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What You’ll Learn:
Connecting with people consumes a lot of time, but that investment is incomparable in terms of what you get in return.
Dr. Shereef Elnahal, President and CEO of University Hospital in Newark, NJ knows that finding what speaks to someone builds trust and opens the door for change. As a kid struggling to get his Type I Diabetes under control, his attitude towards his disease was changed when a nurse found a way to reach him. That small connection had a big impact and even influenced his career path.
In this episode, you’ll hear why Dr. Elnahal says a CEO’s job is to work for the success of his team and how to build trust with those you lead.
What To Listen For: Health equity, meaningful connection, change management
Rebecca: I’d love to take a minute to kick us off today to talk a little bit about the last year, which has obviously been rife with different challenges and tribulations in light of COVID. You are a new CEO so we’d love to hear a little bit about the last year for you.
Clearly the most difficult time for us in an acute way was the months that span between early March and June of 2020, when we were filled with patients with the disease that we knew little about. The level of appreciation our greater communities showed us was an incredible display of support. But in many ways during that acute phase, we became a stronger team than ever before. That solidarity, the fact that we all went through it together, is something that still binds us. But it is also something that’s causing post-traumatic stress in a lot of people. It’s important to make sure that the continuous support that we saw back then for our healthcare heroes continues into the future because there are a lot of stresses. In many ways, we’re more stressed than we were back then.
Rebecca: What are some tactics that you use to come in and help the team feel that they were valued?
An important mentor for me once told me that change moves at the speed of trust. And I’ve always kept that mantra in my head, through every leadership position I’ve had, because I knew that in order to get anything done, I would have to gain the trust of people who will actually do the work. There’s no leader who can move the needle by themselves.
A different mentor told me they have to be rooting for you, as much as they are rooting for the mission. Because everybody knows that ultimately the leader either gets all the blame, or most of the credit when things go well. That’s not lost on people. The thing is, it’s your responsibility as a leader to transfer that support, and transfer that credit back down into the organization.
One thing I did during the acute surge and I continue to do now, and even before the pandemic, was personally introduced myself to people in as many parts of the organization as possible. I visited nearly every unit of the hospital in my first eight months here before the pandemic really hit hard. I made sure that everybody around me knew that I viewed my job as one that was primarily working for their success. Because if that didn’t happen, then we wouldn’t be able to make progress on anything.
Rebecca: It takes a lot to be able to show that kind of humanity in the context of being a CEO during a pandemic. How did you do that?
It’s not just about being authentic and talking about yourself and how vulnerable you are, or how confident you are. Because there were times when I did feel more confident than others. But it’s about actually responding and following through and being honest when you can.
I couldn’t promise people that they’d have the PPE they needed. It was a really tough thing to admit because right across the Hudson, I saw pictures of healthcare workers wearing trash bags instead of isolation gowns, and having to reuse N95 masks way more than is appropriate. Thankfully, we didn’t have to go there, but knowing that folks were aware of that risk and that I was forthright enough to communicate that risk, ironically allowed us to really, really build trust in the organization.
Rebecca: You’ve said this over and over here in this conversation, about not making assumptions where somebody is coming from, but rather meeting them wherever they are, and being compassionately curious to understand more.
I think the best motivator for change is modeling behavior and showing people it works. But also in turn caring about them and respecting them. If you have a dynamic where you’re the only trusted person in the organization, but every layer of management in between is not trusted, that is unsustainable over time. What’s not talked about enough is the burnout, the fatigue, and the post-traumatic stress that exists with everyone from supervisors closer to the frontline, to middle management, to executives who have all the pressure on them in many cases when something goes wrong.
And so being mindful of, across the board, displaying your values of respect and gaining trust with the people who immediately report to you and everyone under them. That is also extremely important. It’s something can be forgotten with even empathic, well-intentioned leaders.
Rebecca: You’re clearly a very special person, but can you share a time when you felt seen in a way that you always wanted to be seen?
I’ll recount one of my experiences in Washington when I was a fellow. I was a young person trying to get stuff done in a government agency that I’ve never worked in before. I’d never lived in Washington, was grateful to be working with a pretty high-level government official in the VA. He decided to invite me to a congressional briefing to staffers. I did not know the agenda; it was sort of a last-minute invite. But he spoke out about the work I was doing and said to all these staffers that he’s our “secret weapon.” I just thought that was a funny and nice compliment that he didn’t have to do share. And the fact that he didn’t tell me he was going to do that made it all the more special, because I thought I was just going to be a fly on the wall in that room. That’s an experience I remember because I know how it made me feel and it reinforced what recognition can do for people.
Recognition is often the most powerful currency in an organization. And I use that word currency very purposefully. Because it’s not just about how much you’re paid, or your bonus, and especially in government, you often don’t have those levers to pull. But even in the private sector and even in nonprofits, like the one I run now, it is often recognition that makes or break the cohesion of a team.
