Rest, journaling and listening: The habits hospital leaders developed this year

As hospital and health system leaders evolve in their role, they often pick up new habits that stick with them. 

Becker's Hospital Review asked some of these leaders to share a leadership habit they've developed in 2019 and why it is important to them. Read their responses below, presented alphabetically.

Note: The following responses were lightly edited for length and clarity.

Vanessa Benavides
Senior vice president and chief compliance and privacy officer at Kaiser Permanente (Oakland, Calif.) 

As a leader, your response to situations that don't go as planned can help others transcend disappointments. When you remove blame, you help others to grow and to see a path forward following a setback. This year has deepened my appreciation of grace and introspection as a path to renewal. 

Joseph R. Betancourt, MD
Vice president and chief equity and inclusion officer at Massachusetts General Hospital (Boston)

I listen carefully to the language and terms people use. I've been fascinated by how, through subtle communication strategies, we can rebrand efforts to energize them, or dodge tough issues by obscuring them with carefully placed words and terms. For example, leaders in healthcare have always known about the impact of public health on health outcomes, yet the term "social determinants of health" has reenergized this effort; same issue, different term, newfound energy. Similarly, whereas there was great attention to racial and ethnic disparities in health in recent years, the emergence of the term social determinants of health has become a broader bucket term that creates the opportunity to avoid discussing directly the impact of race and ethnicity on healthcare and health outcomes. As I try to advance work in equity and inclusion, being a student of language and communication has become a key leadership habit I've honed over the last year.

Tricia Smith-Edris
Chief strategy officer of AdventHealth — Central Florida Division (Orlando)

One of the leadership habits I have been working on developing this year is being a better listener. Empathic and active listening to understand not just what is being said, but the deeper messages and meaning behind the words. I find listening is an undervalued leadership skill — most communication classes and workshops focus on how to make one's point, and the use of language to inform and inspire, but don't mention listening. And I think most of us believe we are naturally good listeners. In reality, I can remember only a handful of leaders I have worked with who were really good at listening. As I've been intentionally working on being a better listener, I have found it is not easy. Like all things, it requires discipline and practice in order to become a habit. It requires me to set my agenda aside to hear what others are really saying.

I am learning the quality of my listening directly correlates to the quality of my relationships. And relationships are central to everything I do — whether that is in creating new partnerships, developing consumer experiences to deliver on our brand promise, or engaging with our community.  As an organization, AdventHealth has also been growing and expanding our consumer listening skills with positive results. We are putting the consumer at the center of everything we do. Having effective and intentional processes to listen ensures we are meeting people's needs, providing solutions and driving value.   

Chris Ghaemmaghami, MD
CMO of University of Virginia Medical Center (Charlottesville) 

I have learned to be more appreciative of the hard work of the teams and to promote more gratitude by thanking people whenever there is an opportunity. A handwritten thank you note to a team member goes a long way to improve engagement and build relationships. 

Kelly Jo Golson
Chief marketing officer of Advocate Aurora Health (Downers Grove, Ill., and Milwaukee)

In today's "always-on" culture, more and more of our team members — whether clinical staff or corporate professionals — struggle with burnout. Over the past year, I've focused on cultivating resilience both personally and throughout my team to fight burnout, adapt to change and hone a growth mindset as we tackle the challenge of transforming healthcare.

On a practical level, this has meant relentlessly pursuing clarity around priorities and expectations so that we avoid feeling overwhelmed, as well as taking the time to celebrate small wins as we chip away at big goals. Most importantly, building resilience has required establishing psychological safety by demonstrating a willingness to make mistakes and take risks. I make clear that no one who reports to me will be penalized for speaking up or broaching what seems like a crazy idea. The trust that this attitude engenders creates meaningful workplace relationships and gives us the courage to pursue transformative ideas.

I can't change the world's technology-fueled sense of immediacy or our industry's increasing complexity. I can, however, control how I respond to stress and how I encourage my team to respond. By creating a workplace culture that champions people's whole selves and builds resiliency, I like to think I'm demonstrating to tomorrow's leaders that professional success and personal fulfillment need not be mutually exclusive.

Richard Helmers, MD
Vice president of Mayo Clinic Health System's northwest Wisconsin region 

The leadership habit I have tried to develop this year is to consciously try to get more/enough sleep every night. I read this in a business leadership journal. It pointed out that you make the best decisions when consistently rested, and that is better than not getting enough sleep due to reading every detailed  email and every report, and those you lead are better off when you are better rested but  less well-read!

Kecia M. Kelly, DNP, RN
CNO of CommonSpirit Health's Northern California division 

I have become more intentional in practicing self-care.

As a busy healthcare executive who also happens to be a nurse, caring for others first comes natural to me. Not only am I caring for those I serve at work, but also my family and other loved ones. It is easy to place myself on the back burner. We nurses are very guilty of this.

I have always started my day with exercise. For me, exercise is as routine as eating breakfast or driving to work. It is just who I am and what I do. I am able to dive into my day knowing that I have placed myself first. I have always considered this a lifestyle choice to keep me healthy and provide longevity so that I can one day play with my grandchildren. This year, however, I have begun to view it more in the context of leadership.

My role and responsibilities have expanded this year; therefore, health and wellness have become critical to me being able to endure the challenges and opportunities of leading in a rapidly changing healthcare environment. My mind feels clearer to make the tough decisions, and I have the presence of mind to be fully available to my team. For me, these things really matter. I have peace of mind knowing that not only have I been able to care for myself, but that I’ve been able to give 100 percent to my work while still caring for my team, and ultimately coming home to spend quality time with my family.

