On Best Practices

Healthcare for all: ensuring inclusivity in LGBTQ+ patient care

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June is Pride Month. In recent years, LGBTQ+ rights have come under attack. All this after the landmark Supreme Court decision in 2015 supporting marriage equality. These attacks are taking many forms – “Don’t Say Gay” bills in state legislatures, bans on drag queen story hours, protests and intimidation at events, bomb threats at children’s hospitals providing gender affirming care, and more.

A March 7, 2023, piece in the Boston Globe by Renee Graham, “Understanding the intersectionality of hate”, begins by highlighting the number of bills pending in state legislatures. “The American Civil Liberties Union is tracking more than 380 anti-LGBTQ bills in nearly three dozen state legislatures, ranging from bans on gender-affirming care for trans youth to prohibiting classroom discussions about LGBTQ people or issues”.

In the face of these attacks and threats, and anti-LGBTQ+ legislation, allyship is more important than ever. Who doesn’t have a gay family member, friend, or colleague? Allyship is showing up and speaking up. There are many ways to do this as individuals and organizations, especially during Pride Month.

In 2015 I wrote a post titled “Marriage equality, it’s personal”.  I talked about the experience of my aunt when her longtime partner was hospitalized in her final days and how my aunt was treated. That was 1990. We’ve come a long way in healthcare but need to continue these efforts given the strong anti-LGBTQ+ sentiments.

I’m proud to have worked at Boston Children’s Hospital in recent years. Despite bomb threats due to their gender affirming care program, they are not deterred from their ongoing commitment to providing comprehensive and affirming treatment for LGBTQ+ patients and families. They have been awarded the Healthcare Equality Index’s (HEI) Leadership Status every year since 2015. They provide LGBTQ+ patient and family centered care in four key areas: patient non-discrimination, equal visitation, employment non-discrimination, and training in LGBTQ+ patient and family centered care.

The HEI is the national LGBTQ+ benchmarking tool that evaluates healthcare facilities’ policies and practices related to the equity and inclusion of their LGBTQ+ patients, visitors, and employees. Nearly 500 healthcare facilities achieved the top score of 100 in 2022 and earned the LGBTQ+ Healthcare Equality Leader designation.

My 2015 blog also referenced this HEI designation. I was working at Michigan Medicine then and they too were recognized with HEI Leadership Status. I closed that blog hoping that in the coming years, thousands more healthcare organizations would receive this same designation. There is progress, but more is needed.

Resources:

National LGBTQIA+ Health Education Center – Ten Strategies for Creating Inclusive Health Care Environments for LGBTQIA+ People

Human Rights Campaign Foundation – Transgender-Affirming Hospital Policies

Amplifying the voice of nurses

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May 6-12 is National Nurses Week. Nursing has been the most trusted profession for the past 20 years according to a Gallup Poll. That’s no surprise when you think about the nurses you have interacted with as a patient or as a colleague.

I’ve written a post about nurses almost every year since I started this blog. Do I have anything truly new to say this year? Yes, in that I want to highlight how the past three years has taken a toll on all our clinicians, in particular nurses. The public health emergency is expiring. Health care providers are adapting their policies as they continue to deliver care. We have entered a new phase for healthcare organizations, staff, patients, and families.

Staffing challenges are at the top of the list of concerns for many health executives – staff shortages and clinician burnout. There are no easy solutions. The toll of the past few years on our nurses was highlighted in a May 2nd NPR article by Jaclyn Diaz – “Nearly a third of nurses nationwide say they are likely to leave the profession“. The article starts with some sobering findings from the 2023 Survey of Registered Nurses conducted by AMN Healthcare. The survey examined the impact of COVID-19 on the career plans, job satisfaction, and mental health and wellness of more than 18,000 RNs. Key findings:

  • Close to 1/3 of nurses nationwide say they are likely to leave the profession for another career due to the pandemic. This level is up 7 points since 2021.
  • 89% of RNs said the nursing shortage is worse than five years ago, 80% expect that to get much worse in another five years.
  • Younger generations of nurses are also less satisfied with their jobs compared to their older counterparts.
  • 80% of nurses experience high levels of stress at work, an increase of 16 points from 2021.
  • 77% of nurses reported feeling emotionally drained, up from 62% in 2021.

