Heroes of Healthcare
Heroes of Healthcare

Episode · 3 months ago

Servant Leadership: A System’s Approach to Crisis

ABOUT THIS EPISODE


Some of the most successful healthcare leaders embrace servant leadership. In a crisis, there’s no better approach for rallying your team behind a cause.

In today’s episode, Dr. Jeremy Blanchard, System Chief Medical Officer at North Mississippi Health Services, explains why vulnerability, humility, and a willingness to follow are vital to effective leadership.

Topics covered:

  • How hardships in childhood informed his leadership approach
  • Using a personal vision statement as a career guide
  • Bringing compassion and care to rural communities
  • Leveraging data and modeling during the COVID-19 pandemic
  • The vaccine push in Mississippi

Heroes of Healthcare is hosted by Ted Weyn.

To hear this interview and more like it, subscribe to Heroes of Healthcare on Apple Podcasts, Spotify, or wherever you listen to podcasts.

You were listening to heroes of healthcare, the podcast that highlights gold, selfless professionals in the healthcare industry focused on transforming lives in their communities. Let's getinto the show, welcome to the heroes of health carepodcast on your host Ted Wayne. Today, I'm joined by a hero who has dedicatedhis life to serving both his country and community doctor Jerry Blanchard isa chief medical officer of North, Mississippi Health Services. DoctorBlanchard has a wide breath of experience. Working as a c Mo in tworural health care systems had a regional and institutional level inWashington and in Montana, most recently he was head of player andfamily wellness for the Alliance of American football, a start upprofessional football league. His experience also include C Mo and SeniorVice President of innovation for language of caring, a culturaltransformation group serving health care systems and individual physicianpractices. He served in the. U S: Army Medical Corps for eleven years,clinically Doctor Blanche's background is as an internist and an intensives inboth the U S Army and in rural Washington. He completed hisundergraduate studies at the University of Montana and his medical studies atthe University of New Mexico. He completed his internship and residencyand internal medicine at Madigan Army, Medical Center and his fellowship incritical care and will ter read Army Medical Center. He has a master'sdegree in medical management from the University of Southern California'sMartial School of business. I know you'll love to hear his passion offaith, family and his community and country Doctor Blanchard and bodyservant leadership and, as you will hear, he gets more done in his daybefore most of us get up. Welcome to the hears of Healthcare Podcast, DrBlanchard. We're excited to have you here this morning. Yeah I'm excited tobe on A. I really appreciate and Moor to be on this podcast just is Hidallo.It's very. It's going to be fun and we're going to get into some greatinformation before we jump in. If you don't mind, would you share with ourlisteners a little bit about yourself? I've, given them your bio background,but I always think people love to hear a little bit more about the personbehind the voice yeah. You know that sort of they do as you think about whatyou want to share with someone or how do you encapsulate your life and and aswe were, having a pre discussion that I, what really popped into my head was inthis whole link back to my hero at end, is you know I probably was born to be aserpent leader I was raised by Sandeman lived in a trailer, for example, when Iapplied to medical school, we only need have enough money to probably the onemedical school my mom and made my suit. You know no win my family evergraduated from college. I have a moonshine runner in my family history,I to my family history and engineer in my family, history, travers and Augers,and all sorts of glue, color backgrounds, and so you know go tomedical school as me on. I think that entered anyone else's Moy I was bornand I was injured with four set, and so I had a physical therapist that tookcare of me, and this was in fourth grade and I had to wear a halo. So ithad a metal band went around my head, it was covered with leather and it hada metal strip that went down to a shoulder part that was attached to aleather chin, strap that was hen cut, so it didn't even look like a footballshin, strap and then bars went down my back around my hips and then connectedunder my arm, and my shoulder now were that every day, every night in fourthgrade I lived in Eureka Montana, which is not a friendly place for guess a kid,that's disabled, but I had this physical therapist. Then, whenever hecame in you never saw that I mean, I really believe we just saw the evanishhim wow. So that's why I wanted to become a physician. I thought he was aphysician, that's what I wanted to do and I think why I was born to be aservice leader is for a long time. I...

...felt really good about my journey. Isort of a claimed independently my success in my jury, but when I thinkthat I mean my uncle paid part of my tuition, my mom told me could beanything you want to be. You know Mabeso, and everything like that. I hadpeople who gave me extra jobs have watched, I sevare, so that I can haveenough money to help my mom and then later to be over way. The army, youknow meet my way through medical school gave incredible training. So you knowit's certain leader which I was not fully developed into, but has to has tolean on others and be vulnerable enough to accept help and empower othersthrough their life, and I probably did that, but it was. It was a crude Solooversion and then I think you call my professional career. So I did mymedical school through the army and I did that. I have a free ride.Scholarship from a NEAT scholarship that I turned down and accepted themilitary scholarship for two reasons- one I believe freedom is a free and Ifelt like that was an important personal decision to be willing to givemy life for freedom. I smelt like the Co that and then the second thing was,is I look to see the level of Ford scores coming out of training programsand the militaris were much higher than many of the academics and I just feltlike I know, I'm not the smartest guy in the room I never in, and I often inthe hardest worker or motten tious or a process at a different level in adifferent way. So I have unique attributes, I'm not being somethingbige, but I'm not the smartest gruner in, and so I knew that you know. Iwanted to put myself in a position to get the best train because we want toget trained once. So. That's why I went into the military I planned on retiringin the military, but my mom got breast cancer and at the time I was running aneural travel research group at rare. I weltered in to search also wasattending both medical surgical, iu in the wards, medical wars and well toread, and then I was attending to Johns Hopkins is a mural period care dock aswell, and when I left that was the first time in my life, but there'sanother episode where people were irritated with me for making thedecision on me. But I was felt like if I ve had a tomb stone and I won'tbecause my wife goes. I literally put my ashes and my favorite rivageprostitution, which me or rotate in listeners, but it's going to happen andbut I wanted, on my tune, stone to say your lines, a good son. Your lie hasbeen your lie: It father your lives of o friend, O big school man, nothingabout being the doctor, so I don't really define myself, I'm a profession.I define myself by my character in my compassion and mind. Take in my courage,because I think I have all this so that was a really important change and Iwanted to open the nice to you for the scratch. I actually have been pursuingthat in the military we were looking at some other options. I college was alittle bit friend of mine who's, pretty high profile and solar opportunitiesare very large institutions to do that. But then, with my mom's politcal change,I really made different encies when I went to a world community in Washingtonbuilt a pretty cal care program with another intensives n and labor a versemanager, and that intense of US left after a couple of years, but that icewent to number one in the nation on quality cost. We had one time sixty, Inurses, with towers turnover at a is I'm sorry how many sixty m wow yeah andwe had wellness bundles in two thousand and nine N. I e you so we really lookedat. How can we meeting a person's wellness when they're admitted so youknow there's a huge boss of strength, an Relyin that so we actually have youknow a dedicated physical, therapist and people say well Gosh. You know Icould get that. Well, I did that be being able to translate the assagiesfrom our length of Statin from caldy...

