Insights for Hospital CEOs during COVID-19: Be calm and confident

By Don Smithburg,  SVP Hospital Operations for CHC & Interim CEO for Rehoboth McKinley Christian Health Care Services

Facing uncertainty has become a fact of life for all Americans in the midst of COVID-19. Pundits say one thing, public health agencies say another and elected officials send divergent messages. In the healthcare space, hospitals have been competing for PPE and seeking expert advice for treatment protocols. We have all struggled with the scale and scope of the pandemic, which has strained our healthcare organizations and created economic hardship for people and organizations across the country and around the world.

The challenges also present an opportunity to lead. Hospital leaders are facing the ongoing challenge of remaining focused, operating efficiently and maintaining worker morale. There are several best practices for leading effectively amid this health crisis.

Call upon other experiences. Leaders can draw from some relevant experiences — regional disasters such as hurricanes, tornados, fires, floods, nuclear reactor explosions, and gun violence. No one should ever minimize the impact of these cataclysmic events, but these crises also call us to be our best. Moreover, these disasters give us a model for how to lead during a time of crisis. Hospital leaders can all put best practices learned during other challenging times into action now, when the crisis we face is larger than ever before experienced.

Stay true to your purpose. Above all, hospital leaders are institutional stewards called to fulfill a patient care mission regardless of societal issues. Despite the unique mystery and unknowns surrounding the coronavirus, current times call for CEOs to be steady. We must set the tone.

Identify reliable team members. Disasters often reveal who we really are. In tragedy, the strengths and weaknesses of leaders and “doers” become apparent; history teaches us that some who are designated to fulfill specific duties during a disaster rise to the occasion, and some regrettably do not. As a CEO during mass casualty and destruction events, I learned to realign and streamline my team to reflect those most reliable, beyond the incident command team with their own clear duties. For example, the Supply Chain Manager and CNO were built for crisis response and rose to the challenge. Our team also handpicked medical staff and clinical team members who could and would handle the situation with professionalism and skill. These key people became the go-to COVID-19 clinical advisors, regardless of their official position. Together with the admin crisis group, it was our responsibility to inspire strength as well as get things done.

Establish back-up plans. It’s important to consider that the virus also can sideline leaders. Household members and other loved ones may get sick given the pervasiveness of COVID-19. Therefore, the “kitchen cabinet” of crisis leaders should also inspire the value and maintenance of work-life balance during these unprecedented times. Invest in deeper ranks of the workforce by developing a formal succession plan. That process itself is an opportunity to celebrate the confidence the leadership team has in other staff to step up when called, while allowing for personal sick leave when needed.

Top leaders must stay fresh, focused, and inspirational; self-care is key. The most effective way to stay on task is to get adequate sleep. As leaders, we quickly become ineffective, or worse, if we overwork and under-prepare. Rest is vital to maintain performance. Once your support team is identified, tasks can be delegated.

Communication is key. A communications strategy is also essential. Keep all internal and external stakeholders informed about relevant facts, and if possible, coordinate messaging with other healthcare entities to maximize impact. Leverage the media to help push out hospital information and updates. Operationalize the governing board to be community ambassadors by providing them specific messages to communicate. The most effective role trustees can play during a crisis is to follow the CEO’s lead by reinforcing the hospital’s essential message to the community.

Stay open to new ideas. If there ever was a time for innovation, the pandemic presents a just-in-time opportunity. Leaders should allow themselves to be open to ideas that have been incubating yet not aggressively pursued. Telehealth is perhaps the most vivid example, as this patient care technology stretched more quickly and effectively than previously thought possible. Innovation can also apply to seeking affiliation opportunities with other providers and institutions that may provide beneficial long-term partnerships borne out of necessity. Mutual aid agreements can be the foundation for such multilateral relationships. The virus is pervasive, so fighting it should similarly be an allied effort.

Think long term. While long-range planning may seem irrelevant, there are strategies to consider based on likely market changes resulting from the pandemic. We know, for example, that local and regional economies are devastated. The unemployment rate is high; the service sector is sagging and manufacturing jobs continue to wane. Obviously, this translates into, among other things, higher uninsured rates in the population.

Payer mix is likely to take a negative shift. Acknowledging and planning for this change will reduce the negative impact to your facility. Moreover, planning for service line adjustments, such as expanded virtual care, is important. For some institutions, developing financial exigency plans is relevant. Many facilities already on the financial brink before the pandemic could not survive long when operating rooms were suspended and other virus-related changes were required. As a result, strategic planning remains an imperative while, at the same time, leadership deals with the crisis here and now. In effect, we are called to change the flat tire while continuing to drive the car.

Find support. Lean on CHC Consulting, an organization offering a robust set of tools to guide, monitor, and pursue financial and regulatory priorities regarding COVID-19. CHC Supply Trust has focused on PPE needs and other critical material during the pandemic, including finding alternative supply sourcing to bridge gaps. Similarly, CHC clinical and operations teams are helping hospitals explore alternative care models.

As hospital leaders, we are not alone. There are learned lessons that are instructional. Moreover, there are shoulders to lean on.

Don Smithburg joined CHC in 2019. Formerly, he was CEO of the LSU/Charity Hospital System in Louisiana during and after Hurricanes Katrina and Rita. He has published and spoken extensively on disaster management.

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