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Bill Klaproth: SHSMD members play a critical role as to the organizations and communities they serve. This special edition of the SHSMD med podcast as part of the COVID-19 Conversations series featuring members’ stories and resources in an effort to provide insight into how some organizations are managing this unprecedented crisis.

Diane: Well, welcome everyone. I'm here with Lisa Crockett. She's the Executive Director of Strategy and Planning at Providence Saint Joseph Health in Olympia, Washington. Hello Lisa.

Lisa Crockett: Hello Diane. Great seeing you.

Diane: You too. I'm so glad that you're able to carve some time out in your day to be with us today. We're really interested in capturing the planning standpoint in what has been a very difficult situation for the entire country. We know that your area is one of the first to be hit and we just would like to hear a little bit about your story. Maybe start telling us basically what stage you're at right now, if you can, in the evolution of COVID in your community and the area that you serve and how you're all doing right now.

Lisa Crockett: I appreciate you asking Diane you know, in some ways it's hard to describe what stage we're at. So from my role serving with Providence Saint Joseph Health, while I live in the State of Washington, which has the very first COVID case in the country within my role, I have to think seven States wide cause Providence is serving in Alaska and Washington and Montana, Oregon, California, Texas and New Mexico. And so every location is having a slightly different experience. And so certainly volumes have been high within Washington. We've seen that. But things are starting to improve there. I think that we're cautiously optimistic that we are seeing a flattening of the curve and you know, and I take it as a sign kind of positive reinforcement that decisions that were made early on are making a difference and that we need to keep going with that.

But I also know that some of our areas may still have some heavy days yet to come. But you know, from my role within strategy you know, one of the things that I would want to share with you is just how impressed I have been by the resiliency and the steadfast this of not only our organization but really healthcare across the country. That when I talked to other SHSMD colleagues in other States, we're all in very similar places of essentially faced with an unprecedented situation. And yet we're responding to what's in front of us. We're using our skills and abilities every single day to make a difference. And it's pretty impressive when you see the way in which the full US healthcare system is rallying around this situation. And so while there are definitely, there's definitely long days, there's also a lot of things where I take a lot of hope and inspiration that this is what we were called to do.

There's a reason that we went into healthcare because we wanted to make a difference. This was our calling and now we get to share that calling and experience with so many more people. The eyes are on us healthcare right now. And we have a chance to tell our stories to explain what this is like on the front lines to be able to form strong working relationships with other partners in the community with our patients, with their families. That's really incredible. Not always have we had this sort of platform or opportunity that has been so front and center for us to say we're all in this together. And now we get to bring together those stories and be united as one. So long as we have that platform and eyes are on us, I want to make sure that we're reaching out and we're connecting with people like never before.

Diane: Yeah. Yeah. And some amazing work that has been done. And thank you for what you and your teams have been doing to be so resilient in these times and you're right, we're seeing it across the country. So impressed with that human spirit and energy that people are just harnessing to get through all of this. Do you think that that change in perception that is, it's palpable across the country right now is something that is with us for a longer term than just for COVID now? Do you think it's going to have a lasting effect?

Lisa Crockett: Well, I certainly hope so. So that's one of the things that as I look beyond just the COVID situation in front of us, I hope that there are lasting impacts around some of these new working relationships and partnerships that have been forged that you see people stepping up to be united as one, but we're sharing resources and best practices and knowledge transfer at a rate that I'm not sure that I have seen at other times in my healthcare career. That people are so willing to share what they're trying within their teams, what's working, what's not working, how we can truly learn from one another. And so I hope that looking within the realm of healthcare strategy, healthcare industry at large, I hope that that sort of partnership continues because I think that there's just so much knowledge and incredible work out there. And yet sometimes we forget or we take for granted what is truly only an email or a phone call away of reaching out to people who are experts in the space that we are not in this alone either. We're surrounded by people who are doing what we're doing day in and day out as well. So let's feed off of one another.

Diane: Can you name a couple, two or three of the most critical partnerships that were forged to play, to support you in COVID?