...care. We delivered from our Turnercrudest. I was able to translate to different audiences to leverage ouropportunities, and so we had. In the end we had five intensives two were toperport certified and Internal Medison Great Fair fetus disease. One wasTRIPARTI. Remember this is a world town,Washington, really true eastern Washington world. He was wort certifiedthe internment, critical care, Polonay and rld critical care, then another one.I recruited, because I believe you can build this Tranto team by looking foropportunity. So she was very fast I with it, and then I had the leadershipinside of the House and we built a nurserie watching her eecitin ALprogram and and many different things. So that was a really incredibleexperience and at the time we were transfering patients out of the IU tothe Hospital of service who had have four different medical directors overthe previous couple o years and were unable to actually recruit to a fulltime musician. They had twenty two fte and you saw full time positions, butonly eleven of them were staffed with whole time. Dogs and the rest werelocals. So they at the time were burning through about five point: sixmillion dollars a year. You know I mossier kinds of things and possiblesand such- and you know at least a lot of money now true talk o thatdifferently, but so I was asked for the fifth time to take over that program.So I took over that program and it specifically remember- and I think thisis part of who I am so that's- why I told me the journey this way, but Ispecifically remember going home to my family because I got off for that jobthat morning, when I was off it the job I actually was when you elect the chiefof staff, we'd never had employed physician, so I was a first on potposition on the medical staff and normally they have a nominatingcommittee and then that person gets approved. It's very rare. They don'twell Mommah on it, medical executive committee and a pediatric Ian Nominatesme from the floor, and so I ended up getting elected instead of a personal,a nominating committee have by one vote with a large hospital, the firstemployed physician, so I was cheapest at the time I had just been made. Chiefof the the Governing Board for physicians. I was handled the criticalcare program head of the hospital was awkward head of hospal pro and justfound out. I got accepted my masters and was a work and then participating in my childchildren's a wife's life. I was really committed to that. So it was a really interesting time. So Iactually let my family vote on whether I would accept that job and I have adaughter with learning disability. So I remember- and I made it cheerful onthis- but I remember specifically her saying- and you know she has he'slearning disabilities and but she's wise to she has a lot of gifts indifferent worlds and I remember Sang Yeah. This is your dream to buy pair and if Ican be part here for me that I want me to do it an excuse me, it was extremelypower Mo my life, I'm sure in sure. So any way I ended up doing that. We turnon the hospitals spoken in in, but when I ate was you know, inducted into thebusiness on or society a never made the medical onor sign to make the businessa society, and then, from that standpoint I saw a decision byPresident of the hospital I thought was egregious, so he created a order. Alean project take place on lock time to the surgeons. Now I was in a surgeon,but I ran I a lot of my clients. A lot of my customers were surgeons andcertain palpations in the CT trauma a surgery, envirements survey, so Ireally, you know, recognize their Aluaro and when he did this, he had tomake the meeting where he could make it,...

...but it was that new and no surgeon canmake a new meeting it just as unfadable to do that. So what happened was. Is itcame a the rock tones without any support from insurgents, except forunemployed classic certain and the certains wet ballistic, and he firedall three of the nurse leaders out of the R and it was really a protectingself kind of move. I felt- and so it irritated me so I went to the CO of thesystem, who I knew well and I said: Hey you know, is he going to be the futureleader here and he said Dan? I think so and then I said well, you know, I don'tknow if I can say that I've created secession, a leadership and I'm gonnago be my masters and I actually approached them previously aboutmasters and said they could increase like contract for three years and theysaid they really weren't interested in that. So I went and got my masters andcame back, and then I created secession leadership. So I left and became a Coand what was your master's in? Was It in hospital administration? No, it's amedical management out. F E us. Okay, then, with an emphasis and Atrim, Iactually built an end. O Live company that took to market and then decided itwas going to pull me out of health care totally into the business world, andthat wasn't ready for that. So I hibernated it, but I gone from all theit stuff proply riding trade parking et CETERA. So I became to see him all upthe Washington and south at one hospital, two hossmen three hospitals,and then I really realized that there was a big difference between leadership.Skill sets at a medical direction level and a at different time lines. Youreally have what appears to be a lot O poorty, like you, have real syroauthority, got a lot in influence and how you develop that influence and suchand we'd ended up, not being a culture that was really very effective for me,but I learned at time it was probably my most accelerated learning point andI've been through a lot of the persite even had the Cadi cadle, where it enthe IU had to get a train, mores in state, a dock and his antecedit. When Ihired it so you know I mean I had had a lot of different stars and in differentsituations. I had you know Rivero actually so through this I don't knowif I thried through it, but I came out of it driving. It grew a lot. My momgot sick again, so I'm gonna come on Tan is and see. If all and in bothplaces I brought in this company called language of carry, the Latae ofcarrying is focused on treating advance communication techniques and the use ofempathy and what it does is. It allows a great intent of what I think allphysicians and nurses actually be felt by the patient, because differentpeople have different skill sense like for me. That was a very I had a veryhigh level of that ability, but I remember the day after I won an awardrelative to that being written up by a family for the first time, never forbeing patronizing, so you know what it. What told me was his is that you needan Armentarius of communication skills to flect to your audience, for them tofeel your grade. In ten and when your great intent is fell by my burnout,because now we goin be gratitude, enjoy a practice and most things that willwhy you a need to help parents so anyway, I've brought in this companyboth of settings are either supported it or brought it in, and it were. Itwas very successful. Pate experience cars went a recruitment when a position,satisfaction with em, and so I really liked it, and so I really was feelinglike I wasn't making a difference I want to make. So I went to the range ofcarry and said Hey. I think you need sea, so I had created eight boxes thatwere each point, two five ftes, so two full positions with a different set ofresponsibilities based on this device called the Compito, and it's a tenNigran that has four circles molasis. You know, what am I good at? What doesthe world need is a second sir of the third is: What can I get paid for andthe Fort? It is. What do I love doing, and so you mind those for your purpose,so I created this job description that they could take these boxes andinterchanging to come up with one FTE...

