POST 258. June 26, 2022. CORONAVIRUS. “For a long time, whenever companies wanted to hire a CEO or another key executive, they knew what to look for: somebody with technical expertise, superior administrative skills, and a track record of successfully managing financial resources.”..” That practice now feels like ancient history. So much has changed during the past two decades that companies can no longer assume that leaders with traditional managerial pedigrees will succeed in the C-suite..”

This curated note on innovation was inspired when I recently reconnected with Drs. James Veney & Arnold Kaluzny, my doctoral advisors at the University of North Carolina Gillings School of Global Public Health, pioneer researchers on innovation and evaluation in health care (Google Veney & Kalunzy). Thanx! Jim and Arnie for your singular roles in jump starting my career.

for links to POSTS 1-258 in chronological order highlight and click on

https://doctordidyouwashyourhands.com/2022/06/coronavirus-tracking-links-to-posts-1-258/

“For weeks now, as COVID-19 cases have ticked upward in the Northeast and mid-Atlantic, pundits and political leaders have offered a supposedly reassuring refrain: Cases might be climbing, but hospitalizations aren’t yet following suit. In some places, that has been true. Several health-care workers around the country told me they’re seeing the lowest caseloads since last summer. A few aren’t having to treat COVID patients at all. Others are only seeing mildly sick people who need little more than IV fluids. “I don’t think there’s a huge amount of anxiety over what the next month might bring,” Debra Poutsiaka, an infectious-disease specialist at Tufts Medical Center, told me. “I could be wrong. I hope not.”

The Biden administration shares those hopes: Having apparently given up on curtailing the coronavirus, it is counting on vaccines and treatments decoupling infection from severe illness enough to prevent the health-care system from becoming inundated again. The CDC’s current guidelines effectively say that Americans can act as if COVID is not a crisis—until hospitalizations reach a high enough threshold.

The country still may be heading to that point. Hospitalizations are climbing in 43 states, especially in the Northeast. In Vermont, the rate of new admissions has already neared the peak of the recent Omicron surge. Earlier this month, “three different emergency-room docs said this is by far the worst that COVID has been at any point,” Tim Plante, an internist at the University of Vermont, told me. “They’re bewildered that it’s happening again.” Meanwhile, people in most of New York City are now advised to mask indoors again, after rising hospitalizations triggered the CDC’s “high” alert level.

But even in calmer spots, Biden’s strategy overlooks a crucial truth: The health-care system is still in crisis mode. The ordeals of the past two years have tipped the system—and its people—into a chronic, cumulative state of overload that does not fully abate in the moments of respite between COVID waves…

The problems are substantial and numerous enough that “if this moment was occurring without the horror of the moments that preceded it, we’d be shocked,” Lindsay Ryan, a physician at UC San Francisco, told me. “The calamity of the last years has numbed us to the calamity of the present moment.”..

Even when missing people can be replaced, missing knowledge cannot. The pandemic pushed many veteran health-care workers into early retirement, lowering the average experience level in American hospitals. “I don’t think the public really understands how great the loss of this generational knowledge is,” Cabrera told me. In her current job, she had just four days of orientation, which she describes as “shockingly short,” from some people who had been in the ER for less than a year. When inexperienced recruits are trained by inexperienced staff, the knowledge deficit deepens, and not just in terms of medical procedures. The system has also lost indispensable social savvy—how to question an inappropriate decision, or recognize when you’re out of your depth—that acts as a safeguard against medical mistakes. And with established teams now ruptured by resignations, many health-care workers no longer know—or trust—the people at their side. “In an industry where our communication has to be spot-on and effective, that’s a setup for unsafe conditions,” Lisa Zegan, a patient safety officer based in Maryland, told me.” (A)

“From Queensland, Australia…

1. Innovation was enhanced by “adaptive” management style and processes. Rather than incremental movement and gradual refinement leading towards eventual change; in the COVID context, participants described an openness on the part of managers which facilitated change through processes that were adaptive and focused. This enabled staff to propose and implement logical and constructive innovations, then review and refine. “All of the myths about what we can change and what we can’t have been blown up. People are open to things.”

