Living like a leader: A day with Tenet's Northern California CMO Dr. Gabrielle Gaspar

Gabrielle Gaspar"The needs of patients don't really fit into an eight-hour day, and the responsibility we have as leaders doesn't either. Leadership is largely about communication, and it doesn't fit neatly into a workday, especially in a patient care environment." 

 

However, most leaders succeed despite these challenges. And they each have their own habits, hacks, styles and methods in doing so.

Gabrielle Gaspar, MD, joined Dallas-based Tenet Healthcare in June 2018 as CMO of its Northern California Group, which consists of six hospitals spread across 200 miles in Central and Northern California.

Prior to joining Tenet, Dr. Gaspar spent eight years at Sacramento, Calif.-based Sutter Health serving in several roles, including vice president of accountable care and vice president of medical affairs. In addition, Dr. Gaspar was CMO at the Washington State Department of Corrections in Olympia, where she helped vulnerable, incarcerated populations.  Dr. Gaspar is board certified in family medicine and medical quality.

Here, Dr. Gaspar talks with Becker's Hospital Review for our "Living like a leader" series, which examines influential decision-makers' daily routines to offer readers an idea of how they manage their energy, teams and time.

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

Question: What's the first thing you do when you wake up in the morning?

Dr. Gabrielle Gaspar: During the week, I try to set aside time to spend with my family and dogs before heading into work. Starting my morning that way grounds me and allows me to bring my best thinking to the day. We can learn a lot from the animals in our lives. My pups start each morning with a nice long stretch, followed by enthusiasm and playful energy. I try to do the same. And my love, Mark, always makes me a beautiful latte, for which I am grateful. I do regularly meet with physicians early in the morning, so my home routine often gets shortened.

Q: Do you get any work done before you get to the office? Do you work from home after work?

GG: It's such a privilege to work in healthcare. It's not a 9 a.m. to 5 p.m. job. The needs of patients don't really fit into an eight-hour day, and the responsibility we have as leaders doesn't either. Often, I am communicating with physicians, staff or other members of the leadership team early in the morning or late in the evening via emails and text. Leadership is largely about communication, and it doesn't fit neatly into a workday, especially in a patient care environment. I enjoy doing these activities from home because there are fewer interruptions, which allows me to be focused and productive. The work I do at home is generally scattered throughout the evenings or mornings based on need, but I also try to respect family time. It is good to take time to unwind and renew. It is about finding that balance.

Q: What's the first thing you like to do when you get to work?

GG: For me it's about the people. So, the first thing I like to do is check in, say my hellos and see how my executive assistant and others on the team are doing. In high-performing hospitals like ours, everyone has so much on their plate that it is easy and tempting to run into our offices to start chipping away at the pile. I used to fall prey to that. But it's important to remember that it really is all about the people. Taking the time to let people know we care as an organization is essential, but also letting them know that I care is important to me.

Q: Is there anything about the office setup or layout that you think is unique?

GG: I have a very nice executive office with a desk, meeting table and white board on my wall. I usually keep a small espresso machine in my office to hosts guests, but I do not have it set it up at this time. The white board, though, is something I have found most useful over the years. While I use the board for brainstorming and tracking key initiatives, the most important thing on it are three fundamental questions: What are we trying to do? How do we measure success? What do we need?

It's a good reminder for me, but it also there for others to see. When people come and meet with me on projects, they know those questions will always be where we start.

Q: How often do you complete rounds?

GG: Fortunately, our entire leadership team prioritizes rounding daily immediately following the morning huddle. It is one of my favorite parts of my job. We focus primarily on our patients and how we can provide an exceptional experience for them, but it is also an opportunity to speak with staff and learn about their experience and perception of the organization. I have found that rounding is the best way to learn about the hospital, identify improvement opportunities and be visible as a leader. I gain so much insight simply by walking around, observing and chatting with people at every level of the organization. It also gives me an opportunity to watch workflows and look at the infrastructure from the patient and staff perspective.