...and then five salary options withdifferent levels of wrist and said you really should hire because they didn'thave a see a hall. So that's creating your own opportunity yeah. So I sort of learned to do that, becausewhen I was trying to figure out how he could effect the world in a greater waythan as a c Mo initially, I actually decided to reach out to sixteen change agents across the world, whom Iknew who who had heard about or were introduced to me during this process,to ask of what was the most important question. They learned in their tin,their transition, because I was looking for people that the transition in andout of health care to sort of help Pang what would be in part of questions,because I knew the questions I knew and the questions I knew. I was prettycomfortable with the answers, but I knew I had a jacares window withquestions. I had the light Moser, the really important ones, so I had anAustralian entrepreneur. I Have Havre politician and catalamus talent agentat US C, Professor, a change agent, a Isalco Ante Clo, a Dag Farber when theybabecan the wrong people therapy agent and fill the patient. The CIO of hymns,which is you know, the governmental agency that looks at meaning for usewith electronic medical records. So this very broad group of people that Iidentified and I just email them- Co, callan linked in and say. Can I do ahalf hour I and when I did that I got a couple o questions. That M reallyimportant and one question was from Palmas talen agent was, you know, doyou feel that you can change health care for the internal position rig andI knew even as Ye said it was a big note, so that was part of the legamencarrying the second one was a pris prementi chain agent? She said MockGerman you're unique. Your still said. Is You going to think, as you needyou're going to have to create your own position? So you need to figure outwhat you want, then you got to go, get it and I've done this a couple of times.I get eight positions that was, I was the first higher into that world soanyway, so it to lady to carrying and then o behold my friend back to themilitary, who was a high profile. Their intensest was on the the NFLUENCE and lowners. Association had into Injury Committees was also on board and Google,and he got called by joy, Paul Malu and bill polion lawyer, rich shaffer to saywould did they know anybody that would be the right fit as a chief medicalofficer for a new Cote football and troy had this, who you know played withPittsburgh, stealers is in the hall of fame. He does a head and satecommercials. He incredible guy. He wanted somebody really that was goingto create a wellness culture and the AR mission statement ended up being youknow, every player will be treated with dignity, every play in their family. Wetreat with time and support it psychologically, emotional andphysically and spiritually now for the rest of their life. So that was ourvision state and he didn't have that quite articulated. But with me we wereable to articulate that, but he was looking for that person, so in the endof what they did as they actually hired two of us, one that was a sports smoand then I was ahead of the wellness program for the players relations, butI got a cold call from him. Never met him before asking me if I would do thisjob, and so I left language of carry a went to this start up and I've takenforty percent pig cut in my life and a thirty percent take up my life tochoose to do what I felt was fulfilling M to try to change the world, and thenit went to my bankrupt and when they went bankrupt. I really had noopportunity because troy was an incredible, is an incredible leader andI had the opportunity to say you know: I've looked in the wrong place. It's upuntil that point. I had been a start up for a turn around kind of guy. Well,the jobs were never built that way, but the end of a being at, and I decided,I'm not going to take a job, I'm going to take me job, so you know and that'show I ended up in the North Missisipi...

Health Service. If I was aware of it, afriend of mine that died during my search actually was the one who made meaware of the Alpen because of I handed out harkness her us on to Holdridge,and so when you went up all and Ocamo your dark, you put all of your dataonline forms, and so I would, I always go through a ravage, their forms tolook at good programs, or so you yet yether, it's a great model, Sure Yep,and so I had this communication plan from them. A I hand out o places of myfriend linked the two and recommended, so I was actually being interviewed forVirginia Mason. Second Hospital Co. I pulled out of that because I knew Iwanted to be all in or I city health services. So you know I actually boughta house before I was offered the job I put contingencies on it, but theydidn't know, but I really knew this is where I was going to come to and- and Icame here because relationships matter and moral health cares very unique.It's a place where the relationships and the access to health care is oftenlimited and has obstacles so there's this incredible opportunity to createsystems and processes to a servant, leadership approach to power people andthen, when I came here immediately covet hit. So I came here December,nine, two thousand and nineteen, but we came in to January and we and we hadsafety hues and we response going February. Our first station was marchfourteen. What was really interesting to me is when I took this role, youknow the Co knew who it was from the interview, but I mean to see him all. Ihad taken that I I'm sort of a different position. He was a system cowith the primary focuses at our Lake Ship Hospital T. I'm a system seem witha primary focuses assistant, so I have seven hospitals. Forty three clinics offor nursing holds that I overseed penticle and I really wanted that kindof role, but the Co. What he did was still to this day, if I so honored byit and humble by he made a decision to put me in leave for the whole response,and he had only known me for three months, two months and a seven and onone month, if you think about when you started doing that, and that was in theand that was in the middle of Ovid. It was at the beginning and so before,right as it started, and I remember when we were doing an interview at onepoint said you know a really good servant leader anstice a problemsometimes, and that's what I joke to do in Verger I mean it's been a wonderfulexperience, that's the Best Sera leadership or whatever I mean, there'sno greater honor than the leader of the crisis and there's no no model thatwill work well in the crisis, ogresses an ole period of in other than Servinleadership. That pot. We believe that. So you know. That's that's really mystory professionally. My personal story, you know is, I have an incredible life,she calls me everywhere and she doesn't really follow she sort of wants. Insideeverywhere we go she's a great friend, very different than me very quiet, Ogentle fiercely stubborn, which is sort of fun and Otille disabilities of aspretty pocus and Ooma. These incredible unique talents about them, and I justto try to ask whatever in what an amazing story. Man Do you sleep, youknow actually in Yesso, very efficient good, so I get Itry to get at least sit, hopefully seven hours in sleep and if I feel Pire,when I wake up, I sacrifice over other parts of my Love Ness plan other thanmeditation to maintain miles. So I get up every morning between three and fouro'clock, usually at three I do Peleton workouts make my own crying. My own hasto make my o coffee. I do yoga meditation and then I make breakfast mywife and we didn't leave it in the frigerator and then I get to work earlybefore anybody else, because I look like an export or that concess is anIntero. So it's essential for me to in...

