Episode 85:
Leadership Beyond the Pandemic
Michael Dowling, Dr. Roxanna Gapstur, James Hereford, Dr. Rod Hochman, Kevin Mahoney, Jim Skogsbergh
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In this episode of Fireside Chat, we invited six CEOs, all of whom have appeared previously on the show, to explore leadership beyond the crisis. We spoke about the lessons learned during the pandemic and how this crisis will shape healthcare and its leaders in the years ahead.


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Gary Bisbee 0:03
What a year 2020 was. The coronavirus pandemic was largely unimaginable in January 2020 when Fireside Chat was introduced. A shortage of information governed throughout the year, particularly through the first surge. Health system leaders were in uncharted territory and frontline workers mastered the uncertainty and fear to treat the sick and dying. CEOs and health system leaders reported new levels of communication with employees and the community and humbleness caused by sheer magnitude of the pandemic. Leadership called on creativity, whether scaling up telehealth capabilities, scaling down surgery, creating systems for remote working, or learning more about and working with public health agencies. Epidemiologists and their modeling became highly prized. COVID protocols evolved throughout the year. Vaccine administration built on the infrastructure strengths of health systems. The lessons learned were many. What will happen as the pandemic recedes? How will strategies evolve? In this episode, we invited six CEOs, all of whom have appeared previously on Fireside Chat, to explore “Leadership Beyond the Crisis.” I’m Gary Bisbee and this is Fireside Chat.

Michael Dowling will share his thoughts about preparing and supporting the frontline workers not only with PPE, but with their mental well being; Jim Skogsbergh will describe Advocate Aurora Health’s usage of clear and concise communication; Dr. Rod Hochman will share his thoughts on trusting the judgment of his leaders; Dr. Roxanna Gapstur will explain the benefits of transparency when managing a large organization; Kevin Mahoney will describe restructuring his organization for innovation, and James Hereford will speak about exercising humility to reconsider what it means to be an effective leader. Now for our guests. Michael Dowling experienced firsthand what it was like metaphorically to be “in the trenches” during the COVID surges. He told me about walking through ICUs and the importance of leaders making themselves visible in times of crisis. Here’s Michael Dowling, president and CEO Northwell Health describing his experiences and the strategies of communicating the plans to carry forward post-pandemic.

Michael Dowling 2:25
Continuous communication. And you’ve got a number of different communities here. You’ve got the public, which we communicated with continuously in every medium we could find. And basically, the message was, “We’ve got this. It’s difficult. There’s gonna be bad things happening, but we’ve got this. At the end of the day, we are going to win this battle. This is not going to defeat us, we’re not the group that will be defeated here.” The second large group, which was unbelievably important that I spent extraordinary amount of my time on this, and that was the staff. The staff on the ground, the troops on the front lines are the people who make things work. So we communicated verbally, in written form, websites. It was continuous daily communications. And I and my leadership team, we were on the front lines almost every day. I walked every ICU in every one of our facilities during the height of the crisis, because I believe that it was important to be out there with the staff to let them know that we knew that their safety and security and morale was top priority for us. They needed to see us out there. Leadership doesn’t hide in a crisis. Leadership makes themselves very visible in a crisis. And by being out there, by the way, it also helps in putting the book together because I could observe exactly what’s going on each and every day, and this is where I saw the unbelievable compassion and courage by employees. And we also, of course, had to focus in on the employee’s mental well being, psychological well being, and physical well being, which means that they wanted to know that we had enough supplies of PPE, that they will never run out, and we were able to reassure them that that is the case. So the communication was consistent. And the other group I had to deal with, because obviously, I communicated pretty regularly with my board, most of it by Zoom, of course, on the weekends, and then we had the politicians and government we were communicating with. And as you know, Gary, I was working very, very closely with Governor Andrew Cuomo, whom I believe did an absolutely spectacular job here. But I was in constant communication with him and helped him coordinate a lot of stuff in the New York area. You cannot over communicate. And as somebody once said, “The danger of communication is thinking that you have actually done it successfully.” So you have to do it over and over and over again. And the message has to be one of optimism, has to be upbeat, proactive, and has to be reality-based, but also focused on that, “We will win this. There is no defeat here.”