Lisa Crockett: So I think that there's been a few things as I look at Providence Saint Joseph Health and some of them have been I would say slightly more uncommon or atypical partnerships. So I look at the relationships that we have with local manufacturing companies. There's a furniture manufacturer here in the State of Washington that has come into partnership with Providence and they're making masks for us. You know, that's a resource that's obviously we haven't had to go to in the past. And yet there's now this very tight collaborative effort to make sure that our employees have the PPEs that they're needing. And so I think, you know, just looking creatively at when we have challenges like this, what are some of those other places that we can turn for solutions beyond what might normally be in our go to list within our Rolodex or email?

I think too that you know, from a knowledge transfer standpoint there's a lot of colleagues within SHSMD and beyond that I think communicating with over the last number of weeks and they have been very open to sharing their communication tools. They're you know, whether it's certain podcasts that they have tried or even simple policy. So, you know, we're now to this space where we're having to have employees work from home. What good communication tools does everybody have around doing that so that we're not having to recreate the same thing. So, you know, whether we look at the atypical partnerships or the more common ones, I think what we're finding overall is that there's just a lot of knowledge and resource that we can leverage to solving us together.

Diane: Right, right. Well tell me a little bit about what, what comprises your, your planning team. Who works most closely with you and how did your role in their role change at the onset of this and how is it now? So we'll start with when it first started and what you stepped in to do.

Lisa Crockett: Yes, but for starters, I have a very small but mighty planning team. That's the way that we think of ourselves. So there's a handful of us at the system office level for Providence Saint Joseph Health, and we work in partnership with the strategy leaders in each of our regions and down through our administries. But we also have a lot of sister departments or collaborative departments that we work with. I'd say early on in this, my first priority of course is about caring for my team. And I think that that's something that we have to keep in mind is that we have the hats that we wear as strategy leaders and the work that we show up to do day in and day out. But there's also a very personal side to this for all of us. And you know, in healthcare we talk about the importance of whole person care, of making sure that we're caring beyond just the diagnosis or the illness that somebody has, but rather that we see them as a whole person the same way.

That I need to look at them as a whole person and understand what it is that they're bringing into work every day. And so that has led to more frequent team huddles. Where part of that huddle is simply gathering together and saying, so how's your health? How's your family's health and those that you care about? What's a concern for you today? You know, sometimes it's as simple as brainstorming. Has anybody found a place where we can get toilet paper and anti-bacterial wipes that we're needing at home or some of those other basic necessities? But it's always started there, in order for us to be effective in our roles, we may need to make sure that we're whole ourselves. And that my team feels supported and well cared for. I consider them an extension of my family, hands down. And I will hope that my team has seen through this and at all times that I will sacrifice anything to make sure that they are well cared for, that they know that they're loved and supported and that together we're going to figure out how to overcome this challenge that's in front of us.

Diane: Appreciate that so much from you, Lisa, that that is a great way to be a solid leader for your team. So thank you for that insight.

Lisa Crockett: Well, it's about returning to the basics, right? So you know, you care for people first, and love on them. Beyond that you look at your team priorities of what is it that we have to keep moving forward on and what is it that we might need to slow down, pause, delay. And so that was the stuff that we took early on as well, just given within our department of looking at our own operating plan of, you know, obviously we entered 2020 with very different aspirations in mind, you know, like so many people. We had a plan that was clearly written. We had action steps that were all delineated that had names and dates next to them, well I'm pretty quickly that has gone by the wayside. So elements of that that are very important for us. And so being able to work together as a team to say, let's take stock of this plan because there are some things within that that we actually need to speed up on because they're imperative to what we're doing right now.

There are other things that we need to continue to hold status quo on. If we have something that we're producing on a monthly basis, like a metric dashboard, that's still important information that we need to be getting out to folks. And so there are some things we continue to go just as though things were normal. There are other things that are now slowed or paused appropriately so, and some of those things may come back in a few months, but those are things that we'll continue to reevaluate. And then I'd say that there's a small handful of things both within our department and within the organization where we may say, we need to stop all together. This is something that isn't necessarily relevant for us at least in 2020, potentially further on from that. And so, and that's one that, you know, as I take that looking at the impact on like our department operating plan and the priorities that we set each day, I began to then apply that to what we look at within our system strategic plan.