...that quiet time, yeah t t that quiettime is critical. So I love your story and I love everything you share, butthus thank you so much. I mean you're and being transparent, but wow what anaccomplishment you've done and- and I know you are a humble man at heart- andso I don't I want to over- but I'd love to just I love to back up a little bitand just unpack some of the things that you shared with us. One of them is soagain first of thank you for your service. You know so thank you forbeing in the military and, yes, freedom isn't free and we have to. We have tobe defending it all the time. So thank you for your service and your timedoing that, but obviously growing up with the challenges that you had. Iactually had a friend when I was growing up who had the similar halothing that you did and his expression was. He said I felt like I was carryingaround a swing set on my shoulders all the time, and he said it jokingly, butyou know B, but obviously it was a hardship for him. So I understand andempathize what you having to go through, but obviously those things when we'reyoung those hardships as challenges we go through and stuff like that becomepart of the fabric of who we are, they develop the character of who we become,and certainly it sounds like that's a big part of your story. So if youreflect back on those times, how do you see that those things helped you? Howdid they help you in the military? How do they help you make the decisions youwanted to make had they help you become a servant? Led leaders that you are?You know we grow from the adversity and how do you look back at that and seethat yeah? You know I no worlds has to quote the hockey and less have the SPand it's you know, adversity doesn't build character, reveals it. I think the stability my mom created in my life rot love in my life,really because my dad was pretty much a smack. I know people don't want to hearthat, but it's a reality. So my mom gave me this stability of you can beanything you want to be that you know how you treat other people is alwaysyour choice and the treatment that you will accept is always your choice. Soyou know I mean we really nos. I just felt like you know it never was goingto be easy. I just knew that. So she said you just have to work hard, ananybody else, so I think what happens since you be when you don't have a dadlike that, and you have a mos like that, but you know I mean she had her on yourshoes going on as well. It was pretty depressed you carting episode to nightmack on thing. I think what you do is you look for people to emulate, so myhome was really good about that. She's. Like I remember, Michael Jordan,article of Michael Jordan mark he didn't make his de. I think his jam,Basketball Team and his brother did- and you know- and so he really you know,we started to work harder, so that was on her frigerator some things like that.But I really look for people who had try and corporate person, and you knowan example that people may or may not remember, is Curandis in the in the NDA,so curt Ramdas play for the Lakers. You know, and you know, Magic Johnson atrakers and Larry Bird Calotin. You know and then the bad boys Detroit it builtan beer. So you know if you look at Bill and beer and you compare them toto her handis grandis had to take gogols. He had you know ankle bracesand he couldn't jump for the dolent he ponce out every time he go on the floorevery time and I just inoui could be the smartest, but you know I justwanted to. I wanted to do the absolute best that I could do and so that sortof men the pattern, my life and then I begin to re, define what that was. Sowhen I got to the to the military, military was very easy from because itwas regimented and I like routine. I knew that routine and consistencyallowed me to perform at my best, which...

...means that a player that have thepotential to be Peter if they worked hard to be deep because it didn't workas hard. Consistency is an effective strategy in many regards and then Ibegan to see Troan. I can't remember who talk this, but that failure withwas a pearl. So, for example, we just did a program.Yesterday we had our last meeting on this program. It was a collegialconsult from for a primary attending who's. Trying to manage an in of lifesituation in was not making headway for them to be able to bounce how it feltand what they were thinking with two of their college. So it really was aconsul aimed the primary attending supported by two of their colleges, andit ended up. It wasn't used the way we wanted it to, and so I remember theteam sort of not wanting to let go wanting to change the scope of what wewere doing, which would be a different project in Sasha. What this is? Yes, wefail, but did we fail? gloriously we developed the process we developmetrics we may Rin. We found that it wasn't effective. It allows us to stopdoing this because it isn't effective and to do something else, but theyreally were ready to stop to something, and so what I realized is when you'reable to do failure and you're able to take risks calculated risk, yousuddenly become very you know there aren't very many of us that are willingto take risks to go into other areas. For me, my creeters, as straight as anArrow, how can I change the world in the maximilist? elately? God is giventhat's my personal mission statement and so for me the overcoming thefailure of wearing a break, so I played football in high school in the end youknow I wore like a big padded thing and the race was following, but I didn'tpay well, but I played football. I played basketball, you know I continuedto pursuee those things and then I develop friendships where they werewilling to be coaches Ay. So I didn't fly fish or hunt till I was older andtheir passions of mine had a best friend. who was writing that way and hetook the time to teach me and then I just study really all and that's whatI've done with everything in my life. So I think you're right that a lot ofmy habits, you know not giving up but beingwilling to change my path to be successful, and then you know, learningthat you know respect and honor and outery cannot be sold. So I amunwilling. If I, if somebody put something is to my bank, I would takeit back, even if they said no just take it. I still would I mean I'm unwillingto sell my honor for any pits really and, and then out of that was reallyhelpful, so that got me to a medical corrector level. What I, what I learnedthen was we just can't work harder every time you just can't take it allon yourself. You actually have to empower others, because it will makethe vision smaller you'll make it smarter vision, and I begin to learn tohave real joy in watching my teammates be successful, it's extremelyfulfilling and then, as I learned, that I realized that I was living a bit of afacade of a life and it's like the inverse clothing Parabol, where theemperor you know is killed all the tailors and last Taylor doesn't knowwhat they can do so the they actually, you know make it invisible outfit,which really doesn't exist right body, so afraid of the import when he puts iton they tell him how great it looks like walks around naked Ike has on thisthis you know beautiful suit. Well, parable of that is you know. I mean, ifyou don't allow other people to influence. You you'll, never know whatyou really look like and you'll be an effective in the stakers. I do and alean vulnerability, which I believe is...