2. Devolved authority structures enabled innovation. An important factor commonly described was a devolved authority and management… During the early days of the COVID response, key staff felt empowered to make decisions about service change to a level they had not previously experienced. When management enabled some devolution of authority, it facilitated the introduction of new models, the pace of change, and subsequent adoption.

3. “Management said, ‘Go make it happen.’” Trusting the capability and actions of staff facilitated innovation. Closely connected with devolved authority was the sense of trust that accompanied most examples of innovation among allied health professionals. Service managers spoke about the trust they needed to place in their staff, and staff described being (and feeling) trusted in ways that were not typical of their usual experience. The foundation of trust between service leaders, managers, and staff in the COVID context appeared instrumental in fostering innovation…

On reflection, it was evident that enacting the above enablers will necessitate a level of reframing or “unlearning” current assumptions and practices, which currently constrain innovation. ..Potential areas for unlearning to support implementing and sustaining innovative practice include:

• Reframing concerns about imposed changes. Rather than disruption being seen as a risk and threat, COVID-related disruption precipitated constructive action towards positive outcomes. This requires management openness to change.

• Unlearning the status quo. By setting aside the usual frame of reference to clinical practice and imagining different ways of tackling often long-term  perspectives brief challenges to delivering care, managers and clinicians have room to ‘relearn’ new approaches to care. “We could give things a go and learn from it, rather than having to get it perfect first.”

• Unlearning traditional views of roles. Rather than allied health professionals simply being seen as providers of therapy and clinical services, in the early part of the COVID crisis, they were permitted to be effective problem-solvers and creative thinkers. This requires management to foster such latitude.

• Rethinking how we incorporate change. Rather than potential innovations being fully refined, trialled and evaluated prior to implementation, the above examples were dynamic processes, involving adaptive change, and often included a subsequent and ongoing process of monitoring,reviewing, and refining. This requires some challenging of the goal of perfection prior to implementation. “Perfect is the enemy of good.”

• Unlearning some management practices. In contrast to the prevailing view that managers must take control and guide decision making, especially in a crisis, devolved authority and shared decision making was conducive to innovation.

• Recognising the importance of trust. In contrast to the perspective that managers should oversee the details of staff actions in times of uncertainty, trust was integral to the implementation of innovative practices. In the context of uncertainty, staff were able to effectively utilise and build upon the trust placed in them. This requires unlearning of some management styles, particularly in situations of crisis and change.

During the COVID pandemic, the capacity to set aside past assumptions and ways of working was clearly demonstrated in a number of allied health settings, as well as across the health system. A challenge facing health services, and particularly managers, is to sustain this momentum and harness the opportunities afforded to staff, patients, the workplace, and the service system. This will in part be supported by an understanding of key factors that enabled innovation as well as future explorations as to how those innovations were implemented.” (B)

“Minnestoa. “Final thoughts and lessons learned: Put a stake in the ground early on from a clinical leadership perspective as to what the goals of the response are, through a medical operations coordination center if possible. It’s like trying to drive on the highway while other people are yanking on the steering wheel. You have political, commercial, and healthcare system interests trying to get your attention, and it’s a fight to stay on the road, doing what you know needs to be done. There were many well-intended thoughts and requests from various parties that were not consistent with what we needed to do strategically, mainly reflecting a lack of understanding of how the ACS would support the overall COVID-19 response….

(SE TEXAS) Final thoughts and lessons learned: Politics and being able to defend the decisions you are making are both huge challenges. Not backing down when you know what is being done is in the patient’s best interest is key. We will continue to ingrain that into our process…” (C)

“When the winds of change blow, some people build walls, others build windmills. This Chinese proverb reminds us that crises present choices. Those choices, in turn, shape organizations’ future growth paths. Last fall, we wrote about the healthcare sector’s successful shift from merely sustaining core operations when the COVID-19 crisis hit to driving rapid innovations that saved lives and lessened the pandemic’s impact. But the winds remain strong, with new outbreaks and variants of the virus continuing to destabilize our lives and economies, even as vaccines are rolled out. Maintaining the innovation momentum will be critical to a continued effective response…

To better understand how healthcare leaders’ priorities have shifted, we interviewed executives from across the value chain. Specifically, we examined how they plan to position their organizations to deliver on their innovation aspirations and which innovation capabilities they expect to grow in importance. They highlighted two main areas where the COVID-19 pandemic has brought major changes they expect to endure.

