"She just landed from overseas this morning," Carrie Herzke, MD, chief medical officer at Johns Hopkins Hospital in Baltimore said, referring to her chief nursing officer counterpart, Deborah Baker, DNP. "I was probably the second person she texted after her family."
It's a quick aside, but sums up the commitment both women have to their roles at Johns Hopkins and their partnership as a leadership team.
The two have worked alongside each other since 2019 when Dr. Herzke became the hospital's associate CMO. Having worked within the health system since 2008, she left only briefly in 2022 to serve as CMO for the Medical University of South Carolina in Charleston. Within two years, Dr. Herzke returned to Johns Hopkins Hospital as CMO in early 2024.
Dr. Baker has been with Johns Hopkins since her time as a student, earning her bachelor's, master's and doctoral degrees at the university's School of Nursing before joining the hospital as a clinical nurse in 1992. Besides serving as the hospital's CNO, Dr. Baker is also the senior vice president for nursing of the entire Johns Hopkins Health System.
Shared Goals, Core Values
When reflecting on what makes their partnership unique, Drs. Herzke and Baker both expressed a shared commitment to a perhaps overlooked clinical leadership tool, rounds.
"Being a visible leadership team is a core value for us," Dr. Baker said. "In addition to scheduled executive rounds, we also round with staff informally on nights and weekends."
Dr. Herzke attributes much of their success with rounds to Dr. Baker, or, as she calls her, "Deb."
"I appreciate how Deb can go on a floor and really relate," Dr, Herzke said. "Deb has set [the] expectation and demonstrates how she legitimately and genuinely cares about her team. It's one of the lessons that Deb has taught me, to get out and chat with the folks that are actually doing the work."
Acknowledging Interdependence
Dr. Herzke recalls watching Dr. Baker in action on rounds during the first wave of COVID-19, which happened shortly after Dr. Herzke stepped into the hospital's associate CMO role. She remembers walking with Dr. Baker through a specific unit that had been flipped into an ICU.
"We were asking people to do things they weren't familiar with. We didn't have vaccines. People were very nervous," Dr. Herzke said. "It was really touching to see how Deb knew and worked with the nurses. Walking through that unit and hearing our physician and nursing colleagues talk, seeing how proud they were, that was a defining moment."
Dr. Baker said her inclusivity can be attributed to their overemphasis on interdependence.
"Carrie and I are intentional about including stakeholders that are impacted by decisions, with patient quality and safety as guiding principles," Dr. Baker said, highlighting "solution session forums" attended by human resources, nursing and executive leaders where staff can share concerns.
Responding Together
An example of their inclusive leadership style is their leadership response team initiative. Through the program, anyone on a care team can request a problem-solving huddle with executives.
"The team huddles as many times as needed to resolve the issues," Dr. Baker said. "[It's] particularly valuable when the usual chain of command is unsuccessful in resolving critical issues. The nurse, physician and administrative leaders working well together [are] key to creating a healthy work environment."
The program is one way Dr. Herzke and Dr. Baker push forward on Johns Hopkins' mission of patient safety and quality first. A mission, Dr. Herzke said, that cannot be achieved if hospital care teams feel like their leaders are not similarly aligned.
"We want John Hopkins to be the best place to work as a nurse, as a physician, as a pharmacist — we want to be the best place to work, period," Dr. Herzke said. "That really takes a leadership team that works together. And two big partners of that are the CNO and the CMO."