...is one of the greatest stones. Fates ofo Believin, especially a servant her. So I think each of those learnings inchildhood have been Interiere to greater learnings and greateropportunities for S, leadership that wor part ones or what I have to relearnand those happen a lot yeah. So you know I love the fact that you've talkedabout your personal vision statement and I think that that is such a animportant part to act. As you know, as we go through life a bit of a NorthStar, it gives us purpose. It gives this direction. It allows to recenterourselves when we start to get pulled. Potentially off of the thing tell meabout: How did you come up with that and how long ago has that been your?Has that served as your North Star? When did you say you know this is thisis my purpose, and this is where I see it, and this is where it's going todrive my pursuit yeah, I mean, I think you know a version of it developed thefirst time. I met that physical therapist, because really what if I, ifI'm successful making the word lie, means the individuals will feel bybefore they a and that's where I keep talking about the power of that. So Ithink that's that part and then my best friend, the one you taught me out, offly fish and cut. I had landed this incredible job and I can't rememberwhich one was causal I shared in is sad. My Gosh, I got to say Ebil job. What amI going to do now because you know God's giving me a shop howel? I live upto to my potential ten who thinks I have to do you know how will I be goodenough to do this and said he said, Jeremy. I love that you got to get overyourself. You got to have a friend like that. Youknow really just right or your and on over time over the next few years. Ithink it was probably the critical hair position in the next few years. Youknow I developed my intent of this Partha. I said every day when I walkedup unit. That was heard more. Let me be humble, so you don't have to hobblebecause of size and then, as I became Sedalia, I adjusted that, for it washer more. Let me be humble, so you don't have to humble me because ofpaining and help me to learn from my mistakes. Why me teach dot, and I think,as I begin to reflect on that, I realize that my leadership was notabout me at all. has nothing to do with it's reallyabout empowering others, which is really what you know if you think aboutfaith and religion, a matter which you religion, you're talking about? It'sreally about empowering people to love themselves, and for so I went throughthis transition of really learning to love myself, as I am now soil. A stake written in the whole thing,because, if I can do that- and I can take- I would raent ignoring in work-is out. We norit, I really make a difference and then, when I learnedwhen I was a piece of I learned that I processed a introvert. That was a hugestep forward and being Ablle to do that, because now my private time, I sort ofthink of it as being a a look in the year. You know when I go back back andso on, hunting so o an that's not for the you know the fine of part, so youhave to be able to look in the year. If you honestly yourself you on her truand,you learn a about yourself, and so I think I think it's a real interditekind of thing. THAT'S A SOM! No, I think it's a great lesson for all of usright which is, and it is life's a journey. It's not a destination, andyou know along the way we pick up those little pieces and everything. So I lovethat I want to shift a little bit. You know you talked about spending time atWalter Reed. You spent some time at Johns Hopkins, not small institutions,not you know. You know, obviously both with very good reputations, butobviously you have a real heart for the rural facilities. I mean that's whereyou re. It's clear: your passion goes there. You want to serve theunderserved and bring them compassion and care, which is an important thingfor us here at the show and and a lot of places that we go thou that webelieve everybody deserves compassion...

...and care. But talk about that in termsof what did you learn at the Walter reads and the John Hopkins of the worldthat helped you, then, when you said, let's, let's let's get this out andlet's support the rural people. You know what are some of those lessonslearned and what were some of the things that you were able to reallybring to help support the rural communities with health care. Sure Ithink, there's obviously the confidence of training right, like I said youronly train once so. You know what I give my fellowship of all to read andthey ask me to say that was a great thing, because you're working at asuper high level. So you know that only makes you better or more than a Havitin cans, iron, yeah, interesting, lady army s very different than civilianacademic. Is You know to get a military scholarship was extremely competitive,and yet he were a certain amount for certain core values that really wereattracted to that, in other words, the work and so like, for example, I don'thave any friends left for my medical school class, I mean I don't haveanimosity toward on a hat any friends right. I have many friends left from myarmy days. Then it's really that idea of if you would die for your country,if you would die for your brother or sister, you know, or for anybody, andthat kind of thing, and that puts a lot of serious, is in the play, and Ideployed the eight stuff like that. So so I think what I learned there is thepower of a mission, so I actually, but I went to cable. They had a missionstatements, the hospital, nobody knew it, and so I watch I watch people notbe really ITIF and huge turnover prior to that year that we have no turn over.We went through years of thirty five percent if we were rebuilding that. Uand so what I is. I created a mission state, so I learned in the military hadthat omission and it was every page OL receive compassion. I E Hika who's inevident space, medicine and a Tin Howardian. So from that we were able torecruit in the trap to hold people accountable. I was held a capital. Imade the states and teammates call me out, and I have the smolder back andlisten and help us go forward, and so I think that from the military I learnedthe power of mission from John Hopkins, one of the most powerful things I'velearned is: They actually have a step version of nursing advancement in theirunits and they were a Magnan hospital, and I think at the time- and I learnedthe power of developing a culture where nurses wantto stay in the e, because when you don't have to retrainyou don have to read to and it everybody is part of that team of proudof Arati mean we went three years without a Scombri down eventyrassociated Emona, several line infection or Capila associated it, yourInja, you know you don't do that without incredible commitment tometiculous care and yet team work and support, and so from Hopkins. I learnedhow many operational ize team more in a civilian world, and so when werecruited our hush man, if ye we were looking for very specific it. She was acritical hair at all. He was our college, so we had a critical careersmanner, come down comedy and that really was super powerful and then, asI went along, I learned that in a civilian world every voice needs to behurt. Now can happen in the military moral, but it it really is set up in amartial system. So it is in this proto, but in Simian world, if you createspace for all voices to you heard, and you don't have to make consensusdecision, may necessarily I don't believe, but you have to heareverybody's voice and make it clear how you're going to make the decision andwhen you do that people will respect the decision, even if they disagreewith it and they feel their pace. I Er and it's sure, yeah, and so so I feellike that was part of that. wondership ship technique be came into play andthen I think the other part high reliability was developing at that time.I, and what I knew was is there's you...