Of all the blog posts I’ve written about nurses, this one from five years ago has the strongest message – “Celebrate nurses, but more importantly listen to them”.  This is true now more than ever. From the bedside to the boardroom we need to listen, amplify, and prioritize the voice of nurses.

IT leaders won’t solve the staffing challenges. But we have a role to play. The systems and solutions we provide and support as health IT leaders and vendors must help nurses do their job more easily and efficiently, not make it harder. We need to reduce the burden on nurses and ensure they are integrally involved in decision making, prioritization, and design processes.

From workaholic to fitness enthusiast: living a healthier lifestyle

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When I turned 50, I joined a gym – it was a birthday present to myself. Many years of working long hours, commuting, and raising two daughters kept me from regular workouts. I figured at 50 it was well past time. I knew that no one at work was going to come into my office at 6pm and tell me to go home and take care of myself. I had to own it. I have belonged to a gym almost continuously since then though I’ve lived at 5 different addresses in that time.

I had another major milestone birthday last week. And I can honestly say I have never been as physically active as I am now. Go figure. Guess that’s what happens when you work less!

At a minimum, I walk a 1.3 mile loop late afternoon almost every day with our two dogs. I go to 4 classes a week at the YMCA if I register before there are wait lists. I play pickleball every day I can when the weather is good. And I’ve signed up with a women’s golf group to play 9 holes once a week when my schedule allows – I know this will be more fun and social than exercise.

If you are a golfer, you know that’s a humbling experience! From 2000 to 2012, I had periods where I golfed 9 holes once a week but never took lessons. In the past 10 years, I’ve golfed only a few times at charity outings. We moved to a planned community in late 2021 and our townhouse is on one of the two golf courses. We see a lovely but challenging par 3 hole from our deck – we see golfers tee off hoping to hit it over the junk and then we see them hunt for their ball around the green. This summer I decided it was time to get back into golf myself. Continue reading →

HIMSS as a networking event

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For those of you attending HIMSS23 in Chicago next week, it will be a mix of education, vendors, and networking. Let’s face it, while education and the exhibit hall are what our organizations are willing to invest in, networking is what we all look forward to each year. Seeing colleagues we’ve known for years, finally meeting in person people we’ve only known on zoom, and making new connections. Especially after a few years of virtual only conferences.

I won’t be attending this year. But that doesn’t stop me from giving some advice on the networking front.

Whether you are in transition and looking to make connections for your next opportunity or you are focused on learning from your peers and sharing success (and failure) stories from your own work, effective networking is critical to your work and your career.

Here’s some general networking advice:

Network extensions – Everyone you know knows a few more people who could potentially be helpful. Proactively and respectfully work your network.

Professionalism – Always present yourself as the consummate professional whether at work, online, or in business interactions after hours.

Two-way street – Figure out what you need from a connection and what you can offer to them.

Diligent follow-up – If you commit to provide a reference, make an introduction, or something else, be sure to do it in a timely manner.

Networking is one of the greatest values of the annual HIMSS conference and HIMSS provides many ways to find people with similar interests as yours. Here’s some slightly modified advice specific to HIMSS from previous years posts: Continue reading →

What makes an effective sales approach?

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HIMSS23 is less than two weeks away. The second annual ViVE event happened last week. It is a busy time of year for healthcare vendors and their sales staff. I’ve been on both sides of this relationship – for many years as CIO and buyer and for fewer years selling services. It gives me a unique vantage point.

