November 20, 2025 • 48 mins
What if the hardest part of quality isn’t finding the right answer, but making the right action unmistakable for the people who deliver care? That’s the thread we pull with Dr. Hilary Babcock—infectious disease physician, longtime infection prevention leader, and now chief quality officer helping steer a 12-hospital system of 33,000 people through transformation without losing its soul.
We talk about learning to lead beyond subject-matter expertise and how COVID pressure-tested every leadership instinct. Hilary shares how she and her team turned dashboards into decisions, building a centralized quality hub with deep resources and a one-page “top five” for each priority so busy managers could act today. She explains why outcome views must be paired with real-time process visibility—knowing not just that CLABSIs ticked up, but exactly who is overdue for a dressing change right now—so data becomes a map rather than a mirror.
We also go inside vaccine policy and trust. BJC implemented one of the nation’s earliest influenza mandates, treating it as a safety tool within a clear accommodation process. During the COVID rollout, transparency, values, and personal candor anchored tough choices about prioritization and access. The organization’s values—kindness, respect, excellence, safety, teamwork—moved from posters to practice, and a shift to centrally led, locally embedded quality teams helped spread best practices across hospitals while protecting local relationships.
If you care about healthcare quality, leadership, and culture, you’ll leave with practical tactics and renewed optimism. Hit play, then share this with a colleague who wants to turn analytics into action. If the conversation resonated, subscribe, leave a review, and tell us the one change you’ll try this week.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
We were the second hospital or health system in the
country to implement aninfluenza vaccine mandate.
When you stop thinking of it asa mandate and you think about it
as one of many tools that helpto drive a high influenza
vaccination rate among youremployees, the literature and
data is clear that the mosteffective intervention to drive
(00:22):
high influenza vaccination ratesamong healthcare workers is with
a mandate.
SPEAKER_01 (00:36):
I'm your host, Jason Meadows.
unknown (00:47):
Dr.
SPEAKER_01 (00:47):
Hilary Babcock is one of those rare leaders who
can hold complexity in one handand deliver clear, doable next
steps with the other.
She trained as an infectiousdisease physician and hospital
epidemiologist, led infectionprevention and occupational
health for years, and now servesas vice president and chief
(01:08):
quality officer at BJC Health inSt.
Louis.
An academic community systemspanning a dozen hospitals and
33,000 people.
During COVID, Hillary went fromstay in your lane infection
prevention to system-levelincident command.
Then into her CQL role, whereshe learned fast how to move
(01:32):
from subject matter expertise toleading other experts.
That shift shows up in how sheworks.
Translate uncertainty withintegrity.
Make the right thing the easything.
(01:52):
Turning dashboards into action,and then into one-page top fives
a nurse manager can actuallyuse, building a centrally led,
locally embedded quality modelwithout letting performance
slip, and navigating contentiousmoments like vaccine policy by
being transparent,values-anchored, and human.
(02:15):
If you care about moving ahealth system without breaking
it, this conversation is amasterclass.
I like this episode because it'sconcrete and immediately
applicable.
We get into how to simplifywithout dumbing down, how to
pair outcome views with processvisibility, how to communicate
when the evidence is evolving,and how to keep culture aligned
(02:39):
to kindness, respect,excellence, safety, and
teamwork.
You'll also leave with a coupleof gems from her bookshelf and a
renewed sense that the peopledoing this work are the reason
to stay hopeful.
Dr.
Hilary Babcock, welcome to theshow.
SPEAKER_00 (02:58):
Thank you.
Happy to be here.
SPEAKER_01 (03:00):
I wanted to get started with your background and
just a little bit of thebackstory and what's led you to
this point.
Your career started as aninfectious disease physician and
a hospital epidemiologist.
Tell me a little bit about justhow you've gotten up to this
point.
SPEAKER_00 (03:17):
Sure.
I went into infectious diseasesbecause I really like the
variety and the variety onmultiple levels, both like we
see patients of all ages, um,from all different backgrounds
and with all different kinds ofproblems in every organ system.
And we have some patients, asyou know, that we might follow
for years, or we might be theprimary care provider if they're
(03:38):
an HIV patient.
And we have some patients thatthey have a short-term
infection, we treat them, wecure them, done, never see them
again.
And so it's a nice mix ofthings.
Infection prevention is kind ofsimilar to that.
There are problems that go onforever.
Um, there are more immediateproblems, there are outbreaks
and clusters of infections thatneed to be investigated.
It has a lot of the same sort ofapproach that infectious disease
(04:01):
and epidemiology have, where weneed to ask a lot of questions,
do a lot of sort of figuring outof what's going on, and then
develop a plan to try to resolvewhat's happening, respond to
what's happening, and keep itfrom happening again.
So I think all of those thingstogether really brought me into
the infectious disease andinfection prevention world.
Um, and I did some clinicalresearch as well earlier in my
(04:24):
career.
And again, sort of similar, likewhy do these things happen?
How can we keep them fromhappening again?
Try to define that on a largerscale in ways that might be
helpful for other people.
SPEAKER_01 (04:34):
Yeah.
And so you you led, if I'mcorrect, uh you led infection
prevention and occupationalhealth for nearly two decades, I
think 16 years at your currentinstitution.
How did that role kind of evolveover time?
What experiences or insights uhduring those years ultimately
led you towards the chiefquality officer role?
SPEAKER_00 (04:55):
Sure.
So I started with infectionprevention and occupational
health, more in the occupationalhealth world to start with, and
then infection prevention, doingit more at a hospital level
initially, and then moving intoa system role where I was
helping to guide and direct andadvise about infection
prevention across amulti-hospital system here where
(05:16):
we are in St.
Louis, in Missouri and Illinois.
And I really enjoyed that work.
You work with a great team ofpeople, um a lot of infection
prevention specialists, a lot ofother physicians who were
interested in the same thing andall working together.
So it had definitely a teamsport feeling about it, which
was good.
And there's really sort of nevera dull moment in infection
(05:38):
prevention because there'salways something that's bubbling
up or going on.
So I really enjoyed that role.
I actually thought that thatwould probably be my role for
the rest of my career.
I would probably retire fromthat job.
I enjoyed it.
I was very happy in that role.
And then we had this smalldisruption of a global pandemic
that arrived sort ofunexpectedly in the middle of
(06:02):
all those things, and reallyobviously was a big disruptor
for everyone in a lot ofdifferent ways.
And um doing that work, workingwith the system in the system
incident command center reallygave me an opportunity to work
with a broader group of people,advise on sort of a broader
range of issues, and connectedme with leaders across the
(06:27):
organization in a different waythan I had in my previous role.
And so the chief clinicalofficer of our system um came to
me and said that they were gonnasplit.
They had sort of a combined CMOand CQO role, and they were
gonna split that into two rolesand have a CMO and make a true
CQO role.
And would I be interested inthat role?
(06:49):
And when they talked to me atthe time, um and my division
chief and ID, they said, we feellike you're kind of at this
career split where you coulddecide do you wanted to go in an
academic leadership role and doum division chief and department
leadership and those kinds ofthings, or you could decide do
you want to be more on theoperational side and stay in
more of a hospital and healthsystem-based role.
(07:10):
And I had really enjoyed theoperational work during the
COVID pandemic work.
And so I said that I would bemore interested in staying in
that lane rather than going backinto a more purely academic
role.
And I also feel like thepandemic was, you know, terrible
for a lot of us on a lot ofdifferent ways and a lot of
(07:32):
different levels.
And it didn't seem possible tome, really, to just think that
at the end of that, I would justgo back to what I had been doing
before.
It just didn't seem like it, itseemed almost like a
disrespectful or like adishonoring of the degree of
disruption and all the thingsthat had happened during that
(07:53):
time.
So I was very appreciative ofbeing given an opportunity to do
something new and differentmoving into this quality space.
SPEAKER_01 (08:03):
It sounds like the pandemic forced you to see even
more broadly, perhaps, thanyou'd been used to, kind of the
entirety of the health systemsthat you were working in.
Is that fair to say?
Did you become more of a systemsthinker than than you were
before as a result of that?
And was that a new experience?
SPEAKER_00 (08:23):
I think so.
We did a lot of sort of systemwork and trying to move towards
acting more as a system withinthe infection prevention world,
but we also had a clear sort ofmandate, like your lane is
infection prevention, and youshould sort of stay in your lane
of infection prevention.
And during the, not in a badway, like most infection
prevention people want to stayin the infection prevention
(08:45):
lane.
That's where we want to be.
During COVID, being sort of theID specialist advisor and the
infection prevention personmeant that it was working across
like outpatient, inpatient, lab,just you know how it was, like
everything, everything that wedid needed, like sort of an
infectious disease review.
(09:06):
So that you really did see, likeoutside of your lane of
infection prevention, sort ofsaw a broader view of what all
was happening.
So I feel like some of thesystems thinking is similar in
this role, but I added so manylanes to my highway that are in
my portfolio that I amresponsible for.
(09:27):
So I continue to have infectionprevention as one of my lanes,
but I am also responsible forpatient safety and regulatory
accreditation, our patientexperience team, our clinical
analytics team.
So that's not the full list, butthe it gives a sense of the more
lanes that are in the portfolionow.
SPEAKER_01 (09:47):
I mean, that's it's a hugely broadened portfolio.
And and just to take you know astep back and zoomed out, can
you give me a kind of a broadoverview of what BJC healthcare
uh looks like in terms of itsnumbers?
SPEAKER_00 (10:02):
Sure.
So BJC um is a health systemthat is um sort of along the
Mississippi River in St.
Louis between um Missouri andIllinois.
And we recently merged withanother health system on the
western side of the state andSt.
Luke's health system in KansasCity.
(10:22):
So we are still sort ofaligning, but are largely still
separate in the clinical spacesbetween what we now call the
West region and the east region.
So when I talk about BJC healthcare, is part is the east region
of BJC Health System now.
