Rounding in a virtual world

If you are a regular reader of this blog, you know I am a fan of lean concepts and practices. In fact, my posts on lean have been some of the most popular ones over the years. So, it is no surprise that I have embraced a form of rounding or “gemba” now that I am serving as interim CIO at Boston Children’s Hospital.

As part of our commitment to being a High Reliability Organization (HRO), Boston Children’s Hospital has a program called “Rounding to Influence” (RTI). With this program, senior leaders meet with staff in their areas to discuss a specific topic and solicit input. The Rounding to Influence program is facilitated by David Davis, Vice President, Patient Safety, Quality and Regulatory Affairs. When I learned about the RTI program several weeks into my interim engagement, I was quick to start participating.

My first experience was tagging along virtually with Laura Wood, EVP Patient Care Operations / System CNO, on her rounds with clinical staff along with a few of my IT leaders. Given the topic for that session was about having the right information to perform your work, it was a great place to start and hear from our clinicians and support staff. Here were the questions:

Having the right information and data is important to everyone in order to perform their roles effectively.  Depending on your role, do you have trouble finding the information or data you need to do your job?  Do you know how and where to get the information/data you need?  Do you have concerns you are seeing incomplete or unreliable data?  How would you know?  How can we be more reliable in our information and data sharing?

The obvious next step was to start virtual rounds with our own IT staff. Here is how it works. Continue reading

Yes, culture matters

“I love this organization”. That is exactly what I said to my husband last Thursday after hearing several presentations in three different forums as part of the team at Boston Children’s Hospital. It started with the monthly Department Heads meeting that opens with a patient and family story and closes with an inspirational quote.

That meeting was followed by a lunchtime every other week series (dubbed Fireside Chat), open to all employees focusing on how we are supporting our patients and each other. Dick Argys, Chief Culture Officer and Chief Administrative Officer is the host. As part of our Juneteenth series of events, the topic was “The History of Juneteenth”. Our guest speaker, Theodore Landsmark, PhD, JD, Distinguished Professor of Public Policy and Urban Affairs at Northeastern University along with Peter Faiteau, Patient Services Administrator for Oncology/Hematology/HSCT, talked about the history and significance of Juneteenth.

The Juneteenth series was announced in an email from Dr. Kevin Churchwell, President and CEO to all employees last Monday – before it was declared a national holiday. He acknowledged that it was only the second year Boston Children’s was celebrating Juneteenth and closed his email with this: “Boston Children’s celebration about Juneteenth is all about learning from each other. And the more we learn about our history, the better equipped we are to build a brighter and more inclusive future for all”.

That was followed by an open forum for all employees, “Transforming Tomorrow: Investing in Children, Families, and Communities”. Dr. Churchwell and a panel of leaders described the new inpatient building opening in summer 2022 (far enough along for an inspiring video) and the new ambulatory centers being planned in nearby towns making care more accessible to families in the broader Boston area.

And earlier in the week we had all been invited by Dr. Churchwell to a virtual celebration to announce and congratulate the entire Boston Children’s team on being ranked the number one children’s hospital in the nation in the 2021-22 U.S. News & World Report “Best Children’s Hospitals” rankings. Continue reading

One year later – an increased focus on diversity, equity and inclusion

A year ago this week a small number of Minneapolis residents witnessed the death of George Floyd. Within days, the world knew what had happened and responded. There were mass protests in cities across the country and the world.

It was a time to reflect as companies across the country looked internally at their own practices and culture. Many started programs focused on Equity, Diversity, and Inclusion (EDI). Those with programs already in place revisited and strengthened them. At Boston Children’s Hospital where I am currently serving as interim CIO, they reaffirmed their commitment. This past week, Dr. Kevin Churchwell, President and CEO, sent a note to all staff outlining some of the work that has been done in the past year in support of their six core EDI commitments with the subject: “One Year after George Floyd’s death, our work continues…..”

The core commitments are:

Goal 1: We will be truly inclusive.

Goal 2: Our team will be as diverse as the patients and families we care for.

Goal 3: We will eliminate racism from our processes, practices, and guidelines.

Goal 4: We will continue to educate ourselves to be an inclusive working environment.

Goal 5: We will work to eliminate health disparities in our community and across the nation.

Goal 6: We will develop and use metrics to continually improve our performance in equity, diversity, and inclusivity.

As Dr. Churchwell said in his message, “George Floyd’s name became a rallying cry for millions and yet another compelling reason to discuss tensions around racism and social injustice. One man’s life became a symbol of so many lives lost needlessly. Disparities and inequities long considered to be “part of the system” became impossible to ignore. Here at Boston Children’s, we took a hard look at ourselves, and we realized that we need to be part of the solution to these important issues.”

Many of you or your CIO may be members of CHIME. In 2020, I joined the CHIME Diversity and Inclusion Committee which was established in early 2019. Continue reading

Remote work – what next?