Digital acceleration. The healthcare sector has long been a laggard in digital adoption, but the pandemic delivered a massive jolt of urgency to embrace new tools and technologies. Providers rapidly scaled offerings and were seeing 50 to 175 times the number of patients via telehealth a few months into the pandemic compared with what they did before…

Workplace of the future. Many parts of healthcare require in-person care, but the pandemic has illuminated the extent to which healthcare can be delivered remotely, such as virtual care and remote patient monitoring, and virtual collaboration for professionals in the pharmaceutical and medtech industries. This model supports greater flexibility and has enabled organizations to draw from a more diverse talent pool. “You can now attract anyone, anywhere,” one executive said in reference to hiring. Healthcare leaders are also reevaluating old workplace norms and introducing new measures, such as offering assistance to help combat videoconferencing fatigue. “COVID-19 has shone a light on culture, good or bad,” another interviewee told us, and it has led healthcare players to reassess work conditions and extend greater flexibility to employees…

Choose. In a world of dynamic change and heightened uncertainty, it is more important than ever to actively manage portfolios of innovation initiatives, consciously choosing to invest in innovation during a crisis. “There is so much chaos, it’s like a constantly changing game board,” one healthcare leader said. “We need even more discipline to make sure we don’t miss something or get overly enamored of shiny new things.”…

Evolve. Another priority that healthcare executives cited was evolving their business models to address new delivery constraints and client expectations. This finding is in line with our recent analysis of profit pools in the sector, which suggests healthcare players that develop innovative business models will generate disproportionate value…

Accelerate. From vaccines to new designs of personal protective equipment (PPE) and ventilators, numerous recent examples demonstrate the healthcare sector’s ability to innovate at previously unimagined speeds. In the United States, the US Food and Drug Administration deployed a range of measures (such as issuing new guidance, establishing new industry engagement models, and issuing emergency use authorizations) designed to support the COVID-19 response across the range of products it regulates. In several instances, the FDA stipulated or requested that manufacturers gather data derived from the real-world use of products in order to better characterize performance, understand supply-chain vulnerability, and support additional development activity, both throughout and beyond the pandemic…

Extend. The COVID-19 pandemic has highlighted the benefits of nontraditional and creative partnerships and collaborations in quickly finding creative solutions to urgent problems—from the health and auto industries teaming up to build ventilators, to pharmaceutical sector competitors collaborating to hasten the development of a COVID-19 vaccine, to healthcare providers partnering with technology companies to deliver COVID-19 apps and solutions…

From the rise of the sharing economy in the wake of the financial crisis to airport security measures following the 9/11 attacks, deep crises tend to create shifts that stick. The COVID-19 crisis is likewise bringing changes to the healthcare sector that are here to stay. As past downturns have shown, innovation is a critical part of any recovery and will be necessary for healthcare players to stay abreast of their industry…” (D)

“Life and business will never be the same after the pandemic, especially in healthcare.

Everything from how patients see their doctors and get treated to how hospitals use tools and share information will forever be altered.

The healthcare industry has long been ripe for innovation, and the pandemic has served as a powerful catalyst. Research from McKinsey found that 90% of healthcare executives believe COVID-19 will fundamentally change their businesses, and 85% predict lasting changes to customers’ preferences.

Innovative practices are being used not only to fight the spread of the virus, but also to continue delivering care to all types of patients in the safest ways possible.

Here are 10 examples of healthcare innovation in the face of COVID.