I encourage my team to always practice self-care too. You cannot pour from an empty cup.

Adam Levy, MD
Vice chair of network and strategic planning and medical director of pediatric ambulatory subspecialty services at the Children's Hospital at Montefiore (Bronx, N.Y.)

As a pediatric oncologist, I can think of no greater honor than parents trusting us to care for their children.  Just as I appreciate that trust, I appreciate everyone’s role in that care. As a physician-leader I make it a habit to demonstrate that appreciation as often as possible.

More and more, I start each interaction with appreciation — for a job well done, for acknowledging that we can and will do better, for simply listening and being present. My appreciation is authentic. All of our colleagues in healthcare deserve praise for choosing to work in the service of others.  Everyone in the building, every person within the institution, shares our mission to care for our patients, their families and the community.

Appreciating a colleague focuses attention back to the patient and the important role the colleague plays. Appreciation shows that on this day, the colleague is contributing to making someone’s life better. This is true for those interacting with patients, colleagues with roles behind the scenes, colleagues managing and maintaining the facilities, administrative team members who are working to make sure the health system is operating well and financially healthy — all are helping improve the lives of others. How awesome is that?

It should be easy for a leader to appreciate team members— we define the roles, we have influence on staffing and choosing personnel.  Leaders know how much we all rely on each other to perform our best. Sharing our authentic appreciation is the right thing to do as a matter of common decency.  Appreciation is infectious.  And from a leadership perspective, it also happens to be a most compelling motivator.

Theresa Madaline, MD
Healthcare epidemiologist at Montefiore Health System (Bronx, N.Y.) 

In my role as hospital epidemiologist at Montefiore Health System, I'm tasked with navigating a large, complex organization in order to safeguard the hospital and its patients against infectious diseases. Healthcare is a fast-paced industry in which many different people must work in concert to improve the health of patients. This year, I've focused on how my team and I react to barriers or indecision. By taking a step back and reframing the problem, I have been able to encourage my team to return their focus to what is most important: the patient. Once we've examined a problem through the human lens and unite around the common goal of providing the best possible care to those we serve, the way forward comes into clearer focus and a sense of urgency and engagement emerges. Reframing in difficult moments is crucial to fostering a growth mindset, building consensus among members of a care team, creating space for innovative solutions and promoting a patient-centered culture of safety.

Daniel Morissette
CFO of CommonSpirit Health (Chicago)

This year, CommonSpirit Health came together as a new health system as the result of the merger between [San Francisco-based] Dignity Health and [Englewood, Colo.-based] CHI [Catholic Health Initiatives]. What is exciting to me as a leader is that our people are embracing our vision to transform healthcare. 

While our mission and values remain the same, our enterprise is evolving rapidly to meet the needs of our patients today and into the future. That's why it is so important that we as leaders communicate more transparently — and more effectively — than ever before. In times of change, I believe the best thing I can do is to communicate, providing timely information to preempt questions and dispel any feelings of uncertainty. 

Now, what we may think of as over-communication is anything but that. We send regular email updates to our employees,hold regular team calls and town halls, and make a point to have meetings in person. 

I believe inspiration is a two-way street — when times call for innovations in the way things have always been done, you never know where a good idea will come from. CommonSpirit has a unique opportunity to enhance the delivery of healthcare in communities across the country, and we want every person in our organization — from the radiologist technician to the physician's assistant — to be inspired to provide the best possible care to every patient, and to each other, every single day. It is my hope that every person in CommonSpirit is inspired along our journey. 

Lori C. Pickens
Senior vice president of oncology services and executive director of Yale New Haven (Conn.) Health's Smilow Cancer Hospital 

Over a year ago I transitioned to a new organization after 14 years of leadership at a peer institution.  As I reflect on my first year, the most prevalent habit I practiced was the age-old art of listening to the many people around me, processing what I heard and saw and asking, hopefully thoughtful, questions.  I know it seems so basic, and while it's not a new habit, it is a practice I've cultivated over several years.  I believe there is an art to active listening and engaging, and it is important to me because it generally produces innumerable long-term, meaningful results.

Kristin Ramsey, MSN, RN
Chief nurse executive of Northwestern Memorial Hospital (Chicago)

One of the skills I've tried to honed over the past year, year and a half is reflection. It has been something I've done over my career. But if you don't stick to it on a daily basis and carve out that time to think about decisions you've made, situations you've been in, that time of reflection before you go onto your next day, that can kind of get pushed aside. Folks can do it in different ways — journaling or just personal reflection or maybe some type of meditation. I like to journal. That way I can go back and see if over the year I've really grown.

We did work here two years ago on [a book called] The Happiness Advantage, and reflection is one of the techniques that can help you create a positive attitude and create your own happiness. So for the past year I've tried to ensure that I have time each day — whether it's at the beginning of my day or at the end of the day — to reflect on what occurred previously, the previous day or the previous week and how might it change what I'm going to do this week. 

Bernard J. Tyson,
Chairman and CEO of Kaiser Permanente (Oakland, Calif.) 

I continue to set aside on a quarterly basis a special recognition to someone in the company who is doing extraordinary work. I call it the CEO Hero Award. They are invited to my meetings and they receive a certificate to use for a charity of their choice.

Chris Waugh
Chief innovation officer of Sutter Health (Sacramento, Calif.) 

Maintaining agility. Healthcare is shifting quickly. In our team we operate on 90-day cycles. This allows us to confirm, every quarter, that our product development, innovation strategy and metrics are high- performing. By maintaining flexibility, we can evolve with the needs of the organization, make small shifts in products as needed and drop work (if necessary) without feeling overburdened.


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