After 14 months of remote work for many, organizations are making plans to bring people back to the office. Most healthcare CIOs that I spoke with in the past year plan to have their staff either remain fully remote or back in the office part-time for a “hybrid model”. Only one CIO that I spoke to had his full IT team onsite throughout the pandemic. They were considered critical support staff and available to augment staff in other departments if needed.

With this transition there are many articles covering all sides of the topic and the challenges facing organizations and employees. Two recent articles from Harvard Business Review are worth checking out.  The first one, “What Mix of WFH and Office Time is Right For You?”, is aimed at individuals assessing their own workstyle when it comes to work location. If the employee has a choice, the article suggests they do a self-assessment and then discuss with their boss what would work best for them. The second one, “How To Do Hybrid Right”, is aimed at organizations trying to determine the right hybrid model in terms of employee types and workspace design.

A recent opinion piece in the Boston Globe by Jon Levy, “The Hybrid Workplace Probably Won’t Last”, talks about the pendulum swinging back to onsite work. Jamie Nelson, CIO at Hospital for Special Surgery, made similar projections in her recent podcast with Bill Russell on This Week in Health IT and talked about being onsite herself through the pandemic and the importance of leaders in healthcare organizations being present.

Bill and I covered the topic extensively on This Week in Health IT Newsday show earlier this week. A few of my thoughts on the topic: Continue reading

Resources for your digital health journey

My StarBridge Advisors colleague, David Muntz, wrote an excellent blog series on Digital Health over the past year. His latest in the series is titled, “Digital Health – Planning for the Virtual Campus”. David’s ability to define digital health and provide a blueprint for organizations is impressive. This most recent post does not disappoint. He describes the changes that health systems have made in care delivery during the pandemic and poses the question – where do we go from here? He outlines 12 steps organizations should take. Here is a partial list just to whet your appetite:

  • Embrace the same discipline and framework to create the virtual campus as for a traditional campus
  • Query a broader representative sample of stakeholders than you have in the past
  • Plan for the underserved and those who might be excluded because of the digital divide
  • Personalize the experience for providers, patients, and families
  • Use augmented intelligence (AI) and machine learning (ML) during the data collection process

I encourage you to check out the entire post. If you are interested in any future posts in David’s digital health series, subscribe to View from the Bridge to get notifications of new posts. Our team of advisors regularly contributes posts on a wide range of topics relevant to today’s healthcare executives and IT leaders.

The New England HIMSS 2021 Annual Spring Conference: “Empowering People to Impact Health Through Information and Technology” was this week. Continue reading

It’s transition time again

“Until every child is well” is the tag line used by Boston Children’s Hospital, the number one pediatric hospital in the nation as ranked by U.S. News and World Report. I am thrilled to share the news that I started as their interim SVP and Chief Information Officer two weeks ago. What an incredible organization to be able to serve. I am excited to be part of a healthcare provider organization again – even though it is temporary.

Boston Children’s treats more children with rare diseases and complex conditions than any other hospital. In addition to caring for the sickest children in the Boston area as well as nationally and internationally, Boston Children’s is a leading research institution. It is home to the world’s largest pediatric research enterprise, and it is the leading recipient of pediatric research funding from the National Institutes of Health.

Boston Children’s is investing $24M in digital health initiatives (D2.0) over a three-year period with solutions for patients, their families, clinicians and administrative staff. Under the leadership of Chief Innovation Officer, John Brownstein, they have an Innovation Digital Health Accelerator (IDHA) which is partnering with many technology start-ups to provide solutions both internally and broadly to others in the healthcare community.

And let us not forget about the importance of an organization’s culture. The public statement on their website says a lot about the kind of organization they are and strive to be:

“Boston Children’s is dedicated to creating a culture where all patients, families, clinicians, researchers, staff, and communities feel empowered and supported. We are committed to working together to support health equity and promote anti-racist practices. This is not merely an aspirational goal, and in August 2020, we shared our formal Declaration on Equity, Diversity and Inclusivity that will be our guiding compass in making this goal a reality. We will continue to evolve to ensure we provide a welcoming, inclusive environment for all staff and families. Our diversity makes us stronger.”

As the search for the permanent CIO continues, I will be focused on moving the current IT strategic plan forward, gaining alignment on the EHR strategy, and assisting the search firm, AMN Healthcare, to find the best candidate for the future. Continue reading

Adapting to virtual project work

It is encouraging to see major system implementations continue to move forward during this period. Seattle Children’s, UI Health and Steward Health Care are just a few examples of EHR go lives in recent weeks. Kudos to all the teams who are working to ensure they go smoothly and safely as they provide a combination of virtual and onsite support.

My StarBridge Advisors colleague, David Muntz, and I just completed an ERP selection with a client. We have moved into the contracting and planning phase. All our work has been virtual. There was a short period where the client team was partially back in their offices but as case numbers in that state rose, they returned to the work from home arrangement with the exception of senior leaders in the office on certain days. The vendors successfully conducted virtual demos over several days with very high participation and engagement by the client organization.

