Breakthrough Leadership · Betsy Chapin Taylor, FAHP serves as CEO of the health care consulting firm Accordant. Accordant advances philanthropy and purpose-driven partnership to

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Breakthrough Leadership in a Time of Uncertainty

Breakthrough Leadership I N A T I M E O F U N C E R T A I N T Y

by BETSY CHAPIN TAYLOR, FAHP

http://www.accordantphilanthropy.com




The following is a transcript of remarks by Betsy Chapin Taylor, FAHP,

to open the 2020 Convene AHP Conference.



The COVID-19 pandemic reshaped our world seemingly overnight. We lost control and social interaction…and replaced the quiet confidence of normalcy with fear and ambiguity.

Articles from The New Yorker to Politico to Deloitte dubbed the pandemic a Black Swan event—something extremely rare, unforeseen, unpredictable and with severe consequences. And, who could have imagined all that has happened...and that we still face uncertainty with no clear end in sight. It is surreal.

However, we often see good things emerge from the crucible of crisis. Whether it was

war, terrorism, economic downturn or disease, times of immense pressure often spur positive personal growth. Researchers call this “post-traumatic growth,” and it often results in resilience, determination, strength, courage and wisdom. It can increase our gratitude for the good in our lives in a way that increases our overall satisfaction with life. It also can strengthen our shared values and intentions. And, honestly, the world needs for all of us to bring our best selves right now.

In an opinion column in The New York Times, Thomas Friedman shared, “In moments like these, when the choices we make are so impactful, people desperately want to believe their leaders know what they’re doing. But they quickly learn that in times like these, leaders either grow or swell—they either grow out of their weaknesses and rise to the level of the challenge, or all of their worst weaknesses swell to new levels.”1

1 New York Times, We Need Great Leadership Now, and Here’s What It Looks Like, Thomas L. Friedman, Opinion Columnist, April 21, 2020.



So, what are you going to do…both now and going forward? Are you going to grow and rise? Or, are you going to sit by and wait to see what happens next? You know this: a choice “to wait and see” is a choice...a choice to buckle, hesitate, withdraw and be irrelevant as a leader, and I don’t believe that’s your aspiration—or the best choice for your organization.

The decisions you make and actions you take in 2020 will have repercussions for your organization and for your career that will extend far beyond this time. This is a moment that demands breakthrough leadership, and your organization is counting on you to:

• Turn the crisis into a catalyst for positive change.

• Uncover new opportunities within the chaos.

• Address evolving needs while simultaneously crafting a destination for the future.

So, let’s talk about what growing and rising look like. I believe taking your leadership to the next level and being relevant demands several things:

Î Shifting to a future focus

Î Earning trust

Î Demonstrating agility in decision making

Î Articulating a strategic path forward

Î Taking control of our destiny where we can

Î Uncovering new opportunities

Î Anchoring our path in purpose

Your journey begins by shifting your gaze beyond our current circumstance and toward the future.

However, to paraphrase Helen Keller, “When one door closes, another opens; but we often look so long at the closed door that we do not see the one which has been opened for us.”2 Similarly, McKinsey and Company noted in late April that, “Great uncertainty, elevated stress and anxiety” prompt tunnel vision

A choice “to wait and see” is a choice...a choice to buckle, hesitate,

withdraw and be irrelevant as a

leader, and I don’t believe that’s your

aspiration—or the best choice for your

organization.2 “We Bereaved” 1929 / https://www.afb.org/about-afb/ history/helen-keller/helen-keller-quotes.



in which people “focus only on the present rather than toward the future.”3

We see these practices happening all around us. We keep looking back at what we had, how we did things and what was expected. While it is amazing “the good old days” were just months ago, we can’t expect our world to snap back to that former state. We can’t let what we were accustomed to and what we expected become the very things that hold us back. Dwelling upon what has been lost is a luxury we simply cannot afford. Our energy and focus must be directed toward what is next.

To guide your team and your stakeholders forward, you must consider what people need from a leader now and your ability to deliver upon those promises. Gallup has studied what people say they worry about, fear and need from leaders during nearly every major crisis of the past eight decades including:

• the Great Depression

• World War II

• the terrorist attacks of 9/11

• the 2008 financial crisis

• the COVID-19 pandemic

Gallup research says people have four key needs of leaders in a crisis:

Of these, “trust” takes centerstage over and over again. In fact, trust is not only the bedrock of a healthy relationship but also is essential to “cooperative and collaborative leadership.”4

In Steven Covey’s book, The Speed of Trust, he discusses two types of trustworthiness: character and competence. Character is about who you are as a person—your integrity, maturity and commitment. Competence is about your talents, skills and capabilities. You must have both to give others the confidence you can lead.5

Trust

Stability

Compassion

Hope

3 McKinsey & Company, A leader’s guide: Communicating with teams, stakeholders, and communities during COVID-19, April 17, 2020, Ana Mendy, Mary Lass Stewart, and Kate VanAkin.

