This latest interview is a special one, as we do a deep-dive into the particular relevance of collective resilience in the healthcare sector – a timely and critical application of the practice of Building Resilient Teams™.
Our guest is healthcare professional Stephanie Selby. Stephanie is Chief Clinical Operations Officer at University of Maryland Medical System Health Plans, which administers government sponsored insurance coverage for Medicare Advantage and Medicaid managed care.
Hi Stephanie! Thanks for chatting with us. Tell us a little about who you are and where you’re from.
Well, I was born, raised and still reside in Maryland. I live in a tight knit, rural community with my husband Jason and two sons, Flynn and Jameson.
What can you tell us about your education and career background?
I often say that I’m a jack of all trades, master of none. From the time I graduated high school I worked and went to school at the same time. As a young child I wanted to be a lawyer, then I thought I wanted to be an elementary school teacher. My path took many directions based on where I was working and the opportunities that crossed my path. I never turned down a chance to do something different or new. I gravitated to jobs in health care, starting at the ground up in the most entry level of positions, only changing what I did when a chance to learn something new presented itself. I studied liberal arts at Notre Dame of Maryland University majoring in English and Philosophy, with a minor in Business. Later in life I went back to school to study nursing at Harford Community College. I’m a Registered Nurse in the State of Maryland.
What drew you to healthcare – and nursing in particular – as the career path you wanted to pursue?
I spent many years working for health insurance administrators and then a growing continuing care retirement community. I enjoyed collaborating on, then eventually managing projects for health services lines of business – pretty much across the continuum of care. Then I fell into an electronic health record project, the first of its kind at the organization. There I found a passion to intersect process with technology in health care. It was like I found a calling where this jack of trades could utilize nearly all of her skills. I flourished in that role for many years building new skills in technology.
Eventually I was presented with a sponsorship in that organization’s newly developed Six Sigma team to become a Black Belt. I jumped on that! I earned my Black Belt (while pregnant and on maternity leave with my oldest son). Ran some incredibly fun projects with fantastic teams. I continued to be drawn to healthcare technology. My work life was morphing from jobs to a career. I was spending more time in the healthcare technology sector, mostly in IT departments with brilliant programmers and developers. But all the cool jobs were for nurses – you know R.N. required. That did it for me, that’s when I decided to go to nursing school. That changed me. I learned things about myself in nursing school.
Who is a role model that you’ve interacted with in your life that inspired you toward this career trajectory?
I feel like there have been many role models in my life. My dad is the first I think of. He was always a hard worker, he worked many hours. He was in sales and attended workshops about sales and customers. When I was pretty young, we used to sit and talk about what he learned. He would teach me about body language, voice modulation, and most importantly a good handshake. My mom shaped my beliefs about family. My husband taught me about real compromise and partnership. Professionally, I will never forget the lessons and advise a former boss gave me about maintaining my ‘toolbox.’ She is the one professional mentor who really pushed me to grow my skills.
What did you find most rewarding in RBLP’s certification training, and the most applicable for individuals working in the healthcare sector?
This might be the most nerdy response, but here goes. I really enjoyed the coaching sessions. I was fortunate to work on my certification early on, so I was coached by Dr. Gene. Each week, I looked forward to the reading and the videos, and especially the discussions with Dr. Gene. RBLP is really the most practical of any leadership training I have participated in. You can immediately apply the framework of knowledge to your day-to-day. Industries that are highly regulated for safety and compliance are innately stressful.
Healthcare is a broad industry in that there are many facets of healthcare: bedside, in the home, in a hospital, in the field, and now even on a device. Regardless of the setting, you never know what you’re going to get each day. You’re almost always working in teams towards a common goal, and you have adapt to a situation that could be changing by the second. I am a firm believer in being elbow to elbow with my teams in the healthcare trenches. The best teams have been those who have worked together through adversity. They are strong, smart, efficient, and mutually supportive.
I sponsored a team of frontline managers to also participate in the RBLP training. We took advantage of being immersed in training together to have our own management team debriefs about the training content and how to apply it to the smaller teams. That experience has allowed our managers to build high performing teams that are cross collaborating in ways they never had before.
When it comes to being quick-footed and adaptable within different healthcare industries, what are your immediate experiences with the teams you’ve worked with and how it’s really benefited them?
I’m not working on a hospital floor anymore, but I have friends who are very much embedded in the hospital units and ICUs, and being a part of the U of Maryland medical system I participate in some leadership calls as their own task force and command centers are dealing with COVID-19 outbreak in hospitals. When you are in healthcare and delivering patient care, you are reacting to the patient’s presentation. If you are noticing vital signs doing something that they’re not supposed to be doing… there are certain things that you tune into as a clinician that send off cues that something’s happening here that I need to react to. It’s very in the moment [ and] reactive and in many situations it’s seconds of reaction time. In a matter of seconds or minutes we can be looking at a worst case scenario. That’s very much what’s happening in hospitals, and field hospitals, they are reacting that quick. This is a very unknown area for us right now; there’s just not enough evidence yet to have a protocol for COVID. So that’s something that has been evolving as the pandemic evolves.
