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Q&A: How NorthShore's CEO fought Covid-19 as a patient—and a health system leader

May 4, 2020

    J.P. Gallagher, President and CEO of NorthShore, recently spoke with Robin Brand, Senior Director at Advisory Board, about the health system's quick and coordinated response to the Covid-19 epidemic and how his experience being diagnosed with Covid-19 informed his leadership strategy.

    Q&As: How top health systems are tackling Covid-19

    Question: Thank you for taking the time to speak with me. I'd like to start off on a personal note; you recently shared that you were diagnosed with Covid-19. How are you doing?

    J.P. Gallagher: Thank you, I'm doing well. As I'm sure you've seen Covid-19 is presenting differently for various patients and I was fortunate to have had a very mild experience when compared with others. Early in March, I had what felt like mild fever symptoms, including a slight temperature, some chills, and modest muscle aches. As a precaution, I went into one of our immediate care sites for a screening and I began working from home. My initial test results all came back negative, but my symptoms didn't pass. I had no respiratory issues, but the muscle aches actually got a little bit worse.

    I was eager to get back to work, but I got screened for Covid-19 first to make sure I wasn't going to be a risk for others. I was very surprised when the results came back positive.

    I wasn't worried about myself when I got the diagnosis, because my symptoms and my experience with the virus was mild. However, I was very concerned about my family. Although I had taken some precautions at home, I hadn't self-isolated to the extent that one probably should. As a result, my wife and my three kids were definitely exposed to me, and since my eldest daughter has type one diabetes, it was serious.

    I immediately self-isolated. Then I worked closely with our employee health team to make sure that enough time had passed before I physically came back to the office. I was able to return to the office a week later, so that part of the experience was manageable. But as a parent, the experience hit home hard and we were very scared in terms of what impact it might have on our family.

    Q: I was impressed by how openly you shared your experience. What compelled you to share your story with your team members and the public? How did that experience shape your approach leadership?

    Gallagher: I was very cautious at first about how I shared my story with team members. Experiences with Covid-19 can vary widely, so I didn't want to suggest the virus was not something to be concerned about. However, I did feel it was important to be transparent about my journey so employees knew I could relate to some of the fear and uncertainty they were feeling surrounding the epidemic.

    I sent a letter to our staff and all of our team members sharing my personal experience. In the letter, I expressed my commitment to continue to keep our employees safe and acknowledged that the virus and its trajectory across our service area was continuing to escalate.  

    In hindsight, I think it resonated with a number of team members and staff and I think it opened up some powerful dialogue that helped me fully appreciate the impact of our frontline workers. Soon, people across the organization started to come up to me and share their experiences with Covid-19.

    I think the most important attribute of a successful leader is a genuine sense of empathy. So my experience was humbling because I was able to connect with members of our team across the organization in a way that genuinely conveyed appreciation for not just their work, but the risks they take coming in every day to care for patients. On a deeper level, particularly as a parent, I was able to experience firsthand that there is real fear and uncertainty about what this virus can do to the people you care about. At the end of the day we're all parents or siblings or friends who care about the people around us, and that doesn't change. That was probably the most powerful lesson.

    Q: Yes, I can only imagine the perception shift from knowing the fear and experiencing it in real in life. And as a NorthShore patient, you were able to also experience firsthand your system's approach to Covid-19 testing?

    Gallagher: Yes, and I can say firsthand that being a patient definitely gave me an appreciation for just how valuable our testing capabilities have been and continue to be in our ability to manage the new coronavirus and Covid-19. Getting testing results to patients and to caregivers is incredibly important in terms of keeping people safe, and allowing them to make decisions that are needed to minimize the spread of the disease elsewhere in the community.

    Q: NorthShore was one of the earliest entrants into the testing market. What prompted your response and approach there?

    Gallagher: We have typically been turning around our Covid-19 test results within 24 hours, which has not been the norm across much of the country or even in the Chicagoland area. I'd say our success there is largely attributable to two things: the ability to scale and creativity.