So BJC Healthcare, which iswhere I've spent most of my
career, is um, depending alittle bit on how you count it,
(10:46):
about 12 to 13 hospitals,ranging in size from a small
35-bed critical access hospitalto our largest academic
hospital, which has about 1,250beds.
We have about 33,000 employeesacross those organizations.
So it's a pretty sizable.
Our large academic hospital is,I think, the sixth largest
(11:09):
hospital in the country.
So it's a pretty big academicfootprint.
And we also have a freestandingchildren's hospital, as well as
then a range of communityhospitals in both Missouri and
Illinois.
SPEAKER_01 (11:20):
Wow.
So that's a real, it's anunderstatement to say that
you've you've broadened yourscope of responsibility.
SPEAKER_00 (11:27):
Yes.
I also like when I started,before I started in this role, I
think like many in academics, Ihad really not had direct
reports that reported to me.
I had worked with some researchcoordinators who reported to me
and a couple of other people,you know, and worked with a lot
of people, but not as directreports that I was directly
(11:50):
responsible for.
And when I started in this roleat the system level, I started
with four direct reports andthen I added like two direct
reports, and then we wentthrough an integration process
where different functions cameunder me, and we also integrated
those functions across theorganization so that our
infection prevention teams don'treport locally at their
(12:11):
hospitals.
They're embedded locally andwork at their local hospitals,
but they report up through asystem infection prevention
director who reports to me.
So in the last three and a half,four years, I guess, almost four
years that I've been in thisrole, I went from having no
direct reports to having fourdirect reports.
And now I have uh um eightdirect reports and uh a
(12:32):
department of about 225 people.
So it's been sort of a rapidevolution.
And I have been very lucky withthe team leaders that I have,
the directors and executivedirectors that I have working
for me are all really wonderful,very strong, very good at their
jobs, real deep subject matterexpertise in their functions.
(12:56):
Because the other thing that Ithink is kind of interesting
that was interesting for meabout this transition is that I
had always felt that myleadership role was really based
on my subject matter expertise.
I was asked to be a leader inthose spaces because I knew a
lot about infectious diseasesand about infection prevention.
But I came into this role and Iam not a deep subject matter
(13:20):
expert on each of the functionalareas that report to me.
And because I picked a lot ofthem up in a very short period
of time, it was not possible tofollow what probably would have
been my default setting, whichwas to try to become a deep
subject matter expert on each ofthose different functions.
That's really not possible whenyou add like seven functions at
the same time.
(13:41):
So I got actually a really goodpiece of advice from uh the
chief nurse executive who was umhere at the time when I started,
who has since retired.
And she said, when you reachthis level in the administration
and an executive leadershiprole, you're not really being
paid anymore for your subjectmatter expertise.
You're really being paid foryour leadership, for your
(14:01):
ability to build a team withsubject matter expertise, to
lead and support them, tonavigate for them and help them
and grow them.
That you can't be the expert oneverything anymore.
And that was a very helpfuladvice because that was a big
mind shift for me.
SPEAKER_01 (14:18):
I can imagine you went from being such a technical
expert to being a system leader.
What helped you make thattransition from evidence to
influence?
SPEAKER_00 (14:29):
I really do think that the process of leading
through COVID did sort of buildconfidence in your ability to
say, this is what we know now,and these are the principles and
philosophy that we work on, andtherefore these are what we
should be doing next, and we mayneed to adjust because things
(14:50):
may change.
So when it started, none of uswas a deep subject matter expert
on COVID because nobody was,because nobody knew anything.
So I think that was helpful.
And then starting in this role,again, really having a great
team that I was very lucky tostep into who had that knowledge
(15:11):
base and could really sort oflet me not have to be that
person because I knew that theywould know and that they could
help and support me.
And that the leaders I workedfor also recognized that I had a
good team and that they couldtrust that I could find the
information, bring back goodadvice and recommendations if I
didn't have them off the top ofmy head in a, you know, at any
(15:33):
given moment.
SPEAKER_01 (15:34):
Yeah, so many great questions I can think of to uh
to delve more into your yourtime, you know, your CQO role
kind of crystallizing uh duringCOVID.
What was that whole period likefor you?
SPEAKER_00 (15:49):
COVID or the transition to CQO or both, or
yeah.
SPEAKER_01 (15:53):
So maybe I can maybe I can hone my my understanding
of the timeline.
The I think you became CQO afterthe COVID pandemic started,
right?
SPEAKER_00 (16:03):
Yes.
So COVID started in early 2020,and I was offered this role in
November, um, or started in thisrole in November of 2021, and
then um, which was immediatelyfollowed by the Omicron wave of
the beginning of 2022.
So, in some ways, my new rolefelt a lot like my old role for
(16:24):
its first four to six months,where it was still really
managing through that wave.
So, really kind of started forreal in like the spring of 2022.
And things were sort of gettinga little more manageable and a
little more predictable in theCOVID space around then.
SPEAKER_01 (16:41):
Okay.
I guess getting in getting tosomething specific that I know
you talked about before, uh,you've spoken about taking
complexity and uncertainty andproviding clarity and simplicity
without losing, you know,integrity or reliability.
That's a hard needle to thread,as it were.
And uh, I'm wondering if you canshare an example of when you had
(17:02):
to do that in in real time,maybe during the COVID pandemic.
SPEAKER_00 (17:07):
I think that uh there are lots of possible
examples.
I think, well, I can't think ofa great detailed example
necessarily.
We had to do a lot with whatkind of PPE recommendations we
had.
We all had to navigate aroundwhat was available for PPE
recommendations.
(17:27):
And in the background, you know,we did a lot of outreach to
other organizations.
What are you doing?
How are you managing this?
What do you have available andhow are you bringing that
forward?
And then we, the team sort ofbrought together this will be
our plan.
This is what we'll work on, thisis what we're going to
(17:48):
recommend.
And then we needed to be able togo to our large team, to like
all of our employees, and say,this is what we know so far
about the way COVID istransmitted.
This is what we recommend foryou to wear.
We think this is safe because ofthe research that we've done and
what we know from other places.
(18:09):
And if we have to makeadjustments, we will.
And I feel like that so much ofquality work is that kind of
distillation of what do wereally need to convey to a
frontline employee about what itis that they need to do to
(18:31):
support the quality outcomesthat we're trying to achieve.
And because that frontlineperson is balancing so many
things that so many people wantthem to do for so many different
outcomes while still being acaring and compassionate person
interacting with a patient, thatit doesn't, it's not reasonable
(18:55):
to say, like, I'm gonna give youall of the literature and I'm
gonna give you all of thebackground and I'm gonna give
you everything.
At the end of the day, what Ineed you to know is that it's
critically important that you dothe chlorhexidine, put a
chlorhexidine dressing on everycentral line and it that it's
(19:16):
clear and it's simple, and youcan follow with the why, right?
We we need you, in order toprevent infections that put our
patients at risk, we need you toput a chlorhexidine dressing on
every central line every timeyou do a dressing change.
And that's really in some waysall that is needed.
But to be ready, if there arequestions like why do I do that
(19:38):
and how why is that better thanif I already cleaned it with
chlorexidine, why do I have toput that dressing on?
Your team has to be confidentthat you have all of those
answers behind therecommendation that you've given
them so they can get to that ifthey need it.
But at top of mind, they justhave to know like this is what I
need to do right now.
(19:59):
And I feel like that is aconstant quality struggle, but
is a really important goal forall of us is to try to make
those things simpler.
One of the things that we didsince I've been in this role, we
started a quality and safetyhub, an online website for our
(20:19):
employees where they can go andfind information about some of
our key outcomes.
So there's a CLAB C title, aCaldi tile, there's a glucose
management tile, there's apatient experience sort of tile
on the um website.
And each one of them has loadsof information and great
guidance and tools andresources.
(20:39):
And we got that all together andI was super excited and very
proud.
And then I said, you know whatwe actually need?
We need like just a top five foreach one of these things, like a
very simple like, here's the topfive things you can do to
prevent CLABSY.
And here's the top five thingsyou can do for patient
experience.
(21:00):
Because for a unit that istrying to get better in their
patient experience or in theirCLABS, it's great to have all
that information.
I want that all to be availableto them.
But for a busy nurse managerwho's like, I need to get my
CLABSY rates better, just lookat this top five, see which ones
you think you're doing well andwhich ones you're not, and work
on the ones you're not.
(21:21):
Here's the other information ifyou want it, if you need it,
resources, posters, like allkinds of stuff, background
literature, guidelines, papers,all the things.
Do these five things.
And so I think that that's beenpart of our messaging is to try
to take all of that complexityand make it easy for the
frontline person who's the onewho actually actually do the
(21:44):
thing, know what the thing is,and know how to do it.
SPEAKER_01 (21:48):
Well said.
I couldn't have said it better.
Um, you know, to have that thatcrystal clarity, it's it's
almost like your first draftcontains all of the background
work you did, and the finaldraft just includes the the
essentials.
So I love that.
You also helped lead andcommunicate uh an employee
vaccine mandate at BJC.
(22:09):
And I remember watching a videoabout you communicating about
this actually online.
And uh, this is a leadership anda communication challenge.
I know it probably felt evenmore sensitive at the time than
than maybe it it might today ina in a less tense atmosphere.
How did you and your teamapproach that decision?
How do you feel about it today?
SPEAKER_00 (22:30):
We were the second hospital or health system in the
country to implement aninfluenza vaccine mandate when
we implemented that mandate in2008.
And at the time, we had had alot of discussion about it and
conversation with our healthteam and our leaders, and really
just felt like it it was theright thing to do.
(22:53):
We had seen that another placehad been able to do it, and
really felt like we had a veryclear justification in terms of
all of the things that we haddone already in terms of that
tried to drive up that influenzavaccination rate.
And we had done, you know, allthe incentives and the
cheerleading and the um supportand the raffles and the roving
(23:16):
carts and everything you canthink of.
And when you stop thinking of itas sort of a mandate and you
think about it as one of manytools that help to drive a high
influenza vaccination rate amongyour employees, the literature
and data is clear that the mosteffective intervention to drive
high influenza vaccination ratesamong healthcare workers is with
(23:39):
a mandate.