Buyers attending these conferences will be looking at vendors who have solutions they need now (and have budget for) and vendors who are new and interesting with innovative and niche solutions that they may want to explore further in the coming year (explore is the key word here). And they will be meeting with their current vendors to strengthen connections and get educated on what is newly available or coming soon as they leverage their existing investments.

Sales staff will be working hard to get the attention of potential buyers. They may even reach that stage of annoying and overbearing. We all know that kind of salesperson.

In my work as principal at StarBridge Advisors, I recognize it’s all about relationships. As I said in a previous blog post, it’s not just about who you know. It’s about who you are and how you show up with people. You need to be capable and competent with the right knowledge and experience, but also honest and authentic with high integrity. That’s what it takes to be successful in a business that is all about relationships. One of the best pieces of sales advice I got from a colleague was the “know-like-trust-need” model. People need to know who you are and what you can do, they need to like you, and they need to trust you. If you have all that, when they need you, they’ll call you. Simple. That’s why I focus on relationships.

My husband and I were recently on the buyer side of a sales discussion. By the end I thought, this will blog, meaning, there’s a kernel here to learn from and share. So, what happened? Continue reading →

What advice would you give your younger self?

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I love this question. It was one of the questions for a panel I was supposed to be on this week. The NEHIMSS chapter has an annual Women in IT conference, and I was one of four invited panelists for the three-hour event. But 40 miles into my 100-mile drive to the venue, cruising fast on the freeway, my left front tire totally blew out – down to the rim. Scary yes, but I got myself over to the shoulder and called AAA. My second call was to the panel moderator explaining I wouldn’t be able to make it. An hour and a half later I was again on the road with the spare tire that is designed for maximum 50 MPH taking the back roads home to avoid freeway speeds.

I was looking forward to the event and the panel. I love sharing stories with next generation leaders so this was going to be a fun night. I was ready after the usual panel prep call to cover the range of questions we had agreed on.

While I didn’t get to do the panel, I don’t want this question to go to waste – here’s what I was ready to say when asked what advice I would give my younger self:

  • Know your big rocks – I’ve written on this in the past, “Do you know your big rocks?”. It comes from Stephen Covey and it is a spot-on analogy. Our families and closest friends are our big rocks. Don’t let all the little stuff take up your space first leaving no room for your big rocks.
  • Don’t take crap from anyone – In my 30s, two of my peer managers seemed out to get me. One even threatened me. I was the only woman on the management team for a 5-year period. After a lot of stress and wasted energy processing it all at night talking to my incredibly supportive husband, I decided enough was enough. I let our boss know what was going on and told him that I would let him know of any further incidents. He was going to have to deal with it because I couldn’t. In another situation where a male manager from another department got overly friendly with sexual advances, I reported it to compliance. Hard as reporting something may be, it is necessary to stop the behavior if you can’t stop it yourself.
  • Have a strong support system – Whether it is family or friends, everyone needs a support system they can turn to. I could tell plenty of stories about my incredibly supportive husband and how he has been there for me back when I was a young working mother in management and going to school at night for my MBA as well as the decades since (our 47th wedding anniversary is in a few weeks).
  • Accept that you can make choices – One of my staff wanted to consider coming back from maternity leave after she had her first child in a part-time role but worried about how it would stall her career. She was a project leader on a management track. We talked about her options and I encouraged her to keep in mind that she had choices. After a period of part-time work, she eventually came back full-time, picked up again in a leadership role and then had two more children a few years later. She made choices right for her and balanced growing a family with growing her career.
  • Own your own career and be open to the possibilities – Before I left my CIO position at Brigham and Women’s Hospital for a similar role at Michigan Medicine, we were going through major staffing changes in IT. My staff were concerned about their future in supporting legacy systems vs the new EHR coming in. I told them they had to own their own career and be open to the possibilities. When I make that second point now, I emphasize that there are jobs today that no one heard of 5 or 10 years ago and there will be new ones in the future we can’t even imagine now.

