Event Recap: Industry Perspectives Panel Discussion
Last week we kicked off the Laudio Industry Perspectives blog series – “Maximizing Organizational Performance in the COVID Era.” In Part I, Dan Gross, recently retired executive vice president of Sharp HealthCare, laid the foundation for the panel discussion by outlining the priorities for the healthcare industry at this time:
- Leader and workforce imperative
- Economics
- Consumerism
In this blog, we further explore these topics from our panel’s perspective and what they are seeing within health systems, and the impact on leaders and the workforce.
There’s a lot there to unpack with these priorities. I’ll start with Mark from Northwell Health System. Regarding the key areas that Dan highlighted, what do these look like at Northwell? How have you adapted over the last year and a half or so? And what are the changes, or what will you do differently from an operational management perspective for future success?
Mark Solazzo: Let me start by saying that from an” economics” perspective Northwell is on a significant growth curve. We’re growing at the rate of about 10% a year or nearly $1 billion dollars annually. That alone poses some significant challenges. You add the pandemic on top of it, and you lose a little sleep sometimes. Growth is great, but when we talk about growth, I worry about two things. Maintaining the culture that we’ve worked to establish. And making certain that we attract the right talent for our culture.
I believe that one of our strengths is that we’re a “people business”. As Dan mentioned in his comment on the leader and workforce imperative, we were fortunate to have our engagement scores grow during COVID. And we significantly increased our ranking in the Top 100 Places to Work in the U.S. News & World Report. I attribute this to our communication strategy and flow during the pandemic early on.
We made it very clear that we had three imperatives:
- To keep our staff safe, first and foremost.
- To keep our facilities safe
- To serve everybody that came to us – this gets back to Dale’s point about equity.
We accomplished these goals by making certain we had beds, equipment, and staff. And by far the staff is always the most important.
Our whole philosophy and our culture have been built on engagement. I think that’s one of our strengths. And I believe that’s what carried us through this pandemic so well. It’s allowed us to grow at the rate we’ve grown. But as I think about some of the challenges that the pandemic created I will start with Dan’s comment on economics. The pandemic took $1.5 billion out of our revenue stream in the first six months. So that was a significant challenge. We had to try to figure out how to recover from that. We’ve bounced back strongly. In fact, what I see with respect to economics is almost a pent-up demand among the management staff ranks to work on anything but COVID. There is a desire to not only get back to normal but to get back to normal with vigor. So, what I see in my organization is a desire and a passion to move beyond COVID. They are looking to expand the programs that were growing pre-COVID. And to do it at a rate that we’ve never seen before.
I appreciate Dan’s comment about being careful with the pace of change an organization can take. But I also think there’s another side. If the organization is demanding change, you must unleash them. You have to give the team members the power to move things forward. We’re very fortunate to be witnessing this right now.
We do have an issue of access though. Access meaning that this pent-up demand both internally and from the community has resulted in a change in consumer behavior in certain segments. Some segments are back to normal practice, operations, and normal physician practice operations. But we also have more patients that want to see us now than we can accommodate. So, we’re taking what we’ve learned through COVID. We’re trying to understand how we can use telehealth, what we’ll call “connected health,” in a different way. As an extender to the physician or the advanced practice clinician.
We’re also trying to build a balance between standardization of process and flexibility of design and nimbleness. We want to be able to get to market faster and be able to meet the consumer demand faster. With that, we’re doing a couple of things with digital access. We are pursuing digital in a forceful way. Not only digital for access but digital to really trim back the paper involved in the provider and the consumer or patient experience. We want to remove the noise to bring back that sacred relationship. On the economic side, again, we are also trying to diversify our revenue streams. We’re trying to move into more consumer areas. Looking at where we can do more for profitable businesses, diversification, and to minimize the overall risk for the healthcare system through this diversification of revenue.
I’d like to touch on the topic of engagement and communication that you highlighted. We’ve heard from numerous healthcare leaders across the country that engagement during COVID increased. And research will tell you that it’s not uncommon for teams to bond when they go to “war,” so to speak. But once the war is over the emotions begin to surface and the impact then follows.
The question for you, Dale, is about communication. It was at a heightened level during the pandemic. Between the C-suite and the frontlines, there was a higher frequency of communication leveraging new channels and new methods. It had a powerful impact on engagement during a very difficult time.
How do we maintain this? What are some of the things that you’ve learned that you’re taking forward to maintain that engagement and satisfaction?
Dale Beatty: I appreciate this question. It’s the secret sauce, so to speak, of how we make the organization run. One of the things that we did at the Stanford Health System was to leverage existing structures that were already in place. We’re an organization that believes heavily in shared leadership. Dan talked about frequently inviting individuals that “do the work” to provide feedback on how care should be delivered. We did more of that. We continued with our shared leadership structure. We needed more communication, more feedback, more direction, during this time of change – not less.
We also looked for ways to communicate more simply. We found that change was happening so rapidly that we needed new methodologies and modes of communication. We experienced version control issues in our communication because the information was changing so fast. So, we created one-point lessons and a website that housed all information. A place that everyone could access to get the most up-to-date information.
We also collaborated externally with other organizations. Even outside the acute care sector. We collaborated with skilled care. We reached out and had conversations about how care was being delivered in different places. Interestingly these conversations were still the same regardless of the sector – leveraging your workforce, understanding what their needs were, and making sure they had the information that they needed.
Quite frankly, safety was number one. We as leaders needed to understand this. We needed to make sure the environment was safe. And when issues with PPE or staffing arose that they were addressed quickly and frequently. Huddles, as Dan highlighted, is an excellent way to find out what is happening on a day-to-day basis. But the frontline engagement of leaders with frontline staff is critical. So, I want to echo Dan’s comment about middle management and top management working with the frontlines, finding out what’s going on and how we can support them.
We too had a similar example where our engagement scores went up. And our COVID units’ engagement scores were the highest in the organization. You would think they would be the lowest. But we put a lot of focus on safety and soliciting their feedback. I believe it made a difference. We also dropped our turnover rate from 14.1% to 7%. So, this is an opportunity for us to really engage with our frontline as we move forward.
So, being practical in a crisis created these outcomes. Is it practical to think that you can continue that level of communication and that level of engagement going forward?
Dale Beatty: I believe it’s important that we do maintain it. It’s also important in our generational work. We must understand that the needs are different from a generational workforce perspective. I have found that millennials have a greater need to be involved in how work is done. COVID pushed us forward to engage in that regard. And I don’t see that changing. Nor do I see the speed of healthcare changing or slowing down. So, I think some of the tools that we’ve come up with are going to be critically important. We must begin to provide information to leaders in a succinct way so they can prioritize, and focus, and support the frontline.
It’s critically important to look for solutions, build solutions, and provide tools that enable us to work more effectively moving forward. Because the change impact is here. We are no longer working on one project at a time sequentially. They are coming at us in multiples. We must be able to prioritize and focus based on outcomes. It’s our responsibility to make sure that our frontline has a voice and can contribute to the solutions we are developing.
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