And so we set out to say, like,we've done all of these things,
and we just really need to saythat based on our value of
safety, we need every employeeto be vaccinated against
influenza.
We had, as you might imagine, alot of conversations.
We had a lot of umpresentations, we had a lot of
discussion, we had a lot of workaround process in terms of how
(24:03):
people could request um medicalexemptions, how people could
request religious exemptions,what the process would be for
review and how that wouldevolve.
But we really, overall, it wentvery smoothly.
We definitely had a lot, peoplehad a lot of concerns, and we
had to talk through a lot, a lotof support for managers and
leaders to be able to have thoseconversations with their staff.
(24:26):
But at the end of all of that,it did actually go fairly
smoothly and has now been inplace with really not, it's
really just kind of thebackground now here.
So it's it's not a bigdiscussion every year.
Every year we're just like thisyear the date is November 17th,
and everyone needs to bevaccinated.
And we send out reports and wetell everyone what they need to
(24:48):
do, and we give the informationto leaders and we tell them what
the process is.
We did, like I think a lot ofplaces did, we initially
required the COVID vaccine whenthat was sort of an OSHA thing
that you should and a regulatorything that you that you needed
to have everyone vaccinated, andthen did not maintain that
requirement as things got morecontentious in discussing
(25:11):
vaccine politically goingforward.
One thing that did happenbecause of those conversations,
our process for um religiousaccommodations became more
flexible than we had beentraditionally.
And I think following sort ofsome of the court cases that
(25:32):
occurred and some of the rulingsthat happened, like really felt
like that needed to be a littlebit more of a flexible process.
And that has increased ournumber of religious
accommodations and people thatare not vaccinated because of
that over the last couple ofyears since COVID as well.
We do require people who are notvac vaccinated to wear a mask
(25:56):
when they are in the umhealthcare facility to be sure
that people are still protectedas best that they can be.
SPEAKER_01 (26:03):
And and it was a time I I can imagine where um
during COVID where wheretensions and emotions might have
run high.
And I remember the theme of justbroadly uh trust being being a
big issue, you know, throughoutNorth America and beyond.
How did you manage trust?
And were there a lot of ofchallenges with maintaining
(26:26):
trust that that staff had in theface of all of this, including
the vaccine mandates?
SPEAKER_00 (26:32):
I don't think we got everything perfectly right every
time, but we tried as much aspossible to be as transparent as
we could be about what we knewand what we didn't, what we had
available and when we thought wewould have more.
There was a lot, uh, you know,when the vaccine first came out,
it's hard to remember now withthe way people feel about the
(26:53):
vaccine now.
But of course, there was a lotof pressure and concern about
like who would get it in whatorder, how soon would we get
more, like when could we get it?
Those were terrible, you know,conversations to have to have
and to manage through.
And in the in the end, we didget it rolled out fairly quickly
and it was available to everyonein in fairly short order.
But in those first week or two,there was definitely a lot of
(27:15):
concern as we tried to balancelike who's at highest risk of a
terrible outcome if they getCOVID, but who is at highest
risk of exposure to COVID in thehospital and where they're
working.
And that ended up meaning thatwe prioritized older employees
first based on their risk of badoutcomes, which was not a
(27:35):
popular decision with our, youknow, trainees and with our
residents who are the front lineof that, you know, interaction
with patients a lot of the time.
And the the delay was reallyfairly short.
It was, you know, within thedays to a week or a week and a
half between when we started andwhen everyone could get, but
that didn't feel great forpeople at the time.
(27:55):
And we really did have to, youknow, try to message and be sure
that we had stuff available assoon as possible and open things
up more quickly as we got alittle more vaccine in.
We did uh have a lot ofconversation and again tried to
be very transparent and veryopen about the value of the
vaccine and what we saw.
(28:16):
And we had people, myselfincluded, who had lost family
members to COVID before vaccinewas available.
And we talked about that invideos that they made for, you
know, for people to be able tosee that like what it meant to
us to know that other peoplewere able to get this vaccine,
that our family members werenot, and that that that drives
(28:37):
the importance for us ofrecommending vaccine and trying
to be sure that people can canget vaccine.
And I think that that kind ofsort of vulnerability and
openness about like whatpersonally it really meant for
me and for some other folks whoparticipated in that, I think
also helps to build that trust.
(28:58):
Like I'm not just saying thislike as just like a policy
statement, that it's reallypersonal to me, how important I
think this is.
SPEAKER_01 (29:07):
Yeah.
I mean, that's that's so wellsaid, and sharing a little bit
of yourself goes a long way withthat.
Were you also leading culturechange?
I mean, was that one of theupshots of this that you were
ultimately leading some someelements of culture change at
BJC?
And and have there been anypositive, enduring aspects of
that culture change that thatare still around today?
SPEAKER_00 (29:30):
I think like a lot of organizations, during COVID,
we we are already anorganization that um speaks
freely about our values.
And we have five values that wetalk about a lot kindness.
At the time it was compassion,and we've recently rebranded
into kindness, um, respect,excellence, safety, and
(29:52):
teamwork.
And we talk about our crestvalues a lot.
And it is one of the things thatI really enjoy about working for
this organization is that peopleJust we talk about that all the
time.
So just in meetings and ingroups, people will be like,
well, leaning into our value ofsafety, I really think we need
to do such and such, likeinvoking our value of teamwork.
(30:13):
We really need to, you know,look at the way this team is
working together.
You know, we're we want to beexcellent.
So, and so that I think set usup actually really well to going
into COVID.
Everyone really did pull thosevalues to the forefront, come
together, really work as a team.
Everyone chipped in.
People from the ORs and Periopareas that when all of our ORs
(30:37):
closed down, they many of themcame over and helped us stand up
an occupational health callcenter and you know, develop our
policies and processes for ouremployees to be able to call in
and get guidance about what theyshould do.
And one of our ID doctors whoreally does um a lot of parasite
research in um other countries,he had been an EIS officer in
(31:01):
the past.
And he essentially came up to meand was like, How can I help?
Put me in, coach.
Like, where can I go?
And I was like, could you, couldyou run the standing up of this
occupational health call centerand all of the scripts that we
need and the guidance that weneed?
Like I can say, here's what weneed and what we're gonna do.
And then can you check me thatthat's right?
(31:21):
And then can you make that allhappen?
And he was like, Yep.
And he totally did.
It was, it was a wonderful thingto see.
And he did a great job.
I think for for us, as for a lotof others, as we came out of
COVID, it's been hard tomaintain that sort of focus
because it's easier to geteveryone to like get on board
and do something quickly when weare all doing the same thing.
(31:44):
Fighting one common enemy withone common goal is easier than
when, you know, in our usualstate where we have a lot of
priorities and a lot of thingsgoing on.
And it's easy to get bogged backdown into like constant
consensus building and trying toget more and more people on
board and approving things andmoving the losing a little bit
of the ability to move fast.
(32:05):
So we look back to that COVIDtime often and say, we need to
pull out like that ability tomove fast.
We proved we can.
So we need to do that again forthis particular thing or for
whatever it is.
The other cultural issue orcultural change, I think that
we've seen while I've been inthis role is we have been, as I
talked about a little bit when Italked about my number of people
(32:27):
on my team, is we've gonethrough this integration process
and moving to a more umcentrally reporting, locally
embedded, centrally reportingsort of model.
And that has gone actuallyreally well.
But as we started that work,there was a lot of um resistance
might be too strong a word, butthere was a lot of concern,
(32:48):
there was a lot of reluctance,there was a lot of fear about
loss of control, about loss ofum connection to your local
team.
I had multiple leaders say tome, like, you can't break
anything.
Like, we can't have quality getworse.
And I kept saying, like, I'm thequality officer.
(33:08):
Like, I am not interested inhaving quality get worse.
Like I share your goal and thatcommitment is mine.
Like, yes, totally with you.
We cannot have anything go inthe wrong direction.
So it has actually gone reallywell.
And I think now people really dospeak about the value of having
these more integrated teams,about having some, some of our
(33:31):
quality leaders at the directorlevel support more than one
hospital in what we now callsort of a micro region.
That has really helped sharepractices across and allowed us
to flex some staff when needed.
If there are people that are outor people who leave, that we can
really support the hospitalsbetter in this model.
(33:52):
So that has really been acultural shift for us.
We always talked about being anintegrated academic health
system, but we had reallystarted as kind of a loose
affiliation of hospitals.
And it was through some of thisprocess, which wasn't just in
the quality space, was alsohappening in HR and finance and
some other functions, that theymoved into more of this model
(34:15):
has really driven us more toreally living that system
structure and culture a lot morethan we were before.
Still not a hundred percent likeall integrated perfectly, but a
lot closer than we were before.
SPEAKER_01 (34:32):
Yeah.
It's good to hear that there'ssome, you know, some aspects of
of that COVID learning, becauseit feels so far away sometimes
now.
But I know that, you know, evenas I was digging a little more
into uh the research for thisepisode, seeing just how how
vividly, even more than the restof us, how vividly that was a
part of your your day-to-daylife for that that period of
(34:53):
time, and and then shiftingroles uh as it was unfolding,
it's really remarkable.
In your role in infectionprevention, you were using a lot
of of data, I'm I'm guessing.
And then I imagine there was ascramble to to incorporate that
as much as possible into thework during COVID, knowing that
the data would be you knowsometimes incomplete or
(35:15):
provisional based on evolvingclinical trials, etc.
And then now we've had kind of areturn to to normal for a little
while now.
Has the the way that you thinkabout, use, and communicate data
changed?
SPEAKER_00 (35:32):
We I would say we're sort of already moving towards
trying to make data more visibleand available to teams, but the
COVID work really did acceleratethat.
We have um really amazingclinical analytics group and a
um business intelligence anddesign systems group that build
(35:52):
a lot of our um dashboards andreports.
And during COVID, all of asudden, like everyone wanted to
be able to see a lot ofdifferent things all the time
and really learned like howquickly we can turn those
around, stand those up, get thatvisibility.
