Agile (adj.)- able to move quickly and easily. Agile is a word that has been thrust into every industry during the last year, thanks to the COVID-19 pandemic, and healthcare is no exception. Healthcare operations as we knew them had to be drastically changed in short order, while guidelines and new information was being provided on a daily basis. Healthcare systems were faced with multiple issues ranging from workforce and ICU bed shortages to patient care constraints, supply chain issues, and revenue challenges. Healthcare systems had to be agile and adaptable to changing guidelines or they would crumble.

To combat workforce shortages, hospitals had to redeploy their staff to areas of need, such as the intensive care unit. To achieve this efficiently, the Cleveland Clinic divided its workforce into 3 groups.¹ One group consisted of providers that could be re-assigned, one of nursing staff that could be trained to care for COVID patients, and one group that could help with everything else (e.g., setting up testing sites, building screening, etc.).¹ The system would pull from these 3 pools to staff appropriately. To remedy ICU bed shortages, hospitals set up triage sites in non-care facilities or parking lots and converted facilities to specialized units. Reid Health, in Indiana, for example, converted the urgent care to a site that only treated respiratory illness.² Cruise ships and hotels were also options to set up as care facilities.²

Due to the contagious nature of COVID-19, personal protective equipment (PPE) became a scarce commodity. From June 2020 to March 2021, surgical mask usage tripled and gown usage doubled.³  Healthcare systems had to adjust their inventory management system to monitor their PPE inventory and procure a robust supply chain through multiple suppliers, including the federal government that could accommodate the increased demand. They were forced to stockpile PPE and now the average hospital has about 200 days of N95 masks on hand.³

Patient care for traditional patients also had to be modified. Telehealth increased almost 300% compared to 2018 numbers.⁴ People were hesitant to leave their homes, even for doctor’s appointments; virtual appointments became a primary option for patients to still receive the care they needed. Health systems had to decide quickly on their preferred telehealth platform and implement it into their offices. The data suggests that health systems did a great job at adopting technology to provide a positive patient experience. NRC Health data showed 92% of patients surveyed gave a positive result of their virtual health care experience.⁴

With the adoption of telehealth, came the discussion around reimbursement. Given the circumstances, CMS and private payers addressed reimbursement for telehealth visits and provided incentives to health systems to utilize technology for patient visits.⁴ CMS and insurance companies were not alone in having to be agile financially. Health systems had to adapt in real-time as well. Increased spending on PPE, new sites of care, staffing, and technology, all while patient volume was lower, created a financial struggle in traditional budgets. Jenny Alvey, the senior vice president and CFO of Indiana University Health states “To me, agile planning means taking a continuous planning approach, which grants flexibility to better leverage resources, take advantage of new opportunities and realize returns from investments sooner”.⁵

The COVID-19 pandemic put health systems to the test. They were tested on staffing, supply chain, technology, and financially. Although systems across the country were burdened to handle an extraordinary circumstance, the agility and resilience of health systems and the nation is something to marvel at.

Resources

--Adapted from “Resourcefulness: A Key Leadership Skill,” Healthcare Executive, Fiona Libsack, FACHE, Chief Development Officer, Great Plains Health, North Platte, Nebraska

As leaders, we are called on to pivot quickly in a crisis—often more rapidly than we are comfortable with—finding new ways to meet goals and encouraging adaptability among team members. Now more than ever, it is the skill of resourcefulness that can provide value to organizations and drive leaders and their teams to a higher level of success.

In times of crisis, resourcefulness is even more essential. In November 2019, Great Plains Health experienced a cyberattack that shook the organization at every level. The 116-bed, independent health system was fortunate to have good leadership and expertise in its information systems department, medical staff, and the senior leadership team to guide the organization through the incident. Successful handling of this crisis also came from the resourcefulness of its leaders.

The Great Plains Health team showed resourcefulness largely by leaning on the relationships and trust it had previously built with regional and national experts on its EHR, security and software suppliers, insurance carriers, media, physicians, leaders of other health systems who had experienced similar cyberattacks, and many others. Without strong relationships and the ability to weave those relationships together in a meaningful and effective way, the health system’s cybersecurity incident could have been catastrophic. Intentional or not, the work that went into critical relationship-building before the crisis even occurred strengthened leaders’ resourcefulness skills and became invaluable in a time of need. Relationships are an essential component of resourcefulness, and leaders are advised to spend time developing them.

Just three short months later, the COVID-19 crisis began to emerge. The healthcare organizations managing this crisis well are those who have strong, resourceful leaders in place. They own their roles and the outcomes that they can directly affect through effective accountability. They plan ahead using good time management practices and develop game plans for varying situations by effectively pulling together stakeholders and facilitating discussion and quick resolution.

