Listen: Outgoing Winnebago Hospital CEO reflects on progress made improving tribal health

After more than four years, Danelle Smith is leaving the Winnebago Comprehensive Healthcare System. As the CEO, she oversaw the merging of the reservation’s hospital and public health department. Nebraska Public Media News spoke with Smith about her time as CEO of the health system. This conversation was edited for clarity.

Aaron Bonderson, Nebraska Public Media: Looking at your time as the CEO, what do you think your biggest accomplishment was, in your years running the Winnebago Comprehensive Health System?

Danelle Smith, CEO of Winnebago Comprehensive Healthcare System: We've spent a significant amount of time, in the last four and a half years, really building the organization. We had to set up all of our administrative functions from scratch, because previously, they were operated by the Indian Health Service. And, from the health department standpoint that was under the tribal government. So, we really created an organization from scratch.

Bonderson: What are the most pressing health care needs on the reservation?

Smith: Throughout Indian country – and Winnebago is no exception – we have higher than average rates of lots of different chronic health care conditions, such as diabetes, heart disease, and obesity. Those types of things. Behavioral health is also another primary need in our community. Those are some of our focus areas. One of the things that we are really focused on as well is the preventative side of healthcare. And, looking at the whole person and the whole public health aspect – population health of our community. That way we can work towards prevention and focus on that, so we don't have people who end up in situations where they have a chronic condition that impacts their quality of life.

Bonderson: How did you make sure those needs were met given how spread out the population of the Winnebago Reservation is?

Smith: I think that communication and transparency is really key in doing that. Engaging with the tribal leadership, engaging with the patients, and looking at data are important. Throughout the last four years, we have gone through a process of evaluating the services. And we looked at how we go about carrying out those services and processes and things throughout the organization. That was in an effort to look at: what was done before, what worked, what didn't work, how can we do it better?

The other aspect of what we've done, too, is establish partnerships. And, reach out to our neighbors and look at what works in other communities. We wanted to know how we might be able to adapt that to fit our community. One of the benefits, I think, of having a public health department in combination with the hospital and primary care is just the access to data and engagement with the community.

Bonderson: Looking more at the last couple years, how did you and your team choose to handle the COVID-19 pandemic?

Smith: We came together in a way, really, that I have not experienced in my professional career in working with the tribe. The community stepped up and stepped forward, which became one of our marketing themes for promotion of the vaccine. It was called “Step Forward Winnebago.” And, I think that Winnebago did that.

Also, the Winnebago Tribal Council pulled together all of the leaders of the various tribal organizations in the community and established a Winnebago Pandemic Task Force. That task force met at least weekly for several months just to communicate with each other, to provide information, to keep a pulse on what was happening throughout the entire community. Our public health department, in cooperation with the hospital and throughout the whole health care system, organized educational materials for the community. We utilized social media quite a bit, as well as paper, for those members of our community who are not on social media. We were handing out flyers and information and things like that.

Bonderson: On a more of a personal note, you're going back to practice law. Why make that change now?

Smith: I practiced law full-time for about 15 years. I think that in my discussions and conversations with the tribal leadership, we had discussed the fact that I wanted to [be the health system’s CEO]. I wanted to take this role, and the tribe trusted me to do so – in an effort to just get the organization stabilized and on the right foot. I think we're there.

I think that from a personal standpoint, I’m going back to my original passion of being an attorney and providing legal work for Indian country. That it’s just time. I know that the board and the tribal leadership is really engaged right now in a search to identify the next CEO. I'm confident they'll find somebody who will be able to move the organization to the next level and onward into the future.