(36:13):
And growing from that, we haveincreasingly built dashboards
for other outcomes and for otherthings that we want to track and
now sort of house them alltogether.
We have a My Analytics websitewhere you can go to My Analytics
and you can go through, likehere are the clinical
dashboards, and you can seepretty much all the quality
(36:34):
outcomes have differentindividual dashboards that you
can find the information for,and that most people can get to
that data so they can answer alot of questions for themselves
about what is going on and whatis changing, what is better,
what is getting worse, what dowe need to do.
And then we also then took thatdata and recognized that for a
nurse manager, for example, itis a lot to ask a nurse manager
(36:58):
to go to 10 different dashboardsto see what your performance is
and then be able to have sort ofa gestalt of how are we doing.
Um, so they also made um we calla my IQ dashboard that has sort
of little insets, 10 littleinsets that show like here's
your CLBsy rate and is it red,green, or yellow?
(37:18):
And is it going up or down and alittle trend line?
And then there's CLBsy, caughty,falls, pressure injuries, you
know, with several othermetrics.
I think there are 10 littletiles on there.
So that has been a real help aswell.
We're still working to try toget something similar to that
for process measures in a waythat nurse leaders and nurses
(37:40):
can use to say, of all thepatients in my unit or
department right now, who isoverdue for a dressing change,
who is overdue for being turned,who is overdue for, you know,
didn't get their glucoseadjusted and they're, you know,
likely to get hypoglycemic.
So we're still working on makingthat more visible, those sort of
(38:01):
process pieces, but we've made alot of progress on the outcome
pieces, which is which has beengreat.
SPEAKER_01 (38:07):
It sounds, as I'm hearing it, almost like the same
principle you applied withconveying simple directions to
people during COVID was the isthe principle you're trying to
apply with data to the frontlines.
SPEAKER_00 (38:22):
I think so.
We we are, as an organization,we love data.
And we, I think manyorganizations are like this, but
we sometimes say that we aredrowning in data, but we don't
know what to do.
So we have been trying more andmore, and our analytics team
more and more to take the datais available.
Everyone can go look atdashboards and everyone can can
(38:45):
use it.
But how can we make it lookactionable?
How can we tell you, how can wetie this data to those top five
things that you can do if yousee things moving in the wrong
direction?
Um, and for our analytics teammembers who used to just sort
of, you know, say, here's somedata, um, but now also to have
them say, here's some data, andhere is what the data says, here
(39:08):
is what it shows from a trendperspective, here's where your
opportunities are, and may werefer you to this hub and to
these other places to see whattactics you need to follow.
So I think yes, we are trying totake the data and tie it more
directly to actions that peoplecan take and to try to make
those actions sort of clear andeasy.
SPEAKER_01 (39:31):
And this is something that I've I've spent a
lot of time thinking about andtalking about with other quality
leaders because it is a uniquechallenge.
We think, you know, that thethat building the dashboard,
seeing the the data will willtranslate into both inspiration
and action.
And uh it really does neither ofthose things.
SPEAKER_00 (39:50):
It does not.
It does not.
Yes, it's true.
It can it can, and sometimes itdoes.
Yeah, but right.
SPEAKER_01 (39:58):
Yeah.
But yeah, that is a it's auniversal challenge.
Um you know, you helped leadthrough what we hope is a
once-in-a-generation challengethrough COVID.
And I want to look ahead for youand for healthcare quality more
broadly.
And so, uh, you know, how hasthe the CQO role changed since
you entered it?
(40:18):
And what new capabilities willtomorrow's CQOs need, do you
think?
SPEAKER_00 (40:25):
Um, having not been in the role for a super long
time, I feel like the changes,the things that have changed in
the role since I came into therole are mostly to do with um
being sort of the strategicthinker, like trying to take
recognizing the subject matterexpertise and the leaders that
(40:45):
work for me and with me to letthem do their work and to really
try to stay for myself a littlemore one more level up at the
strategy level and the broaderstrategy level, because each of
them are doing strategicthinking for their specific
function area.
But for me to try and thinkabout how do we put that all
together?
(41:06):
And I think that that abilityfor quality officers to take all
of the many things that we aretrying to work on and improve
and um drive forward and to tryto look at them holistically.
How can we make that kind ofwork for the people, again, that
are the ones that have toactually do the things?
(41:27):
How can we make that as simpleas possible and as easy as
possible for those people to dothat?
The number of things that weneed to track and follow, the
impact of changes in paymentsystems, the potential changes
in insurance status for folks,like things are not gonna get
easier in healthcare.
(41:48):
And so I feel like our job is totry to make the work that our
frontline folks need to do assimple and as easy as we can
make it, knowing that there arejust gonna be constant headwinds
and competing demands and otherthings going on.
And and to the extent that wecan again take all of that and
(42:13):
distill it to all of thesethings are happening, but what
but we all need to do right nowis this hopefully more simple,
easier to understand, um, youknow, list of things or
activities and and goals that weneed to be working on.
So I think that kind of skillset is just gonna continue to
be.
(42:34):
I think it's important forquality officers now, and I
think it's just gonna becontinue to be put to the test
over the next few years.
SPEAKER_01 (42:41):
Knowing that, if you were to advise, I guess, your
your past self on on that, wheredo you go to learn that?
How do you seek that out, otherthan just getting it through
through experience and and trialand error and and the difficulty
of of everyday you know worklife?
SPEAKER_00 (43:00):
Yeah, if you find a great answer for that question,
I would love it if you wouldshare that with me.
Um I do feel like the you know,the the way that we met through
the IHI course, I think that umVisiant has some executive
networks as well.
I do think that a lot of it forme is those conversations and
(43:23):
being able to have a peer groupof folks who are working through
the same things is really themost helpful in thinking about
strategy and sort of forwardlooking because you can hear and
incorporate and think about whatthat means for you locally.
There are, I do read likeleadership books.
There are lots of leadershipbooks that are helpful on like
(43:46):
specific skills and specificways to think about things, but
I have not found a great thingthat sort of teaches me how to
do that sort of strategicgestalt overall view of
everything.
SPEAKER_01 (44:02):
Right.
Just thinking that thinking oneor two layers above.
SPEAKER_00 (44:05):
Yeah.
If you know one, let me know.
SPEAKER_01 (44:07):
You know, I I that you've you've put the you've put
the ball right back in my court.
Since you mentioned the thebooks, um, are there any that
you've read that have beenimpactful or that you'd
recommend to others?
SPEAKER_00 (44:20):
So I will share one of my favorite books of all time
from in a nonfictionperspective, is a book called
4,000 weeks, Time Management forMortals.
Um and I don't know if you'veread that book, but I love this
book.
It's by a guy named OliverBerkman.
He calls himself a recoveringproductivity guru.
And it's really, and it's notjust about work, it's really
(44:43):
about life in general.
And it's 4,000 weeks is theaverage human lifespan.
Um, and when you put it inweeks, it does just sort of sink
in a little differently.
So, like I'm 57, so I'mdefinitely more than halfway
through.
So 2,000, 1,500 weeks is likethat's what I have left to go
through.
So you start to think about likewhat really matters and what do
(45:05):
you want to spend your time on?
And the other thing he said thatI really appreciate is that
there is always more to do thanyou will be able to do.
You will never actually be ableto catch up, you will never be
able to do it all.
This was also a criticallearning for me from COVID
because before COVID, I actuallyfelt like I could mostly get
everything done.
COVID made clear that that wasnot, in fact, possible.
(45:27):
You cannot get everything done.
And so you always have toprioritize, and then you do want
to be sure that like you'redoing the most important things.
So that is a really, really goodone.
And I am recently not all theway through, but I've started
reading Crucial Conversations.
And that's a really good one.
I love the structure so farabout thinking about what level
(45:47):
in a conversation you want tobe, how not to be pulled into
somewhere else that you need to.
And just had a conversationearlier this week where I
thought, you know what?
I wish I had finished that bookbefore going into this
conversation because that didnot go in fact the way that I
wish that it had.
So I think that's gonna be areally helpful one for me as
well.
SPEAKER_01 (46:04):
That's great.
I've I've heard of both thecrucial conversations
recommended uh to me by anotherguest as well.
So I'm yeah, I'm grateful forthat.
I'll put those in the show notesso that other people can uh can
find them.
Looking forward, what makes youmost hopeful about the future of
healthcare quality work?
SPEAKER_00 (46:23):
The people.
The people.
So the people who are dedicatingtheir lives all the time to
trying to make things better atall levels within the quality
arena.
So the other quality officersthat I work with, the other
healthcare leaders that I workfor, and then the the frontline
team members as well and theday-to-day, like the work that
(46:43):
they put in, the commitment thatthey show.
Like, I think it's easy to getdiscouraged.
There are a lot of headwinds.
There's a lot of things that westruggle with, but seeing the
commitment and the energy thatpeople bring to doing this work
and to making things right forour patients and putting the
patient at the center every day,all day, that's what gives me
(47:04):
the most hope.
SPEAKER_01 (47:05):
I love it.
It's the same reason we go to uhthe IHI conference is why we we
meet online and discuss ideasbecause it's uh it it is that
shared kind of human endeavor ofworking together towards uh a
better healthcare qualityfuture.
SPEAKER_00 (47:20):
Yes.
Yes, absolutely.
SPEAKER_01 (47:22):
Well, as we come to the end of this conversation,
um, for listeners who'd like touh follow your work or connect,
what's the best place for themto do that?
SPEAKER_00 (47:33):
I mean, I think people should probably could
email me.
That's probably the best way toreach out directly.
I am on LinkedIn.
Um, I am on uh Blue Sky.
Um, so I I am there as well.
SPEAKER_01 (47:48):
Great.
So we can we can link yourLinkedIn and your and your Blue
Sky if you're uh willing toshare in the in the show notes
as well.
That's great.
Well, uh so we'll we'll link tothose.
So Hillary, uh Dr.