I think that, you know, my advice or counsel for others would be, now's a really opportune time to be revisiting those plans. You should be treating strategic plans as a living, breathing document anyway. They shouldn't be. Something that we create once we admire, we put on a shelf and say, wow, you know, didn't we put together a great plan? They are something that should continue to guide us. But I would argue that every single one of us came into this year with probably a three or a five year strategic plan that was in front of us. Those things were intentionally long-term. And so just because we're facing a challenge like COVID, it does not mean that we throw out the plan wholesale and say, well, you know, unprecedented times, none of this is happening. Instead, what we have to do is look at those strategic plans very much like we did our operating plan as a team. What is it that has to be sped up because it's the right thing to be doing right now and we need to be able to leverage some of those strategies that we were going to be pursuing anyway. What are the things that we continue to March on? What do we slow and then what do we stop?

Diane: Okay. Can you give, that's great advice. Thank you for that. Can you give me an example of something that you may have excelled, that was in your plan that you realized you need to have in place to move forward with now and actually helped the situation kind of helped accelerate that coming to fruition?

Lisa Crockett: Yeah, absolutely. I think the one that's top of mind for me was the acceleration around our telehealth and virtual care strategies. So like, so many health systems across the country. You know, I know that many of us within our strategic plans saw that over time we were going to need to increasingly shift more volumes, more opportunities to serve patients through those digital and virtual platforms. However, this has certainly created a true burning platform right now of, you know, not only is that important, but it's critical. And so being able to quickly stand up some of those resources, I think that we have found that through this perhaps an important lesson learned, that we can be very nimble and very fast when we want to be, when we need to be. And so, you know, what I've observed within Providence and what I have seen from other colleagues across the country is that many of us were scrambling on those digital solutions of seeing that as an avenue of connecting with patients and families in the broader community.

So that we didn't have those folks coming into our emergency rooms or hospitals and instead that we were able to serve them very appropriately for those other settings of care. And so some of the targets that we had set for those strategies, good heavens, we've already surpassed some of our year end targets and where we thought we were going to end up. And that's a really positive thing. And so when I look beyond COVID of, you know, what might stick coming out of this, one of my hopes is that the momentum that we have seen around using telehealth and virtual care visits and some of those digital solutions, that that's the sort of thing that will stick, that this just becomes a new way or an additional way of how we care for people best. But not always, you know, did people have a need to use it. You know, perhaps it was something that they heard about and went, eh, I'm not so sure about doing a virtual visit. I'm not sure what that's going to be like. Now many of them have had that firsthand experience. I think it'll be a while yet before we know how sticky that is, the rate that then return to using virtual visits after they have the opportunity or ability to go back to their primary care clinic or urgent care ERs etcetera. But my hope is that more of that will stay around because that's the direction that we needed to move anyway.

Diane: Right. And with those firsthand experiences, they may now see the benefits that it was really hard to imagine before, but it's crystal clear now, so that's great. So hopefully some the lasting benefits from that. So what were some of the early steps you had to take when the COVID crisis first appeared in your community, and how did you mobilize your team around some of these new tasks?

Lisa Crockett: Yeah, well, I can only speak to what was happening within our department. You know, clearly there were a lot of actions that were taken system wide. This is a prime example of that no one person has all of the moving pieces and oversight for it. And that this is really a time of standing shoulder to shoulder with a lot of colleagues system wide and leaning on everybody's area of expertise, recognizing that we all hold a piece of the puzzle and that together we can form those pieces into the big picture. And so within my team, within strategy and planning, we had a couple of things that we needed to do right away. One is that several of our [inaudible] States. And so as we looked at the prospect of needing to expand care, the beds that we had available in our hospitals, and perhaps look at alternative sites of care or satellite sites, we knew that there were some regulatory things that we were going to need to work on.

