Don’t just sit back and complain; do something about it.
There’s no better way to capture the spirit of Sheree Mcfarland than the sentence above. Not only has she spoken those words; she has lived them throughout her career. Whether it was by seeking out an interim CIO role at Lenox Hill Hospital despite a lack of technology experience, or working tirelessly to promote diversity through various CHIME initiatives, Mcfarland has always been a doer.
Recently, healthsystemCIO caught up with HCA West Florida’s longtime CIO to talk about the organization’s Covid-19 response – including how technology is being innovated to improve tracking, and the keys to keeping teams motivated during a crisis. Mcfarland, a native of Belfast, also discussed the unique circumstances that brought her to the United States; why she is so passionate about inclusion and creating opportunities for others; what she believes are the most valuable skills in today’s leaders, regardless of gender; and why, despite the progress that’s already been made, she feels the Women of CHIME are “only scratching the surface.”
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- Developing a tracking mechanism proved enormously helpful in HCA’s ability to respond to Covid. Even more important, however, was “communication and education,” along with the ability to respond and work with competitors.
- Don’t underestimate the power of motivation – particularly during a crisis. “When you have something bigger that yourself to focus on, that becomes your rallying cry.”
- CIOs need to recognize the potential for burnout. “People are Covid-weary, and so you need to make sure you’re tuned in and you’re emotionally intelligent.”
- Although technology acumen is necessary, it’s not everything. “You need to get your culture right; create the right team, celebrate diversity, and focus on inclusion and on incorporating everyone’s ideas as part of the solution.”
- Involvement in professional organizations, paired with education, can provide a strong foundation for career development and can set individuals apart from others.
Q&A with Sheree Mcfarland
HCA – West Florida’s Covid-19 response
Gamble: I wanted to talk about your team’s efforts in response to Covid-19, including what you’ve done with tracking.
Mcfarland: As a healthcare system, we’re super organized. The efficiencies that we have because of our economies of scale and our supply chain are unsurpassed in the industry. Being a large healthcare system, we’re organized at the division level, and so during Covid, the division president has started the calls, and each facility reports in.
One thing my team was to build tracking and reporting capabilities for PPE (personal protective equipment). Very early on, we appointed a PPE czar at each hospital — typically a nurse — who was responsible for all the supplies at that hospital. We were finding that a nursing unit in one hospital used 96 N95 masks during a given shift, and another unit used 25. What was the reason for the variation? We knew that if we were going to get through this and not run out of critical supplies, we needed to be able to track it, and nobody does measurement and tracking better than HCA. And so my team worked diligently, and what would’ve probably taken six months in a normal schedule was done in less than four days. My development team worked with the division president, the chief nursing officer, the chief administrative and financial officer, the supply chain CEO, and the czars to come up with a tracking mechanism. And it ended up becoming a best practice. The developers were able to release that application to corporate, which then took it system and enterprise-wide. In fact, 10 of our 14 divisions were, and still are, using it.
My team was called upon to be very innovative in figuring out how we could help — not just the facilities, but also with things like PPE, and that was remarkable. That happened in early April. And then it became about vigilance and working every day on conference calls. We have an app that was developed called Rhythm, which pulls from another self-developed app at HCA corporate called Nate. I’ve got 47 tiles on this app; it’s exclusive to HCA and we’re able to track all of our utilization statistics in one application, which is absolutely fantastic. It will tell you the number of PUIs, the number of Covid positive cases, the number of observations, statistics on every single facility, number of ER visits, how many N95s and K95s were used, etc. We’ve got tracking down to a tee. It’s absolutely been the difference in arming our executives with information at their fingertips so that they’re able to know the statistics, report on the own statistics, and be able to educate the workforce.
Communication and education during crisis
Mcfarland: Communication and education were key during Covid, along with our ability to respond and work with our competitors. With the GE Clinical Command Centers, if we knew we were having an influx of patients from a nursing home, we could work with other facilities in HCA as well as our competitors to make sure we were meeting the needs of our very sick people.