Hilary Babcock, thank you uh somuch for translating all this
the comp the complexity of ofscience and COVID into clarity
(48:08):
and trust.
Um, this is one of the mostpowerful conversations I've had.
I really appreciate your time.
Thank you.
SPEAKER_00 (48:13):
Thank you, Jason.
This is really fun.
SPEAKER_01 (48:17):
Thanks so much for listening to today's episode of
Leading Quality.
If you enjoyed the show, pleasetake a moment to like,
subscribe, and share it withsomeone who might find it
useful.
You can find all our episodes atleadingquality.buzzsprout.com or
in your favorite podcast app.
The show was written and hostedby me, Jason Meadows, edited by
(48:37):
Milan Milosavievich, andproduced by Thrive Healthcare
Improvement.
See you next time.
We were the second hospital or health system in the
country to implement aninfluenza vaccine mandate.
When you stop thinking of it asa mandate and you think about it
as one of many tools that helpto drive a high influenza
vaccination rate among youremployees, the literature and
data is clear that the mosteffective intervention to drive
(00:22):
high influenza vaccination ratesamong healthcare workers is with
a mandate.
SPEAKER_01 (00:36):
I'm your host, Jason Meadows.
unknown (00:47):
Dr.
SPEAKER_01 (00:47):
Hilary Babcock is one of those rare leaders who
can hold complexity in one handand deliver clear, doable next
steps with the other.
She trained as an infectiousdisease physician and hospital
epidemiologist, led infectionprevention and occupational
health for years, and now servesas vice president and chief
(01:08):
quality officer at BJC Health inSt.
Louis.
An academic community systemspanning a dozen hospitals and
33,000 people.
During COVID, Hillary went fromstay in your lane infection
prevention to system-levelincident command.
Then into her CQL role, whereshe learned fast how to move
(01:32):
from subject matter expertise toleading other experts.
That shift shows up in how sheworks.
Translate uncertainty withintegrity.
Make the right thing the easything.
(01:52):
Turning dashboards into action,and then into one-page top fives
a nurse manager can actuallyuse, building a centrally led,
locally embedded quality modelwithout letting performance
slip, and navigating contentiousmoments like vaccine policy by
being transparent,values-anchored, and human.
(02:15):
If you care about moving ahealth system without breaking
it, this conversation is amasterclass.
I like this episode because it'sconcrete and immediately
applicable.
We get into how to simplifywithout dumbing down, how to
pair outcome views with processvisibility, how to communicate
when the evidence is evolving,and how to keep culture aligned
(02:39):
to kindness, respect,excellence, safety, and
teamwork.
You'll also leave with a coupleof gems from her bookshelf and a
renewed sense that the peopledoing this work are the reason
to stay hopeful.
Dr.
Hilary Babcock, welcome to theshow.
SPEAKER_00 (02:58):
Thank you.
Happy to be here.
SPEAKER_01 (03:00):
I wanted to get started with your background and
just a little bit of thebackstory and what's led you to
this point.
Your career started as aninfectious disease physician and
a hospital epidemiologist.
Tell me a little bit about justhow you've gotten up to this
point.
SPEAKER_00 (03:17):
Sure.
I went into infectious diseasesbecause I really like the
variety and the variety onmultiple levels, both like we
see patients of all ages, um,from all different backgrounds
and with all different kinds ofproblems in every organ system.
And we have some patients, asyou know, that we might follow
for years, or we might be theprimary care provider if they're
(03:38):
an HIV patient.
And we have some patients thatthey have a short-term
infection, we treat them, wecure them, done, never see them
again.
And so it's a nice mix ofthings.
Infection prevention is kind ofsimilar to that.
There are problems that go onforever.
Um, there are more immediateproblems, there are outbreaks
and clusters of infections thatneed to be investigated.
It has a lot of the same sort ofapproach that infectious disease
(04:01):
and epidemiology have, where weneed to ask a lot of questions,
do a lot of sort of figuring outof what's going on, and then
develop a plan to try to resolvewhat's happening, respond to
what's happening, and keep itfrom happening again.
So I think all of those thingstogether really brought me into
the infectious disease andinfection prevention world.
Um, and I did some clinicalresearch as well earlier in my
(04:24):
career.
And again, sort of similar, likewhy do these things happen?
How can we keep them fromhappening again?
Try to define that on a largerscale in ways that might be
helpful for other people.
SPEAKER_01 (04:34):
Yeah.
And so you you led, if I'mcorrect, uh you led infection
prevention and occupationalhealth for nearly two decades, I
think 16 years at your currentinstitution.
How did that role kind of evolveover time?
What experiences or insights uhduring those years ultimately
led you towards the chiefquality officer role?
SPEAKER_00 (04:55):
Sure.
So I started with infectionprevention and occupational
health, more in the occupationalhealth world to start with, and
then infection prevention, doingit more at a hospital level
initially, and then moving intoa system role where I was
helping to guide and direct andadvise about infection
prevention across amulti-hospital system here where
(05:16):
we are in St.
Louis, in Missouri and Illinois.
And I really enjoyed that work.
You work with a great team ofpeople, um a lot of infection
prevention specialists, a lot ofother physicians who were
interested in the same thing andall working together.
So it had definitely a teamsport feeling about it, which
was good.
And there's really sort of nevera dull moment in infection
(05:38):
prevention because there'salways something that's bubbling
up or going on.
So I really enjoyed that role.
I actually thought that thatwould probably be my role for
the rest of my career.
I would probably retire fromthat job.
I enjoyed it.
I was very happy in that role.
And then we had this smalldisruption of a global pandemic
that arrived sort ofunexpectedly in the middle of
(06:02):
all those things, and reallyobviously was a big disruptor
for everyone in a lot ofdifferent ways.
And um doing that work, workingwith the system in the system
incident command center reallygave me an opportunity to work
with a broader group of people,advise on sort of a broader
range of issues, and connectedme with leaders across the
(06:27):
organization in a different waythan I had in my previous role.
And so the chief clinicalofficer of our system um came to
me and said that they were gonnasplit.
They had sort of a combined CMOand CQO role, and they were
gonna split that into two rolesand have a CMO and make a true
CQO role.
And would I be interested inthat role?
(06:49):
And when they talked to me atthe time, um and my division
chief and ID, they said, we feellike you're kind of at this
career split where you coulddecide do you wanted to go in an
academic leadership role and doum division chief and department
leadership and those kinds ofthings, or you could decide do
you want to be more on theoperational side and stay in
more of a hospital and healthsystem-based role.
(07:10):
And I had really enjoyed theoperational work during the
COVID pandemic work.
And so I said that I would bemore interested in staying in
that lane rather than going backinto a more purely academic
role.
And I also feel like thepandemic was, you know, terrible
for a lot of us on a lot ofdifferent ways and a lot of
(07:32):
different levels.
And it didn't seem possible tome, really, to just think that
at the end of that, I would justgo back to what I had been doing
before.
It just didn't seem like it, itseemed almost like a
disrespectful or like adishonoring of the degree of
disruption and all the thingsthat had happened during that
(07:53):
time.
So I was very appreciative ofbeing given an opportunity to do
something new and differentmoving into this quality space.
SPEAKER_01 (08:03):
It sounds like the pandemic forced you to see even
more broadly, perhaps, thanyou'd been used to, kind of the
entirety of the health systemsthat you were working in.
Is that fair to say?
Did you become more of a systemsthinker than than you were
before as a result of that?
And was that a new experience?
SPEAKER_00 (08:23):
I think so.
We did a lot of sort of systemwork and trying to move towards
acting more as a system withinthe infection prevention world,
but we also had a clear sort ofmandate, like your lane is
infection prevention, and youshould sort of stay in your lane
of infection prevention.
And during the, not in a badway, like most infection
prevention people want to stayin the infection prevention
(08:45):
lane.
That's where we want to be.
During COVID, being sort of theID specialist advisor and the
infection prevention personmeant that it was working across
like outpatient, inpatient, lab,just you know how it was, like
everything, everything that wedid needed, like sort of an
infectious disease review.
(09:06):
So that you really did see, likeoutside of your lane of
infection prevention, sort ofsaw a broader view of what all
was happening.
So I feel like some of thesystems thinking is similar in
this role, but I added so manylanes to my highway that are in
my portfolio that I amresponsible for.
(09:27):
So I continue to have infectionprevention as one of my lanes,
but I am also responsible forpatient safety and regulatory
accreditation, our patientexperience team, our clinical
analytics team.
So that's not the full list, butthe it gives a sense of the more
lanes that are in the portfolionow.
SPEAKER_01 (09:47):
I mean, that's it's a hugely broadened portfolio.
And and just to take you know astep back and zoomed out, can
you give me a kind of a broadoverview of what BJC healthcare
uh looks like in terms of itsnumbers?
SPEAKER_00 (10:02):
Sure.
So BJC um is a health systemthat is um sort of along the
Mississippi River in St.
Louis between um Missouri andIllinois.
And we recently merged withanother health system on the
western side of the state andSt.
Luke's health system in KansasCity.
(10:22):
So we are still sort ofaligning, but are largely still
separate in the clinical spacesbetween what we now call the
West region and the east region.
So when I talk about BJC healthcare, is part is the east region
of BJC Health System now.
So BJC Healthcare, which iswhere I've spent most of my
career, is um, depending alittle bit on how you count it,
(10:46):
about 12 to 13 hospitals,ranging in size from a small
35-bed critical access hospitalto our largest academic
hospital, which has about 1,250beds.
We have about 33,000 employeesacross those organizations.
So it's a pretty sizable.
Our large academic hospital is,I think, the sixth largest
(11:09):
hospital in the country.
So it's a pretty big academicfootprint.
And we also have a freestandingchildren's hospital, as well as
then a range of communityhospitals in both Missouri and
Illinois.
SPEAKER_01 (11:20):
Wow.
So that's a real, it's anunderstatement to say that
you've you've broadened yourscope of responsibility.
SPEAKER_00 (11:27):
Yes.
I also like when I started,before I started in this role, I
think like many in academics, Ihad really not had direct
reports that reported to me.
