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In coming to the Children’s Hospital Los Angeles (CHLA), Luigi Estrera took on a role in which his predecessor spent an unprecedented 56 years before moving on to another position in the organization. Fortunately, Estrera was brought in under a succession plan that allowed him to spend a year soaking up all that institutional knowledge. He gained a deep understanding of how his organization had grown and how he could continue that growth during his own tenure.
“I’m in my seventh year of acting in these types of roles,” says Estrera, the director of perioperative services. “That leaves me 49 years shy of Nancy, my predecessor. It’s a very humbling experience. I feel like the quarterback who got drafted while Aaron Rogers was still on the field. But I’ve been fortunate to have an incredible teacher who was willing to share so much of what she’d learned throughout her career with me.”
Estrera—a Navy veteran with a master’s degree in health administration and a doctorate in nursing practice—has been in his role at CHLA for only a couple years, but his résumé includes some of the finest health institutions in the country: Mount Sinai, Keck Medicine, UCLA Health, and Cedars-Sinai, where he originally worked as an RN.
“Obviously, at the end of the day, we will do what’s best for our patient and figure it out. But the more we can do to streamline other costs and expenditures, we should be doing it.”
Luigi Estrera
The day before speaking with American Healthcare Leader, Estrera had hosted a retreat for his department to kick off goal setting and strategic planning as well as engage in some team building related to his organization’s fiscal year 2025 strategic plan. That plan centers on three pillars: demonstrating excellence, ensuring sustainability, and cultivating trust.
One of the major objectives under the demonstrating excellence pillar includes an intensive BlueBin integration aimed at simplifying the supply chain process. Estrera says this implementation will include having access to supply chain data and analytics like never before, with an eventual AI component to be rolled out over time.
“This is a high priority for us because we firmly believe that we could save the overall organization anywhere between three and five percent,” the director explains. “When you’re a health system with our patient demographic, that’s incredibly important.”
Robb Swan, Chief Marketing Officer of BlueBin, agrees. “Luigi Estrera and his vision for supply chain operations in all the surgical services areas at CHLA is collaborative and driven for long-term success and efficiency. BlueBin’s solutions perfectly fit CHLA’s needs to reduce clinician burden, gain insights through data, and boost engagement across all staff—enabling better care.”
Over 70 percent of CHLA patients are covered by California’s Medicaid healthcare program. For Estrera, that means every dollar needs to be stretched as far as it can. That also means that the rest of Estera’s organization will immediately feel every efficiency and savings he can create.
“Obviously, at the end of the day, we will do what’s best for our patient and figure it out,” Estrera says. “But the more we can do to streamline other costs and expenditures, we should be doing it.”
Space is another issue taking up a fair amount of the director’s time. During the pandemic, CHLA’s surgical needs spiked, and the numbers haven’t returned to their pre-2020 levels. Estrera is tasked with finding the best route to growing CHLA’s surgical volume, specifically its inpatient footprint.
Because of CHLA’s reputation as the preeminent children’s hospital, not just on the West Coast but also in the country, the hospital is a go-to location for patients with the rarest and most complex conditions. Growing that surgical capacity will require a two-pronged approach.
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“To continue to carve out those complex services, we need to expand our outpatient services to be able to handle some more of those more traditional procedures,” Estrera explains. “The other issue, unsurprisingly, comes down to cost.”
The director says that clinicians, nurses, and even administrative leaders have a tremendous amount of career options, with premier health organizations clustered within a stone’s throw of LA. How is CHLA hoping both to attract and retain its high-caliber talent?
“We think professional development can be one of our differentiators here,” Estrera explains. “When people leave an organization, we know that so many of those reasons are beyond compensation. Sure, sometimes it is all about the money, but who you’re working for, who you’re working with, and what you’re working toward are huge parts of why people choose to stay or leave. I’m continuing to zero in on what makes us stand out and what will continue to make us stronger in the future.”
Estrera himself is no stranger to finding himself in a challenging work environment. When the director got recruited to go to Mount Sinai Health System in New York City, Estrera respected his wife’s desire to stay in California to raise their family. Estrera logged 150,000 miles in a single year traversing the country every weekend. He’d fly home Friday and take a red-eye flight back to New York days later. He managed the schedule for three and a half years. After he got stuck in New York for 60 days during the pandemic, he decided to come home for good.
“Experience is part of the reason I take my time with my family so seriously now,” Estrera explains. “They have been so patient through my military service, my schooling, and the demands of my job. When I’m with them, it’s time I don’t take for granted. They have my undivided attention.”