1 . Health Company Uses Drones For Medical Supplies Deliveries

North Carolina’s Novant Health partnered with Zipline, a company that specializes in delivering medical supplies to remote areas, to create a drone to deliver COVID supplies…

2 . ResMed Enables Cloud-Based CPAP Monitoring 

Ventilation device company ResMed sped up the European release of its patient data management software AirView to better serve patients during COVID…

3 . Docdot App Can Detect COVID Remotely

Instead of seeing their patients in person, an app called Docdot allows doctors to track patients’ vital signs virtually and detect COVID symptoms with medical-grade accuracy…

4 . TytoCare Monitors Quarantined Patients Via Stethoscope

COVID-19 has been a boost for telehealth, but one company is taking it a step further. TytoCare has partnered with major hospitals to use special stethoscopes that both listen to patients’ hearts and transmit images of the lungs…

5 . Military Unveils Low-Cost Ventilators For Expanded COVID Care

As part of the Department of Defense Hack-a-Vent Innovation Challenge, military scientists and engineers designed a low-cost, easily assembled ventilator that can be used in hospital and field settings. These ventilators can be quickly produced for less than $500..

6 . Hospitals Use VR For Training

The pandemic has re-emphasized to healthcare workers the need to continually upskill and learn. Unable to meet in large groups but still wanting to quickly train on up-to-date methods, hospitals are turning to virtual reality training…

7 . AI Software Company 3D Prints Nasal Testing Swabs

Faced with a shortage of testing supplies around the world, AI software company Axial3D designed 3D printed nasal swabs for COVID tests.

8 . Mayo Clinic Uses De-identified Data To Create Treatments

Before the pandemic, Mayo Clinic had partnered with AI company nference to de-identify patient records, but the project accelerated when COVID hit. Together, the groups created the Clinical Data Analytics Platform…

9 . Hospitals Use Robots To Deliver COVID Relief

Moxi is a one-armed rolling robot designed to help hospitals. Unveiled shortly before the pandemic, Moxi’s duties have pivoted to deliver PPE, lab samples and COVID tests…

10 . Sutter Health Expands Chatbot To Cover COVID

Sutter Health quickly added COVID to its chatbot symptom checker. By answering a series of questions, the algorithm evaluates a patient’s medical history, risk factors and symptoms to provide a recommendation. Sutter’s bot is the equivalent of having 60 doctors in a patient’s pocket to answer questions around the clock…

Healthcare will be permanently changed by the COVID pandemic. But these innovations show that the industry is primed to grow and find new solutions to deliver the best care possible, no matter the circumstances.” (E)

“Lessons Learned

Lesson 1: The Health Care Workforce Is A Ready Source Of Creative Ideas

During the pandemic, the common image of a creator as entrepreneur or artist was expanded to include professionals on the front lines of the COVID-19 response. We saw critical care doctors and nurses creatively re-purpose split-respirators, baby monitors, snorkels, and hairdryer hoods for COVID-19 care; supply chain supervisors contact laundromats and hardware stores to help maintain personal protective equipment; and environmental services managers experiment with sanitizer placement and clever signage. As vaccine distribution faced challenges, public health workers turned closed Sears stores into vaccine centers…

Lesson 2: Creativity And Standardization Are Complements, Not Antagonists

Prior to COVID-19, creativity was often described as contradictory to health systems’ goal of evidence-based standardized care on the theory that creativity introduces variance whereas standardization seeks to reduce variance. COVID-19 showed, however, that these “contradictory” processes can be complementary and thus managed jointly. Creativity supports the identification of innovations worth standardizing. Clear surgical masks to facilitate lip-reading and family inclusion in palliative care virtual discussions have become standard practice in some organizations, for example…

Lesson 3: Implementation Of Creative Ideas Can Be Fast And Effective

It is reported that evidence-based medical practices, which often start as creative ideas, take 17 years to be incorporated into routine practice. Telemedicine—a creative, evidence-based practice of electronic and telecommunications technologies used to provide care at a distance—appeared to be on this path until COVID-19. After a decade of slow uptake, virtual visits rose 150 percent in a month during the pandemic, with organizations such as Emory Healthcare scaling their programs within eight weeks. Similar rapid implementation occurred for other creative ideas that had been marginalized, such as integration of behavioral health services into primary care, which have streamlined previously siloed care delivery processes…

