026, HR Healthcare__Keynote Presentation_Understanding Why Culture

Lisa Abbot, Chief Human Resources Officer, Boston Children’s Hospital: Good morning, everybody. Good morning. Mic is on. Thank you, sir. Thank you. Good to see you. I was looking for you when I came in. Glad, glad you can make it. All smiles. We're gonna talk about that. I am Lisa Abbott, the Chief People Officer at Boston Children's Hospital. Pleasure to be here with you this morning.

Um, listening to the theme, bend without breaking, resiliency, workforce, the people. I am known for Lisa-isms in my organization. Some of my colleagues will, will tell you that we start many meetings with a quip, sometimes funny, sometimes a little more grounded in our mission, sometimes trying to guide us around purpose.

Um, is this the clicker? Neat. It looks like a walkie-talkie. Is anybody back there? Um, but I wanna start this morning with, you know, often I'll say, let's, you know, when we're having, we have a problem, how serious is the problem? Well, did the world continue to spin on its axis? Okay, we're in good shape. Did we all wake up today on the right side of the ground?

We're pretty good. Most days, though, I wake up thinking about how to create an environment where our people bring their very best selves to work, but more importantly, they bring their very best selves back home. Why is that important? It's important because if you can imagine the, the dining room table conversation around, "How was your workday, honey?"

The people that we want coming back the next day are the ones that say, "It was great. It was great. I had a great day. I, I had a great patient experience. I had a good encounter with a family. I had a colleague that did something wonderful." Or even, you know, "I screwed up. I made a mistake, but my boss was there for me."

Those are the people that are engaged. Those are the people that are cultivating goodwill in our communities. Those are the folks that are our patients and their families. So that's how I start every day. How do we create an environment where people bring their very best selves to work, and they bring their very best selves back home?

Is the big green arrow the forward one? Yes. Excellent. So at the end of the day, I think we all want a lot of the same things. We're in healthcare. We're here to cultivate great patient experiences. These are really rough times for people. Nobody's in the hospital because they wanna be. They're there because they have to be.

They're at the doctor because generally there's a condition or an issue or a situation for themselves or somebody that they care deeply about. So we want to create experiences that are great for these patients. We want-- Boy, oh boy. Let's see. Up, down. Transition lenses. Uh, we want high performance. We want people that come that, that are really charged up no matter what their job, no matter what they're there to do, they- they're there because they wanna be there and they wanna do a great job.

We want great outcomes. We want our patients to have great outcomes. Nobody wants a bad patient experience. They happen, but we want those to be a rarity. We want-- Can I do any better without the glasses? Not really. Oh, Mercy, you're my hero. They made the, the words bigger. That's awesome. That's really awesome.

It's like, wow, the wonders of technology. Did AI do that? Did I just will that to happen? I think I willed that to happen. Um, we of course want great retention. Y- you know, one of the themes that we're still talking about many years after the pandemic are workforce shortages in healthcare. Even though healthcare is one of the most stable, uh, environments, one of the most stable employers you can be in, it's still really hard for us to attract, which makes retention all the more important.

We want stronger engagement. We want people coming to work, feeling good about their job, feeling like their work matters, feeling like their boss cares, feeling like there is purpose. And of course, we want improved financial outcomes, not for the sake of making money. Many of us, not all of us, but many of us work in not-for-profit healthcare.

Not-for-profit doesn't mean we don't make any money. No money, no mission. It means we make money to reinvest, to reinvest in our people, to reinvest in technology, to reinvest in our space so we have decent places to work and decent places to care for the, the patients and the families that we're seeing So what does that look like?

We touched on this in, in the opening comments today, right? People are at the center of this. A strategy's not at the center. We don't look and say, "Let's build a, an, a, a program around a strategy necessarily." The people are at the center, and if the people aren't the strategy, the strategy isn't executed.

So what makes this possible? What makes us have higher performance, higher engagement, better patient outcomes, better financial performance? It's putting the people at the center. It's having a strategy that involves engagement, and it's making sure our leaders really understand their obligation, their responsibility, their commitment, and their desire to lead people.

Not the tasks about leading people, right? Not the approval of the payroll and the approval of the time off and the completion of the oh-so-beloved performance appraisal. Everybody loves that. It's engaging in how do I grow the talent? How do I make sure my people feel rewarded and recognized and appreciated?

How do I coach and, and, and consult when people make mistakes? We're, we're humans. Making mistakes is part of our humanity, but how do we approach the, the making of a mistake so people feel like there's a learning there and not just condemnation?

So what are we doing? What are we, what are we thinking about high performance and, and engagement? Do we know that our work matters? Are we creating an environment where our people can work top of license? We use that expression a lot as it relates to clinical care in the workforce, but we all in administrative jobs, support jobs, research jobs, all kinds of jobs, we wanna know that we're working top of license, that we're putting our education or our learning or our training or our passion front and center, and we can, we can perform at a level that is most contributory to the organization that we're serving.