In the early days of the COVID-19 surge, the Great Plains Health team quickly realized it would need to rely on a different way to deliver patient care. Telehealth was the answer, but it took a team willing to be open-minded to a new and different way of delivering care to pull it off. It also took a team that had strong, existing relationships with physicians, outreach clinics and hospitals, patients, and telehealth vendors.

Throughout the COVID-19 crisis, it has been resourcefulness that has allowed the health system’s leaders and team members to stay nimble and find workable solutions to many challenges. When the organization was short on masks, it figured out how to set up a reprocessing center. When it struggled to secure face shield shipments, it collaborated with local schools and libraries to use 3D printers to make its own. When hand sanitizer ran low, the health system worked with local liquor distilleries to find an alternative.

Leaders at every level can also enhance their resourcefulness skills by taking on projects or assignments that require them to stretch outside their comfort zones, working specifically in the areas of relationship-building and problem-solving. Leaders can also strengthen their resourcefulness by scanning industries outside healthcare for creative solutions and new ideas. Surrounding oneself with intelligent people at all levels and from many different disciplines to create contacts that can be called upon in a crisis can help a leader become more resourceful. Finally, senior leaders can identify resourcefulness in emerging leaders and help them grow this skill so it can be naturally drawn upon during a crisis.

Resourcefulness in leaders emerges when they do the following eight things:

When healthcare executives cultivate the skill of resourcefulness, they become better leaders and ultimately create better outcomes, especially in a crisis. When healthcare leaders get better at being resourceful, the field as a whole improves.

On March 2^nd, 2021, MCACHE hosted a wonderful event that really gave participants a glimpse into the disparities of care, as found by the Michigan Coronavirus Taskforce. In addition, participants were also able to learn more and discuss in more detail what that means, and what healthcare professionals and organizations can do to mitigate and improve on those disparities.

The event was moderated by David Brooks MHSA, FACHE, Chief Strategy Officer at Patient Education Genius, with the panelists being 3 great leaders of the Metro Detroit Healthcare Community and fierce advocates for better care: Dr. Asha Shajahan, MD, MHSA, Attending Physician & Director of Health Equity and Health Disparities, GME at Beaumont Health, Denise Fair, MPH, MBA, FACHE, Chief Public Health Officer, Detroit Health Department, and Denise Brooks-Williams MHSA, FACHE, Senior Vice President & Chief Executive Officer North Market, Henry Ford Health System.

Denise Brooks-Williams started the event by providing an update from the Michigan Coronavirus Taskforce on “Understanding and Addressing Racial Disparities Associated with COVID-19 in Michigan.” The findings did indeed showcase how the communities of color were impacted disproportionally by the pandemic. This task force was put together in April of 2020 and the work focused on areas and actions that would change the impact of the pandemic on these communities such as increased testing, free masks, push to improve data quality to address the disparities, outreach, and focus on communication, etc. The impact was equally impressive, as the work did manage to change the curve, deaths have diminished, and the rate of death is now proportionate to the overall population. This really emphasized how crucial testing, access, and equity really impact the health and death in our communities. The next steps in the work of this task force include high-priority initiatives and broader themes that will be identified and addressed (ex. cultural education sensitivity, telemedicine access, etc.). Vaccine strategy is also part of the work; the group is focused on ensuring information is transparent and accurate so to boost public trust. The Taskforce was lauded as a success, a group that was put together by the governor, not just for optics, but truly did a lot of work to address and improve outcomes.

Dr. Shajahan spoke of her own experience as a frontline provider during the pandemic, but also the work that Beaumont Health is doing to address gaps in care. She also touched on the importance of Implicit Bias Training, how important it is for new and existing providers in order to better understand different segments of population. Denise Fair spoke of her experience as a very new Chief Public Officer for the city of Detroit, and how the start of the pandemic coincided with her being new in the position and having to learn from the experience.

The discussion wrapped up with some insights from the speakers on the future, as the state begins to reopen with increased vaccination rates. The event was very well attended, and the participants did ask a lot of great questions. We look forward to the next update from the Michigan Coronavirus Taskforce on a future similar event!

MCACHE was delighted to have a C-Suite conversation with Luanne Thomas Ewald, Chief Operating Officer, FACHE, M.H.A., of the University of Michigan C.S. Mott Children’s Hospital and Von Voigtlander Women’s Hospital on March 15, 2021. Luanne covered a variety of topics from the best career advice to how feasible work-life balance is for a C-Suite. One of the few positive aspects of the global pandemic is that the MCACHE networking event Conversation with a C-Suite was held virtually, which allowed triple the normal attendance. Below is a synopsis of the conversation and her valuable advice.

