'We needed to think differently': Northwell Health's Dr. Annabella Salvador-Kelly on sharpening leadership skills during the pandemic

When the pandemic surged in New York this spring, Northwell Health was hit especially hard, treating more than 41,000 COVID-19 patients between March and May. Annabella Salvador-Kelly, MD, who serves as senior vice president of medical affairs and associate CMO at the New Hyde Park, N.Y.-based health system, had a front row view of this initial surge and has since played a critical role in Northwell Health's pandemic response. 

Dr. Salvador-Kelly co-chairs Northwell's clinical advisory committee, which oversees clinical decisions and equipment usage related to the virus, as well as patient testing and visitation, and the approach to employees exposed to COVID-19.

She told Becker's she is proud of how her organization has responded to the pandemic, and that being part of this response allowed her to sharpen/strengthen her skills in team-building, communication and decision-making. She shared her greatest challenge as a female leader, discussed how she stays inspired on hard days and revealed what she's learned during this unprecedented time.   

Editor's note: Responses were lightly edited for length and clarity.

Question: Who had the biggest influence on your decision to go into healthcare? 

Dr. Annabella Salvador-Kelly: My family. I was the first person in my family to go to college and medical school. My parents grew up in Portugal, went to school until the fourth grade and then decided to move to the United States in search of a better life. I am first-generation American. During my childhood, I watched my parents struggle to make a better life for themselves and their family. They often faced challenges obtaining healthcare. Many times, when ill, we were forced to wait and not seek care. In Portugal, my grandparents struggled with lack of access and appropriate healthcare. My grandmother suffered from poorly controlled diabetes mellitus and its complications. Both her legs were amputated due to gangrene, and eventually, she succumbed to sepsis. My grandfather died of an acute myocardial infarction. When he complained of chest pain, the local physician came to the house, but there was nothing he could do. There were no ambulances to take him to a hospital, so he died at home with no treatment. These family events were very personal and influenced my desire to become a physician. I didn’t want others to suffer the way my family did. I wanted to be able to guide and care for my family, my patients and my community. It is important to help those in need, and making an impact on a patient’s life, however small, is the most rewarding thing I can think of. 

Q: What do you enjoy most about being in the industry? 

AS: I enjoy the impact that being in this field has on patients, team members and the community that we serve. Every moment matters and makes a difference. I am passionate about delivering the best healthcare and helping people feel better. I have worked at Northwell Health in New York since 1999 and have seen our health system grow. It is exciting to be part of a journey to expand, create, innovate and deliver optimal healthcare. I enjoy creating a culture that builds strong relationships and delivers patient/customer-centric care. Being in this industry, we embrace the diversity of our patients, teams and communities. We are all unique, and I learn so much from others’ uniqueness. I also enjoy the innovation and challenges of working in healthcare. Healthcare is always exciting and changing. I love being part of a team that seeks opportunities to enhance our performance and make things better for patients. It's our mission to bring wellness and hope to all. 

Q: What is the greatest challenge you face as a female leader? 

AS: As a female leader, my greatest challenge is trying not to micromanage or becoming paralyzed by perfectionist tendencies. During times like these with COVID, I find myself working long hours. As a female leader, I feel the extra pressure of performing well at work and at home. It is important for me to be available to my family, especially my son Dylan, yet be very involved with my work and career. 

Q: How do you relax outside of the C-suite? 

AS: Spending time with my family is sacred. In order to relax, I love to travel and be outdoors. COVID-19 has made traveling very difficult, and I definitely miss it. Under normal circumstances, we would be traveling to various locations and exploring new sights. For extreme relaxation, you might find me on a small island in the Bahamas … like Spanish Cay, Elbow Cay, Guana Cay or Green Turtle Cay. Our family loves the beach, boating, fishing and swimming. Likewise, I enjoy doing things like exercising, hiking, snowboarding, cooking, gardening, spending time with friends and family and community service. All these activities are therapeutic for me and help to clear my mind. 

Q: How do you stay inspired on hard days? 

AS: My faith and my family revitalize and relax me. When times are tough, I try to stay focus and take it one day at a time. Thinking too far ahead can be overwhelming, so I tend to limit my focus to small chunks of time or one project at a time. 

Q: What is your daily mantra? 

AS: I have a few mantras that I enjoy sharing with my son, Dylan. Before bedtime or when things are tough, we often say them together. Work hard and play hard. Dream big. Your destiny is to save the world. Open the door and explore. 

Q: What do you consider your greatest career success? 

AS: I have several career successes that I am proud of. A recent success involves how Northwell Health managed and continues to manage the impact of the COVID-19 pandemic. We were impacted heavily, and we were one of the health systems in the epicenter of this pandemic. My role at Northwell is senior vice president of medical affairs and associate medical director. My responsibilities include leading medical affairs throughout Northwell Health, including credentialing and privileging of providers, standardizing policies and procedures, and recruiting and mentoring talented physicians. In response to COVID-19, I co-chair Northwell's clinical advisory committee, which is responsible for oversight on clinical decisions related to standardization of COVID-19 treatment guidelines, the usage of personal protective equipment, patient testing and cohorting, patient visitation, and the approach to team member COVID-19 exposures. Our clinical advisory committee collaborated with several other committees to ensure the best care was delivered to all our patients. We participated in load-balancing initiatives where we transferred patients throughout the system to avoid any one hospital from being overwhelmed, in addition to moving around medications, ventilators, vital equipment and team members. Our team members were key to make our success happen. I am so proud of Northwell, all our heroes, and my contribution in our response to this pandemic. 

Another great career success is mentoring and inspiring others, especially other women. Over the past 10 years, our organization has been on a journey to formalize our approach to diversity, inclusion and health equity. We know that women currently make up about 50 percent of medical school classes, yet we know that at the senior level the percentages for women are much lower. Change is in the air. Diversity, inclusion and health equity is so important to me. One of my goals is to recruit, retain and engage diverse faculty, physicians, and team members so that our organization better reflects the communities we serve. Having the opportunity to coach, educate and guide the next generation of physicians and team members is such a privilege. It is empowering when I see them succeed and become leaders. 

Q: What leadership skills have you learned/sharpened during the pandemic? 

AS: During times of uncertainty, like a pandemic, many skills are needed. I have definitely sharpened/strengthened my skills in team-building, communication and decision-making during this crisis. Rapid change during this pandemic created anxiety and uncertainty. The speed of making decisions and communicating in an urgent, clear and transparent way was needed, although it created an extraordinary challenge. The risks of delaying decision-making and wasting vital time during a crisis can be dangerous and may lead to even greater devastation. 

During the pandemic, we were making important decisions by the hour. We were creating and implementing guidelines and policies on a daily basis. We build teams of subject matter advisers and team members who were engaged and offered diverse opinions to guide us on important decisions. Communicating with transparency meant providing honest and accurate information of our situation and being as clear and concise as humanly possible about what we knew, what we anticipated and what it meant for us in our health system. It was important to communicate frequently and constantly as new information came to light. 

Other important skills that were strengthened during this crisis were the ability to be flexible and innovative. We needed to think differently and deliver care in ways that had never been done before. 


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