...know. Plane does not have a personality,it doesn't have a child doesn't have a mother, it is a human. A nuclearreactor. Doesn't have love, it doesn't have to passion, divines ECT, so highreliability is important, but you want to create the space for human variation.Just have the whole people accountable to share. You know why they vary, soyou can improve the process of systems and so that human approach to thatapplying high reliability. That was really present in the military esced ofthe van you know, expectations and then learning how individual input can helpfor that. But if you can teach a systematic approach that it empowerspeople to operate at the top of their license, you really can make change the world from the effectivenessof out care deliver. So I'd say those were Polipi, those lessons for thoseacademics and that's what you brought to the rural communities and those areprobably very sought out values and processes and programs for those ruralfacilities. Who sometimes are you know, I don't know the right word isunderserved or resource constrained Y. A. I think that there's a couple otherthings that I brought you know probably was a little bit of my my food colores. I is, I brought alittle edge to there. You know I meant dot to the nigh and that talk toHopkins. So I wouldn't want to take care of my family. You know, and yetthey have these incredible degrees, and things like that, so the degree doesnot make sure, and I knew that for my mom, but I mean I think that wasimportant, because in a world setting you can you can end up shooting lowbecause you don't think you deserve high and I absolutely felt we weregoing to be the best of the nation in pre. That's why we went to number oneof a hundred and thirty seven on the lie hospital. Well sure you got to yougot to create that vision in that you know for that and that's otherwise youdon't achieve it right. You have to set that bar hi and go for it yeah. I anyou. Do I mean a lot of people. You talked about earlier, the ball dridgeaward and for the listeners who don't know Malcolm Balldridge, an award givento companies of service excellence, and it's one of the highest awards.Companies can receive for that. Rich Carlton is an example of a multi time,winner of Bulga Award and, if you've ever been to one of those locations.You know why, because the service you get is as unbelievable, but a lot ofpeople say just going after the Bulga award is an amazing process, because,even if you don't win the process of trying to win, make your organization awhole lot better. It just elevates the whole organization, so yeah there's alot of value to those those programs and those processes to help theorganization achieve greatness yeah. I think there's a I think when you knowwhen you have a leader that doesn't feel like we should be. You know thatwe shouldn't be as good as Virginia nation as good as Swedish as good. Asyou know, University of Washington, you know if you have a leader thatabsolutely feels it's no reason we can't git their huts, then what happensis, as you end up building now. What's really interesting is, if you look atDavid Logan and fishers from tribal leaderships definition of travelleadership, that's not the highest level. You know saying that my team cankick your teams, but is not the highest level. The highest level is arching, sogood. Let us help you be good too, and so we got to that level. We were it'sthe it's the first shop. I've been in until this one way and Lanyon know myyeah first one, except for this one, where we really level five, which is wewent out and we began to share our learnings with all other hospitals thatwere available. We began to publish, and so I think that's a real importantpart of what we ought to is the ability to publish and the ability to do introuble, research and design projects and abstracts and really try to bringforward on message of excellence, because it all you accountable to itsure yeah. So you know it's kind of funny how it's sometimes theseconversations you know, take different...

...paths and that's why I love about justsaying we're going to have a conversation, and I love the there's, alot of leadership and a lot of value and purpose in the thing and obviously,you've been able to take those lessons from the military and the biggerfacilities and really excel and help grow some of these rural ruralhospitals, and so, as you said earlier, you've landed in northern Mississippi.Let's just talk a little bit about what your experience has been there. Now Iguess you said you've been there about. Eighteen months, you came in a littlebit before Ovid went through Ovid. I know when we had our our pre call. Youtalked about using data and different things like that to help you guysmanage through the crisis in a very and and sounds like your outcomes were veryon a relative basis, very positive. You saw a good benefit from that. Do youmind charring with the listeners some of that and how you guys, approach thewhole ovid dynamic from data and modeling sure yeah? One of the thingsthat's interesting about the world helter system is, you know, I usuallyby definition, has multiple little aspes, which means multiple worldcommunities, so the prevalence of virus is going to move at different speedsthrough different communities based on their masking based on the exposureetcetera. So so I really felt that that was a strength. If we Levis, we haddone a lot of work. I co an a lot of work, trying to make us see ourselvesas a system, but we are still sort of in that transition for the holdingcompanies with some ses and we're still there, but we're farther along ovidreally accelerated that, because what we did is we said, look we can'tfunction as seven hundred hostile well, so we have to function as as a system,acute care and put an clinics and long term care. So we developed communication plans that wereboth internal and external over and coverand both monologue and dialogue, and we had those parent paradigms that weactually leverage and in strategically manners, and then we recognize that wehad to the people transition at differentspeeds, so bridges model of transition talks about you, know different speedsof transition, so we had to help people a sition, a different speed. So, forexample, the people on the front lines delivering car in our cohort Coviniwere moving much faster than say the hopsit psychiatry or surgery thatweren't dealing acutely with his and they really felt like they didn't knowwhat was going on and they were more frightened, often in my experience,some of them than what was going on in the front line. So we have to helpbring vision of what was happening in transparency and Fulva ility. You knowI actually bought shirts for two other leaders that I worked with. That said,I don't know really. I don't know what I'm happy to give in my opinion,because I felt like I said that five pounds a day every day and as long aswe had on to that, transparence and home ability develop a system approach,help people accountable to that system approach and did that from a broadperspective. We were successful. So how did we define the broad perspective? Soit wasn't. Just you know, sort of philosophical would actuallyoperational ize it. So what we did is we knew that you know all of ourhospitals had a had a catastrophic response plant through their femaledevelopment, and you know Fema helps, give you these guidelines and how areyou o, o o o a situation, and so we looked at that, but it really wasn'tset up for a pandemic, but it gave us the ability to bring a group of peopletogether. So we did that and then we began to transition. How are we goingto respond to a pet? We have a little bit of history with preparation forEGAD SARS, but we really didn't. We really weren't reading, though this. So we sort of pick where we're going to beour sights of truth, and then we look at how are we going to handle thisindependently? Then, if we had to expand O a region and pan to a state,so we develop what I call contraction...

