Tag Archives: leadership

At the intersection of racism and healthcare

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It has been two weeks since George Floyd was murdered by police in Minneapolis. Since then, millions of people have joined protests in major cities and small rural towns around the world to make their voices heard. They have said enough is enough, racism must end and real change is needed.

When the protests end and our national focus begins to shift, we can not go back to business as usual. The statements of support and solidarity made by so many these past two weeks must turn into action.

At the local, state, and federal level we must hold our government leaders accountable for change and exercise our right to vote for those committed to change. With the focus on police brutality, we are beginning to hear some major cities announce planned changes in policing. New York Governor Andrew Cuomo has introduced his “Say Their Name” agenda to reform policing in New York state. House and Senate Democrats have introduced the Justice in Policing Act.

In recent days, we have seen many “white coat” rallies as well – White Coats for Black Lives. My social media feeds are filled with pictures and stories of hospital staff rallies – many of them organized by the residents. Brigham and Women’s Hospital in Boston, UMass Memorial in Worcester, Massachusetts, and Henry Ford Health System in Detroit were just a few of them. And these are hospitals who saw thousands of COVID-19 patients in recent months. Truly our healthcare heroes.

In 2014, after Michael Brown was shot by police in Ferguson, we saw similar support. Students at 70 medical schools around the country organized a national white coat die-in saying it was an “important time for medical institutions to respond to the violence and race-related trauma that affect our communities and the patients we serve”. They lay down for fifteen and a half minutes. Eleven minutes to represent the number of times that Eric Garner said “I can’t breathe” as he was in a choke hold by police in New York City and four and a half minutes to represent the four and a half hours that Michael Brown’s body lay in the street after being shot by a police officer. And yet here we are in 2020.

These hospital staff rallies along with the many statements of support from hospital and health system CEOs are an important show of support but we also need action and attention to health disparities. I want to share two heartfelt CEO statements that were the most impactful for me. They are from healthcare leaders I have worked with and greatly respect. Continue reading →

Be a part of the change

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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 →

Year of the Nurse: We must support our nurses

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The first time I cried during this pandemic was March 17 when I read that in Italy people over 60 years old were being left on gurneys in the hallway to choke on their own sputum. Patients with coronavirus had

Message from Brigham and Women’s Hospital OR nurses: #StayHome

exceeded the hospitals’ capacity. I had been watching the news and stories from Italy closely in anticipation of what was going to happen in our country assuming we were just a few weeks behind them in this crisis. I cried then not only for Italy but for myself. I wondered if I was going to be one of those over 60 left to die if our hospitals were also unable to handle the potential number of very sick COVID-19 patients.

The second time I really teared up was when I thought about my daughter who is the Chief Nurse Practitioner (NP) on the inpatient orthopedic/spine service at Brigham and Women’s Faulkner Hospital in the Boston area and reassigned to work shifts in the ICU with COVID-19 patients. I feared the worst for my family. That she would get exposed and transmit it to her husband and five-year-old daughter who both have very bad asthma and are allergic to almost everything. We knew this virus was not just killing elders. People of all ages and especially those with underlying conditions were and are still at high risk.

Most of the times I have had tears since then has been watching a nurse or physician tell their story on the news. Describing what it is like to care for intubated COVID-19 patients, helping their patients’ families understand there is nothing more they can do, and sharing the fears they have for their own families when they go home from their shift. I have also cried when I see the stories of family members dying within days of each other from this virus, many of them people of color who are essential workers who can’t stay home.

I have listened to my own daughter describe the days she was assigned to work an ICU shift with COVID-19 patients. While it was not the overall intensity of what we have seen on the news in New York City hospitals, every individual case she described was just as sad and heartbreaking. And the emotional and physical toll on the nurses, doctors and respiratory therapists was obvious.

On the brighter side of this crisis, I have smiled with joy as healthcare workers in NYC celebrate the 500th or 1000th COVID-19 patient discharged from their hospital. Continue reading →

IT requests increase while budgets decrease

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As hospital systems develop their COVID-19 recovery plans, the financial impact of this pandemic is deep and far reaching. IT budgets are no exception. IT leaders are being asked to take salary cuts, furlough staff, and deal with a capital freeze for the rest of the year. This comes at a time when the demand for technology solutions is only increasing. And at a time when IT teams have performed at their peak in providing and supporting new solutions with agility and in record time.

In a recent Becker’s Hospital Review article, Hospital IT Spend Pivots to Mission Critical Projects: 7 Leaders on the Key Focus for the Next 12 Months, IT leaders covered telehealth, digital transformation, analytics, informatics, and of course the reality of cost reduction facing them and their organizations.

IT leaders have long faced the supply vs demand challenge. And they have long faced the need to reduce their budgets while meeting a growing user base and increased demand for technology solutions. The days of significant year to year budget and staff growth in IT are a distant memory.

