Gathering strength through adversity

D-H CEO Joanne Conroy on the management and personal lessons she learned during the pandemic

BY AMANDA ANDREWS

THE FIRST CASE OF COVID-19 in New England was discovered in an employee of Dartmouth-Hitchcock Medical Center in Lebanon — on Joanne Conroy’s watch.

The employee had just returned home to New Hampshire from a trip to Italy, and brought a hazardous souvenir back with him. While the transmission to others was low — there were only three confirmed cases from his interactions while infected — it was the starting point of a system overhaul that would carry the hospital through the pandemic.

“We stood up Incident Command the next week. Incident Command at hospitals like ours is a group of 15 to 20 people that are chosen because of their level of expertise, but there are no senior leaders there,” said Conroy, CEO and president of Dartmouth- Hitchcock. “Our role is to not get involved; just step away and let them do their work. They met two to three times a day solving problems: standing up a lab, looking at our supply chain, how many masks we had, how prepared were we?”

Like most everywhere else, a lot had to change structurally and logistically. When businesses started to shut down, Conroy stepped in. At the time, she spoke with Dan Jantzen, D-H’s chief financial officer.

“I said, ‘Dan, this is a big deal. Not just from an operational perspective, but I don’t know how long we can survive financially by shutting everything down.’ So, we went in and met with the team.”

After considering their options, Conroy made the decision to shut down 75 percent of the organization’s operations. “We didn’t lay anybody off. We didn’t furlough anybody. We were going to need everybody,” she said, adding that she told employees, “We don’t know in what role, but we’re going to need you. So don’t worry about your job. Just worry about taking care of patients.”

Joanne Conroy led Dartmouth-Hitchcock staff through the pandemic without layoffs. (Photo by Allegra Boverman)

TRANSPARENCY, COMMUNICATION

As if leading a large healthcare organization during a pandemic wasn’t stressful enough, Conroy’s husband Douglas died shortly after its start and, only two weeks later, her mother suffered a debilitating stroke.

“I had to bring her up here from South Carolina and renovate the first floor (of my

house), so she would have a place to stay,” Conroy said. “My life has changed considerably. I’ve got mom duty before and after work — a live-in caregiver. I feel so fortunate that I can do that. I appreciate there are some people who can’t do that.” Instead of keeping personal matters secret, Conroy chose to inform her team about them.

“It’s important to share that with the employees, so that they know that we’re all dealing with the pandemic in our separate ways,” she said. “I try to be as authentic as possible, even pre-Covid. But I think it became even more important during Covid. When people are exhausted, they want leaders to be straight with them … They want to know that you’re in it with them.”

In an effort to be as transparent as possible with her team and patients alike, Conroy created “Joanne’s Journal” online in early 2020, to show that she was working through the thick of it alongside everyone else.

“I am in awe of employees that are dealing with child care, aging parents, home situations that aren’t optimal and then showing up to work every day and being 100 percent present. It’s pretty impressive. But unless you’re being authentic and sharing that, they don’t want to see you as this sort of stiff, predictable person,” she said.

Conroy said she makes sure she connects with employees on a regular basis, even if it’s by sending a simple email. She takes a ground-up approach, where she’ll ask managers to learn questions or receive feedback from employees, so she can address everyone’s questions as thoroughly as possible.

Conroy said, “We operate on the principle that we have to keep our communities and employees safe. But also, we had to create a sense of psychological and economic safety for our employees as well. They shouldn’t be worried that they wouldn’t have a job. And they shouldn’t be worried that they were going to get sick at work.”

Joanne Conroy, and other hospital leadership, signed a beam during construction of D-H’s Patient Pavilion

EMPLOYEE BURNOUT

The pandemic exacerbated many prevalent problems in the healthcare industry but none so much as burnout and mental health. When the first surge of Covid cases hit in early 2020, the staff at Dartmouth-Hitchcock took it in stride, she said.

“They were pretty pumped because they did a good job and recovered quickly,” said Conroy. The second surge? Not so much.

“(The staff) were exhausted, and they were like, ‘Really? Again?’ It was greater numbers, more intense. People were sicker … They didn’t have a lot of gas in their tank for the second one. And that’s when we actually started to see the signs of burnout.” To address this issue, leaders at D-H, including Conroy, established an employee assistance program with chaplaincy at the hospital visiting high-intensity units, where workplace stress and burnout were widespread. A 24-hour phone line was also set up for employees to talk to someone, offering resources where needed.

Conroy also invited a psychologist from the West Coast to be available for full-time residents at Dartmouth-Hitchcock. Some of the residents were in training, which is stressful enough sans pandemic, and others had just moved to the area to help out during the beginning stages of the pandemic, often dealing with increased feelings of isolation.

She said she plans to organize a similar program for the rest of the staff, providing access to a psychologist for mental health resources and counseling.

As another outlet for employees, Conroy said their team plans to roll out a social media-based platform for peer-to-peer support to address behavioral and mental health in the workplace.

“Peer support is very effective with burnout, exhaustion, energy depletion from just being in healthcare,” she said. “We’re rolling that (platform) out this year, because (the pandemic) is not over. It’s going to be a long time to get to a place where people feel like they have a normal life.”

TEAM-BASED APPROACH

One organizational change Conroy wanted to pursue was addressing a need for more teams to handle the increased number of patients and cases. For instance, nurses who didn’t normally work in the ICU would be paired with ICU nurses to ensure there was a more appropriate allocation of medical staff to patients, thereby distributing their knowledge and expertise efficiently.

“We need to weave some of those team- based concepts into how we deliver care. Sometimes we think a lot of healthcare is solo — you’ve got one nurse, one doctor. But it’s more effective when there’s more peer support,” Conroy said. “I do think in the future we have to look at how we deliver care in a different way, and it’s going to be led by teams. It’s empowering the teams to make those decisions.”

The hospital also deployed a volunteer program called D-H Reserves, where supervisors and other leaders were helping out in other departments such as housekeeping, pharmacy and food services. The goal is to surface logistical and structural issues that can be addressed to increase efficiency and better distribute bandwidth throughout the hospital staff.

Conroy mentions, “These jobs are difficult to recruit for in the workforce shortage we’re in right now … (and) you actually see some things that you should change when you’re helping, and you’re like, ‘why are we doing that?’”

Throughout it all, Conroy said she knew she had to be a strong leader for everyone, so she makes sure to follow a couple of guidelines of her own.

Joanne Conroy receiving a flu shot on-site at Dartmouth-Hitchcock along with other staff members. (Courtesy photo)

“I learned to give myself a break … I don’t give myself a bunch of grief about (being late). Sometimes it’s not the most important thing. Especially since I’m traveling between sites, and I’m always cutting things down to the last five minutes.

“The second thing is sleep. I look at my FitBit every morning to see how long I slept and the quality of my sleep, because if you’re exhausted, you can’t lead … It doesn’t matter who you are or what your job is, you need at least seven hours of sleep,” Conroy advises.

While Covid-19 caused a lot of strain on businesses everywhere, Conroy used it to push Dartmouth-Hitchcock into becoming an organization that can better address access to care, establish more avenues to provide mental health care, and maintain the well-being of all staff.

“Together we will be a stronger organization because of this. We will learn from it. There are things that we will change about how we do business, all in a good way,” she said. “I think we’re at an interesting inflection point in terms of how we deliver care, where we deliver care and our business model.

“It feels like we pushed over the crest and all of a sudden, things are going to be happening more quickly than they had over the last 10 years. I think Covid has catalyzed that. That’s a good thing. I’m a cup-half-full person. And my cooking skills are way better.” x