Because you know, in our prior state there would have been months of approval processes and applications and things that, you know, frankly, we weren't going to have time to be able to work through in this situation. And so one of our first priorities was taking stock of those situations of what is it that we need to be working on in partnership with our government affairs teams, legal affairs state agencies, you know, people that we work with throughout the year in other capacities? But now it was a time together to problem solve around this particular situation so that we could find a way to get emergency proclamations in place that would allow us to bypass some of those regulatory restrictions that would prevent us from expanding. And so that was priority one of making sure that we were doing our part to ensure that there was capacity to care for all the people who are coming to us.

Beyond that, you know, what I see within strategy and planning is that we've been called on to essentially use the skills that we have in different ways. You know, we're already skilled in planning and project management and analytics and other areas. And so sometimes there were days where we were just doing a lot of ad hoc analytics and data supports for other areas that were asking things like, you know, do we in fact know the number of licensed beds at all of our hospitals and not just our hospitals, but other providers across our States. Of those, do we know how many ICU beds are available? Some of that basic data was information that we needed to have at our fingertips right away so that other clinical leaders and supply chain leaders and other folks could make very informed decisions around some of our next steps. So our team was able to support that work. The deeper that we get in every day presents a new question or a new challenge. And so now we begin to look at things like, what do we have to document for some of the reimbursement channels that we're going to need to pursue either through the State or Federal government.

What does that require? How do we help to ensure that there are structures and plans in place to capture that needed information? So that we can be made whole again or as whole as possible. So it's a variety of different things in which, you know, we come into play and then I think, you know, coming out of this or perhaps even constantly through this, I think one of our roles is about being that voice of calm. The reminder to see the big picture. You know, within a time like COVID, you know, there's always this give and take between the operations and the strategic sides of the organization. And clearly operations has needed to be very front and center, but at the same time, there is that need to look long-term to see that big picture and recognize that, you know, this is not we're not moving away from our mission. We're not moving away from our values, from our vision from the overall strategic plans that we had put in place. If anything, this situation solidifies for us the importance of those, that we find our grounding in our mission vision and values and those plans, recognizing that we're working towards something far greater. And that there's a lot that we don't have to move away from even in some of the frantic pace of the day to day where we're seeing a lot of change.

Diane: Yeah. I could just imagine many of our listeners are feeling the exact same way that this is so important in some very tied to what's critical in terms of values and what we're all about, is organizations and our plan. So, so thank you for that comment. I think it rings true for a lot of us. And I promise to keep this short with you. I was thinking you know, it'd be good to hear what you think the next phase might be as the number of COVID cases starts to reduce, and you're past that local hump that all of a variety of the communities are going through right now. What do you think is next on the horizon? Just start to regain some of that traction with your plan while potentially retaining some of the great accelerated momentum you've had and aspects of your plan.

Lisa Crockett: Yeah, great question, Diane. So I think that there's a few things. You know, one of the things that we're looking at is that you're right, we don't want to lose the momentum that we have gained through some of the strategies that we needed to accelerate. So how do we continue to support the digital strategies or the virtual care strategies that have been really important for us, not just now, but that we see as being pivotal in the future. You know, one of the things that I think folks should be keeping in mind if they're not already, is that we have to look at building solutions for future needs, not just about putting in place solutions that solve for something in the moment. And so some of the things that we're doing now really are ones that support those longer term efforts. What we have to be intentional about doing with our plans though too, is connecting the dots for folks. So as we're taking stock of what we're speeding up, what we're slowing down, we need to make sure that we're explaining the why behind it.