Our teams at the health plan have had to essentially stop what we were doing and redirect to a whole new way of doing business for the past two months, where some things we were previously spending our time on – everyone is home, they’re not getting elective surgeries, they’re not utilizing emergency rooms and hospitals like they used to. But we’ve got these other things going on, so a quick redirection of resources and figuring out what is the best way to take care of our members, and it has literally changed every week. We’re developing new policies and desktop procedures, and it’s strictly watching CDC, CMS, our own state health department websites to make sure we’re following most current protocols because, it’s changing every day.
Harvard Business Review recently published an article comparing hospitals that are overwhelmed at the moment to start-up businesses, and how their success or failure can hinge upon their teams’ ability to constantly incorporate learning into the process. It seems as though you really need to have a team that is resilient and can keep all communication channels open to achieve that.
You really do, and I’m hard pressed to look back on a team that I’ve been on within healthcare that was not resilient… It really takes coordination of the entire team, whether it’s doctors, nurses, speech therapists, respiratory therapists, aides, housekeeping, radiologists… it takes a real coordination of efforts, and everyone has their role. They are experts at their thing, but it’s that team aspect that everyone works in tandem and in a synchronous way, the unit is just functioning at such a high level.
I’m in some nursing groups and I hear from friends in different states how their hospitals are furloughing employees or downsizing. That’s just not what we’ve experienced here in Maryland, the strategy here is keep everyone working but we have to move them to the volume. So there was a lot of on the fly education, whether it was a nurse who was on your med-surg floor [dealing with] post-op knee surgeries or someone who had a stomach virus and wasn’t handling it well – we know that they’re going to start getting more acute patients. The ICU’s are going to be jam-packed with patients who are ventilated and intubated, and very quickly we [realized] we need to teach these other units how to handle these more complex patients. All of the healthcare staff, they stepped up to the plate and learned what they needed to know about more respiratory conditions and medication interactions.
So that’s very much been a part of the whole healthcare response and it makes you very proud to be a part of a profession that despite the drastic efforts to conserve PPE and a high stress environment, they come back every day into these uncertain conditions. It’s really been impressive on how, as tragic and eerie as the event has been, it’s really been… I almost hate to say it because it sounds so morbid, but almost been a breath of fresh air because it’s forced systems like hospitals that don’t normally have to change fast toward that start-up mindset of “We’re going to get some real curve balls on any given day,” and be prepared for that.
In your mind, what is the best definition of “resilience” for those who might be unfamiliar with the program that RBLP offers?
To me, resilience is working through adversity and coming back for more. Right? Realistically that’s what we do every day. In the most basic of scenarios we go to work with a schedule and a plan. The day dictates what happens, not the schedule. Sometimes our plan has a solution for the something we encounter, sometimes (maybe a lot of times) it doesn’t. That is our moment to learn. We analyze what’s going on, we adjust our plan and we keep going. At the end of the day we reflect, take inventory, and devise a plan for the next day. Along the way you learn more about the goal and how to reach it, you build relationships, this sets a tone in the environment. Like or not, you’re building a culture and an organizational structure. To me, that is the essence of RBLP – cohesion, climate, purpose. RBLP offers a framework of understanding for everyone, from the frontlines to leadership.
What are the three most important aspects of RBLP, in your opinion, that you wanted to convey to your fellow healthcare providers as a valuable training resource?
1. Leaders aren’t always in traditional leadership roles, but they are just as important as traditional leaders.
2. Cohesion, climate, and purpose are organic, just like nature. They are going to grow with our without influence. Groom them!
3. You might not realize it, but you already embrace experiential learning: Do – Reflect – Conclude – Learn – Plan – Try. Add formality to the experiential learning.
The entire healthcare community is facing unprecedented challenges in the workplace as they treat thousands of coronavirus patients nationwide. How can the practice of building resilient teams help keep them safe and prepared?
Oh my! Well, this is kind of what we prepare for. We have had to overhaul all everything we do. Frankly, I’m astounded! Every protocol we follow has changed, and most have changed multiple times. We are reviewing, modifying, and implementing new or changed protocols and policies constantly in order treat patients or keep ourselves safe. Healthcare is a field driven by evidence based best practice, yet the evidence is still being compiled and will be for many more months. We are literally mini-cycling experiential learning on warp speed. And we come back, every day, to do it all over again. If that’s not resilience, I don’t know what is.
RBLP leadership certifications are about Building Resilient Teams™ that overcome adversity and then can adapt and grow! As always, we are #StrongerTogether.