Steve Smith has learned a thing or two about putting out fires during nearly 16 years working at one of the most prominent medical complexes in Texas.
But before entering a career in healthcare, Smith once literally fought fires — as an officer in the United States Army when local firefighters struggled to contain wildfires that broke out in eastern Washington and Idaho during the 1990s.
“They were overwhelmed, so they called on the military for help,” Smith says. “They were running out of people, so we got trained up and we deployed for almost a month fighting fires.”
“Putting out fires” is a phrase that’s almost as old as the facility management profession. It serves as an industry catch-all to describe the many duties that managers are tasked with daily – typically and seemingly, all at once, and often unexpectedly.
Through a career that started in the Army and continues at a consistently expanding medical center, Smith has been trained to learn that anything at any time is possible in the career that he’s chosen.
“It’s definitely not a 7:30 to 4 job at all,” he says of facility management. “I don’t think any facility manager, I don’t care what kind of place you're running, is that way. But healthcare is 24/7/365, so my phone rings quite a bit.”
Adjusting on the fly isn’t new to Smith, the director of facilities at Clements University Hospital at the University of Texas Southwestern Medical Center in Dallas.
Smith grew up in a military family, so he was used to adapting to new areas to live and meeting people from all walks of life. He likes to say he’s a 30-year military veteran, including the 20 or so years he moved around with his family before enlisting.
After eight years in the Army and rising to the level of battalion staff operations officer, he transitioned into civilian life. He served from 1991 to 1999, a relatively peaceful time as the first Desert Storm was ending and he transitioned out before 9/11, so his duties involved lots of training and preparing for any future conflicts.
While his military duties did not translate into civilian life, the leadership skills he gained as an officer set him on a path to his current role.
“It’s the best leadership training program out there,” Smith says of the Army. “I think it teaches you a lot about diversity, working with different people from different backgrounds. I think everybody should do at least some time in the military.”
After leaving, Smith worked in the private sector for almost 10 years as a service operations manager responsible for upgrading and maintaining automation control systems. One of his clients happened to be a familiar name, a relationship that paid off a few months later when a reorganization left Smith looking for a job.
“One of my customers was UT Southwestern, so I put in an application, interviewed, and was in their controls department and project management team under utilities,” he says.
He was with the utilities department for a few years before moving over to Clements hospital, where he’s been ever since – first as manager of facilities before rising to his current position of director in 2018.
Clements is part of a 15-million-square-foot medical complex that includes patient care hospitals, a research center and a medical school. Smith’s responsibility is the Clements hospital, an acute care facility where he manages 70 facilities employees.
“We’re dealing with the sickest of the sick,” he says of Clements. “If you go to some of the more regional hospitals, if they cannot figure out what their patient’s ailment is, a lot of times they will refer them to us. We have the research arm, and we have the academic arm, to bring together a whole lot more resources than you would find at a typical hospital.”
Smith is a healthcare leader in the middle of a booming time for the industry, and Texas in general. He played a critical role in the building of the Clements hospital in 2014. When it opened, it was a 1.2 million square foot facility with 460 beds.
Only two years later, the hospital was already in expansion mode to reach its current level of 752 beds and 2 million square feet.
“I could probably fill up another half of the hospital with the number of patients we turn away,” he says.
A current project involves construction of a new children’s hospital, which requires the demolition of three buildings and carries a price tag of almost $6 billion.
“We have a double challenge in Texas,” Smith says. “One, healthcare is booming everywhere because of the demographics in America, and the other thing is Texas is a huge net importer of people from all over the country. We’re having a lot of folks coming in from higher costs of living states into Texas, and a lot of Fortune 500 companies.
“They’re bringing people, and they’re bringing jobs, but there is not enough infrastructure to support them, so we’re constantly building.”
Smith was a recipient of FacilitiesNet’s 2023 Facility Champion award in part due to his role in helping get the Clements hospital up and running. During an October 2023 interview he described the project as one of the highlights of his career.
"It was such a success that planning began within a year of opening to expand,” he said at the time. “From the design of the expansion to the construction in 2017 to 2020, nothing was more exciting and challenging than running a maintenance team while being able to have input on a major expansion into a fully occupied building.”
Thea Vanderhill, AVP of Clinical Design and Transition Planning for UT Southwestern Medical Center, has worked side-by-side with Smith for a decade and nominated him for the Facility Champion award. Vanderhill praises Smith for his attention to detail.
“It’s his relentlessness,” she says. “Not taking the wrong answer as a final answer or letting you know good enough isn’t good enough to be the right answer, it has to be the best answer, and he doesn’t let those issues simmer. He addresses issues from a facilities perspective and that’s not always the first instinct for everyone, but it is for Steve. He’s very consistent and has high standards.”
While the definition of a facility manager includes protecting the systems and buildings that people occupy, it also includes the occupants themselves. In Smith’s case that includes patients who are facing life-or-death situations.
“I have 752 beds in here and I think of every single one of those patients as individual people that are struggling to get better in life,” he says. “My job and our team’s job is, ‘How do we make that happen?’ and we do that by making sure the doctors and the nurses and clinicians all have everything they need to do their jobs, whether it’s lights, plumbing, air conditioning, proper pressures, everything that is working in those systems.
“My focus is the people that are living in those beds who can’t do it for themselves, to make sure nothing goes wrong in that building to prevent the care that people need, so they can go back home with their loved ones.”
Attending an endless string of meetings, either in person or remotely on Zoom or Teams is hardly anyone’s idea of a pleasant job experience.
In a rapidly growing, heavily regulated healthcare setting, it’s not Smith's cup of tea either, though he realizes that’s part of the job considering his position at the hospital.
“I think I’m in meetings probably 60 to 75 percent of my days during a week,” he says. “Some weeks are better than others and the rest is just working with our staff.”
It’s the duties outside the constant flow of meetings that keep Smith challenged and focused on improving himself, his staff and the building he helps manage.
"My role is managing people,” he says. “Even though I have a hospital that I’m responsible for, I’ve got 70 people that help manage that hospital. I’ve got to make sure they have the time, the resources and the training to do their job.”
Smith’s job involves plenty of planning for renovation and modification projects that are constantly evolving at the hospital. He keeps a chart of key performance indicators that focus on making the hospital’s systems more productive and efficient.
When Smith does find free time during his day, he goes out on “rounds,” not dissimilar to a doctor or nurse checking in on their patients during the day.
“When a meeting ends early and I have nothing to do for the next 30 minutes, I’m in the hospital and I go find my staff,” he says. “I will go see what my staff is doing in rooms. I like to find out what my staff is doing, and not only find out what they need, but finding out how everything is going in their personal lives.”
Archana Cronjaeger is Smith’s boss and the assistant vice president for Hospital Facilities at the hospital complex. She describes Smith as a people person and unique motivator who encourages his employees to better themselves.
“He likes to make sure that his staff can rise,” she says. “He does a lot of stuff to increase morale and encourage staff to move up, get their masters, or if you’re a traditional technical person, go take some classes so we can move them into leadership.”
Smith hasn’t lasted this long in his career without taking chances and striving to improve. It’s a message that he’s always sharing with his colleagues and team.
“Don’t be afraid to fail,” he says. “I think so many people I run across are afraid of losing their job because they don’t want to try something new. They’re just afraid of speaking up in a meeting, but I firmly believe that for anybody in any industry, especially healthcare, go ask those questions.
“Keep pushing yourself to learn more, but don’t be afraid to fail. If you do fail, you can learn from it, and you’ll be better for it.”
Dave Lubach is executive editor of the facility market. He has more than nine years of experience writing about facility management and maintenance issues.