While the vendor of choice is understandably anxious to meet with the client team in person, that is not happening for the foreseeable future. By the time of go live in Spring 2022, it should be a very different situation with onsite work. But for now, it will be all virtual work. And even when regular travel and onsite work is considered safe, I expect more work by the vendor and their implementation team to be done remotely to save on travel costs and time.

Bottom line, we have all made this virtual way of working a success. Yes, there were a few times when being in person in the same room would have really helped – the initial period of work when we were getting to know the client team and some of the key decision meetings. Learning the culture and “reading the room” can be a challenge in the virtual world but it is all doable. Continue reading

Starting a new job or client project in a virtual world

If you are starting a new job or a new client engagement during this pandemic, you are most likely missing (and even craving) the in-person contacts that you are used to. The job interviews and onboarding may have been all virtual and the actual work may still be all virtual. For a new client engagement, you may be doing not just the kickoff meeting but all the subsequent work virtually. And this virtual mode may be the situation for the foreseeable future.

Neither of these scenarios is the same as a team or group of people who already know each other well and have formed good working relationships to suddenly be working virtually.

Given our work is often all about the relationships, what are some of the challenges of this new way of working with clients or starting a new job? And how best to address them? Some lessons and tips from my latest client engagement experience:

Culture – We have all heard the phrase “culture eats strategy for lunch”. You must work that much harder to understand the culture of an organization when you are not spending time together in person. Early on, find out what the norms and values of the organization are from your key contacts. Observe and listen. And don’t be afraid to ask questions.

Politics – Every organization has its politics. Best to stay out of them if you can. But you need to be aware of the politics and how best to navigate to get results. The politics may be less evident (a good thing) in the virtual world but are still there.

Who’s who – If you are used to getting to know your new colleagues or clients more informally to build a good, trusting working relationship, then this is all new. Continue reading

7 Tips for effective virtual meetings

If you have the kind of job where you can work from home, you have probably been on hundreds of virtual meetings in the past four months. And this will most likely continue for the foreseeable future as many companies have no set date for when they will have employees return to their offices. There are plenty of articles with overall tips for working from home. Here are my tips for effective virtual meetings:

Follow meeting norms – If your company had meeting guidelines and standard practices when you were all in person, continue to follow them. During my interim engagement at the University of Vermont Health Network, I became very familiar with the meeting norms in IT and shared them in a previous blog post – “We’re at meeting norms”. I consider them best practice. They included behaviors that contribute to productive, collaborative work. I can honestly say that the meetings there were some of the most productive, focused, and efficient meetings I have seen in all the organizations I’ve worked in. One of the most useful is having 25- or 50-minute meetings. When you are working in whatever home office setup you have, you do not have to move between meeting rooms. But you still need time between calls whether it’s a bio break, time to stand up and stretch, organize your follow-ups, or get ready for the next meeting.

Know how to use the tools – Get to know all the features of your preferred/default video conference tool and be comfortable navigating in it. But be flexible and quick to adapt to other tools as needed if the meeting host has a different default tool. Be patient when technical issues arise and work together to resolve quickly or find a workaround. People are more supportive and tolerant of issues now compared to when there was just one or two people remote with everyone else in a conference room together wondering why the remote people were having issues. Continue reading

Be a part of the change

I have watched with sadness, anger, and disappointment the events of the past week. Amid a public health crisis and a historic level of unemployment that are disproportionately impacting people of color we saw captured on video the death of a black man, George Floyd, at the hands of four police officers in Minneapolis.

I am a liberal white woman. I grew up in a white neighborhood in Northeast Minneapolis. As a young adult, I lived in South Minneapolis and later North Minneapolis – much more racially diverse parts of the city. My sister and brothers, nephew and nieces, and their children all still live in the Minneapolis area. My nephew has lived for over 20 years just off Lake Street in South Minneapolis where nearly every business has been damaged or destroyed in the past week. But this destruction was not limited to Lake Street which you saw on the news. It happened all over the Twin Cities area as people intent on causing trouble and more divisions scattered to set fires and smash windows. As of late Sunday night, 270 businesses had been damaged or destroyed. It broke my heart to see that beautiful, diverse city so broken. And then to see that destruction spread in other cities over the weekend.

I am old enough to remember the riots and social unrest of 1968. I came of age during the women’s movement in the late 1960’s and early 1970’s. I have been to my share of peaceful marches and protests over the decades starting with an anti-war demonstration in 1970 on the University of Minnesota campus with one of my high school teachers and several classmates. In recent years, my husband and I have showed up for women’s rights, gun control, and immigration reform.

While I have experienced sexism, I also experience white privilege. I try to understand racism and its impact on people, but I cannot fully understand what it is like to be a person of color in America.

As a citizen, it is our right to peacefully protest. Thousands of people are in the streets in every major city across this country peacefully protesting racism and police brutality. A small number of extremists are turning these protests to violence and destruction each night.

We are seeing the best and the worst in people right now. Continue reading