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A aloft action pilot and emergency allowance physician, Dr. Stephen Markovich knows a affair or two about assuming beneath pressure. And those ancestry accept absolutely been activated as the admiral and CEO of Columbus-based OhioHealth has guided the 12-hospital arrangement through the COVID-19 pandemic. He accustomed an adventure command centermost that meets circadian and said he’s accustomed his administration aggregation the freedom they charge to actualize a plan that’s adjustable and adaptable. Markovich batten with Modern Healthcare Managing Editor Matthew Weinstock. The afterward is an edited transcript.
MH: You are a month-and-a-half abroad from your one-year ceremony of demography over at OhioHealth. Obviously this is not how you accepted your aboriginal year to go. How has the communicable activated your boldness as a baton and how has it afflicted your administration skills?
Markovich: A year ago, I apparently would accept been in (the) adventure command (center), potentially alike active the adventure command process. And I knew aback this affair kicked off, I was activity to charge to drag this. I’m in a altered role now, a altered job. And so this was a adventitious to coach and advance some of my added inferior folks; accord some association a adventitious to flash and advance their wings. That was apparently the better affair … my accustomed addiction was to appetite to go deep, and aback you’re in the CEO armchair you can’t do that. You’ve got to accept added association accomplishing the legwork.
MH: Talk about the adventure command center. Was it in abode alike afore the communicable started?
Markovich: We accept an adventure command action that we would use for any emergency, accumulation blow fire, aloft adeptness abeyance or disruption. But this was on a altered level. We saw it coming, we stood it up adequately early. We were apparently three weeks advanced of a lot of added organizations that I talked to. I set out about eight bright goals for everyone.
First and foremost, focus on the mission. We’ve got to booty affliction of our patients. We’ve got to booty affliction of our bodies because after demography affliction of the people, we can’t achieve the mission of abundant accommodating care. And aback I say booty affliction of our people, I mean, physically, psychologically, economically. We bare to be cerebration about it from all those altered parameters. We had heard already from the East Coast and added aloft busline areas that (personal careful equipment) was activity to be a challenge.
We knew that how we chronicle to government admiral and the authority of accessible bloom was activity to be important. How would we acquaint with our patients? We knew that they were activity to be afraid, they weren’t activity to apperceive what was activity on, they weren’t activity to accept this communicable ache process. And again in the big picture, we knew over time, we’re activity to charge to repatriate all these association that were accepting their procedures delayed. And while all that was activity on, you had to calmly put it in the aback of your head, what if the really, absolutely big adversity happens?
It affected a new akin of collaboration. The four aloft bloom systems in axial Ohio got together, and we said, “Listen, if we’re activity to accept to do a big major, about a action blow accumulating point, let’s do it together, let’s not do it alone.” And so we went to the canton commissioners and the (Ohio Emergency Administration Agency), and started on the abstraction of how do we booty the assemblage centermost and about-face it into a thousand-bed hospital. And while we’re accomplishing all that, you’ve got to accept your accounts aggregation saying, “OK, what altered scenarios can comedy out here? What options are available? What levers can we pull? What government and federal opportunities are accessible to advice us out?”
All those things were accident at the aforementioned time.
MH: Your adventure command centermost is affair daily. Who’s involved? How do you set priorities?
Markovich: We fabricated the accommodation adequately bound that my chief team—the amount chief carnality presidents and above—were activity to try to fly aloft the affray as abundant as we could and let the association who were the agreeable experts and abutting to it footfall up. And we absolutely looked at it from three perspectives. At the aboriginal point, there was the acceptable hospital operations—PPE, meal service, security, supplies. You had analytic operations. What are the behavior and procedures we’re activity to put in abode to accumulate bodies safe? How are we activity to administer ventilators? What are we activity to do to communicate? And again you had HR … like abounding added systems, we saw big falloffs in ER visits. Elective surgeries went away, joint-venture surgeries went away. So as the volumes are falling off, you’ve got 30,000 or 35,000 associates of your workforce that you’re aggravating to manage. How do you redeploy them?
It was a challenge, but we had a abundant aggregation that stepped up. At that carnality admiral level, those eight or nine anatomic areas that ultimately were the key leaders—whether it was communications, facilities, HR, operations, physician leadership—came calm and they would accommodated basically 24 hours a day. And again at atomic already or alert a day, the chief aggregation would (connect virtually). Our job was to breach barriers, to absolve them and get those silos out of the way. You accept to basically say, “Listen, we’re activity to let go of a little bit of ascendancy actuality to accumulate the action moving, because time is your enemy.”
MH: You say breach bottomward those silos, but yet you’ve got a centralized command center. How do you antithesis operating things from a arrangement level, but let your alone accessories accomplish as they charge to based on their caseload?
Markovich: You’ve got an adventure command at every campus. You’ve got an adventure command at the headquarters, let’s alarm it. And again you’ve got the chief baton aggregation aloft that. The chief baton aggregation creates the vision—here’s the expectation, here’s what we’re aggravating to do. Cascade that bottomward … their job is adeptness allocation, authorize bumpers, authorize guidelines and rules, and again let those campuses do their affair aural those ambit and address aback aback they hit obstacles, address aback aback they hit barriers. Whether it’s PPE or they apprentice article that happens at that campus—they can accompany that up to the centralized adventure command centermost and again we administer it.
I’ll accord you a abundant example. We abstruse bound that nurses were activity into apartment to acclimatize IV poles. They adeptness accept to change an IV out or acclimatize it. They were accepting to put PPE on and off and access the allowance aloof to acclimatize the pole. And one of our hospital leaders said, “Why don’t we aloof get best tubing, accumulate the IV out in the alley so that bodies don’t accept to absolutely go into the accommodating room?” As anon as we had that, let’s lateralize that as bound as we can, so that everybody’s accomplishing it. And all of a abrupt you’re attention one of your best basic resources, which was the careful equipment.
MH: If we alpha to attending at addition surge, maybe in the backward summer, aboriginal fall, are there some key things that didn’t go the way you anticipation they should?
Markovich: A brace of abundant big acquaint we abstruse aboriginal and I array of accepted with our adeptness is that there is a amount in actuality in a big system. What we would alarm the adeptness of systemness; the adeptness to advantage those acquaint abstruse from beyond the campuses. The added affair that is hard—it doesn’t appear artlessly for a lot of people—is you absolutely do accept to assurance your bodies and admit that you’re operating in an amiss world. You’re operating in a apple area your ability isn’t perfect. You may accept 80% of what you need. Normally you’d accept a aggregation that puts calm abundance of abstracts and PowerPoints, and you anticipate through every accommodation and all of a sudden, what in the accomplished adeptness accept been 15 bodies about the table becomes two bodies continuing up in bristles account saying, “OK, based on what we know, here’s area we’re activity to go.”
You’ve got to abutment bodies who are in that affectionate of bearings and admit that the ambiance is fluid, and you’re activity to accept to adapt. You may accept to change what you did bygone (because it) may not assignment today. It’s connected disruption.
MH: You’re a aloft action pilot and ER doctor. How did those adventures advice you in this crisis?
Markovich: I’ve consistently anticipation there’s a bright alignment amid what I did in my antecedent career and again in healthcare. It’s actual mission-focused, actual focused on people. Aback you booty a distinct jet and get it into combat, it took bags of bodies to accomplish that one affair happen. Healthcare is actual abundant the same. Actual abundant a safety-driven culture. You get into elements of leadership, ambidextrous with analytical resources, time management. All those things associate actual awful with what I acclimated to do and what we all accept to do now.
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