Leadership advice from 9 women across Yale New Haven Health

Female leaders have been crucial to Yale New Haven (Conn.) Health's COVID-19 pandemic response. Across the organization, they have led incident command centers and are planning recovery operations.

Here, nine female leaders with Yale New Haven Health and its entities share with Becker's Hospital Review their advice for navigating through the pandemic.

Note: Responses have been lightly edited for length and clarity.

April Alfano, BSN, RN, manager of disaster preparedness and response for Yale New Haven Health: Have one source of truth. One voice. Clear lines of communication across the organization are critical in a disaster. As a leader in disaster preparedness and response, a significant area of focus for me was in assuring that there was one source of truth for the organization. This required working with our senior leaders through the Hospital Incident Command System and ensuring key information and decisions from the emergency operations center were carefully cascaded to the entire organization.

We created an email template that was easy to follow and predictable. We identified themes and any new updates were sent in red so employees could immediately identify new information. We also included electronic links to supporting documents as well as attachments. The themed categories were operations, planning and logistics. Personal protective equipment fell under logistics. That was always an area of concern. Most employees had the same concerns and questions. We held one venue daily for leaders to submit updates. We sent out information daily before the close of business, Monday through Friday. We have multiple service lines in our organization, and we discouraged specialty areas in the hospital from sending out their own information. This cut down on confusion and duplication of efforts between service lines. Employees began to look at the emails from the emergency operations center as their source of truth for the pandemic.

Strategically, our organization began to utilize hospital incident command for all events, large or small, for the last two years. Utilizing this system frequently was a strength for our team. This comfort in the Hospital Incident Command System structure made communication seamless during a time filled with uncertainty and challenges.

Maribeth Cabie, director of clinical redesign for Yale New Haven Health: After establishing the Yale New Haven Health System COVID-19 Call Center that is hitting a milestone of 100,000 calls from the community since opening in early March, one piece of advice would be to consistently hear the voice of the patient/community. It has been critical that we understand the current needs, provide immediate medical expertise, adapt nimbly to new concerns, and anticipate future opportunities as the pandemic has progressed. Having this pulse on the situation has allowed us to be a resource for the community, provide the most current education, offer immediate clinical assessments, order testing over the phone/video visit, and keep the volume of patients utilizing the emergency departments for COVID assistance minimized to emergencies.

Kerin Da Cruz, MSN, RN, chief nursing officer of L+M Healthcare (New London, Conn): Never let a crisis go to waste. Throughout this pandemic we have seen our teams do extraordinary things. They have been innovative, collaborative and courageous on a daily basis.  The speed in which they have come together to fight a common enemy is unprecedented. We cannot control the pandemic, but we can control our response. And the response has been swift, heroic and nothing short of miraculous.

We didn't have a best practice play book to follow, so we created it. Out of a crisis comes a new way of doing things that make us all better for having been a part of it. There is tremendous loss and despite that loss there is an incredible hope for the future. It is a future in which there is hope, remembrance, gratitude, and inspiration because throughout the chaos, we have come together in a way that was not possible before.

Anne Diamond, president and CEO of Bridgeport (Conn.) Hospital: Be creative in finding multiple channels for communication. Show transparency, embrace technology for town halls and real time chats, round with staff and it's OK to show emotion. As women we often work very hard to not show emotions but when you have an event of this magnitude it is important to show our vulnerable side, it gives permission to our staff to get in touch with their emotions so they can manage them in a healthy way. 

My second piece of advice [is to] get your leaders into the right incident command roles. The right leaders for planning and managing during the event are not always the same leaders for recovery and transformation.

Denise Fiore, COO of L+M Healthcare: Lead with humility and agility and balance that with honest, consistent and adaptive communication. Early in the pandemic there were unknowns and there was the need to ensure our teams were cared for, whether they were front line caring for our patients or not.  The well-being of our associates and our patients was paramount. Our associates needed to see us not only visible in the work environment, but also demonstrating that we were honest, timely and consistent in our communication as we navigated the pandemic. At times admitting that we did not have all the answers but that we were supported by each other as executives and across the health system in making decisions to ensure that our teams of people were kept safe, cared for and that we were addressing matters as soon as they arose strengthened trust amongst everyone. This fostered greater pride and increased will "to be in this pandemic" taking care of our patients.