Trust is huge. Trust is huge. Do I trust my leader? Do they say what they mean? Do they mean what they say? And do they execute when they tell me they're going to do something? If they don't, if they make a mistake, do they own it? Do they help me grow in a way that makes sense for my desire, my career, where I am stage in life?

Do I feel connected? We know on the Press Ganey survey anyway, we always have the question about, do I have a best friend at work? We know that when people have friends at work, they are more inclined to stay in our organization. So how are we cultivating that feeling of connectedness, that feeling of community, that feeling that I belong, that I matter, that I should be here?

Do people have energy? Do they have energy to do their job? Are we managing the workload in a way that makes sense? Can we help people bend, not break? That's about helping manage the workload. We all have pl- anybody here not have plenty to do? Anybody looking for like a side hustle, something else going on?

I know you got a side-- I like your side hustle. We're gonna talk about smiles here in a minute. Um, yeah, bend without breaking. How do we do that? How do we manage the workload? So purpose, trust, connection, wellbeing, right? That whole theme of wellbeing. Wellbeing is, is about a lot of things, and we'll talk about that a minute.

If we can get those things right, if we can help people feel connected to their work, they're working top of license, they feel like they can trust you, they're connected because they have a friend or two at work, or there's a community in their, in their respective part of the organization, and we create and foster an environment of wellbeing, then we end up with engagement, execution on our mission, and organizational performance optimized So what are we doing at Boston Children's, right?

We-- Some of this is about what's in action that's actually working, what's not working, how do we cultivate, uh, some flexibility and agility in the workplace and, and you touched on this as well, my friend from Deloitte, that if something's not working, let's name it, let's try something different, l-let's figure it out.

So we, we s- have spent a lot of time in the last couple of years on different kinds of listening tours. We have done, of course, employee engagement surveys. We've done physician well-being surveys to really get the-- take the temperature of our physician population in particular and our clinicians. We have done focus groups, lots of focus groups around different things.

What's our employee value proposition? What's our total reward strategy, and are people connected to it? They-- Do they feel like they see something that's important to them in the grand scheme of our comp benefits and other ancillary supports that we offer? What are we doing with that information? What happens when we go on our listening tours, and how do we make people feel heard in that journey?

Is leadership visible? So we spend a lot of time at-- Anybody familiar with high reliability organization, that principle, right? We're a high reliability organization. We do a lot of rounding. There's a lot of rounding that happens, and we take that back, and we distill what we're learning and what we're hearing, and we try to make organizational improvements through all of the inputs that we get, right?

You get a lot of inputs, so themes emerge. Sometimes there's one-off, but often themes emerge about what's important to people and are we focused on what's important to people. Not just doing what we did ten years ago or five years ago or two years ago or yesterday. What matters to people now that's gonna keep them engaged, connected, and working top of license for us?

Capacity is really important, right? Lots of people are working really hard. Or cr-- Are we creating space so people can take time away from work, so they can have flexibility to do things with their family? Are they taking their vacations? There's three months of summer in New England, and everybody wants to take their vacation during that three months of summer in New England.

So how do you run a healthcare system when everybody wants to take three months off in the summer? We figure it out because it's important that people have the time to recharge, reset, re-engage then come back to work feeling well, feeling rested, feeling healthy One of the things that was really important to us, and I'll, I'll give you a couple of examples of what we've done, was make sure that we hear from every employee, every shift Every role.

So two things, two examples of, of projects that exemplify our listening in action. One I mentioned is the Physician, uh, Wellbeing and Resiliency Survey. So we partnered with the Chartis group to do some specialized and targeted surveying of our, of our clinical teams. Very actionable data comes out of these surveys, and we took some of that data from our, our emergency department and, and mobilized a plan.

The people said, "We don't have anywhere to get away from the chaos of the emergency room. We don't have anywhere to hang our hat, to drink a cup of coffee, to maybe have a rest for a few minutes." So we said, "Okay, that's pretty actionable." We put a, a, a team together that focused on what we could do with short dollars in a short amount of time, and they created a respite room.

They created a really beautiful breakout space. It's not big, it's not fancy, but physicians, nurses, and staff put their heads together and said, "This is what we want. We want you to design this space for us that accomplishes these goals." And we did that. We resurveyed these folks. They are so happy that, that not only do they have a space now, but that somebody listened to them.

They were listened to, they were heard, they felt heard, they felt seen. They felt like this small thing for a few dollars was, was actionable, and now we move on. The second thing we did, and I give all the credit in the world to Margaret Wingate, who's sitting at table number one behind, uh, door number one, prize to you.

