Healthcare leaders can’t go wrong if we keep the patient at the center of every decision

As I begin my term as chair of the American College of Healthcare Executives, I’ve been thinking a great deal about integrity, the fundamental value that is one of our profession’s most essential attributes.

Indeed, it has been critical in our ability to navigate the COVID-19 pandemic. I witness it daily in the superhero-like resilience and excellence—and the vulnerability and emotional exhaustion—of our front-line clinicians. Just recently I spoke to one of my organization’s own intensive-care unit nurses, who was beaming with pride from the progress of a COVID-19 patient who had come off his ventilator and was sitting up in a chair. His recovery was headed in the right direction, and the tenacity and joy she exhibited made clear to me her rock-solid dedication to patient care. What an inspiration!

The extraordinary demands being placed on these individuals, and the levels to which they continue to rise in a pandemic to realize their professional calling, underscore for me that one of the best ways we can honor them is by reaffirming our own commitment to professional integrity.

What does integrity in healthcare leadership really mean? How does it manifest, especially now, in the current crisis?

What resonates for me when I think about the meaning of integrity is one of the most valuable lessons I learned about being a healthcare leader. It came from my mentor, Jack Bailey, who was an administrator at California Pacific Medical Center in San Francisco at the time. He always said, “If you make every decision with the patient at the center of that decision, you’ll never make a bad decision.”

The ability to stay true to a patient-centered moral compass has always been the hallmark of integrity in healthcare leadership. Remaining centered on what is best for the patient and letting it guide our decisions and our relationships with our teams and communities, is our North Star.

As with any core attribute, integrity can be thoughtfully cultivated, bolstered and applied. We will always retain our integrity as leaders when we work intentionally every day on maintaining ethical standards in every decision, communication, huddle and personal interaction.

As leaders, we certainly can’t go wrong when we are transparent, honest and vulnerable, state what we believe and always make sure our actions match our words. The same holds true for having the humility to remember the best ideas often come from the front lines and remaining open to those ideas.

In the same way high-reliability organizations hold safety huddles, start meetings with a mission moment and talk about good catches. I’m a believer in leadership teams having regular conversations around ethical challenges and discussions about hypothetical or real ethical dilemmas.

I’m fortunate to have these kinds of open talks every day with my peer, Julie Miller-Phipps, regional president at Kaiser Permanente Southern California. Our conversations have revolved around critical issues such as ICU bed shortages, and how to share resources as one system so every patient with COVID-19 receives the care they need.

I’ve also benefited greatly from starting leadership meetings with an ethics moment, where a healthcare leader shares the story of a real ethical dilemma. Participants engage in open dialogue with their peers regarding how they would approach the issue and talk through the ethical challenges. The leader then reveals organizational steps taken to address the problem and the outcome of those actions.

It’s not easy for leaders to take the high road in all cases, and to follow a moral and ethical compass in the face of adversity. But we have the amazing privilege of leading those who are serving the front lines and taking care of patients and their families. We do our strongest work as leaders when we harness the best thinking, energy and creativity of our teams and when we keep the patient at the center of everything we do.


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