4 Gallup, MARCH 23, 2020, COVID-19: What Employees Need from Leadership Right Now, Jim Harter.

5 Steven Covey, The Speed of Trust, 2006.



Since the trust of your team and other stakeholders is essential, let’s hope you’ve already built a firm foundation there. If people aren’t already assured of your character and competence, it can be really hard to build it right now. However, here are a few things to consider:

1 Great leaders trust people with the truth. They share what information they can when they can. They acknowledge the current realities and likely tough choices ahead. They share the news others sometimes don’t want to hear. They don’t make promises they fear they can’t keep. While being honest right now might be hard when there is so much we don’t know, demonstrating a commitment to transparency and acknowledging the changing circumstances can assure others they are shooting straight with the information they are providing.

2 Great leaders make tough decisions based upon the organizational mission and on clearly articulated values and principles. You know what is driving their actions, because they don’t get swayed by a desire for popularity or sucked into the politics of the moment. So, it’s easier to understand the

“why” behind what they do.

3 Great leaders know it’s okay not to know everything, so they aren’t fearful of not having answers or of being vulnerable. They admit mistakes and knowledge gaps. They seek the opinions of others…and actually listen to the responses. They build a safe space for honest collaboration and even for admitting failure.



agile & decisiveDemonstrating competence, showing a continued commitment to learning and sharing the business rationale behind strategic choices allow people to trust your leadership.

People’s confidence in your competence also comes down to the outcomes you achieve. In a time of swirling changes, ambiguity and complexity, there are decisions and actions to respond to the new environment or to anticipate what will happen next. You must handle them now and handle them effectively. This requires both agility and decisiveness. Being “agile” means you can anticipate changes and adapt accordingly. Being “decisive” means you consider facts, make the call and stick to it.

Let’s start with agility. The toughest part of agility is that while you think just responding quickly to what has already happened would be enough, you’re going to need to do more than that. You need to get ahead of things and to anticipate what’s coming next. You also have to craft your response with imperfect information, as new changes continue to occur. This isn’t easy, since most leaders frankly aren’t great at foresight.

In David Epstein’s book Range: Why Generalists Triumph in a Specialized World,

he looked at the effectiveness of experts in their field predicting the future within their area of specialty. He found; however, most experts are “horrific” forecasters. In fact,

“Their areas of specialty, years of experience, academic degrees, and even (for some) access to classified information made no difference. They were bad at short-term forecasting, bad at long-term forecasting, and bad at forecasting in every domain.”6

So, we all find ourselves way out on the end of limb trying to figure out what will happen next with COVID-19. But, you have to do your best to try. There are some trends that are already becoming evident where we can glean bits of information to enable us to move. For example:

• It does not take a crystal ball to realize we will likely not see a vaccine for some time. Social distancing will be around for quite a while.

• It is clear health care organizations have taken a significant financial blow that will likely lead to a need for austerity. As a health care leader, you’re about to enter an era of financial constraints.

• This crisis has fast-tracked the migration of organizations into the digital realm in a way that will likely never go away. You’ve got to integrate new and unexpected opportunities that have emerged for telemedicine, virtual donor visits, digital communication and more.

6 David Epstein, Range: Why Generalists Triumph in a Specialized World, 2019.



Next, let’s consider decisiveness. First, when you make a decision, you clearly can’t change your mind for the sake of changing your mind. Sure, if there is new information, you can course correct. However, we can’t erode people’s confidence in our commitments and intentions by dawdling over decisions, especially when the stakes and need to respond are high.

Second, you must also remember no decision is still a decision. When you do nothing, you’ve chosen to leave your fate to chance. You have chosen to step back from steering the ship…and you’re better than that.

Third, you absolutely must choose speed over perfection. So often, we take too long to execute while trying to make something perfect, and that prevents us from getting anything done at all. You’ve likely heard the saying “perfect is the enemy of good.” Recently, author Gretchen Rubin re-popularized the phrase in her book, The Happiness Project. She put it this way:

“Instead of pushing yourself to an impossible ‘perfect,’ and therefore getting nowhere, accept ‘good.’ Many things worth doing are worth doing badly.”7

Sometimes, it takes guts to both anticipate the future and to be decisive in the midst of crisis. Nobody wants to take a stance and then look stupid for it later. However, trusting your own leadership to

take that bold stance is part of being a breakthrough leader.

