Jill Kalman, MD, then medical director of Lenox Hill Hospital in New York City, recalls being in the middle of a "pretty horrible day" before running into Maureen White, RN, chief nurse executive at New Hyde Park, N.Y.-based Northwell Health, during one of Ms. White's visits to the hospital.
"Sometimes I just feel like I take one step forward and two steps back," Dr. Kalman told Ms. White at the time. Ms. White responded, "Well, you're lucky you don't feel like you're taking five steps back," a simple phrase Dr. Kalman said shifted her outlook in a minute.
Years later, Ms. White and Dr. Kalman are still navigating good and bad days together as part of a successful chief nurse executive and chief medical officer partnership, serving the entire Northwell Health system.
The two leaders recently spoke with Becker's about what they have learned from each other and what makes their partnership so successful.
Paths to leadership
For her part, Ms. White has been with Northwell Health for 47 years, becoming a chief nursing executive at Long Island Jewish Medical Center in 1997. Within six months, she would be chief nursing executive at North Shore University Hospital and within two years, chief nursing executive of the entire health system. She remembers when the then vice president/COO and now president/CEO, Michael Dowling, offered her the role.
"I said, 'I'm flattered but what does a chief nursing officer of a health system do?' and he said, 'I don't know.' I kept asking him questions and he kept saying, 'I don't know," Ms. White said.
It was his answer to why a health system needs a chief nursing executive that has stuck with her.
"He said, 'Because we have a chief medical officer and I think nursing is equally as important,'" Ms. White said. "I realized he just offered me the job of a lifetime, and it certainly has been."
A cardiologist by training, Dr. Kalman has led heart failure programs at other organizations across New York City. She joined Northwell 10 years ago as an associate medical director for Long Island Jewish Medical Center, which is where she met Ms. White.
"I would say I've been working with Maureen since I started, because the way her leadership style cascades is really felt throughout every individual."
After eight months, Dr. Kalman became medical director at Lenox Hill. She held that position for three years before becoming executive director in 2018. She has served as Northwell Health's chief medical officer, alongside Ms. White as chief nursing executive, since 2021.
Though not in their current health system partnership when COVID-19 hit, Ms. White and Dr. Kalman still worked closely together during that time. They both remember seeing the effect strong clinical leadership had on hospital operations during the crisis, a period Dr. Kalman calls the most transformative of her entire career.
"You have to talk about COVID when it comes to the nurse-physician partnership," Dr. Kalman said. "What that looked like at our organization was: there are no lines. We are in this together and doing what needs to be done."
The blurring of lines and innate sense of togetherness was not something that simply just happened, Ms. White said.
"That was something that had been cultivated and part of our culture for years, if not decades, prior to this event," Ms. White said. "It put us in this horrible but wonderful position to be able to work together truly as a team, because we had always been a team."
Keys to a successful CNO-CMO partnership
Ms. White and Dr. Kalman both said the guiding principle behind the culture of teamwork and partnership at Northwell is one thing, the patient.
"We all have the same common vision, and that's to do the best for our patients," Ms. White said. "I think that's the secret sauce in the strength of our organization."
It's a secret sauce that has fueled their partnership through the successful implementation of a patient safety initiative called TeamSTEPPS.
In 2007, Northwell Health became the pilot health system for the American Hospital Association and the Agency for Healthcare Research and Quality's TeamSTEPPS program. The program, run solely by the AHA since 2017, trains hospitals and health systems on teamwork skills to enhance safety and communication. Northwell has sustained improvements related to the initiative for more than 15 years.
"The premise of TeamSTEPPS is that everybody's part of the team, the physicians, the nurses, the ancillary support staff, the receptionist. Everybody's on an equal playing field," Ms. White said. "It really was looking at it, not just as individual parts coming together, but as one unified team coming together to improve the quality of care in the organization."
But how can a partnership, let alone a whole team, maintain continued success while managing different personalities, outlooks and perspectives? Dr. Kalman puts it plainly.
"Listen, listen, listen. And when you've listened, listen again," she said.
"For me, it's being open — none of us knows it all," Ms. White said. "None of us are always right."
They both agree that one of the key factors in their partnership's success is how well they disagree with each other. An emphasis on respectful communication and the importance for humility are frequently mentioned when asked what advice they would give to other chief nurse, physician partnerships.
"When you have partnerships like this, it is so critical to have charitable assumption, to go back and forth," Dr. Kalman said. "It's not going to be right at first. But the point is, listen and come back."
"We still may not agree in the end, but we've gained a better understanding," Ms. White said. "That's part of the richness of our partnership and why it's worked so successfully."
A mutual admiration
In fact, their differences are part of what makes their partnership as effective as it is, they both said.
"I think if we were exactly the same, we would both be bored," Ms. White said, reminding Dr. Kalman of the other secret ingredient to their partnership: laughter.
"We're very serious leaders. But Maureen … she's hysterical."
"I don't see interacting with Dr. Kalman as 'work,' it's fun! It's a rewarding part of the job," Ms. White said, sure to emphasize how much she admires Dr. Kalman. "I'm grateful for her wisdom, for her friendship, her partnership, collegiality, and her sense of humor."
It's a mutual admiration and one Dr. Kalman shares each time she reflects on the wisdom Ms. White imparted to her years ago on that "pretty horrible day" at Lenox Hill.
"For someone who truly understands the ups and downs of being a healthcare leader, and it's not easy, the responsibility is enormous," Dr. Kalman says of Ms. White. "To have that sense of wisdom and sense of humor, she really is just a treasure for all of us."