I had worked with some researchcoordinators who reported to me
and a couple of other people,you know, and worked with a lot
of people, but not as directreports that I was directly
(11:50):
responsible for.
And when I started in this roleat the system level, I started
with four direct reports andthen I added like two direct
reports, and then we wentthrough an integration process
where different functions cameunder me, and we also integrated
those functions across theorganization so that our
infection prevention teams don'treport locally at their
(12:11):
hospitals.
They're embedded locally andwork at their local hospitals,
but they report up through asystem infection prevention
director who reports to me.
So in the last three and a half,four years, I guess, almost four
years that I've been in thisrole, I went from having no
direct reports to having fourdirect reports.
And now I have uh um eightdirect reports and uh a
(12:32):
department of about 225 people.
So it's been sort of a rapidevolution.
And I have been very lucky withthe team leaders that I have,
the directors and executivedirectors that I have working
for me are all really wonderful,very strong, very good at their
jobs, real deep subject matterexpertise in their functions.
(12:56):
Because the other thing that Ithink is kind of interesting
that was interesting for meabout this transition is that I
had always felt that myleadership role was really based
on my subject matter expertise.
I was asked to be a leader inthose spaces because I knew a
lot about infectious diseasesand about infection prevention.
But I came into this role and Iam not a deep subject matter
(13:20):
expert on each of the functionalareas that report to me.
And because I picked a lot ofthem up in a very short period
of time, it was not possible tofollow what probably would have
been my default setting, whichwas to try to become a deep
subject matter expert on each ofthose different functions.
That's really not possible whenyou add like seven functions at
the same time.
(13:41):
So I got actually a really goodpiece of advice from uh the
chief nurse executive who was umhere at the time when I started,
who has since retired.
And she said, when you reachthis level in the administration
and an executive leadershiprole, you're not really being
paid anymore for your subjectmatter expertise.
You're really being paid foryour leadership, for your
(14:01):
ability to build a team withsubject matter expertise, to
lead and support them, tonavigate for them and help them
and grow them.
That you can't be the expert oneverything anymore.
And that was a very helpfuladvice because that was a big
mind shift for me.
SPEAKER_01 (14:18):
I can imagine you went from being such a technical
expert to being a system leader.
What helped you make thattransition from evidence to
influence?
SPEAKER_00 (14:29):
I really do think that the process of leading
through COVID did sort of buildconfidence in your ability to
say, this is what we know now,and these are the principles and
philosophy that we work on, andtherefore these are what we
should be doing next, and we mayneed to adjust because things
(14:50):
may change.
So when it started, none of uswas a deep subject matter expert
on COVID because nobody was,because nobody knew anything.
So I think that was helpful.
And then starting in this role,again, really having a great
team that I was very lucky tostep into who had that knowledge
(15:11):
base and could really sort oflet me not have to be that
person because I knew that theywould know and that they could
help and support me.
And that the leaders I workedfor also recognized that I had a
good team and that they couldtrust that I could find the
information, bring back goodadvice and recommendations if I
didn't have them off the top ofmy head in a, you know, at any
(15:33):
given moment.
SPEAKER_01 (15:34):
Yeah, so many great questions I can think of to uh
to delve more into your yourtime, you know, your CQO role
kind of crystallizing uh duringCOVID.
What was that whole period likefor you?
SPEAKER_00 (15:49):
COVID or the transition to CQO or both, or
yeah.
SPEAKER_01 (15:53):
So maybe I can maybe I can hone my my understanding
of the timeline.
The I think you became CQO afterthe COVID pandemic started,
right?
SPEAKER_00 (16:03):
Yes.
So COVID started in early 2020,and I was offered this role in
November, um, or started in thisrole in November of 2021, and
then um, which was immediatelyfollowed by the Omicron wave of
the beginning of 2022.
So, in some ways, my new rolefelt a lot like my old role for
(16:24):
its first four to six months,where it was still really
managing through that wave.
So, really kind of started forreal in like the spring of 2022.
And things were sort of gettinga little more manageable and a
little more predictable in theCOVID space around then.
SPEAKER_01 (16:41):
Okay.
I guess getting in getting tosomething specific that I know
you talked about before, uh,you've spoken about taking
complexity and uncertainty andproviding clarity and simplicity
without losing, you know,integrity or reliability.
That's a hard needle to thread,as it were.
And uh, I'm wondering if you canshare an example of when you had
(17:02):
to do that in in real time,maybe during the COVID pandemic.
SPEAKER_00 (17:07):
I think that uh there are lots of possible
examples.
I think, well, I can't think ofa great detailed example
necessarily.
We had to do a lot with whatkind of PPE recommendations we
had.
We all had to navigate aroundwhat was available for PPE
recommendations.
(17:27):
And in the background, you know,we did a lot of outreach to
other organizations.
What are you doing?
How are you managing this?
What do you have available andhow are you bringing that
forward?
And then we, the team sort ofbrought together this will be
our plan.
This is what we'll work on, thisis what we're going to
(17:48):
recommend.
And then we needed to be able togo to our large team, to like
all of our employees, and say,this is what we know so far
about the way COVID istransmitted.
This is what we recommend foryou to wear.
We think this is safe because ofthe research that we've done and
what we know from other places.
(18:09):
And if we have to makeadjustments, we will.
And I feel like that so much ofquality work is that kind of
distillation of what do wereally need to convey to a
frontline employee about what itis that they need to do to
(18:31):
support the quality outcomesthat we're trying to achieve.
And because that frontlineperson is balancing so many
things that so many people wantthem to do for so many different
outcomes while still being acaring and compassionate person
interacting with a patient, thatit doesn't, it's not reasonable
(18:55):
to say, like, I'm gonna give youall of the literature and I'm
gonna give you all of thebackground and I'm gonna give
you everything.
At the end of the day, what Ineed you to know is that it's
critically important that you dothe chlorhexidine, put a
chlorhexidine dressing on everycentral line and it that it's
(19:16):
clear and it's simple, and youcan follow with the why, right?
We we need you, in order toprevent infections that put our
patients at risk, we need you toput a chlorhexidine dressing on
every central line every timeyou do a dressing change.
And that's really in some waysall that is needed.
But to be ready, if there arequestions like why do I do that
(19:38):
and how why is that better thanif I already cleaned it with
chlorexidine, why do I have toput that dressing on?
Your team has to be confidentthat you have all of those
answers behind therecommendation that you've given
them so they can get to that ifthey need it.
But at top of mind, they justhave to know like this is what I
need to do right now.
(19:59):
And I feel like that is aconstant quality struggle, but
is a really important goal forall of us is to try to make
those things simpler.
One of the things that we didsince I've been in this role, we
started a quality and safetyhub, an online website for our
(20:19):
employees where they can go andfind information about some of
our key outcomes.
So there's a CLAB C title, aCaldi tile, there's a glucose
management tile, there's apatient experience sort of tile
on the um website.
And each one of them has loadsof information and great
guidance and tools andresources.
(20:39):
And we got that all together andI was super excited and very
proud.
And then I said, you know whatwe actually need?
We need like just a top five foreach one of these things, like a
very simple like, here's the topfive things you can do to
prevent CLABSY.
And here's the top five thingsyou can do for patient
experience.
(21:00):
Because for a unit that istrying to get better in their
patient experience or in theirCLABS, it's great to have all
that information.
I want that all to be availableto them.
But for a busy nurse managerwho's like, I need to get my
CLABSY rates better, just lookat this top five, see which ones
you think you're doing well andwhich ones you're not, and work
on the ones you're not.
(21:21):
Here's the other information ifyou want it, if you need it,
resources, posters, like allkinds of stuff, background
literature, guidelines, papers,all the things.
Do these five things.
And so I think that that's beenpart of our messaging is to try
to take all of that complexityand make it easy for the
frontline person who's the onewho actually actually do the
(21:44):
thing, know what the thing is,and know how to do it.
SPEAKER_01 (21:48):
Well said.
I couldn't have said it better.
Um, you know, to have that thatcrystal clarity, it's it's
almost like your first draftcontains all of the background
work you did, and the finaldraft just includes the the
essentials.
So I love that.
You also helped lead andcommunicate uh an employee
vaccine mandate at BJC.
(22:09):
And I remember watching a videoabout you communicating about
this actually online.
And uh, this is a leadership anda communication challenge.
I know it probably felt evenmore sensitive at the time than
than maybe it it might today ina in a less tense atmosphere.
How did you and your teamapproach that decision?
How do you feel about it today?
SPEAKER_00 (22:30):
We were the second hospital or health system in the
country to implement aninfluenza vaccine mandate when
we implemented that mandate in2008.
And at the time, we had had alot of discussion about it and
conversation with our healthteam and our leaders, and really
just felt like it it was theright thing to do.
(22:53):
We had seen that another placehad been able to do it, and
really felt like we had a veryclear justification in terms of
all of the things that we haddone already in terms of that
tried to drive up that influenzavaccination rate.
And we had done, you know, allthe incentives and the
cheerleading and the um supportand the raffles and the roving
(23:16):
carts and everything you canthink of.
And when you stop thinking of itas sort of a mandate and you
think about it as one of manytools that help to drive a high
influenza vaccination rate amongyour employees, the literature
and data is clear that the mosteffective intervention to drive
high influenza vaccination ratesamong healthcare workers is with
(23:39):
a mandate.
And so we set out to say, like,we've done all of these things,
and we just really need to saythat based on our value of
safety, we need every employeeto be vaccinated against
influenza.
We had, as you might imagine, alot of conversations.
We had a lot of umpresentations, we had a lot of
discussion, we had a lot of workaround process in terms of how
(24:03):
people could request um medicalexemptions, how people could
request religious exemptions,what the process would be for
review and how that wouldevolve.
But we really, overall, it wentvery smoothly.
We definitely had a lot, peoplehad a lot of concerns, and we
had to talk through a lot, a lotof support for managers and
leaders to be able to have thoseconversations with their staff.