On Wednesday, April 14^th, 2021, seventeen emerging leaders came together to participate in a virtual evening of friendly trivia competition. Participants included administrative fellows, graduate students, and other early careerists from across southeast Michigan.

Hosted via Sporcle, a dedicated virtual host ran through trivia questions ranging from topics such as the World Series, quotes, and Disneyland. Everyone had a blast showcasing their random knowledge! With pandemic-themed team names, it was ultimately the team We Get Locked Up, But We Get Up Again that prevailed as the winners by nailing the final question on bands from the 1980s.

After the round of trivia, participants had the opportunity to network with one another virtually. Keep an eye out for more details on our next Emerging Leaders Professional Development and Networking Event which will be occurring in July 2021 – it is tentatively being planned as an in-person meetup as we hope to take advantage of the warm weather and increased vaccination rates!

The Midwest Chapter of the American College of Healthcare Executives provided its members with a 1.5-hour face-to-face virtual program on April 15, 2021, entitled “Population Health Focus on ER/Hospital Programming for Addiction and Opioid Intervention.” The program focused on the concerns of addiction and opioid health issues that hospitals and similar community-based outpatient clinics are facing in today’s healthcare delivery. Healthcare providers continue to see addiction and opioid problems with individuals in Emergency Room (ER) settings across the spectrum of life, and mechanisms for immediate response as well as community resources to address these issues were discussed.

The objective of the program was to assist participants with understanding the resources available to support providers in ER settings to address addiction conditions for patients. Three exceptional panelists along with the moderator provided informative data and resources that helped leverage public resources and community agencies to support the care of patients with Opioid Use Disorders (OUD).

MCACHE was successful with engaging four professionals whose work experience involved the core subject matter on a daily basis. The Panelists were Dr. Eve Losman, MD, MHSA, Assistant Professor from the Department of Emergency Medicine at the University of Michigan, Beth Schweitzer, MPH, MCHES, RN, Health Commissioner from the Seneca County General Health District, and Dr. Eric Zgodzinski, DrPH, MPH, RS, CPH, Health Commissioner from the Toledo-Lucas County Health Department. Our Moderator was Dr. Keith Kocher, MD, MPH, Associate Professor of Emergency Medicine, and the Director of Michigan Emergency Department Improvement Collaborative (MEDIC).

Dr. Losman began the presentation discussing the main concerns that emergency rooms face with opioid patients after initial introductory comments from Dr. Kocher. There are so many variables that providers face in these situations and resources must be available to offer clinical as well as emotional and behavioral support. There are many agencies that can support these individuals with addictions. Beth and Eric, as health commissioners, further identified community resources that are available in both rural and urban communities. A robust question and answer timeframe concluded the evening’s discussion with how public health and community-based health services must work in tandem to address the opioid crisis and patient care.

The word volunteer is defined as “a person who undertakes or expresses a willingness to undertake a service or to do something” -- a similar definition could be used for leadership.

Enhance your membership experience by being actively engaged in YOUR MCACHE Chapter. Your strengths, skills, and competencies are invaluable in helping to elevate the Healthcare Executive profession, and volunteering is a great leadership development tool and way to connect with others.

Complete the Willingness to Serve Form if you'd like to volunteer!

Not quite sure yet how you’d like to help? Send a note to mcache@achemail.net. — we will work with you to find the perfect fit.

If you are interested in information about becoming a Fellow, click here or register for the virtual Advancement Information Session on June 23 at 4:30 p.m., click here.

As one of the leading non-profit and Catholic health systems in the U.S., Ascension is committed to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. In FY2020, Ascension provided $2.4 billion in care of persons living in poverty and other community benefit programs. Ascension includes more than 160,000 associates and 40,000 aligned providers. The national health system operates more than 2,600 sites of care – including 146 hospitals and more than 40 senior living facilities – in 19 states and the District of Columbia while providing a variety of services including clinical and network services, venture capital investing, investment management, biomedical engineering, facilities management, risk management, and contracting through Ascension’s own group purchasing organization. Visit www.ascension.org.

Select Medical is one of the largest operators of critical illness recovery hospitals, rehabilitation hospitals, outpatient rehabilitation clinics, and occupational health centers in the United States based on the number of facilities. As of June 30, 2020, Select Medical operated 101 critical illness recovery hospitals in 28 states, 29 rehabilitation hospitals in 12 states, and 1,757 outpatient rehabilitation clinics in 37 states and the District of Columbia. Select Medical’s joint venture subsidiary Concentra operated 522 occupational health centers in 41 states. Concentra also provides contract services at employer worksites. On June 30, 2020, Select Medical had operations in 47 states and the District of Columbia. Information about Select Medical is available at www.selectmedical.com.