...expansion modeling. So at the time whenpeople said modeling, everybody was trying to be addicted modeling of whenwe do have a surgery, how big Wi that really didn't never to me, because itwas going to be what it was going to be. I thought that was a lot of resourcesthat were put into an area. That really was only helpful for this helpful. Manymodels aren't helpful, but it was much more helpful to say well how muchcouldn't how many beds do we have? How manyventilators do you have how many nurses for ye? If we have to explain ormodelers that I was going to say right, Ye had to be at the ability. Also,where could we expand? We know what we have, but in an crisis, where can weexpand? Where is there some elasticity? Well surprising me, we didn't know whatwe had, so you know guy really a Yo start somewhere, that is, action was actually model withinthe community and then within to Poland, then shut one together. How many bedsdid you have? How many Merses did you have a ventilators? Did you have gloves,masks and create that in a system response? So what we did was we wentthrough that we had each team in all. We developed coved teams at each of theinstitutions, and then we developed a process where we could transfer patronfrom any emergency department to any hospital bed throughout the system. Sowe have a central, logistic, patient, logistic center that actually monitorsall bets. We already have that in place, so we leverage that Kay and we actuallywould transfer patients. That would you know we could need a medical surgicalbed, but not some specialty care from our two Colona Emergency Department toour six other facilities, and we did that with surprise. We did that wetesting. We did that with resource human resources peneleos with Heptacle,so we could create protective rooms and we did that with polain procedure andwith Algorithms to care, so we actually created arithmos to care that made thecare of ovid patients as the same across the whole system to the level ofcare they will receive, and we also made our dawning and docking the same t.You know how we use masking. How would you tenditur checking out? We didscreening we developed a Coloman place. You could look them up on the Internetwithin our our internal system and then we developed communications that looklike that as well, but we recognize the failure communication. Is it's usuallya monologue that the sender thinks is a dialogue, so they send an email tothink they've had a dialogue, but all they've done. This had a monolog andnobody reads it. It doesn't matter so we use a communication tactic, calls intopic communication. What it does is. It creates a purpose statement of theTopi says this is the purpose of this communication, and these are the threepoints that are going to emphasize. This is my ask of you and then go lowerthe details, so a dog could screen it really quickly and throw it away or sayyeah this supplies and we created a unique sort of it's a grand rounds, butit really isn't it's caught. I call it the fireside chap based on ftrange sortof a chap with American, and so we used it virtually, but we use tomatin topicsthat the audience was not aware of. So how do we create a standard startingspot that everybody understands? What's calling on? That was our first one andthen how do we create algorithms of care and share with people other beingused? That was our second, so we would do one. The three speakers for afifteen minute presentation tower didactic, ten to twelve slides, andthen we can do a question and answer via the chat mechanism. I wouldfacilitate that or we we do interviews, and so we moved us through this we'vedone fourteen of them now, but we were doing a couple of weeks et a at onepoint, and that was all, and at that...

...point that was all internalcommunication that was just within the system or was that also external to thecommunity? Well, initially, it was internal and then I see that is areally powerful tool. So what you're alluding to we've done many times wetaken things that we were able to leverage in coved and we've translatedthem to our normal practice, and we've looked very very consciously on what dowe want to stop doing that? We stop doing covie and there's no reason torestart, and what did we learn in Ovid that we want to take forward? Anotherthing that was key to this whole conversation is, we always place theproviders clinical acum above in testes, so all of our algorithm, all ourdecision they can were based on the clinical acum of the provider, not on atest resonant Le to ffected collaboration, and so, for example, weprobably had something. Never got reported, but from February Dream Julyof two thousand and twenty I had zero disruptive position wow and it's anjust for the listeners can. Can you define just explain to that? What thatmeans? Yeah I have eleven hundred medical staff, and so a disruptive behavior would beinappropriate. Behavior, for any reason could be sexual could be violet couldbe. You know a derogatory things like that. I've had some before and someafter. We actually have a program by Baneville on professionalism and such,but so we wondered pretty closely but but I'm sure some took place that I wasunaware of, but inlayer's terms, no complaints, yeah well yeah. I guess nocomplaints that that evolved or expanded into inappropriate behavioralexpression sure right. No, not that everybody was a hundred percent happyall the time, but it nothing escalated into what we might be considered asevere. You know complaint that something had to be investigated, etc.I mean there were a lot of concerns and worries and Unhappy People at differenttimes, but each one of those I actually personally met with them personallycall them converted text and the calls I ve shot. You know I did probably twoor three hundred individual conversations during that six sevenmonth period of time D so because I was new and they need to, they need to knowtheir voice was value. We also use humor, we created so people weren'twearing the mask correctly. So I was sitting in was have gone back toMontana. For a personal reason, and when I was in the airport, I could seepeople that arting the mask correctly. I would take pictures of them and Iwould send them to my ice people and I would name them so, for example, ifsomebody had it under their their Chin like this right now and I listen don'thave videos, my nose is exposed it just part of a lower lip. I called that theduel Catcher- This was a Pinocchio, and this was thewas the cowboy you know, and so so we made we have these eight differentnames and then I talked to senior leaders, position and administrativehave their picture taken with these incorrect we held and one of our one ofour folks. I work with one of my team mates genie. Alas, have this idea toput it on a Western wanted poster that yeah that's good right. We would putthese polistes out that approach this person with care, because it could becontagious. That's great well, listen we're comingup on almost an hour and it's been awesome to continue to talk with you.There's a just a couple. Other things I love to talk about before we close out.First thing is talk to me about the vaccine in the rural communities. Whatare you seeing? What are you hearing recently? I was a part of an executiveround table and it was interesting to hear we heard people from big urbanareas into rural areas, but I'd love to hear what are you guys experiencingwith the vaccine and how, as a community leader, are you guys leadingpeople? And what message are you trying to deliver? Yeah what's interesting inthat is, is from the very beginning. We...