(24:26):
But at the end of all of that,it did actually go fairly
smoothly and has now been inplace with really not, it's
really just kind of thebackground now here.
So it's it's not a bigdiscussion every year.
Every year we're just like thisyear the date is November 17th,
and everyone needs to bevaccinated.
And we send out reports and wetell everyone what they need to
(24:48):
do, and we give the informationto leaders and we tell them what
the process is.
We did, like I think a lot ofplaces did, we initially
required the COVID vaccine whenthat was sort of an OSHA thing
that you should and a regulatorything that you that you needed
to have everyone vaccinated, andthen did not maintain that
requirement as things got morecontentious in discussing
(25:11):
vaccine politically goingforward.
One thing that did happenbecause of those conversations,
our process for um religiousaccommodations became more
flexible than we had beentraditionally.
And I think following sort ofsome of the court cases that
(25:32):
occurred and some of the rulingsthat happened, like really felt
like that needed to be a littlebit more of a flexible process.
And that has increased ournumber of religious
accommodations and people thatare not vaccinated because of
that over the last couple ofyears since COVID as well.
We do require people who are notvac vaccinated to wear a mask
(25:56):
when they are in the umhealthcare facility to be sure
that people are still protectedas best that they can be.
SPEAKER_01 (26:03):
And and it was a time I I can imagine where um
during COVID where wheretensions and emotions might have
run high.
And I remember the theme of justbroadly uh trust being being a
big issue, you know, throughoutNorth America and beyond.
How did you manage trust?
And were there a lot of ofchallenges with maintaining
(26:26):
trust that that staff had in theface of all of this, including
the vaccine mandates?
SPEAKER_00 (26:32):
I don't think we got everything perfectly right every
time, but we tried as much aspossible to be as transparent as
we could be about what we knewand what we didn't, what we had
available and when we thought wewould have more.
There was a lot, uh, you know,when the vaccine first came out,
it's hard to remember now withthe way people feel about the
(26:53):
vaccine now.
But of course, there was a lotof pressure and concern about
like who would get it in whatorder, how soon would we get
more, like when could we get it?
Those were terrible, you know,conversations to have to have
and to manage through.
And in the in the end, we didget it rolled out fairly quickly
and it was available to everyonein in fairly short order.
But in those first week or two,there was definitely a lot of
(27:15):
concern as we tried to balancelike who's at highest risk of a
terrible outcome if they getCOVID, but who is at highest
risk of exposure to COVID in thehospital and where they're
working.
And that ended up meaning thatwe prioritized older employees
first based on their risk of badoutcomes, which was not a
(27:35):
popular decision with our, youknow, trainees and with our
residents who are the front lineof that, you know, interaction
with patients a lot of the time.
And the the delay was reallyfairly short.
It was, you know, within thedays to a week or a week and a
half between when we started andwhen everyone could get, but
that didn't feel great forpeople at the time.
(27:55):
And we really did have to, youknow, try to message and be sure
that we had stuff available assoon as possible and open things
up more quickly as we got alittle more vaccine in.
We did uh have a lot ofconversation and again tried to
be very transparent and veryopen about the value of the
vaccine and what we saw.
(28:16):
And we had people, myselfincluded, who had lost family
members to COVID before vaccinewas available.
And we talked about that invideos that they made for, you
know, for people to be able tosee that like what it meant to
us to know that other peoplewere able to get this vaccine,
that our family members werenot, and that that that drives
(28:37):
the importance for us ofrecommending vaccine and trying
to be sure that people can canget vaccine.
And I think that that kind ofsort of vulnerability and
openness about like whatpersonally it really meant for
me and for some other folks whoparticipated in that, I think
also helps to build that trust.
(28:58):
Like I'm not just saying thislike as just like a policy
statement, that it's reallypersonal to me, how important I
think this is.
SPEAKER_01 (29:07):
Yeah.
I mean, that's that's so wellsaid, and sharing a little bit
of yourself goes a long way withthat.
Were you also leading culturechange?
I mean, was that one of theupshots of this that you were
ultimately leading some someelements of culture change at
BJC?
And and have there been anypositive, enduring aspects of
that culture change that thatare still around today?
SPEAKER_00 (29:30):
I think like a lot of organizations, during COVID,
we we are already anorganization that um speaks
freely about our values.
And we have five values that wetalk about a lot kindness.
At the time it was compassion,and we've recently rebranded
into kindness, um, respect,excellence, safety, and
(29:52):
teamwork.
And we talk about our crestvalues a lot.
And it is one of the things thatI really enjoy about working for
this organization is that peopleJust we talk about that all the
time.
So just in meetings and ingroups, people will be like,
well, leaning into our value ofsafety, I really think we need
to do such and such, likeinvoking our value of teamwork.
(30:13):
We really need to, you know,look at the way this team is
working together.
You know, we're we want to beexcellent.
So, and so that I think set usup actually really well to going
into COVID.
Everyone really did pull thosevalues to the forefront, come
together, really work as a team.
Everyone chipped in.
People from the ORs and Periopareas that when all of our ORs
(30:37):
closed down, they many of themcame over and helped us stand up
an occupational health callcenter and you know, develop our
policies and processes for ouremployees to be able to call in
and get guidance about what theyshould do.
And one of our ID doctors whoreally does um a lot of parasite
research in um other countries,he had been an EIS officer in
(31:01):
the past.
And he essentially came up to meand was like, How can I help?
Put me in, coach.
Like, where can I go?
And I was like, could you, couldyou run the standing up of this
occupational health call centerand all of the scripts that we
need and the guidance that weneed?
Like I can say, here's what weneed and what we're gonna do.
And then can you check me thatthat's right?
(31:21):
And then can you make that allhappen?
And he was like, Yep.
And he totally did.
It was, it was a wonderful thingto see.
And he did a great job.
I think for for us, as for a lotof others, as we came out of
COVID, it's been hard tomaintain that sort of focus
because it's easier to geteveryone to like get on board
and do something quickly when weare all doing the same thing.
(31:44):
Fighting one common enemy withone common goal is easier than
when, you know, in our usualstate where we have a lot of
priorities and a lot of thingsgoing on.
And it's easy to get bogged backdown into like constant
consensus building and trying toget more and more people on
board and approving things andmoving the losing a little bit
of the ability to move fast.
(32:05):
So we look back to that COVIDtime often and say, we need to
pull out like that ability tomove fast.
We proved we can.
So we need to do that again forthis particular thing or for
whatever it is.
The other cultural issue orcultural change, I think that
we've seen while I've been inthis role is we have been, as I
talked about a little bit when Italked about my number of people
(32:27):
on my team, is we've gonethrough this integration process
and moving to a more umcentrally reporting, locally
embedded, centrally reportingsort of model.
And that has gone actuallyreally well.
But as we started that work,there was a lot of um resistance
might be too strong a word, butthere was a lot of concern,
(32:48):
there was a lot of reluctance,there was a lot of fear about
loss of control, about loss ofum connection to your local
team.
I had multiple leaders say tome, like, you can't break
anything.
Like, we can't have quality getworse.
And I kept saying, like, I'm thequality officer.
(33:08):
Like, I am not interested inhaving quality get worse.
Like I share your goal and thatcommitment is mine.
Like, yes, totally with you.
We cannot have anything go inthe wrong direction.
So it has actually gone reallywell.
And I think now people really dospeak about the value of having
these more integrated teams,about having some, some of our
(33:31):
quality leaders at the directorlevel support more than one
hospital in what we now callsort of a micro region.
That has really helped sharepractices across and allowed us
to flex some staff when needed.
If there are people that are outor people who leave, that we can
really support the hospitalsbetter in this model.
(33:52):
So that has really been acultural shift for us.
We always talked about being anintegrated academic health
system, but we had reallystarted as kind of a loose
affiliation of hospitals.
And it was through some of thisprocess, which wasn't just in
the quality space, was alsohappening in HR and finance and
some other functions, that theymoved into more of this model
(34:15):
has really driven us more toreally living that system
structure and culture a lot morethan we were before.
Still not a hundred percent likeall integrated perfectly, but a
lot closer than we were before.
SPEAKER_01 (34:32):
Yeah.
It's good to hear that there'ssome, you know, some aspects of
of that COVID learning, becauseit feels so far away sometimes
now.
But I know that, you know, evenas I was digging a little more
into uh the research for thisepisode, seeing just how how
vividly, even more than the restof us, how vividly that was a
part of your your day-to-daylife for that that period of
(34:53):
time, and and then shiftingroles uh as it was unfolding,
it's really remarkable.
In your role in infectionprevention, you were using a lot
of of data, I'm I'm guessing.
And then I imagine there was ascramble to to incorporate that
as much as possible into thework during COVID, knowing that
the data would be you knowsometimes incomplete or
(35:15):
provisional based on evolvingclinical trials, etc.
And then now we've had kind of areturn to to normal for a little
while now.
Has the the way that you thinkabout, use, and communicate data
changed?
SPEAKER_00 (35:32):
We I would say we're sort of already moving towards
trying to make data more visibleand available to teams, but the
COVID work really did acceleratethat.
We have um really amazingclinical analytics group and a
um business intelligence anddesign systems group that build
(35:52):
a lot of our um dashboards andreports.
And during COVID, all of asudden, like everyone wanted to
be able to see a lot ofdifferent things all the time
and really learned like howquickly we can turn those
around, stand those up, get thatvisibility.
(36:13):
And growing from that, we haveincreasingly built dashboards
for other outcomes and for otherthings that we want to track and
now sort of house them alltogether.
We have a My Analytics websitewhere you can go to My Analytics
and you can go through, likehere are the clinical
dashboards, and you can seepretty much all the quality
(36:34):
outcomes have differentindividual dashboards that you
can find the information for,and that most people can get to
that data so they can answer alot of questions for themselves
about what is going on and whatis changing, what is better,
what is getting worse, what dowe need to do.
And then we also then took thatdata and recognized that for a
nurse manager, for example, itis a lot to ask a nurse manager
(36:58):
to go to 10 different dashboardsto see what your performance is
and then be able to have sort ofa gestalt of how are we doing.