Instead of just assuming that people will connect the dots, we need to explain why is it that certain things are going to remain accelerated? Why is it that some things may change? And that's part of the responsibility that we have a strategy leaders. And also an opportunity to work in partnership with our communication colleagues and others to make sure that those explanations are clear. Coming out of this as well, like we have work underway right now where we're reevaluating metrics that we have and taking stock of do metric targets still hold true. Are there any changes that we need to make or is it simply a matter of doing some action planning around how do we get back on track with some of those targets that we had had? Cause some of them were longer term targets anyway. And so just because this year has been unusual and we haven't been able to do everything that we had in mind, it doesn't mean that those metrics aren't still the right things to be measuring. So we don't want to throw out everything that is good simply because we're facing some challenges.

And so a lot of what we're going to be looking at is how do we remain steadfast in that plan? How do we acknowledge to folks that, yeah, some things have changed. And with that we may need to adjust the timing of certain decisions that we're making or efforts that we're pursuing. And then, you know, how do we work on this collectively together? Recognizing there will be, you know, some people that will still be heads down, focused on operations for quite some time to come coming out of this. Appropriately so, but then there's also going to need to be that shift as we continue to engage in thoughtful, strategic planning as we do every year to say what does need to be refreshed within our plans, both as we consider how to wrap up 2020 in a healthy, productive way. And as we prepare for 2021. And so it's a good time to be capturing the lessons learned now, that we can apply to some of our future plans. But then also seek to understand where are some of these solutions that we're hoping are longer term solutions, where have those had an impact where we can leverage them more? Or perhaps where I've been some areas where we've tested some things and we can simply acknowledge, well, we gave it a try and this may not be necessarily the best solution for us in the future, but at least we had an opportunity to test it and pilot it.

So I think there'll be a lot of, you know, lessons to come out of this. And a lot of resilience for just, you know, planners in general, but we have to stick to our guns of being the ones to look at that big picture. One of the things that I've been coming back to is within the SHSMD bridging world, a document where it talks about the importance of being nimble. That's a, you know, a bubble on the bridging worlds document that could be, you know, perhaps expanded many times over. Because I think that we're getting that test of nimbleness that also comes with balancing it with all of those other areas of focus about how are we not only nimble, but how do we ensure that we're partnering in new and different ways? How do we ensure that we're being innovative, where it's appropriate to do so? And where are we being that voice of reason and seeing the big picture and asking the tough questions? So it's a good time to be testing all those fields.

Diane: Yes. It's obvious that you and your team and your organization has been quite nimble in this situation. So, you know, kudos to you for everything that you're all doing. To end this, I'd like you to think about some inspirational thing that happened as part of this journey you've been on in the past few weeks. And anything that's keeping your spirits up to get through the resiliency needed in this crisis.

Lisa Crockett: Oh goodness. You know, there's so many things. You know, I think one that stands out for me is that, you know, we recently had a Doctor's day and you know, perhaps this year more than others. It was definitely a time where we needed to celebrate and recognize our physicians as well as all healthcare providers. And I had reached out to a handful of the physicians that I worked pretty closely with and one of them sent me back a note and he said, you know, today was a challenging day, but there was no better day to be working in healthcare. And you know, and this was someone who I know that he had been in at the crack of dawn doing incident command center meetings. He was there late at night cause I could see the timestamp on the email when he was sending it and that he was still online. And yet his reflection was there's no better time to be working in healthcare than now. And so there's things like that, just those little reminders every day that just speak to my heart and soul of why I went into healthcare. Why I love doing this work so much. You know, not that we ever hope for these crisis situations, but I think through them we find the real strength of the system and these times where we serve together in these ways, this is where friendships and working relationships are truly forged. Because we've experienced something in deep and impactful together. And I have no doubt that we're going to come out of it stronger than ever before.

Diane: Is a critical moment in time and I am so impressed with how your team and organization is rallying through this. And thank you for keeping the rest the SHSMD members in mind by carving time out for us today. Stay well, stay safe and thank you for our time together.

Lisa Crockett: Of course, you're welcome, Diane.

Bill Klaproth: Thanks for listening and know that we are thinking of you during these unprecedented times per general updates and resources on COVID-19 head to AHA.org/COVID19 and visit SHSMD.org for a collection of specific COVID-19 resources for strategists.