Leading Through Unprecedented Challenge And Change

Leading through unprecedented challenge and change

Harnessing our passion, innovation, and member-focused spirit

By Edward Ellison, MD

Edward Ellison, MD

COVID-19 has dramatically altered how we work and live and has impacted our communities in many ways. Our hearts go out to those who are struggling, scared, physically and emotionally exhausted – and especially to those who are mourning.

We live and work in a VUCA world – a world that is Volatile, Uncertain, Complex, and Ambiguous. And yet, in all of my years practicing medicine and leading our Southern California Permanente Medical Group (SCPMG), I never expected to be steering our organization through such turbulent, uncertain, and volatile times. This pandemic is like nothing we’ve experienced in our lifetimes. And yet, in some ways, we have been preparing for this moment for years. I do believe that Permanente Medicine’s compassionate patient-centered, physician-led, evidence-based, culturally-responsive, technology-enabled, and team-based care when practiced within the system of Kaiser Permanente positions us well to meet these challenging times head-on.

We have learned in this ever-changing environment to pay attention to ourselves and the world around us; to make the best decisions we can with the best information we have today; and when we have new information tomorrow, to make new decisions. That is how you adapt and change in a rapidly evolving world.

A thoughtful strategy helps us shine in times of adversity

One of my primary responsibilities leading more than 8,000 physicians who, along with our care teams, care for 4.7 million members in Southern California has been to implement an intentional culture and long-term strategies that position us well to care for our members today and for generations to come. This means taking an honest look at challenges and inflection points that affect us; to capitalize on the opportunities before us and, where those opportunities don’t exist, to create them.

Based on what we have learned these past 6 months, we have an incredible opportunity to re-imagine and reinvent health care delivery for the benefit of our members, patients, physicians, and care teams. There have been 3 key takeaways in these past months: that an organization as large and complex as ours can be nimble and agile; the accelerated acceptance of telemedicine and virtual care by our patients and our physicians; and the extraordinary power of selflessness and interdependence as everyone in the organization has leaned in to help us navigate through this unprecedented time.

SCPMG leadership teams could write volumes about how we expeditiously mobilized and coordinated to secure and distribute PPE, scale the dissemination of evidence-based practices for the quality care of our patients, prioritize urgent care and surgeries, stand up a field hospital to prepare for COVID-19 outbreaks and surges, and implement and undertake one of the largest clinical trials in Kaiser Permanente history in a matter of days. All of this while ensuring our members, employees, and physicians stayed healthy and safe.

Changes that we’ve already made to combat COVID-19 could have substantial, lasting implications for the future of our organization and all of health care. One area where we’ve seen great success is in our virtual care delivery, especially in adult primary care. In a matter of just a few weeks, we increased the percentage of virtual visits from 20% to more than 90%, allowing our patients to receive the care and consultation they need for a multitude of issues, conveniently and without the need to leave their homes. This provided added peace of mind and reassurance which was especially important in the early days of the pandemic when there was so much uncertainty.

No matter the challenges we face, our care teams bring passion, bravery, innovation, and a member-focused spirit to everything we do.

The value of a personal relationship and in-person visits cannot be overstated, so we are exploring these virtual care opportunities to see how we can create that therapeutic relationship while meeting the needs of our patients and still leverage the technology available to us. This can have a lasting impact on how we deliver care. When we improve convenience, access, and affordability while assuring the quality of care we provide, there is a substantial benefit to our members and the communities we serve.

Daily, we continue to evaluate everything from waiting room capacities, elective surgeries, and all aspects of our comprehensive care delivery system to ensure that the health and well-being of our members and caregivers remain at the forefront.

No matter the challenges we face, our care teams bring passion, bravery, innovation, and a member-focused spirit to everything we do. Our health care professionals shine in times of adversity. They know that we must maintain our commitment to evidence-based high quality, inclusive, ethical, and equitable medical care. At the same time, we must also evolve, adapt, and move at an unprecedented pace to confront our current reality.

We have learned that COVID-19 is not something we can look at in the rear-view mirror. It is not behind us. Therefore, we have taken the necessary steps to operate safely within the context of an ongoing COVID-19 environment, providing our members with access to our full care delivery system. Whether virtually, for needed in-person visits or procedural care, it is delivered in a safe and high-quality manner. I am confident we can do this because I know what my colleagues have already accomplished.

Operating from a place of gratitude benefits us

As we look after our patients, we must also look after ourselves. Our caregivers on the front lines are giving their all. Though performing superhuman tasks, they are human. They are tired and they are worried – for our patients, for themselves, and their loved ones. It is our job to support them. From assuring a safe work environment to providing respite and working to address concerns with childcare, we must also be mindful of the enormous stresses our physicians and health care teams are under, the risk of Post-Traumatic Stress Disorder (PTSD), and the importance of providing mental health resources. Most importantly, letting them know they are seen and appreciated.

Practicing gratitude can provide significant health benefits and support resilience. I can’t express enough gratitude for my colleagues, first responders, essential workers, and so many others who are answering the call every day. I continue to find the strength to lead in large part because of their ongoing heroics. Many of my SCPMG colleagues have taken the opportunity to share how COVID-19 has impacted their practice or personal life, and I would encourage you to take a look at the hopeful, inspirational, humbling experiences and perspectives they’ve shared through their #55WordStories.

We are in this together, and we will get through this together. It is an ongoing challenge, but it is also an unprecedented opportunity. We are learning so much about how to be even better prepared to care in the future. Nothing is more important to us than the health and safety of our patients, members, physicians, staff, and the communities we serve. As a leader navigating in times of hardship, it is necessary to be nimble and to look for windows of opportunities to inform, connect, guide, and unite. It is also more important than ever to lead with both the heart and mind.

Edward Ellison, MD, is executive medical director and chairman of the board, Southern California Permanente Medical Group; chairman and CEO, The Southeast Permanente Medical Group; and co-CEO, The Permanente Federation. He also serves on the board of the Kaiser Permanente Bernard J. Tyson School of Medicine. This post originally appeared on LinkedIn. Follow him on Twitter at @EdEllisonMD.