With more than 30,000 employees, Henry Ford Health System is the fifth-largest employer in metro Detroit, and among the most diverse.  For more information, please visit https://www.henryford.com/

Blue Cross Blue Shield of Michigan, a nonprofit mutual insurance company, is an independent licensee of the Blue Cross and Blue Shield Association. BCBSM provides health benefits to more than 4.7 million members residing in Michigan in addition to employees of Michigan-headquartered companies residing outside the state. The company has been committed to delivering affordable health care products through a broad variety of plans for businesses, individuals, and seniors for 82 years. Beyond health care coverage, BCBSM supports impactful community initiatives and provides leadership in improving health care. For more information, visit bcbsm.com and MiBluesPerspectives.com.

The HCS Group is Michigan’s premier provider of mobile imaging services. Based in Plymouth, Michigan, and established in 2005, The HCS Group offers clients comprehensive management solutions along with unparalleled value in the delivery of high-quality imaging services. Our turnkey resource management team handles everything from recruiting top-notch technical staff to comprehensive marketing and sales services to patient scheduling. Under The HCS Group umbrella we have also established IntelliAuth360 which provides insurance pre-authorization, Ultra-X Imaging which provides mobile x-ray and ultrasound services, and Options Staffing 360 which provides supplemental staffing services for the healthcare industry.

At The HCS Group, our culture drives our strategy. We are committed to creating a culture that focuses on people, passion, partnership, and performance. Selected as a Detroit Free Press Top Workplaces, for the past four years, we are grateful for our employees and the commitment they have made to providing exceptional service. To find out more, please visit us at The HCS Group.com or check us out on social media at The HCS Group Facebook and The HCS Group Linkedin.

HED is an architecture and engineering firm with offices in eight cities. We have a reputation for design excellence, believing that all the facets of design must create a positive impact. Nowhere is this more relevant than in the delivery of world-class healthcare environments, which demand continuous learning, adaptation, and experience—along with constantly navigating the complex healthcare landscape. From evolving treatment modalities and changing healthcare laws, to strict building codes and funding uncertainties, we guide our clients to deliver exceptional patient care through excellent design. To learn more, visit hed.design

As the nation's largest health care-focused law firm, Hall Render is distinguished by our attorneys' extensive knowledge and experience. Health law attorneys across the country provide organizations in the highly regulated health care industry with full-service legal representation. Commitment and experience complement the firm's understanding of the evolving landscape of today's health care industry, distinguishing Hall Render as one of the nation's preeminent health care law firms. www.hallrender.com

Johnson & Johnson Health Care Systems Inc. (JJHCS) provides contracting supply chain, and business services to customers of the Janssen Pharmaceutical Companies of Johnson & Johnson including hospital systems and group purchasing organizations, health plans, physicians, specialty pharmacy providers, distributors, and wholesalers, pharmacy benefits managers, long-term care providers, employers, government payer programs and government health care institutions. jnj.com

Patina Solutions Group is a non-traditional consultancy specializing in outcome-driven solutions for complex issues in Healthcare across Operations, Revenue Cycle, Technology, Interim Leadership, and Executive Placement. Patina is delivering compelling engagements across its 11 offices in the U.S. patinasolutions.com

Established in 2015 under The HCS Group umbrella of companies, Ultra-X Imaging is Michigan and northern Ohio’s comprehensive solution for mobile diagnostic imaging services. With its office in Southfield, Michigan, Ultra-X Imaging can perform diagnostic imaging health services for skilled nursing facilities, assisted living facilities, and in the comfort of the patient’s own home.

Recognized as the most efficient and reputable 24/7 mobile x-ray and ultrasound service, Ultra-X Imaging has achieved “Triple Aim” (enhanced patient satisfaction, improved quality through better coordination of care, and reduced cost) by working with local health systems. Our UlltraLynk® systems improve quality by comparing images throughout the continuum—eliminating ER visits and readmission as a result. Since its development, Ultra-X Imaging’s culture which is founded on people, passion, partnership, and performance has landed it on the Detroit Free Press Top Work Places for the past four years. To learn more please visit us at Ultra-X Imaging or visit our social media at Ultra-X Imaging Facebook and Ultra-X Imaging Linkedin

Medija Shaska, Communications Committee Chairperson mshaska1@hfhs.org

Joe Colombo, Communications Committee Co-Chairperson joseph.colombo@ascension.org

Susan Stokes susan-stokes@comcast.net

Caitlyn N. Hakim caitlynhakim@gmail.com

Contact MCACHE: mcache@achemail.net