Lesson 4: Creativity Benefits From Collaborations With Diverse Stakeholders

During the pandemic, creativity was frequently used to build supportive networks and systems to care for vulnerable communities, enhancing commitment and effort to address local needs. Public-private partnerships among community health workers, organizers, and governments fueled the success of pop-up events and mobile vans to deliver COVID-19 testing and vaccine services to Black, Latinx, and underrepresented populations…

Operationalizing Lessons Through Policy And Management

Together, these four lessons indicate the potential and feasibility of leveraging creativity for improvements. Doing so requires actions by organizations and policy makers. Organizations must take at least four steps.

Invite Creativity

Support Creativity By Providing Resources

Creativity And Standardization

Reward Creativity

Updating Regulations

Cross-Industry Collaboration…

Self-reliance is unlikely to generate the creative ideas and implementation required to address the big, remaining issues in health care. While COVID-19 brought much devastation, it also showed the power of creativity and creative potential of the industry to address serious problems. That lesson is something that should not be lost.” (F)

“Eleven students are typing notes on their laptops at Nashville State Community College. For several, it’s been a while since they were last in a classroom.

They’re training to become medical assistants, which will take 12 weeks of work in both the classroom and in the hospital…

Clifford Johnson, 52, was the lead driver for a team that shuttles surgical instruments back and forth to get sterilized. He’s worked at Vanderbilt for seven years…

But like so many hospitals, Vanderbilt is looking for creative hiring solutions. So beyond covering tuition, the hospital offered to pay employees like Johnson their salaries as they train full time.

“The turnover has been tremendous,” said Vanderbilt’s vice president for allied health education, Peggy Valentine. “So the thinking was, why don’t we work with our employees, build a sense of loyalty? And then we’ve got a workforce that’s likely to stay with us in the long haul.”

The “grow your own” concept is catching on around the country as the market for all clinical roles becomes more competitive — from a community hospital in Comanche County, Okla., to community health centers across California.” (G)

“For a long time, whenever companies wanted to hire a CEO or another key executive, they knew what to look for: somebody with technical expertise, superior administrative skills, and a track record of successfully managing financial resources. When courting outside candidates to fill those roles, they often favored executives from companies such as GE, IBM, and P&G and from professional-services giants such as McKinsey and Deloitte, which had a reputation for cultivating those skills in their managers.

That practice now feels like ancient history. So much has changed during the past two decades that companies can no longer assume that leaders with traditional managerial pedigrees will succeed in the C-suite. Today firms need to hire executives who are able to motivate diverse, technologically savvy, and global workforces; who can play the role of corporate statesperson, dealing effectively with constituents ranging from sovereign governments to influential NGOs; and who can rapidly and effectively apply their skills in a new company, in what may be an unfamiliar industry, and often with colleagues in the C-suite whom they didn’t previously know.

These changes present a phenomenal challenge for executive recruitment, because the capabilities required of top leaders include new and often “softer” skills that are rarely explicitly recognized or fostered in the corporate world. Simply put, it’s getting harder and less prudent to rely on traditional indicators of managerial potential.

What should organizations do to face this challenge? A critical first step is to develop greater clarity about what it now takes for C-suite executives to succeed. Yes, the range of necessary skills appears to have expanded—but how exactly? For example, what does the term “soft skills” really mean? And to what extent does the need to hire executives with more-expansive skills vary across organizations?…

Our study yielded a variety of insights. Chief among them is this: Over the past two decades, companies have significantly redefined the roles of C-suite executives. The traditional capabilities mentioned earlier—notably the management of financial and operational resources—remain highly relevant. But when companies today search for top leaders, especially new CEOs, they attribute less importance to those capabilities than they used to and instead prioritize one qualification above all others: strong social skills…