We had our first, uh, active enrollment last year after, I don't know, twenty or thirty years of passive enrollment. We made a number of significant benefit changes, and we knew that that was a really consequential activity in our organization. So Margaret took her total rewards team out on the road seventy, seventy-plus meetings, all shifts, all languages, all hours of the day and night to make sure that we got our people to enroll.

Why did we do that? Well, because we wanted them to enroll, so there, there's that. We want-- We don't wanna have to chase people later. But we wanted them to feel like their questions could be answered, that they would be heard, and that their voice mattered and their, and their shift, their role. I mean, a lot of these meetings, you know, Margaret, keep me honest.

A lot of these meetings were our frontline workers, our housekeepers, our cleaning staff, our, our, um, environmental health workers, right? And then they've never had this level of attention. Never. So they were grateful. They were grateful that somebody came out and said, "This is how you do this, and this is what it means, and these are the choices that you have."

So every voice, every role, every shift, that was really important to us. The leadership piece happens in the small moments. It's the day-to-day interactions. Sometimes it's the big deals, it's the town halls, it's the big meetings, it's the survey result communication, but most of the time it's an attaboy or attagirl.

"You did a good job. Thanks for showing up. Thanks for staying late. Thanks for being here at all," right? We've all had those moments where you just think nobody's gonna show up, and the one person that shows up is like a miracle. You're like, "Thank you for being my miracle today." Be present. Be present. Be o-- be off your phone when you're engaged with your people.

Be in the room. Be inquisitive. Be curious. What's important to them? What's top of mind? What did they tell you the last time you met with them? What mattered? Are you following up? Are you-- uh, do you have continuity? Do you have line of sight? Are you asking the good questions? Are you growing people? Are you accessible?

Is your door open? Are your phone on? Are your, your-- do you let people Zoom bomb you kind of in the middle of the day if you're, if you're not in another meeting? Listening and recognition. Recognition is so important. We're on a recognition journey right now, really trying to create a frame that allows recognition to happen.

Again, all shifts, all people, all roles, all the time. That's what people want. They want the little things. They want the little celebrations. They want those moments where somebody noticed something that wasn't a big deal, but was important, that mattered, that mattered to a colleague, mattered to a patient, mattered to them So at the end of the day, organizational performance is a strategy where people are at the center, where employee experience is the guiding principle.

We have the supports around the outside. It's leadership, it's investment, it's development, it's EAP, it's other support programs, peer-to-peer counseling, cl-clinician counseling. We want everybody to have access to a solution that, that meets them where they are. It's not one size fits all. Of course, it can't be everything for everybody, but it can't be one size fits all.

So we do our best to create a surround sound model where we're listening, we're reacting, we're responding, we're proactive, we're looking at what all of you are doing and saying, "How do we make that happen here, 'cause it seems to be working there?" And when things don't work, we make changes. We make changes because change is important.

Adaptation is important. Moving forward is important. What got us here won't get us there. So listen at every level. Equip leaders to lead. Our investment right now is in our frontline managers and our leaders because those are the people that touch the most people. Those are the people that spread the word.

Those are the people that are making the investment. Those are the people... People leave those people. Our employees don't leave me. Our employees don't know who I am. They leave, they leave you. They leave the frontline manager. They leave the person who didn't say thank you. Atta boy, atta girl. That's who they leave.

So we need to make sure those people understand how important their job actually is. And then build it into the system. Create an infrastructure, create a strategy, create mechanisms where this is inculcated into your culture. This is just what people do. They recognize that as soon as they get promoted to a leadership role, what matters is leading the people, not the tasks associated with leading those people.

Engage, engage, engage. So again, I want people to bring their very best selves to work because I want them to bring their very best selves back home. Smile every day because there might be a time where you can't. So bring a smile to your colleague. I learned that from a really smart guy relatively recently and, um, you know, it's a pleasure to be here.

I hope you get a lot out of the conference and look forward to hearing and sharing ideas with you. Right now, I have three minutes and four seconds to take questions. And mercifully, I'm done with slides Please

Yeah. I mean, we, we do a lot of planning, right? And we know that it, uh, one of the challenges that we have as a children's hospital and a children's system is our ORs are really busy in the summer because people who have elective, who have the, the, the, the benefit of elective surgery as opposed to emergency surgery often plan.

But we do a lot of advanced planning to make sure that we have the staffing and the resources. I think our nurse leaders do an amazing job making sure that they can schedule people during the summer because that's really important. The piece we haven't yet solved for is, is the, um, the notion that seniority matters when you're trying to schedule your time.

So we don't have that quite nailed, but everybody gets the time somewhere in that, in that period of time if they want it, because our nurse managers have, have made that a priority. It is not easy. I am not, I am not suggesting it's easy, but it's, we made it a priority because it's important. Okay. Thank you all. Appreciate your time and attention.