Gary Bisbee 5:05
Now we’ll hear from James Skogsbergh, president and CEO of Advocate Aurora Health. Jim shares his insights on crisis management when difficult situations arise. He goes on to explain why strong communication is key and why the phrase “Calm over chaos, fear over faith” is so important to the Advocate Aurora Health team.

Jim Skogsbergh 5:28
Communication, communication, communication. We have a phrase here, I stole it and it’s caught on like wildfire. “Calm over chaos, faith over fear,” and we use it all the time. And I do think that part of the role of a leader is to model and conduct him or herself in a way that sends the message that we’re going to be fine. We’re gonna be fine. Yeah, this is, this is very challenging, very difficult, not without its pain and suffering. But we’re gonna see our way through this and here’s the plan to see it through. I’ve spent most of my time simply in communication throughout the organization, reinforcing messages, talking about the pivots that we’re making and why we’re making them, explaining the challenges that we have. Our big focus is, “Why. Make sure you’re nailing the why.” I believe that this COVID crisis has heightened the importance of clear, concise, frequent communication, and that’s something we’ve been working on. And then Gary, my gosh, the list goes on and on. I mean, man, if you’re not developing talent, you don’t have a talented team to do the work you’re in a world of hurt, right? So talent development and teamwork, making sure that everybody’s weighing in and utilizing people, sort of, what we call it the top of their license, right. And I don’t mean just clinical folks, I’m talking about everybody sort of at the top of their license. Two heads are better than the one, three heads are better than two. So we focused a lot on that. It’s been fascinating to see how some people step up. And then also, on occasion, discover that not everybody was cut out for these kinds of stressful or challenging times. Because this stuff is revealing, right? It does reveal character and substance and courage and all those things that you want from your leaders, which is one of the reasons I’ve been so encouraged about our 75,000. You got folks that run to the fire, not run away, but run to it.

Gary Bisbee 7:17
Dr. Rod Hochman is president and CEO of Providence. Listen to what Rod had to say when asked about the importance of leading a 120,000 person organization in a crisis. Rod reviewed his approach to empowering his employees to lead at every level of their organization.

Rod Hochman 7:36
I’m staring at a book that I have on the corner of my desk by Stanley McChrystal, you know, the “Leaders: Myth and Reality,” and it’s all about giving up your power to the people that you put in place, trusting their judgment. Because if I don’t trust the judgment of our leaders that are in our hospitals and our clinics in a different place, you’re never going to be able to get things done. Because people have asked me, “Well, how do you manage a 7 state, 120,000 person, $25 billion organization?” Well you manage it because you’ve brought in great leaders and great people. And guess what? You’ve actually listened to what they tell you. And that’s the secret to this. And you know, it’s been interesting in this virtual environment, you know, you can actually sneak into the back of a room now as a CEO and listen to your people as they’re working on problems together. So a lot of times, I’ll just get in the middle and I listen to some of our young people, doctors, nurses, executives, solving problems. I go, “This fantastic,” because they’re so smart. And I think I’ve gotten a better appreciation for who we have out there and what we’re doing. But I think great leaders listen to their people, but great other leaders out there and get out of their way and let them do what they need to do and you’ll have a successful organization.

Gary Bisbee 8:58
Similar to Rod’s lesson of trusting his leaders, Dr. Roxanna Gapstur, president and CEO of Wellspan Health, teaches us a corresponding lesson about the necessity for her employees to trust her leadership. Here’s what she had to say about building that trust.

Rod Hochman 9:15
For me, I think it’s been to make sure that I’m transparent, that I’m communicating, that I’m creating a trusting relationship across all 20,000 employees, to be committed to my team’s well being, and to always be thinking about our team and our patients first, and then to just step back and make sure to look at the big picture. Because whenever we’re in a crisis, it’s so easy to go right to solution mode. And I think being able to step back and focus on the big picture has been really important for us.