    I'll start with the first. One of our strengths as an organization is our ability to execute and operationalize things at scale, and this was very much an example of that. We previously had made significant investments in technology and equipment that allowed us to do these tests at high volume. Then in March, we stood up a drive-thru testing capability in 24 hours and we established an online platform where patients can fill out questionnaires about their symptoms and talk to a clinically trained member of our team who refers them to a drive-thru appointment or a walk-in appointment based on their symptoms.

    The second is creativity, and by that I mean the creativity of our team members. NorthShore's approach to testing was really developed by our chair of the Department of Pathology, Dr. Karen Kaul. She is a nationally respected scientist and researcher who worked closely with the Illinois Department of Health during the SARS outbreak. So back in early February, she engaged some of her colleagues at the health department and developed a strategy for testing that's enabled us to expand our footprint beyond just NorthShore patients.

    In the early days of our testing efforts, NorthShore was accounting for about one-third of testing in Illinois, including testing for first responders and other health systems in the area. Now, we've reached out to with more than 300 organizations across the Chicagoland area, including churches, schools, and municipalities, to raise awareness about testing access, and we're completing about 1,500 tests per day. We're getting some additional equipment to get to 2,000 tests per day.

    Q: I'd like to look beyond testing and discuss your systems overall approach to Covid-19. You recently acquired Swedish and I can imagine integrating a new organization while navigating a major public health crisis could be tricky. How did you manage?

    Gallagher: One of our strengths is that we're a highly integrated organization. I've been with NorthShore for 18 years and the focus on "systemness" has been a strength that we've intentionally invested in for as long as I've been here. We've had one EHR system in place since 2003 and we've had one medical staff across our hospitals, so we easily embedded those elements into a Covid-19 response.

    Back in March, as we're starting to see the number of cases climb we decided to leverage our system and transformed our Glenbrook hospital campus into an exclusively Covid-19 campus. That gave us the ability to triple the size of the ICU and gave us tremendous surge capacity. As we think about our path going forward, we're planning to run Glenbrook hospital as the primary anchor for our Covid-19 patients for the foreseeable future.

    In terms of Swedish Hospital, I think the experience with Covid-19 has heightened everyone's appreciation for being part of a strong system. We've been able to access PPE collectively, have extended testing capabilities to that campus, and have transferred some of the sickest patients from Swedish to our Glenbrook hospital campus. It's all gone very fluidly and I think what it's done is it has reinforced the value of being a system.

    Q: How else are you thinking about the health system's strategy as the first wave of Covid-19 cases eases? How are you approaching the challenge of restarting electives?

    Gallagher: Like every health care provider, we are eager to get back to non-Covid services, but we want to do that in a safe way.

    We connected with physician leaders, administrators, and public health experts, to develop a list of 11 principles that will guide our decision-making on when and how to reopen our services.

    First, we're prioritizing the safety of our team members and patients. Next, our physician leaders are helping us prioritize the risk factors associated with different elective services to determine which elective surgeries we will reintroduce first. We're also recognizing that treating Covid-19 patients will be the new normal for the foreseeable future, which means we can't prioritize elective services that somehow compromise our ability to treat those patients.

    Finally, we're making sure the organization can operate in a way that is operationally and financially sustainable.

    Some of the creativity that's come out of this has been really remarkable and has given me tremendous optimism in terms of our ability to do this well, but it's also going to require proceeding with caution, learning from our experience as we start in certain areas, and then potentially evolve that going forward.

    Q: I know we're coming close on time. But before you go, I wanted to open the floor up to you and ask what's really impressed or surprised you about NorthShore's response to Covid-19?

    Gallagher: The most important point that comes to my mind is the tremendous pride I have in our team. The impact both within our organization as well as across our communities is absolutely the result of a collective effort, and you realize as a leader there's a duty and privilege that comes with supporting that.

    We've seen teamwork across the organization like I've never seen over the course of my career. The ability for people to be flexible, taking on new roles, finding solutions to things when you have constraints, has been really motivating and gives me a lot of optimism as to how we'll continue to adapt through the course of this virus.

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