I also enjoy spending time in the physicians' lounge a few times a week. That is where I build relationships and connect with a very important stakeholder group — our doctors! I make a deliberate effort to be present and available to engage our physicians where they practice, in six hospitals spread over 200 miles in Central and Northern California. The geography can be a challenge, but I enjoy being present and connecting, so it's worth the effort.

Q: How do you think your routine differs from other healthcare executives? 

GG: There are so many ways to be an effective healthcare executive, and I know many leaders subscribe to a specific routine. I really don't have a routine, but I do commit time each day to thinking about innovation.

As leaders we all have our share of what I call "maintenance versus fire drill" activities. In a large, complex organization, there are enough of these essential functions to keep most of us busy full-time. For example, in a 400-bed acute care facility, there is everything from internet connectivity to housekeeping to laboratory and pharmacy functions that are all important to patient care. To provide excellent service to our patients and their families, we must keep our leadership eyes on all these operational components. Yet, over the years I have come to realize none of those activities in themselves will help us flourish long-term. We must grow and evolve as an organization.

So, every day I contemplate how we can do things differently — truly differently. How can we better meet patient needs? How can we turn the care and payment models on their heads to get us closer to the Triple Aim? I guess you could say I plan my days to allow time and space to think outside of the box. This allows me to bring fresh ideas to the organization and provides me with a great sense of joy in my work.

Q: What do you like to have done before lunch?

GG: In the first half of the day, I like to accomplish three things: Connecting with people in the organization, responding to urgent issues and working on innovation. Those are the activities that match with my high energy level. Early in the day is good for questions — the primary one being, "Why?"

Why do we do it that way? Why couldn't we do it better? Why does that work well? Why does that not work? I leverage the time after lunch for responding to emails, organizing and tying up loose ends. For me, the afternoon is also a great time for reflecting on the events of the morning and re-establishing order for the next day.

Q: What is the last thing you do before you leave the office?

GG: The last thing I do is look at my white board. As I mentioned before, my white board details three fundamental questions, has ideas from brainstorming sessions and tracks key initiatives. Before leaving, I like to check in with my white board because it reminds me to come back to the question, "What are we trying to do?" It helps me focus and step back to remember the mission of our organization and my role in driving key changes to meet initiatives.

Q: What would you say is the hardest part of your day?

GG: Just like the most rewarding part is hearing about our positive impact on patients, the most difficult part is when things do not go well for patients. While our facilities are community hospitals, the clinical and surgical expertise of our medical staff is second to none. That said, we serve a population with high medical complexity, and our patients often come to us with advanced illnesses. Patients challenged with poverty and homelessness are issues we face daily, and we strive to help these patients continue their treatment regimens beyond our healthcare walls. However, there is much more that needs to be done at all levels to address issues at the core. Despite an exceptional quality record and a commitment to the highest level of care, patients do not always fare well. It is heartbreaking and discouraging, but it's also a reminder of why we are here and why we need to work across the community to ensure there's a seamless end-to-end wrap around the care we provide.

Q: How do you like to unwind when you get home?

GG: My favorite way to unwind is a trail run. If I can get out on the dirt and move my body, the stress of the day falls away and solutions to problems tend to emerge. Yoga is another great way to do that. But really any kind of workout reenergizes me and is a good transition to the evening.

Q: What is the most rewarding part of your day? 

GG: For me, the joy of work comes from a commitment to an inspiring vision and worthy mission, and just as importantly, working with an excellent team. I get to do that every day. In our morning huddle, we share patient stories and letters. When I hear of a patient or family member thanking our staff for taking great care of them, it truly inspires me. Intellectually, we know we provide excellent care. Our data tells us that. But when a patient communicates the positive impact our team has had on them, it touches the heart.

Q: What is the best advice you have received?

GG: When I was just starting out in leadership in a large health system, my boss said to me, "If you care about something, insert yourself into the process." It was excellent advice, which I have passed along to others. Prior to that, when I was out on my own as healthcare consultant, it was natural for me to get in the middle of issues that I cared about. In fact, for that very reason I founded a consulting group of physician leaders focused on engaging other physicians in healthcare reform. Then, when I joined that health system, my boss' advice was a helpful reminder that no matter where you find yourself working, it's important to pay attention and get involved in the process.

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