Hospital CEOs' hardest day — and what it taught them

Hospital and health system CEOs have a lot on their minds as they guide their organizations through today's financial, workforce and operational challenges. One resource they are able to tap into: Lessons learned from challenges they have navigated earlier in their careers.

Several CEOs recently shared the hardest day of their career — and how they got through it — as part of an ongoing regular series of conversations with leaders of the nation's health systems.

Their responses are below.

Larry Antonucci, MD. President and CEO of Lee Health (Fort Myers, Fla.): The day that Hurricane Ian hit us here and really devastated our community. Sitting in the command center and watching our parking lot in one of our hospitals flood and seeing 400 of our staff's cars underwater and the implications that meant to them; and watching causeways and bridges get washed away was really remarkable; and recognizing the challenges that we were going to face both during and after. One of the things that happened to us that we weren't anticipating is that we lost our municipal water supply at two of our hospitals. It's very difficult to run a hospital without water. We literally had the staff and nurses out at our ponds and lakes doing bucket brigades to bring water in so we could flush toilets until we could get water trucks at the facility to get our water pressure back up. Those 24, 48 hours of Hurricane Ian were pretty difficult recognizing not only what was happening to our institution and our people, but recognizing the devastation to the entire community that it caused.

The corollary question, how did you get through it? It was watching our teams and watching the commitment that they had. We lost all communication, so we had our hospital teams working around the clock, taking care of patients, and they couldn't even reach their families. They had no idea whether their families were OK, whether their houses were still intact. And to see that, I just couldn't be prouder. I couldn't be more happy to be associated with this group of folks.

Mark Keroack, MD. President and CEO of Baystate Health (Springfield, Mass.): I'm going to focus on my hardest day as a CEO. I look back and it was probably in the early days of COVID, probably middle of March 2020. You could probably pick any of those days. We had just seen the first few COVID-19 cases a week before and things were skyrocketing. We got up to over 100 cases across our health system within about a week or 10 days en route to the total peak — the highest in our 1,000-bed hospital was 320 being COVID-19 patients. But early in those early days with these skyrocketing numbers, it was pretty clear things were out of control. You couldn't test. You couldn't get tests back in less than 10 days. We had no idea how to treat it. We really weren't totally sure about how to protect people. We were doing it by extension from other respiratory viruses. So I had this feeling I was putting people in harm's way. That total feeling of powerlessness and not knowing what the right thing was to do made it a very stressful time.

So I was in this thing where things were out of control, and I had no idea what to do. And probably the best thing I did was to delegate the incident command of the response to the virus to our chief physician, who had a military background. And I realized that as a leader, I tend to sort of be deliberative and think things through, and I'm not a fast decision-maker, whereas he was. He could step into situations, and I think we needed that. It freed me up to work on the outside political stuff, public education and advocacy with the state so we could become a regional testing center and a regional vaccine center. So the whole political health policy, public relations side of COVID-19 became my full-time job, and I didn't have to worry about the coordination of our response within the system because I had a person who was really better at that than I was.

Todd LaPorte. CEO of HonorHealth (Scottsdale, Ariz.): Most people think, being the CEO of the health system over these last seven years, that the logical thing would be to say something related to the pandemic. That was certainly a long and sustained mode of crisis management. There was a point in which more than one-third of our hospital beds were being occupied by people with COVID-19 infections. And, for those who are very vulnerable, it was resulting in a much higher mortality rate. 

But what I'm going to share is tangential to the pandemic. I had an orthopedic surgeon who is an accomplished sculptor and wanted to honor his colleagues and their collective response to the pandemic. He sculpted a statue that was in honor of his peers and colleagues. It had a dragon in it. It had an orb that was somewhat resembling the COVID-19 symbol. And it had a nurse holding this orb, keeping it away from this dragon that was engulfing the nurse. It was visually quite bold, but it came from the heart. It was very well-intended and, again, wanted to honor the effort of the caregivers.

I had a focus group from the hospital that the physician was based in take a look at it and said, "Hey, what do you think?" Thumbs up, great. We move forward with being able to put this sculpture on display at the hospital where he was on the medical staff. No sooner than inside of 24 hours, there was a scathing social media backlash coming from a journalistic association feeling as though it had a tone of being anti-Asian. And it was just awful because I knew the artist and his incredibly good intentions. But then I also felt terrible about hurting the feelings of some folks. I had not been smart enough to reach out to understand how they might receive that artwork. And so it was an awful time. What I learned from that is I've got to widen my circle of feedback. 

The situation, in essence, then ended up being part of what inspired our movement in a more organized and expansive way in managing diversity, equity and inclusion. And, of course, there was all kinds of buzz about that in that general time frame, the Black Lives Matter movement and other various forms of bringing attention to that area. And I think we said, "We need to be much more purposeful and serious about this as we move forward." Looking back on it, I probably would have had wider, more multifaceted focus group feedback on it. And, at the end of the day, I could tell you I wish that organization before they had jumped into social media had reached out to me and we could have talked about it. 

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