The beauty was in everybody coming together for a common purpose. It really was purpose over task, which was so critical. That’s part of the Care Reimagined culture that our president, Ravi Chair, MD, has implemented in West Florida, and it shone through. The silos were brought down. Dr. Chari met with representatives from the major healthcare organizations in Tampa: Baycare, AdventHealth, Tampa General, and the children’s hospitals — the folks who typically compete for patients were cooperating and coming together, which was lovely to see. Sam Hazen, the CEO of HCA, really led the charge. He went to visit Washington D.C. and arranged for HCA to lend ventilators to the federal government for New Jersey and New York. It gave us the ability to participate in something bigger than ourselves where the whole is more than the sum of the part. That was HCA’s response on the global scale, and then you bring down to the division level and the facility level.
Every day, the division president hosted conference calls from a Microsoft tablet that were attended by 200 people — everyone from supply chain, pharmacy, and each of the facility executives. Everyone was coordinating, and the messaging was consistent so that we understood our ability to cope and we understood what our needs were, whether it was ventilators, masks, gowns, or gloves. That coordination and our ability to be able to do that is what sets HCA apart from so many others.
Keeping teams motivated
Gamble: It’s amazing that the team was able to develop and roll out apps so quickly. Can you talk about what it takes to foster that kind of innovation, especially under difficult circumstances?
Mcfarland: It’s about keeping people motivated and keeping them focused on common purpose. When you have something bigger than yourself to focus on, I think that becomes your rallying cry. No one complained about working 100 hours in a week. No one complained that they were at their kitchen counter at 10 p.m. on a Saturday and at 7 a.m. on a Sunday as part of the PPE development team. I think that’s what really sets us apart.
We do the same thing with hurricanes. A few months ago when we thought Laura was potentially coming to the Tampa Bay area, we were all on a conference call at 4:30 p.m. on a Friday. Everyone knows the drill. It’s keeping people focused and motivated, and reminding them that we’re here for the patients — and that’s a higher and more noble cause than any individual preoccupation. Fostering that culture of innovation and individual thinking within a larger context is so important; we need to allow people to be innovative and to be able to share ideas and not to be afraid to fail or to make mistakes. It’s saying, ‘Okay, that version wasn’t great but let’s redo it. We’ll regroup tomorrow morning. Everybody go to bed for a little bit.’ Let’s take shifts and care for each other and cover for each other, then give them a day off the next week to go do something fun.
Recognizing burnout & taking action
Mcfarland: I think it’s important as CIO leaders that we recognize the potential for burnout. People are Covid-weary, and so you need to make sure you’re tuned in and you’re emotionally intelligent. I love the idea of emotional intelligence; as a leader, you need to be tuned in to the needs of others as well as the way you are perceived. And so we did a lot over the summer with things like ice cream socially distanced, where we had the IT director bring ice cream to the facility. We ordered lunches because we weren’t able to have picnics in person. WE did a number of all-hands presentations where we demonstrated facility and division pride by showing pictures of people with their masks on going that extra mile for our patients, because we’re all caregivers.
I think showing appreciation is so important. People are working long hours. They’re scared, they’re tired, and they’re overworked. They’re worried about their kids going back to school and maybe one parent not earning income. I think that’s the glue and the secret sauce that has kept us all together — showing a lot of empathy and concern and keeping the team motivated. We’ve historically had some of the highest engagement scores in the organization. Employee engagement and culture are the most important things CIOs can focus on. Technology is great, but it has to be built on top of your culture. You need to get your culture right; create the right team, celebrate diversity — which I learned from my early days in New York city — and focus on inclusion and on incorporating everyone’s ideas as part of the solution. That’s the secret sauce, at least for us in West Florida.
Women of CHIME’s grassroots beginning
Gamble: I’m glad you brought that up, because I really want to talk about Women of CHIME and some of the initiatives there. Can you talk about how it came about?
Mcfarland: I have to give credit to Liz Johnson, who really started it when she was Board Chair a few years ago. Between 2015 and 2019 we started to hold various networking events for the Women of CHIME. It started a grassroots initiative where women would go to focus groups and meetings and realize they didn’t know each other. Even still, the majority of CHIME members are men, so it’s really nice when women can seek each other out.
