The next questions: Stabilization and recovery

We’ve seen a shift in the COVID-19 pandemic over the past few days.

As social distancing and other efforts appear to be flattening the curve, hospitals are beginning to look towards what comes next. It’s no longer just about dealing with the day-to-day operations of pandemic response but also about how to stabilize the organization, bring services back on line and develop an appropriate financial plan for the future. Our CEO David Jarrard has been thinking a lot about these issues in the context of how leadership – both the hospital board and the executive team – should respond to the shift and the questions they need to be asking.

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David Shifrin: Welcome back to JInsights on the High Stakes Podcast. Our CEO, David Jarrard sent us a note a couple of days ago. He’s been thinking a lot about the response of the hospital board and the questions they need to be asking and how they need to be involved in this moment. And as we were discussing further, we realized that this isn’t just about the board, but these issues and these questions are for leadership as a whole. And so, David, tell us what’s on your mind. What are the questions that leaders across healthcare organizations need to be thinking about in this moment?

David Jarrard: Yeah. Thank you, David. And the reason I initially thought of them as board-level questions is because they are fundamental strategic questions for an organization. I think almost everyone agrees that this pandemic has unsettled the foundations of our healthcare delivery system. And whatever it’s going to be, it’s going to be different on the other side.

And as we begin as a country to move through the surge, through some of the most terrible moments in this event and begin to think about stabilization and recovery, I think a lot of vague and even transformational questions are being asked. They’re being asked at the board level for sure, because they are strategic questions. But for the operators, the CEOs, the C-suite and the chief communications officers, how is the world different now?

There are some of the natural go-to issues that we’ve all heard about. You know, telehealth skyrocketed in the last 30 days. That’s going to change. It’s going to create a change in the behavior patterns of patients. That’s a good thing. How do we solidify it and how does that affect us economically? So there are questions like that.

I think there are also bigger questions though about who we are as an organization. If our mission is to protect the health and wellness of our community, well, I think health and wellness have been defined in new ways in the last 30 or 45 days. And I think it’s right to expect that we’re asking those questions.

And also, it’s right to expect these questions to be asked of us because I think the people who pay for us – the insurance companies and the government and the self-insured employers – are going to be asking, ‘What am I paying for now? And am I getting the value out of the cost of the care?’ Cost of care was a huge issue in January. I think it’s going to be a significant issue on the other side of this as health systems try to recover from what’s happening.

Let me just focus for a moment on the finances of it. There’s going to be a need for more money and different kinds of funding to recover. But to recover into what I think is important. And I think as we seek that funding, fair questions are going to be, ‘Well, who are you going to be now? What am I investing in in the future? Ae you really fulfilling your not for profit mission?

Are you really treating your patients well? Are there stories still about you suing patients? Are you billing patients inappropriately? Are you going to get that in line before this next wave of funding hits or the next one or the next ones.’

I mean, hospitals are economic engines as well as healthcare engines in a community and there’s going to be a great desire to support them. I suspect the impression people have, the reputation of providers of all stripes have only risen through this, but that’s not going to stop the questions from coming and we need to prepare to answer them. I think there’ll be questions about, ‘How did you do? Really, what kind of assessment are you taking? How are you taking stock of your organization and what did you learn from it?’

I think there’ll be an assumption for a while that this was a terrible pandemic. It could’ve been worse. So, what are you doing to prepare for the next one? How do you know that you’re going to be ready?

David Shifrin: Okay, David. So with that as background, talk about the role and kind of the process that different leadership groups need to be taking as we move from the day to day crisis to the new world on the other side of all of this.

David Jarrard: As our healthcare systems look at moving forward, we know they’re approaching their thinking in several tracks of work. There’s the track of today. Getting through today, caring for the patients today, caring for their nurses and doctors, moving through those operational realities that will help them stabilize health and recover.

Then help them reignite – getting those patients that have postponed their electives back in, getting that cash flow starting again. So, there are these very operational realities that deserve a high level of attention and are getting it.

But there’s another track, which is in a sense of a board level track, but it’s also for those leaders who can have the ability to think beyond the moment about how this has reshaped us and how do we reshape day to day operations and our strategic priorities and our capital investments to become what we need to be next. And what are our patients and regulators going to expect us to be next. So that does get to questions about long-term, ‘What is our mission?’ but it’s also gets into questions of long-term ‘What do we do?’ I mean, is care at home and telehealth the right place for our future investment? I think almost every board that we have chatted with knows that they’re going to take a hard look at their strategic plans. The plans they had 30 days ago, 60 days ago are very unlikely to be the plans that survive this and maybe a shorter, more condensed version of the plan.

I’ll be surprised if new things aren’t added to it, and in communicating that inside the organization and outside is supremely important. There’s a great desire now and there will be a great desire, particularly on the other side of this, for some sense of stability, some sense of vision.

What’s the plan? You may not know the plan yet. But you can have a plan for the plan. You can have a structure that says, here’s how we’re going to get here. Here’s how you’re going to get involved. Here are the voices we’re going to listen to. Here’s the data that’s going to shape our thinking.

So there’s an understanding of next week and next month and next quarter. And that’s more than we’ve had for a couple of weeks, and that’s a good thing.

David Jarrard