...actually created a super heroperspective of the Communities Response. Well, we love that at Hero's healthcare. We love the Superhero perspective. Well so so I actually would, in myinterviews, identify that the Super Heroes, the captain America's halts,the Super Hands of wonder, Womans- that that those are the community members,because and for the first time they career, they had all the super powersthey asking social distancing and I gi and now vaccination, and so we really,we really created that poppoea of your our heroes. You know how please help usyeah, and so, if we we went into the vaccine situation, we recognize that weneeded to collaborate with our community to be able to do to doadequate vaccination and it's been a struggle. I mean we actually when wesurveyed our employees. We knew that only about thirty or forty percentwould initially agreed to take the vaccine. Low hely small number were avery conservative state. So there's a lot of different kinds of potential forconspiracy theories within the state we had to deal with. You know begin yourDNA with the Johnson with the Marn anyones, or you know the micro chip.That would tell people where you hunted or way you better right right as anyway,many many different things, and so we dealt. We did a lot of different kindsof broad communications with people of diversity. Do that. But one of thethings that I recognized in that setting is when we looked at ourmonticle antibody distribution. We definitely saw a disparity with who wasreceiving that, and so we said well what about ourvaccine? Whats, tough with our vaccine, because we initially did all employeeshere, so you really have a very you know unique number that you're workingwith it doesn't reflect your community number Hesea. If a gun is just stop yousaying what disparity were you seeing in that? We saw that that we can lookat the number within our catchment area, the percentage of African Americans andthe percentage of world and the percentage of social determinants, andwe could see those with lower social determinants. Those that were people ofcolor and those who were world were less likely to get motices, and wasthat a systematic issue or was that their refusal for it? Because we're youknow we're talking about the adoption of the vaccine that you just startedtalking about and there's some resistance. I'm just curious. was thata I don't want it or at it just was a systematic bias. Well, it's! Yes! Yes!Yes! And yes, okay! It's all those! It's that you know it was an accessissue so Mississippi to get an appointment for our state vaccinations.You have to go online or call, and you put on hole. Well, if you're from anarea of low SEC, socio economic development, you know I have the dataplay in a low. You do that right and help literacy issues and transportissues, and so each one of those were trying to bite off and got it. I willtell you that we have a huge vaccination issues and we're stillacting. We do that. I have a meeting with two ministers you know, beginningof next week we have a offers out to our parishes to bring in bands to to avaccine setter. The other thing is: is we chose how to do Johnson and Johnson?We just did WADENA and pizer okay and it's really hard to design aadministration. OPERATIONIS administration, when you don't know howmany Matse you're Goin to have the next week shut right, a yeah, so I hes a logistics challenge to theloges. ICS Is really hard, so we need to stay within those two instead of oneand then we only have one big freezer, so foolisher is a to Palo rather than asmaller. So there are a lot of challenges with that yeah. I didn'twant to say one thing that came up just because I might not have a chance, andI think it's important. You said you know, name names and things like that,and you know we are being recognized as a systemd by the boy scouts in our areaand the hat was called the being...

...prepared. He prepared a war and they'veonly given it out in two thousand and fourteen to the weather man because ofa huge tornado and how he saved lives by emphasizing getting people to go toplaces of refuge, and when we were notified of this award, my ceo and thenlater me, we all refuse to accept a personal award. We said that this hadto be a team award yeah. What I've done is I've reached out to all of theexecutives to reach out to their directors. PS and managers pass for onename from each unit and one ten yet about that person, whether they go withon hands clinical or whether they were in finance or environmental services orvicilinus. Covin is not just a conical disease. It's a conical, it's afinancial, it's spiritual! It's an emotional, and so we are going to do iswe're going it's A. I have a quite that I'll read initialling. I'm gonna readout twenty of those names in that thing yet and then I e ended with Eorsa Elt,so man in the arena, because I really think everything we've done. We've doneis a team yeah and no one person can be recognized. So I really am here not asme, but I'm here, hopefully reflecting positively on the experience of more isCASSII health services. That's important to me, yeah, well, and andthat's very consistent with us on the show. We've heard that over time andtime you know, we've had shows from Mount Sy and I and Dr Brendan cartalking about the unsung heroes, real estate, the engineers, the logistics,the all the people who are non medical or clinical and how they played such anenormous role in you know, helping support the system and you're right,there's. No, so there's no small players in any of the systems who arehelping the organizations deal with these unprecedented times. So that'sthose are the people we love the highlight, and you know we know everyorganization not only has one or two they have usually probably dozens or orhundreds of them those we o the folks who want a highlight on the show andthose are the people who have to be recognized. So I I appreciate yourheart and I appreciate that you making that a point that it's not about DrBlanchard or the C Mo it's really about it's really about the system and thepeople who all serve selflessly to help the community we actually in the middleof coved. We have nice form. I don't know if you remember that a ValentineDay- and you know we have people that stay Nilon days in our hospitals, an weco, Caritatis wow and I personally was driving. You know two hours in themorning to pick people out I get up at you, know for and drive out pick up agroup and ring back in there. Many of us did that and then we also went toCyber Ism O. I think that's missed in the midst of this. All the hospitalstate secretary is yeah, so you know it's been a really interesting timesand beautiful journey. I mean really truly beautiful because of the responseto seeing people very sad, a yeah. Well, we see we see the best of people in theworst of times right. I think somebody said that I know I didn't, but I don'tthink somebody said that well number one. Thank you so much for your storiesand your passion. We love it you're a perfect fit for our listeners. I'm surethey're going to love this, and I really love all the work that you'redoing to serve the underserved. We typically close our episodes with thequestion who's your hero at hum. I had a suspicion. It might be that but yeahit's interesting, because I've received a lot of. Thank you not Ale, my life,and you know because my mom Sarif so much for me- be able to go to medicalschool and to do those kind of things. I would save him in a file which hewould come. I would I would look. I would read them to her that she wantedme to and when she died, I still root them out loud to my mom, a it's. I'vereflected that back and responses to people giving me those notes. You knowtelling them how touch my heart yeah,...

I'm home, and I share that bad and itreally personalize there thank you and gives it value. So it's a pretty cool,a powerful thing and I've then adopted that I have hand I have fifish ing cars.I send up handwritten. Thank you all the time to individuals at all levelsof the organization, and I just passed my leaders. Please identify Herculean,behavior and I'll, send him to thank you know, and I don't care how man. Soyou know my Co. Does that too I found out, but neither one of US publicizethat we just do that. So so your mom's, a legacy of the card notes, continuesto live on and that's awesome. I love the way you honor her with that DrLanger. Think so much it's been a privilege, mine and the shows for youto be joining us, and we just thank you for sharing a bit of your story andcontinued success and keeping the the area growing continues success withhelping the serve the underserved, and I think, they're lucky to have you atthe helm. Well, I'm lucky to be here. Thank you. Thanks for this opportunityto it was a great meeting. You've been listening to heroes of health care formore subscribe to the show in your favorite podcast player, or visit us atheroes of health care, podcast com e t.

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