How Avera Health CEO overcomes distractions, connects with employees

Leaders must be fully present with their colleagues and staff to effectively hear them and respond to them. 

survey of 2,000 employees published by Bain & Co. in 2016 found that centeredness — "engaging all parts of the mind to become fully present" — is fundamental to leadership and improves a person's ability to stay level-headed, listen more deeply and deal with stress. More recently, mindfulness educator Metta McGarvey, EdD, an adjunct lecturer on education at Harvard University, encouraged leaders last April to practice being fully present while working to manage stress and be most productive. 

But being present can be challenging with so many distractions that may take a leader's mind away from the other person in a conversation. The COVID-19 pandemic has also made it harder for leaders to be physically present for safety reasons.  

Bob Sutton, president and CEO of Sioux Falls, S.D.-based Avera Health, said he thinks about being present often, especially considering the pandemic. He views it as an essential leadership trait.

"For me, it's about more than being there and being present. It's being there with people, that they know you're there," he said. "If you can't be with them physically, it's being with them in mind and spirit and knowing that they feel supported by your presence."

This CEO's philosophy about being present

From an administrative standpoint, Mr. Sutton said it's important that colleagues and staff feel there's enough active communication and familiarity with their leaders that they feel supported in their work. And when he can be physically present, it's about taking away his distractions.

"Not saying, 'My phone's ringing' or, 'I need to get to this email quickly' or 'I'm going to get to this text,' but being there, looking in their eyes, listening to the things they say. Not just asking people how they're doing, but really engaging with them and listening to their reply, because if there are things you hear you can do something about, you want to make sure you have that credibility," he said. 

Whether it's physically or remotely, being present looks different for every leader. Some may prefer being present through verbal communication more than through written communication. But according to global nonprofit Center for Creative Leadership, communication is more than words, and attitude and actions elevate spoken and written messages.

At Avera Health — a faith-based, 37-hospital health system in South Dakota, Minnesota, Iowa, Nebraska and North Dakota — the marketing and internal communications team has helped with video messages. A recent one sent to staff includes an Easter message and focuses on the organization's strategic plan and how every part of the health system is affected. Hope is also a key component of recent messaging.

"Spring is a big deal [in the upper Midwest], and we focus a lot on hope — hope the vaccine is bringing hope with changing spring weather," Mr. Sutton said. 

Earlier in March, he said he ran into a small group of Avera Health employees at a restaurant where they were picking up lunch and received positive feedback about the video messages.

"They said, 'Even though we haven't seen you over the last year as much as we used to, we wait to see and hear those videos,'" said Mr. Sutton. "It's important, because our front-line workers need to know our senior leaders continue to support them and that we do everything we can. Even though we're physically removed, that we do everything we can to understand what they're going through and how we can be part of the team with them."

Mr. Sutton also writes dozens of handwritten notes a week to staff. The notes go to people in all different levels of our organization, from senior leaders and vice presidents and physicians to housekeepers and food and nutrition workers. He said he typically writes a note when he hears of something "extraordinary or above and beyond." Recently, a young intensive care unit nurse did a TV interview and discussed her experiences during the COVID-19 surge last fall, including moving a patient so a family could see their loved one during the person's last moments of life. 

"I was so moved by that, and not just me, many people were. I wrote the note the next morning and thanked her for her commitment to our patients and her commitment to her profession and her commitment to our ministry and the compassion that she showed," Mr. Sutton said.

In his DNA 

Although Mr. Sutton has found avenues for being present during the pandemic, being present has always been a staple in his career.

He became president and CEO of Avera Health in 2018, after serving as the health system's executive vice president of human resources.

He said he began visiting facilities immediately after beginning his current role, including regional hospitals, and getting to as many of the organization's critical access hospitals as he could during his first year. 

"It's nothing to be a three- or three-and-a-half-hour drive for me to get to one of our rural facilities, and I love those days, and I relish them because with physicians and nurses, you get to spend time and get feedback," said Mr. Sutton. He said he also specifically takes time to visit with housekeepers to let them know how important they are to healthcare quality.

His passion for being present isn't isolated to Avera Health. As executive director of the South Dakota Association of County Officials, he visited every county courthouse in the state. There are more than 60. Then later as executive vice president for the South Dakota Bankers Association, he visited every bank in South Dakota, and as president of the South Dakota Community Foundation, he drove 65,000 miles a year in the state. 

"I just learned I can lead much better when I've physically walked with the people I have been called to lead. And for me when I've taken time to learn who these people are, learn a little bit about their families, learn about the local community and what's going on there, I have personally reaped benefits and rewards," Mr. Sutton said. 

What he's learned from being present

Leaders can learn a lot from others when they are present. Mr. Sutton learned one such lesson from a physician. 

He said the physician recommended that Mr. Sutton ask staff: "What are the things you think I don't want to hear?"

"It was an eye-opener for me," said Mr. Sutton. "It was brilliant. I've gotten a lot of positive feedback. I've [heard] a lot of things people never felt comfortable sharing because they were never asked. They are asked, 'How are things going?' Even asking, 'Are there things we could be doing better?' That's different than asking people, 'What are things that you think I don't want to hear?' It takes down a bunch of barriers. They feel comfortable that they can open up. And they know that it's not going to come from a place where there's going to be any retaliation for what they tell me, because I'm inviting them to share that. That has served me extremely well in my years at Avera."

Dr. McGarvey, the adjunct lecturer on education at Harvard, agreed. She said last April that leaders should reflect and be honest and open about their decisions.

Advice for other health system leaders

Mr. Sutton acknowledged that traveling to every facility or standing in front of groups of people and talking to them, even employees, is not a great fit for all health system CEOs' personality, style and leadership philosophy. 

He said it's important for health system CEOs to be genuine to who they are. 

"My colleagues in the C-suite are there because they are competent and capable, and they have strengths that I will never imagine having. [Being present] happens to be something that's a passion for me. I think it's important for other CEOs to be present in whatever being present is comfortable for them," he said.

The main goal, he said, is for employees to feel comfortable approaching the CEO, so the CEO has a better understanding of the day-to-day operations at the organization. Mr. Sutton said leaders must also be deliberate and purposeful about being present. 

"We're all busy. We all have meetings. We all have an extraordinary responsibility during a global pandemic. And we have to remember that when things are going well, that is an important time to communicate with our team members and to be present," he said. "But when things aren't going well and when there are challenges, it's exponentially more important to be seen and heard during those times."


More articles on leadership and management:
'The question is not if, but when': World leaders call for treaty to fight future pandemics
Corner Office: St. Tammany CEO Joan Coffman on navigating change and leading with integrity
Corner Office: Saint Alphonsus Health System CEO Odette Bolano on the importance of taking calculated risks 

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