Being adaptive in how we communicate was key as well. Consistent communication allowed us to be proactive with messaging information and also adaptive to tailor the message and communicate the ever-changing reality. It has been an honor to lead a great team through the incident command component of the pandemic and to also then be able to move easily from a command perspective to transforming operations for the future. 

Marianne Hatfield, DNP, RN, vice president of nursing and patient care services for Yale New Haven Children's Hospital and Yale New Haven Hospital Women's Services: As is often the case in a leadership position, you will find yourself being asked to take on more responsibility — particularly in a time of crisis. I found myself running first our flagship hospital's "labor pool" and then within days of that, the health system's "nursing labor pool." We scrambled to put together a team that could quickly inventory all of the nurses with recent acute care experience who were no longer working in direct care roles, provide them with some re-orientation, and get them reassigned to our hospitals to assist in caring for the rapidly growing COVID-positive patients. While we had some early misses on providing resources exactly where they were needed when they were needed, as this extraordinary crisis evolved, we very quickly engaged hundreds of nonclinical nurses to return to the bedside to provide direct care or assistance and support for the other direct care nurses in our acute care units. If there was just one piece of advice that I would share with other women leaders it would be to show up. Leaders need to be present and be visible when they are asking staff to put aside their personal fears and their very real concerns for their own family members, to come in to work and care for patients during a time of crisis.  If you are asking them to come in for patients, you need to come in for them. You need to round with them often, ask them what they need, listen to them, be honest when you don’t know the answers to their questions, and thank them (and thank them, and thank them) for being the amazing people they are. 

Diane P. Kelly, DNP, RN, executive vice president and COO of Greenwich (Conn.) Hospital and senior vice president of Yale New Haven Health System: I believe the best healthcare, and working environment is based on a team concept that supports working together collaboratively and respectfully with a shared purpose. This belief was proven to me tenfold over the past few months. I witnessed amazing collaboration at all levels of the Yale New Haven Health System with the single purpose of safety for both patients and staff. This was again emphasized as YNHHS further collaborated with the state of Connecticut to reach beyond our respective communities.

MaryEllen (Mel) Kosturko, senior vice president and chief nursing officer of Bridgeport Hospital: Presence. In all aspects of the word: daily gratitude during morning safety huddle, 30-minute daily interactive Zoom communications with my broad nursing leadership team, rapid decision-making with senior staff, and sharing on Zoom calls with our health system. Visibly on the floor rounding with the staff and ensuring not to ask them to do anything I would not do. This allowed me to adapt to the changing environment, engage with my team, and make informed decisions to deliver the best possible outcomes for the safety of our staff, patients and families.

Francine LoRusso, RN, vice president and executive director for heart and vascular services, Yale New Haven Transplantation Center and Medicine Services: Navigating the uncertainty of the COVID crisis has required an intense focus on our ability at Yale New Haven Health to coalesce as an integrated and seamless health system, thereby providing extraordinary patient outcomes. To do so successfully, the ability to trust your people to do the right thing has been paramount. The level of engagement, unleashed energy and creative innovation demonstrated by our multidisciplinary teams daily has been truly inspirational.

We have thrived through this shared human experience because we are so grounded in our Yale New Haven Health core mission, vision and values. That is what makes us truly special; capitalizing on our unique relationships, transparent authentic communication, harnessing individual talents, close cooperation and collaboration.

My one piece of advice is that by leading with heart and empathy, learning to recalibrate and reframe along the way, we will continue to be successful. All the while recognizing and mitigating the fears of our brave and valuable staff, leaders, providers, as well as ensuring and acknowledging their achievements.


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