Gary Bisbee 9:46
After the COVID crisis subsides, Kevin Mahoney, CEO of the University of Pennsylvania Health System plans to use the policies that his health system has put in place as a springboard for innovation. Here’s Kevin describing the way that the COVID crisis created a culture of innovation.

Kevin Mahoney 10:04
I think it’s to constantly communicate two things – reminding people why we’re here, which is to take care of our patients, and second, reminding everybody that we’re also here to take care of each other. So when the crisis developed, I rolled out the three P’s and we talk about. First was, we’re going to protect our patients and we’re going to make sure that they had the best possible outcomes although with a new disease. We weren’t quite sure, but we wanted to make sure we were protecting our patients. Second was, we’re going to protect our employees, so the no layoff pledge, no missed paycheck, that you’re going to get personal protective equipment that you need, I think was critical. Third, was, we had to protect our finances. And we went about doing that through taking out a larger line of credit so that we maintain our cash liquidity. We did a lot of maneuvers financially to make sure that we were protecting ourselves for the future. And then the last, the “I” was, how to innovate your way forward, because the only way we were going to get out of this mess was through innovation. And I saw people that hadn’t worked together before just pulling together and we developed what we call Penn COBALT in 9 days. And it’s more or less open table for behavioral health services that we made available to our employees. And about half of our employees have visited the website. It’s been remarkable in that if you need to talk something through, you get to talk to the right person. If that means a licensed social worker, we get that set up. If it means to clinical psychologists, we get that set up. If it means a coach, we get that set up. If it means you need a psychiatrist because you’re having suicidal ideations, we get that set up right away. So the innovation that, that took to put together I think was forged in our ethos of protecting each other. I think the most important thing of leadership, again, is remind people why you exist. In our case, it’s taking care of patients, leadership in a crisis. And second, there has to be unwavering belief by everybody in the organization that I cared about them and I wanted to make sure that they were safe, that their families were safe, and that we were doing everything we could to protect them and their families.

Gary Bisbee 12:21
For leaders like James Hereford, when asked about a crisis impact on future leaders, he sees there are positives. James is president and CEO of Fairview Health Services. Here he is describing the humility and teamwork that he and his employees, faculty, and staff experienced because of the COVID crisis.

James Hereford 12:41
I don’t know how it can’t be shaped by it. I think it would be akin to asking veterans of World War II, “Gee, did that experience change your view of how you look at the world?” I can’t imagine this is not going to significantly affect how future healthcare leaders and CEOs look at their world, because they went through this experience. God, hope we don’t ever have to go through it again, but you got to be careful who you listen to. If you listen to the epidemiologists or the infectious disease doctors, they would say that we’re guaranteed to do so. But I do think it’s going to influence. And I think in positive ways because what’s been clear to me is, there is no form of the individual, “I’m the smartest guy in the room” approach to leadership in this environment that can work. You just can’t be. Too many more smart people, you have to move too fast, you’ve got to create good teams, you’ve got to create an environment where they can make decisions and affect those decisions quickly. You’ve got to be able to be facile with technology and understand its impact, both on the socio and the technical side. It’ll change who we even think about as potential leaders. And then the thing we haven’t really touched on is the level of social unrest, and I think that too, simultaneous coincident to the pandemic is also going to change the way that we think about, what is leadership and who are our future leaders.

Gary Bisbee 14:06
Fireside Chat with Gary Bisbee is a Health Management Academy podcast produced by Think Medium. Please subscribe to Fireside Chat on Apple Podcasts or wherever you’re listening right now. Be sure to rate and review Fireside Chat so we can continue to explore key issues with innovative and dynamic healthcare leaders. In addition to subscribing and rating, we’ve found that podcasts are known through word of mouth and we appreciate your spreading the word to friends are those who might be interested. Fireside Chat is brought to you from our nation’s capital in Washington, DC, where we explore the strategies of leading health systems through conversations with CEOs and other interesting leaders. For questions and suggestions about Fireside Chat contact me through our website firesidechatpodcast.com or gary@thinkmedium.com. Thanks for listening.