioral health, social work services, and dietician services that partner with family medicine providers.  

Of course, there are things impacting the health and well-being of our community that we cannot impact alone or change on our own. This includes housing scarcity, food scarcity, the high cost of living and other large social challenges. We can and do still participate in this work, but in different ways which may include collaboration with organizations who more specifically operate in these spaces or advocating for change by sharing the impact these challenges have on sustaining our local medical center.

What are your short-term and long-term goals for the hospital and clinic system?

We are in the final year of our current three-year strategic plan, so short-term I’d like to see us finish up strong on those objectives. More specifically, while we have worked hard to increase access in our clinic and now have a good number of same- and next-day appointments regularly available, we are also focused on adding providers to our clinic team, to ensure we continue to be able to take on new patients and grow with our growing community; focus on team growth in the clinic is definitely a near-term goal.

As for longer-term, we are currently conducting a master facility plan which will help us set our course for the next ten to twenty years. This process uses data and other inputs to help us understand what services our community is likely to need into the future while considering our changing industry, demographics, and our already full-to-bursting building, so that we can develop a strategic long-term plan to ensure we can sustainably meet our community’s needs for many years to come.  

What are some of the biggest challenges facing rural hospitals like yours, and how are you addressing them?

The challenges facing rural hospitals are vast and also varied. Some are facing significant financial distress and severe workforce shortages right now. I am grateful those are not today’s challenges for Cascade. Challenges common to most of us include: too expensive or not enough housing to recruit even the highest paid team members; not enough trained caregivers in the local area, let alone the nation; the constant upward pressure on expenses coupled with commensurate downward pressure on payments; the ever-increasing resources needed to both negotiate fairly with insurance companies and also fight for the payments we’re contractually due; the complete uncertainty in healthcare driven by both state and federal policy changes; and the ongoing threats around cybersecurity events. To name a few!

These are not easy problems to solve, and yet you’ll find most rural hospitals have figured out how to be nimble and also how to innovate, because we are driven to keep care accessible to our local communities. For Cascade that means continued focus on building a strong workplace culture, including employing strategies to be able to meet market wage demands. I have the opportunity to serve on the Washington State Hospital Association Board and the Regional Policy Board for the American Hospital Association; connections like these help build platforms for advocacy, provide an opportunity to learn from others and how they’re navigating challenges, and sometimes catch a glimpse of something in the earliest stages that we ultimately need to prepare for. Many of our team members participate in other collaborative groups as well, allowing us as an organization to be continuously learning and well-connected. We also are always working to find efficiencies and apply innovation to our operations.

How is the hospital adapting to changes in healthcare technology and patient care delivery?

These are areas of rapid change. The first thing we do is to try to stay attuned to the industry and learn from others. From a technology standpoint, we are working on a project to improve the communication / connection between our electronic health record (EHR) system and other EHR systems. Healthcare’s not great at this in general and yet doing this well has the potential to improve care coordination and patient outcomes, and so we devote resources to this. We are also beginning to utilize an ambient listening tool in our family medicine clinic, which allows the patient and provider to connect without the barrier of a computer between them. We’re also in the midst of a construction project in the clinic which will allow our teams the space to work together more collaboratively as we transition more fully to team-based care. Earlier this year we began to offer patients the option to book appointments using an online tool and we are working on additional ways to leverage technology to streamline and improve both the patient and the care teams’ experiences.

Even our mobile clinic and our mobile integrated health program (in which EMTs and paramedics provide non-emergency touchpoint care in people’s homes) are different ways to reimagine and implement something other than the traditional care experience. One of the challenges for us is having the bandwidth to fully explore and evaluate all the potential options for innovations as the environment changes so rapidly. But we stay well-connected, are constantly learning, and work to move these advancements forward.

Who or what inspires you?

I draw inspiration from many places. My children, for instance, who inspire me by the way they see the world and by their courage to exist so fully in their lives. And I’m fortunate to be surrounded by a whole team of people who also inspire. The baseline at Cascade is above and beyond service, to our patients and to one another. We receive many beautiful notes from grateful patients and one of the common threads running through those notes is our team’s ability to see patients as the people they are and to care for their humanity. I also receive notes and stories from team members sharing something great their coworker did; this ability our team has to really listen, to see and care for people as people, to notice and take time to appreciate the good things – it’s pretty magical. It makes me grateful to be a part of the Cascade team and inspires me to try to be the sort of leader this great team deserves.