As we look to the future after the COVID-19 recovery, some people talk about the “new normal” phase and others refer to it as the “re-imagine” phase. The latter certainly encourages us to think differently. Regardless, it will be with far less resources. So how does IT manage and ensure success in this ever more constrained environment? Continue reading →

What next for health IT?

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Two weeks ago, I wrote about looking ahead to the “new normal” post COVID-19. Since then some states have started slowly re-opening while other states are defining what their phased re-opening approach may look like. Hospitals have started to develop plans to expand their services beyond emergencies and COVID-19 patients – performing elective surgeries and opening outpatient clinics. All of this is new territory. Patient scheduling, workflow changes, and appropriate staffing and PPE to provide safe care must be accounted for and planned for very carefully. This will happen over the coming weeks and months.

Given the financial impact COVID-19 is having on healthcare systems, executives also need to be looking at how to position their organization for not just recovery but long-term success. One of the articles that I have seen on this is a white paper published by the Chartis Group – “After the Surge: Five Health System Imperatives in the Age of COVID-19”. In it they discuss how COVID-19 has fundamentally changed the care delivery landscape. They outline what they consider to be the five imperatives for future health system success:

  1. Engage consumers and other referral sources to recapture patients
  2. Fundamentally reduce the cost base
  3. Restructure the physician enterprise
  4. Transform the clinical operating model
  5. Closely evaluate partnerships, both horizontal and vertical, traditional and non-traditional

Other management consulting firms that work with healthcare providers most likely have a similar analysis and framework. Regardless what they may look like, all of these long-term efforts will require IT support. Continue reading →

Leading through a crisis

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As a leader, you are called upon to lead in good times and bad. At normal times and when there is a crisis. It may be an incident in the community with mass casualties, a natural disaster, or a widespread pandemic as we are living through. Barring any of these truly awful crisis, it might be a system failure and as an IT leader you are front and center. Whatever crisis you may face, it requires the best of your leadership skills.

Here is my list of the needed skills from my own experience and watching the best leaders in our current global crisis.

  • Communicate often to everyone involved and impacted. Be open and transparent.
  • Focus on the facts. Be explicit when you are stating opinion instead of fact.
  • Own the situation. Don’t make excuses. Take responsibility.
  • Be genuine and empathetic. Stay connected.
  • Stay calm and project calmness.
  • Be available and present. Stay close to your team. Provide the encouragement they need.
  • Listen to the input of others, especially the experts.
  • Be adaptable and ready to make quick decisions.
  • Lead by example in all you do.
  • Let your organization’s core principles guide you.
  • When you can, look ahead and past the crisis. Develop a return to normal plan
  • Capture lessons learned.
  • Express gratitude often. There are many heroes in a crisis. Find them and thank them.
  • And don’t forget to take care of yourself.

I have heard many health IT leaders describe the work they are doing in support of their hospitals during this pandemic – some common themes are being nimble, partnering closely with clinicians, staying focused, ensuring the safety of their onsite staff, being responsive with a can do attitude and providing rapid, innovative solutions. I have great respect for all of them as they navigate and lead during this unprecedented time.

Becker’s Hospital Review published a summary of advice from healthcare leaders last week titled “73 hospital leaders in 10 states hit hardest by COVID-19 offer advice to colleagues: If you do nothing else, at least do this”. Respondents are from New York, New Jersey, Massachusetts, Michigan, California, Pennsylvania, Illinois, Louisiana, Florida and Texas. The responses are organized by theme – I focused first on the leadership, communication and strategy theme. Continue reading →

#EachforEqual

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That’s the hashtag for International Women’s Day (IWD) 2020. The theme this year is “an equal world is an enabled world”. Sunday, March 8th, was IWD. According to the official website, “International Women’s Day has occurred for well over a century, with the first IWD gathering in 1911 supported by over a million people. Today, IWD belongs to all groups collectively everywhere. IWD is not country, group or organization specific.”

But it needs to be more than a day to celebrate women, it needs to be a yearlong commitment by all of us. Fighting for gender equality every day in every situation you are in. At work, at school, in your community, with your friends and family, and in politics.

Speaking of politics, I can’t help but go there. While nearly all the female candidates for president have suspended their campaigns, I wonder if I will see a female president in my lifetime. I truly want to believe it’s not if, but rather when. As one of those candidates, Senator Elizabeth Warren, met thousands of young girls across the country, she used the phrase “that’s what girls do”. Meaning, they run for president. She made a pinky promise with them that someday there would be a woman president.

Several well qualified women ran for president. Why they didn’t get enough support to win the nomination is not one common story. But I do believe they were all held to a different standard than the men running – as women often are. For one, there’s the notion of “likable”. Something that doesn’t get asked about male candidates.