I’ve been in CHIME nearly 25 years; I’m a lifetime member and a fellow. For years I felt like I was one of only a handful of women who played in the golf tournaments, and we didn’t really know each other. Then Liz started getting folks together and holding events like golf clinics, painting and cocktail parties, afternoon teas, and receptions so we can get to know each other. The reaction was so positive.
We realized that the Women of CHIME have different needs; they have different requests for curriculum, for education, and for opportunities. And so, this is something I think we really need to take seriously. Then I became a member of the board — I’m in my third year (we’re actually going to serve four years because of Covid). One of the things we talked about on our board retreats was the need for a diversity and inclusion committee, of which the Women of CHIME would be an integral and very important part. We convened that committee, which is chaired by Cletis Earle, and as part of it we launched the Women of CHIME.
What we’re currently working on right now is developing that further. Last year we held a strategic planning session that was attended by about 50 or 60 people. The session we had on Women of CHIME was very popular, and it became obvious we needed to do more. We needed to step up our game. [CHIME CEO] Russ Branzell asked if I would lead the Women of CHIME, and so we surveyed our membership to ask questions like, ‘What are your educational needs? What type of virtual sessions are you interested in particularly? What educational topics would be important to you? What does your organization currently offer? Are you a mentor? What type of things are you doing to develop your brand and deal with different situations? How do you present to your board?’
We sent out a survey, we got the results, and we’re working through those now to see what we can offer in terms of courses and events that are of particular interest to women.
Promoting diversity through scholarships
Mcfarland: And of course, the scholarships became a big focus for us this summer. Back in May, we held a meeting to talk about awarding scholarships to minorities and women. Originally it was going to be two different committees, and we realized after a consult with several different members on the diversity inclusion committee that it’s really one committee. We went through all of the applications and there were three broad categories, as you’re familiar with, the CIO boot camp for CIOs and/or their delegates and then CISO, for information security officials and then clinical informatics.
The CHIME Education Foundation, in conjunction with Diversity and Inclusion and the Women of CHIME, was awarded $100,000 to give out a scholarship this year, and $100,000 for next year. We’ve awarded 29 scholarships — some full and some partial. The first round in July included nine CIOs for boot camp, 10 for the CISO boot camp and six for clinical informatics. Then we did a second round, which included a lot of women and minorities. It was absolutely fabulous to see level of interest in the community. That’s how you unleash your organization’s full potential — with voices and input and participation from all of the different areas. Being able to award scholarships helps put people in the same on the right path.
Professional development & the power of opportunity
Gamble: I actually spoke with Cletis a while back, and he talked about some of the opportunities he had been given. It really hit me when he talked about how important that is and how his trajectory could’ve gone a different way if he hadn’t had those opportunities.
Mcfarland: Definitely. I got a break early in my career at Lenox Hill Hospital when the vice president actually of IT resigned. The current director did not want to be the vice president and I became the interim because I was working on the 5-year strategic plan with Ernst and Young. You need to take advantage of opportunities like that and approach it like, I may not be a technologist per se, but I’m a great organization development executive. I can harness the power of IT to run the business, and I want to step up and take advantage of this leadership opportunity. And that’s what I did.
To this day, I tell Russ that my involvement in CHIME was what enabled me to have the professional development experience that set me apart from everybody else in the organization. I was ready because I had the educational background as well as the opportunity through CHIME to expose myself through concepts and professional development curriculum that I wouldn’t have otherwise had.
That’s why it’s so important for me to offer this to other women and to minorities. I grew up in Belfast in the north of Ireland. I had emigrated [to the U.S.] once when I was 11; I was picked out of a hat of names of children in school to come out of the violence in Belfast to spend time with host families. I came back for two years in junior high school, and so I was able to share in the American experience of education early on as well as the British education system in the North of Ireland. When I emigrated back permanently in 1988, it was that educational background, as well as being a member of the American Society for Training and Development and then CHIME (at Lenox Hill before I was officially a CIO) that helped my career take off, and enabled me to take advantage of educational opportunities.
And so for me, it’s so important that we offer scholarships. I also do this as part of the Rotary Club, because I believe everybody benefits when everybody is educated.
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