Um, so they also made um we calla my IQ dashboard that has sort
of little insets, 10 littleinsets that show like here's
your CLBsy rate and is it red,green, or yellow?
(37:18):
And is it going up or down and alittle trend line?
And then there's CLBsy, caughty,falls, pressure injuries, you
know, with several othermetrics.
I think there are 10 littletiles on there.
So that has been a real help aswell.
We're still working to try toget something similar to that
for process measures in a waythat nurse leaders and nurses
(37:40):
can use to say, of all thepatients in my unit or
department right now, who isoverdue for a dressing change,
who is overdue for being turned,who is overdue for, you know,
didn't get their glucoseadjusted and they're, you know,
likely to get hypoglycemic.
So we're still working on makingthat more visible, those sort of
(38:01):
process pieces, but we've made alot of progress on the outcome
pieces, which is which has beengreat.
SPEAKER_01 (38:07):
It sounds, as I'm hearing it, almost like the same
principle you applied withconveying simple directions to
people during COVID was the isthe principle you're trying to
apply with data to the frontlines.
SPEAKER_00 (38:22):
I think so.
We we are, as an organization,we love data.
And we, I think manyorganizations are like this, but
we sometimes say that we aredrowning in data, but we don't
know what to do.
So we have been trying more andmore, and our analytics team
more and more to take the datais available.
Everyone can go look atdashboards and everyone can can
(38:45):
use it.
But how can we make it lookactionable?
How can we tell you, how can wetie this data to those top five
things that you can do if yousee things moving in the wrong
direction?
Um, and for our analytics teammembers who used to just sort
of, you know, say, here's somedata, um, but now also to have
them say, here's some data, andhere is what the data says, here
(39:08):
is what it shows from a trendperspective, here's where your
opportunities are, and may werefer you to this hub and to
these other places to see whattactics you need to follow.
So I think yes, we are trying totake the data and tie it more
directly to actions that peoplecan take and to try to make
those actions sort of clear andeasy.
SPEAKER_01 (39:31):
And this is something that I've I've spent a
lot of time thinking about andtalking about with other quality
leaders because it is a uniquechallenge.
We think, you know, that thethat building the dashboard,
seeing the the data will willtranslate into both inspiration
and action.
And uh it really does neither ofthose things.
SPEAKER_00 (39:50):
It does not.
It does not.
Yes, it's true.
It can it can, and sometimes itdoes.
Yeah, but right.
SPEAKER_01 (39:58):
Yeah.
But yeah, that is a it's auniversal challenge.
Um you know, you helped leadthrough what we hope is a
once-in-a-generation challengethrough COVID.
And I want to look ahead for youand for healthcare quality more
broadly.
And so, uh, you know, how hasthe the CQO role changed since
you entered it?
(40:18):
And what new capabilities willtomorrow's CQOs need, do you
think?
SPEAKER_00 (40:25):
Um, having not been in the role for a super long
time, I feel like the changes,the things that have changed in
the role since I came into therole are mostly to do with um
being sort of the strategicthinker, like trying to take
recognizing the subject matterexpertise and the leaders that
(40:45):
work for me and with me to letthem do their work and to really
try to stay for myself a littlemore one more level up at the
strategy level and the broaderstrategy level, because each of
them are doing strategicthinking for their specific
function area.
But for me to try and thinkabout how do we put that all
together?
(41:06):
And I think that that abilityfor quality officers to take all
of the many things that we aretrying to work on and improve
and um drive forward and to tryto look at them holistically.
How can we make that kind ofwork for the people, again, that
are the ones that have toactually do the things?
(41:27):
How can we make that as simpleas possible and as easy as
possible for those people to dothat?
The number of things that weneed to track and follow, the
impact of changes in paymentsystems, the potential changes
in insurance status for folks,like things are not gonna get
easier in healthcare.
(41:48):
And so I feel like our job is totry to make the work that our
frontline folks need to do assimple and as easy as we can
make it, knowing that there arejust gonna be constant headwinds
and competing demands and otherthings going on.
And and to the extent that wecan again take all of that and
(42:13):
distill it to all of thesethings are happening, but what
but we all need to do right nowis this hopefully more simple,
easier to understand, um, youknow, list of things or
activities and and goals that weneed to be working on.
So I think that kind of skillset is just gonna continue to
be.
(42:34):
I think it's important forquality officers now, and I
think it's just gonna becontinue to be put to the test
over the next few years.
SPEAKER_01 (42:41):
Knowing that, if you were to advise, I guess, your
your past self on on that, wheredo you go to learn that?
How do you seek that out, otherthan just getting it through
through experience and and trialand error and and the difficulty
of of everyday you know worklife?
SPEAKER_00 (43:00):
Yeah, if you find a great answer for that question,
I would love it if you wouldshare that with me.
Um I do feel like the you know,the the way that we met through
the IHI course, I think that umVisiant has some executive
networks as well.
I do think that a lot of it forme is those conversations and
(43:23):
being able to have a peer groupof folks who are working through
the same things is really themost helpful in thinking about
strategy and sort of forwardlooking because you can hear and
incorporate and think about whatthat means for you locally.
There are, I do read likeleadership books.
There are lots of leadershipbooks that are helpful on like
(43:46):
specific skills and specificways to think about things, but
I have not found a great thingthat sort of teaches me how to
do that sort of strategicgestalt overall view of
everything.
SPEAKER_01 (44:02):
Right.
Just thinking that thinking oneor two layers above.
SPEAKER_00 (44:05):
Yeah.
If you know one, let me know.
SPEAKER_01 (44:07):
You know, I I that you've you've put the you've put
the ball right back in my court.
Since you mentioned the thebooks, um, are there any that
you've read that have beenimpactful or that you'd
recommend to others?
SPEAKER_00 (44:20):
So I will share one of my favorite books of all time
from in a nonfictionperspective, is a book called
4,000 weeks, Time Management forMortals.
Um and I don't know if you'veread that book, but I love this
book.
It's by a guy named OliverBerkman.
He calls himself a recoveringproductivity guru.
And it's really, and it's notjust about work, it's really
(44:43):
about life in general.
And it's 4,000 weeks is theaverage human lifespan.
Um, and when you put it inweeks, it does just sort of sink
in a little differently.
So, like I'm 57, so I'mdefinitely more than halfway
through.
So 2,000, 1,500 weeks is likethat's what I have left to go
through.
So you start to think about likewhat really matters and what do
(45:05):
you want to spend your time on?
And the other thing he said thatI really appreciate is that
there is always more to do thanyou will be able to do.
You will never actually be ableto catch up, you will never be
able to do it all.
This was also a criticallearning for me from COVID
because before COVID, I actuallyfelt like I could mostly get
everything done.
COVID made clear that that wasnot, in fact, possible.
(45:27):
You cannot get everything done.
And so you always have toprioritize, and then you do want
to be sure that like you'redoing the most important things.
So that is a really, really goodone.
And I am recently not all theway through, but I've started
reading Crucial Conversations.
And that's a really good one.
I love the structure so farabout thinking about what level
(45:47):
in a conversation you want tobe, how not to be pulled into
somewhere else that you need to.
And just had a conversationearlier this week where I
thought, you know what?
I wish I had finished that bookbefore going into this
conversation because that didnot go in fact the way that I
wish that it had.
So I think that's gonna be areally helpful one for me as
well.
SPEAKER_01 (46:04):
That's great.
I've I've heard of both thecrucial conversations
recommended uh to me by anotherguest as well.
So I'm yeah, I'm grateful forthat.
I'll put those in the show notesso that other people can uh can
find them.
Looking forward, what makes youmost hopeful about the future of
healthcare quality work?
SPEAKER_00 (46:23):
The people.
The people.
So the people who are dedicatingtheir lives all the time to
trying to make things better atall levels within the quality
arena.
So the other quality officersthat I work with, the other
healthcare leaders that I workfor, and then the the frontline
team members as well and theday-to-day, like the work that
(46:43):
they put in, the commitment thatthey show.
Like, I think it's easy to getdiscouraged.
There are a lot of headwinds.
There's a lot of things that westruggle with, but seeing the
commitment and the energy thatpeople bring to doing this work
and to making things right forour patients and putting the
patient at the center every day,all day, that's what gives me
(47:04):
the most hope.
SPEAKER_01 (47:05):
I love it.
It's the same reason we go to uhthe IHI conference is why we we
meet online and discuss ideasbecause it's uh it it is that
shared kind of human endeavor ofworking together towards uh a
better healthcare qualityfuture.
SPEAKER_00 (47:20):
Yes.
Yes, absolutely.
SPEAKER_01 (47:22):
Well, as we come to the end of this conversation,
um, for listeners who'd like touh follow your work or connect,
what's the best place for themto do that?
SPEAKER_00 (47:33):
I mean, I think people should probably could
email me.
That's probably the best way toreach out directly.
I am on LinkedIn.
Um, I am on uh Blue Sky.
Um, so I I am there as well.
SPEAKER_01 (47:48):
Great.
So we can we can link yourLinkedIn and your and your Blue
Sky if you're uh willing toshare in the in the show notes
as well.
That's great.
Well, uh so we'll we'll link tothose.
So Hillary, uh Dr.
Hilary Babcock, thank you uh somuch for translating all this
the comp the complexity of ofscience and COVID into clarity
(48:08):
and trust.
Um, this is one of the mostpowerful conversations I've had.
I really appreciate your time.
Thank you.
SPEAKER_00 (48:13):
Thank you, Jason.
This is really fun.
SPEAKER_01 (48:17):
Thanks so much for listening to today's episode of
Leading Quality.
If you enjoyed the show, pleasetake a moment to like,
subscribe, and share it withsomeone who might find it
useful.
You can find all our episodes atleadingquality.buzzsprout.com or
in your favorite podcast app.
The show was written and hostedby me, Jason Meadows, edited by
(48:37):
Milan Milosavievich, andproduced by Thrive Healthcare
Improvement.
See you next time.
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