There you go – I had plenty more to say on the panel given the other great questions we were going to discuss but wanted to at least share this one.

And after this car experience, my parting advice is keep your AAA membership current and keep your cell phone charged.

Related Posts:

7 Ways to develop the next generation of leaders

10 tips for next generation leaders

 

STEM needs a youth pipeline

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It has been quite a while since I wrote a blog focused on STEM – the last one was “STEM or not, own your career”. A field trip with my 8-year-old granddaughter, Kylie, and 6-year-old grandson, Colin, to the Boston Museum of Science during their winter break got me thinking it’s time to talk about STEM again. To make this more than just another nana story, I did a little research on current STEM statistics both from a workforce and education perspective.

Here are a few facts I found on a site describing National STEM/STEAM Day:

  • The number of STEM vacancies remains higher than the actual candidates.
  • The average pay for STEM jobs is 70% higher than the national pay average.
  • In the U.S. 8 out of 10 employers were looking for employees with STEM education for important job roles.
  • The U.S. Bureau of Statistics predicts that 80% of the jobs in the upcoming years will require technical skills.
  • STEM jobs were predicted to increase in the U.S. by 16% between 2014 to 2024.

I also found an insightful blog, “The state of STEM education told through 26 stats” from iD Tech – a company that provides tech camps for youth. Here are some highlights on STEM education from that blog:

  • Only 20% of US high school graduates are prepared for college-level coursework in STEM majors.
  • Fewer than half of the schools in the US offer computer science classes.

With a focus on encouraging and preparing girls for STEM careers, it had some interesting statistics:

  • 74% of middle school girls express an interest in engineering, science, and math but only 0.4% choose computer science as a major when they get to college.
  • As of 2019, women comprise just 27% of the STEM workforce.
  • 63% of middle school girls who know women in STEM feel powerful doing STEM.
  • Moms who communicate on STEM leads to girls being +20 points more interested in pursuing their studies.

You can check out the blog for data sources and more insights.

When we talk about pipelines for future job opportunities, it is important that we start all the way back to elementary school ages and expose kids to various fields of study. Continue reading →

Considering a career move?

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The start of the new year is often a career transition time for people. We’ve heard much in the recent period about the great resignation, silent quitting, and remote work options being in demand. And we’ve seen significant layoffs in the tech industry and to an extent in healthcare providers dealing with significant financial challenges. If you or a colleague are considering a job change, some of my previous posts may be useful to revisit.

Career advice revisited is a list of posts providing career advice that I wrote prior to May 2021. I consider many of them “classics” that are still useful – they cover dealing with a competitive market, questions to ask yourself, interviewing and resume tips, and more.

Two more recent posts since that time provide additional perspective and advice. I wrote Reflections on recent career conversations after talking with many colleagues at the 2022 CHIME Fall Forum. And the post Paying it forward with career advice from late summer 2022 includes links to useful articles and tools for comparing opportunities and deciding whether to stay or go.

For more focused posts here are two more to check out – STEM or not, own your career and Know someone interested in a nursing career?

If you are looking for a career coach to help you through a transition, the post, When to use a career coach, could be helpful. I am happy to talk about how I might assist you.

Note – I am taking a short break from writing new posts the next few weeks. With all the blog posts I’ve written over the past 8 years, I’m using this break to share some of my “classics”. Thank you for being a subscriber – I hope you will encourage your colleagues to subscribe in the coming year.

New Year’s Resolutions – one month in

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Do you make new year’s resolutions? Do you share them with others for accountability? Do you use the new year as a time for reflection and goal setting?

I have made explicit resolutions in some years and not others. A few years ago, I framed them as intentions – they were balance, passion and engagement. Regardless of what form it takes, the start of a new year is a good time to reflect on the past year and plan for the coming year in both your professional and personal life.