When we refer to “social skills,” we mean certain specific capabilities, including a high level of self-awareness, the ability to listen and communicate well, a facility for working with different types of people and groups, and what psychologists call “theory of mind”—the capacity to infer how others are thinking and feeling. The magnitude of the shift in recent years toward these capabilities is most significant for CEOs but also pronounced for the four other C-suite roles we studied…

In the years ahead, some companies may focus on trying to better identify and hire leaders with “the right stuff”; others may pay more attention to executive training and retention. But no matter what approach they adopt, it’s clear that to succeed in an increasingly challenging business environment, they’ll have to profoundly rethink their current practices.” (H)

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“Some 20 million babies, toddlers, and preschoolers are now eligible to be vaccinated for COVID-19, after the Centers for Disease Control and Prevention’s Director Dr. Rochelle Walensky signed off on unanimous votes from her agency’s outside vaccine advisers to recommend shots from Moderna as well as Pfizer and BioNTech for children as young as six months old.

“Together, with science leading the charge, we have taken another important step forward in our nation’s fight against COVID-19,” Walensky said in a statement.

Around a third of parents say they plan to get their child in the age group vaccinated, according to CDC survey findings released on Saturday. Some of the long-awaited shots could begin as soon as this holiday weekend. Federal officials expect the bulk of vaccinations will commence after doctor’s offices reopen on Tuesday. 

“We know millions of parents and caregivers are eager to get their young children vaccinated, and with today’s decision, they can. I encourage parents and caregivers with questions to talk to their doctor, nurse, or local pharmacist to learn more about the benefits of vaccinations and the importance of protecting their children by getting them vaccinated,” added Walensky.

The CDC’s Advisory Committee on Immunization Practices voted following a two day-long meeting to mull data on the benefits and risks of the shots in young children. A panel of the Food and Drug Administration’s own outside advisers had also voted unanimously on Wednesday to back authorization.” (I)

• A.What COVID Hospitalization Numbers Are Missing, by By Ed Yong, https://www.theatlantic.com/health/archive/2022/05/hospitalization-covid-healthcare-burnout/629892/
• B.What enabled health service innovation during the pandemic? Crisis, staff, system or management? By Dr Pim Kuipers et al, https://ahha.asn.au/sites/default/files/docs/policy-issue/perspectives_brief_no_19_health_service_innovation_during_the_pandemic.pdf
• C.INNOVATIONS IN COVID-19, PATIENT SURGE MANAGEMENT, by John L. Hick et al, https://files.asprtracie.hhs.gov/documents/innovations-in-covid-19-patient-surge-management-final-508.pdf
• D.The essentials of healthcare innovation, By Daniel Cohen, Laura Furstenthal, and Leigh Jansen, https://www.mckinsey.com/business-functions/strategy-and-corporate-finance/our-insights/the-essentials-of-healthcare-innovation
• E.Here are 10 examples of healthcare innovation in the face of COVID., by Blake Morgan, https://www.forbes.com/sites/blakemorgan/2021/02/01/10-examples-of-healthcare-innovation-in-the-face-of-covid/?sh=41c80299680d
• F.COVID-19 Inspired Creativity In Health Care: Lessons For Management And Policy, Yuna S. H. Lee Ingrid M. Nembhard, https://www.healthaffairs.org/do/10.1377/forefront.20220617.857677/
• G.To fill clinical roles, Vanderbilt begins training truck drivers, cleaning workers and other existing staff, by Clifford Johnson, https://wpln.org/post/to-fill-clinical-roles-vanderbilt-begins-training-truck-drivers-and-cleaning-staff/
• H.The C-Suite Skills That Matter Most, by Raffaella Sadun, Joseph Fuller, Stephen Hansen, and PJ Neal, https://hbr.org/2022/06/the-c-suite-skills-that-matter-most
• I.CDC and FDA clear the way for COVID vaccines for kids under 5, BY ALEXANDER TIN, https://www.cbsnews.com/news/covid-vaccine-kids-under-5-pfizer-moderna-fda-authorize/
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