I’ve read many articles and analysis about Senator Warren who appeared to have the best chance at the nomination. I’ve heard stories that a high percentage of people said they would vote for a woman but they didn’t think their neighbors would. That old self-defeating thinking. Men are often judged on their potential while women are often judged on their performance. Can enough people picture a woman president to someday make it a reality?

Like many women, I’m tired. Continue reading →

It’s handoff time again

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This week I will do a handoff to the new Chief Technology Officer (CTO) at the University of Vermont Health Network (UVMHN), Seth Maynard. I’ve been serving as interim CTO since late May of last year. Seth recently served as CTO at Yale New Haven Health System and is ready to take over from me. We have already had several transition conversations, but we have plenty more to cover in the coming days as part of the handoff.

Anyone who has relocated to join an organization at a senior management level knows there is much to learn. It’s a new market, a new organization, a new set of leaders, a new team, a new culture, a new set of projects, and new issues. Yes, there is much similarity between health care organizations, and you have your experience and knowledge to draw on from the past. But the learning curve in a new organization is still a steep one.

My overarching goal for this week is like my previous interim to permanent handoffs – provide as smooth and comprehensive a handoff as possible. Ultimately, I’m there to ensure the permanent leader gets off to a good start and is successful. That means:

  • Sharing background information that is most critical and useful passing along as much needed knowledge and insight as possible
  • Conducting the meetings that are a critical part of the handoff including focused time with the management team, an introduction at the monthly all staff meeting, as well as initial discussions with key partner departments
  • Ensuring that together we don’t miss a beat on current issues that need leadership direction
  • Stepping back and letting the new leader start making decisions and address issues providing support as needed

When I started this interim, Continue reading →

Major implementations need experienced leadership

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What CIO hasn’t worried about a major EHR or ERP go live? Despite the years of work by your dedicated and talented team alongside your software vendor and possibly an implementation partner consulting firm, you still worry. The Go Live Readiness Assessments (GLRA) at 30-60-90 days have level set all involved on what is complete/ready, what is on track to complete, and what needs help.

It’s that last piece – what needs help or is significantly behind schedule – in bright red on the status report that requires attention. There could be many reasons it’s red, but bottom line it is red. Do you have enough of the right resources and enough time to get it done? Do you have to adjust scope? Do you have to put more money into it? You certainly don’t want to sacrifice quality. And with the scale and complexity of most major implementations, you don’t want to move the go live date. Any good project manager knows that those are the only four levers you have – scope, quality, money, and schedule.

Everyone who has done this before tells you that there will be some yellow and red areas yet at the 30-day GLRA. But they should be minimal and able to be addressed in time for the go live.

If you have a major implementation in 2020 and don’t have an implementation partner or lack full, unbiased confidence in your implementation partner, you might consider a little more help in those final 90-120 days. And not just more staff resources. As the CIO, you may need to bring in an experienced senior IT leader who can assist you by doing a quick project review and risk assessment. Someone who can identify the key areas you need to focus on and if needed bring the expertise and leadership to address them in time for a successful go live. Someone who, at a modest cost, will help you sleep better at night.

At StarBridge Advisors, we have a team of senior IT leaders serving as advisors who have significant experience leading successful implementations in all sizes and types of healthcare organizations. We know what can go wrong and how to avoid it. We know what it takes to be successful. And we will tell it to you straight. Our approach is practical, unbiased, open, and plain speaking. We offer you frank and honest opinions based on real-world experience.

If you have a major implementation in 2020 that you are worried about, let’s talk.

Related Posts:

Plans, processes, people: lessons from a successful EHR implementation

Epic Go Live – report from the field

9 Tips for Go Live support success

10 best practices for project success

10 Go Live Command Center lessons from the field

Crunch time and why IT matters

Bridging the gap with an interim leader

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My husband and I have both served in interim roles this year. Tom left IT in the mid-1990s to become a Unitarian Universalist minister. He is now a retired minister who does a lot of guest preaching and writing and is very active in our denomination nationally. He did part-time interim ministry at two different churches in our area this year. The first was for 3 months early in the year, and the second was for 4 months this Fall. He was filling in for ministers who were on sabbatical. His role was to preach and lead worship on Sundays, work with the board and staff, and be available as needed for pastoral care.

Compare this to the interim CTO engagement I’ve done since late May. A full-time role keeping infrastructure projects moving forward, helping to ensure a successful Epic go live, dealing with day to day issues, and helping recruit the permanent CTO.

Interim leadership roles take different forms. They range from “keeping the seat warm” to turnaround situations where significant change is needed. Regardless of the role, an interim needs to be able to confidently step into the role, build relationships, gain respect, and get up to speed quickly. Continue reading →