Especially now, as we’re seeing the so-called “Great Resignation.” I personally don’t think it’s just the people who are paying the most that will be able to keep teams together, especially in healthcare. It is organizations with leaders who care. And the best way to show that you care is to actually care. Another one of my mentors said that to me. It’s something I’ll always remember. So recognition is just a huge, huge piece of that. And it’s your responsibility as a leader to focus on it.
Rebecca: I love the story about you being the secret weapon and not knowing that that was going to be revealed. When I think about recognition, and what you’re getting at too, is that there are a lot of ways to recognize someone.
The reality is progress and success in an organization is just a lot of small things being done without recognizing those “small things”. Without them, it’s hard to achieve the so-called “bigger things”. All of these metrics around quality, around patient experience, around financial performance, have everything to do with what the daily experiences of a patient or someone who you’re trying to serve is, and that is not just you doing it.
Rebecca: Absolutely. I think so many times, we hear people at the bedside when they’re complimented or recognized say, “Well, I’m just doing my job.” But what they see as the mundane or the every day is the exceptional for so many people. Is there one last thing you want to add?
If I were to leave you with one thing, ultimately healthcare institutions are the center of gravity in terms of need in any community. My appeal has been that we should be using our voice to talk about things outside the square lane of healthcare itself. We are often the quarterbacks for getting folks connected to social services and giving them the opportunity to thrive economically. I know that it’s not me, or us, that are going to solve food insecurity for our patients, but we can certainly be the quarterbacks that connect folks to the right people and diligently follow through on that.
Are there any moments that you can think of from your past that allowed you to have the confidence to really be yourself? How did you get the courage to do it?
I have the benefit of having been in leadership positions before where the assumption upfront when I got into those positions was that I probably didn’t know what I was doing. And the reason I say that’s it’s a benefit is because it’s something that I could quickly prove wrong when I did show my competencies.
But that realization upfront that I simply could not do the job on my own in a comprehensive way allowed me to pick folks on the team that ultimately led the execution of what we were trying to do. Being honest with your team about vulnerabilities and gaps is okay when you express confidence and recruit the right team that fills those gaps.We recruited three new Executive leadership team members here in the middle of the pandemic. All of them had skills that I did not have. The Steve Jobs mantra here about recruiting and hiring people who can teach you and tell you what to do has stuck with me as well, because it’s a way to demonstrate that you’re humble enough to recognize that.
When you identified people for those roles, what were you looking at beyond the resume or beyond the skills?
I think anybody you recruit has to have the same level of dedication to the mission and to the people that you’re serving. That is something that you can never compromise on.
Approaching references is important. But I’ve always tried to get references not only from people’s bosses, but from people who report to them. Because if you don’t get that end of things either, then you just will never get the full picture.
I’ve heard you speak about health equity and how that might play into trust. Is there a story or a moment that led you to realize that healthcare was place that you could share your learnings with others?
When I was in college, I was mentoring kids in a diabetes class. For background, I have Type One diabetes myself. I grew up with it since the age of 12. I was certainly not a well-controlled person with diabetes in the beginning. I was in and out of the hospital a lot. It took one nurse practitioner who was able to come down to my level and understand, and somehow have the intuition of what it’s like to be a 12-year-old. She connected with me in a way that allowed me to trust her. It was this person who really taught me how to manage my diabetes, why it was important, and connect management of my diabetes to things I cared about, like my mother.
One of the things that I think you’ve done a brilliant job with is empowering your leadership team. You talked about building your leadership team and this cascade of gratitude, authenticity, trust, and all of these incredible sort of qualities that you emulate go through the entire organization, not just your one-stop shop at the CEO level. Can you share a little bit if there’s a story or an experience that you had with a leader where you really saw them for the first time in a new way?
Part of what you do when you enter an organization is to feel people out and get a sense for how they fit in the team, what their values are. And those first impressions can be really informative, but they can also be really wrong. I wasn’t so sure about one person on my executive team when I got here. But the degree to which I learned over time that his immediate reports were just so adamant about how much he cared for them was very telling to me.
And in one situation I had one of his direct reports come to me and say that she had a really tragic situation happen to her and her family. He decided to personally show up to her and her family’s funeral. The empathy he displayed for her as a person is something that she wanted to make sure I knew about. It’s always telling when it’s not the person telling you what they’re good at in your organization, but others vouching for it.
I think these hidden qualities can be so informative and often people who are just very articulate and sure of themselves can obscure some pretty bad things too. So it’s really through action that you learn what people can bring to the table and what their values are.
Tell us something about yourself that less than 10% of your work family know about.
My favorite music artist is Kanye west. I think he is the Mozart of our time in a lot of ways and he is an absolute genius at what he does from a musical standpoint.
If you could do anything else in your life as a career outside of healthcare, what would it be?
I would’ve loved to be a talented enough musician to do concerts. I play guitar and bass and dabble in other instruments. Frankly, you’re in the business of making people happy, and while I’m in a business that indirectly does that, it’s much more direct when you’re talking about rockstars.
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