My resolutions at the start of 2022 revolved around life/work balance and I’m happy to say I have made good progress. In 2022, my work schedule was very manageable, I spent more time with family (including fun times with grandkids), got a lot of exercise (including becoming a Pickleball addict), and vacationed without worrying about work.

More time with family may sound like a cliché – maybe more available to family is another way to say it. So, what are some examples of being available? When my daughters tell me about a game or performance that my grandkids are in, I now have the flexibility to say yes, I’ll be there. When my daughters ask if I can take care of their kids for a few days, I now can say yes. That included “Nana Camp” last summer. And when my sister’s husband passed away back home in Minnesota, I was able to spend extended time with her.

I am carrying all these positive 2022 changes and more into 2023. Continue reading →

Lessons from the road

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This is not a consultant’s or salesperson’s road warrior set of lessons. But rather observations and a few life lessons after a two-day drive home from Florida to Massachusetts. While my husband napped during one of my driving shifts, I had plenty of quiet time to think and observe. Here goes on my lessons from the road:

  • Without the big picture and context, it’s easy to make a mistake. That’s what happened when going around Washington DC day two. I lacked context for the different options. I took an exit based on how I interpreted the signage that caused us to get rerouted and sit in the rush hour traffic we were trying to avoid.
  • You need to ask yourself if shortcuts are worth it and at what cost if you are unsure of the outcome. Near DC, I took the express lane with high tolls when I wasn’t sure if I could exit in time for the next highway that I was supposed to take. My goal was to avoid DC rush hour traffic as much as possible, so it seemed worth it.
  • Estimated hours and schedules for anything is just that, an estimate. You never know what obstacles will get in the way to change it. Watching the ETA on your navigation system can give hope until you run into heavy traffic, accidents, or construction work and the ETA starts bouncing around. We ran into so much of all this on the way down to Florida that we had two 15 hour driving days instead of what was expected to be closer to two 10-hour days.
  • Alerts are great for awareness and/or taking action but you never know the true impact until you get in the middle of the situation. Our map/navigation app gives crash and hazard alerts, whether they have been cleared yet or not, and the number of minutes delay they will cause. In most cases, the delay was far longer than the initial alert said it would be.
  • The higher you go in an organization, the more uncertainty you face requiring a steady hand and focus on the goal. On the way home, we decided to take a route that avoided the big Northeast cities and all their traffic even if it meant more miles. At one point driving through Pennsylvania, we had about 45 minutes at 1600 feet altitude with very heavy fog and near zero visibility. My husband’s steady hand on the wheel was reassuring.
  • Everyone you talk to will have an opinion or advice, but you must decide what is right for you. People who make this trip regularly are willing to start off in the middle of the night to avoid rush hour in a big city. That so didn’t sound like something we would do so we left early morning each day.
  • Even two people make a team and teamwork is critical. Friends who have done this drive talk about doing 5 hour driving shifts before taking a break. Not us. My husband and I would drive as long as we each were comfortable and switched drivers often making our pit stops as efficient as we could. Fortunately, our two furry team members were perfect in the back seat – happily sleeping in between each stop.
  • Technology has changed the way we live and travel – duh! I’m old enough to remember when we used a paper trip tik book from AAA for family vacations as a kid. Probably many of you are old enough to remember when we used to have spiral bound paper map books for a state or city with the tiniest of print. Now we rely on smart car navigation systems and apps on our iPhones.

We spent two relaxing weeks visiting friends at their condo overlooking the ocean. The balcony was an awesome office with a view for keeping up on email each day and doing some time sensitive work calls. Daily morning beach walks and afternoon pickleball, lovely sunsets and moonrises, a few museums and some shopping, and seeing a midnight space launch from a 35 miles distance down the coast. Our two dogs behaved and got along well with their two dogs. Good news – we’re invited back next year. Now that we’ve done the long drive that many northerners do in the winter months to spend time in sunny Florida, we know what it takes and learned a few travel and life lessons along the way.