Let’s consider a real, high stakes scenario from just a couple of months ago. On March 11, the NBA suspended its season. Think about the leadership it took to make that decision. The NBA earns a staggering $8 billion dollars per season from TV contracts. There is a huge incentive to salvage the season. At first, as you remember, they considered holding games without fans in the arenas. Then, Utah Jazz center Rudy Gobert tested positive for coronavirus. He was one of the first professional athletes to be diagnosed; so, at that point, it was still unclear how destructive the virus would go on to be. However, the NBA made a gutsy call in the early days of this crisis in order to protect the safety of their players.

Similarly, we must also have the courage to make tough calls for the right reasons

7 Gretchen Rubin, The Happiness Project, 2009.



even with imperfect information. So, here’s an example of one of those tough calls you need to make now.

If you still have a large-scale, public event planned in 2020, it’s time to shift it to virtual or to cancel it. Simply, there is still a long road ahead to finding a vaccine, and getting together is not going to be encouraged under CDC recommendations. Plus, most venues will be required to cut

their maximum occupancy, so you may not be able to have enough people in the room to cover your overhead. However, the most important reason to cancel now is your mission. Many of your donors are former patients in vulnerable or at-risk populations, so they would likely feel fear or anxiety about coming to your event—and they likely don’t need to be there in the first place. Even more, your organization exists to address illness and injury and to elevate health status and well-being. So, when social distancing is the way to bend the curve, the optics of a health care organization going

…if the NBA can walk away from $8 billion in revenue to protect the safety of their players and fans, you can protect the safety of your donors and community by canceling your gala and asking donors to consider supporting your mission rather than paying for chicken and a band.

against CDC recommendations is just not mission-centric. Plus, imagine the front page headlines if your gala becomes the community’s next super spreader event. Mission means it is time to pivot or cancel rather than being out of step with the very reason your organization exists. Plus, if the NBA can walk away from $8 billion in revenue to protect the safety of their players and fans, you can protect the safety of your donors and community by canceling

your gala and asking donors to consider supporting your mission rather than paying for chicken and a band.

This time will require many tough decisions. Let the True North of your organizational mission be your constant guide. It is too easy to make knee-jerk decisions within the chaos of an ever-evolving situation. Mission provides a point toward which we are always faithfully moving. When that is your guide, it becomes easier to overcome the noise, the pressure and the politics to make the types of decisions you want to make.



As Matt Cornner from Advisory Board noted, “The complexity of this moment simply will not permit easy choices. These purposes will frequently be in tension with one another. You will be making many difficult decisions, big and small, many times a day. Some decisions will feel impossible. There is no easy guidance here other than to position yourself to decide, not react. To do so, you must be deeply aware of what matters most at any given moment and in any given decision. The best leaders are relentlessly oriented to purpose. They don’t always make the right decision, but they always make the decision the right way.”8

Let’s return to the fact of knowing hospitals face a challenging financial future. Oddly, the situation reminds me a bit of a movie I saw recently.

8 Advisory Board, How to be an Emotionally Intelligent Leader Amid COVID-19, March 26, 2020, Matt Cornner, Managing Director, Talent Development Solutions.

If you’ve seen The Aeronauts on Amazon Prime Video, you know it is the story of taking a hot air balloon to record breaking heights. It’s 1862, and the standing record for the highest altitude ever attained is 23,000 feet—which is a little under 4.5 miles. At the height of their ascent, one of the two balloonists has to prop open a valve to allow gas to escape to help them come back down. However, the balloon starts collapsing from the loss of too much gas. They manage to close the gas release, but it is not enough to slow their descent; so, they start throwing things over the side. Eventually, they get so desperate that they climb up onto the framework under the balloon and cut the ropes to release the basket. Finally, they crash through trees and hit the ground hard after setting a new altitude record of 37,000 feet—just over 7 miles.



While our hospitals achieved startling new heights of impact and relevance in rising up for our communities and confronting the terror and pressing need of the pandemic, COVID-19 also forced many of our organizations to lose too much gas too quickly. While expenses were cut and stimulus money helped, we now face the terrible choice of either hurtling downward too fast or making tough, and sometimes terrible, choices.

Anyone following the health care trade press knows austerity is coming. For example, even the headline from a new report from Kaufman Hall was chilling: “COVID-19 Pandemic Continues to Ravage Hospital Finances, Driving April Operating Margins Down 282%.” The May 21st report details how steep volume and revenue declines due to cancellations of elective procedures coupled with increased financial needs related to COVID-19 were a one-two financial punch for hospitals. This pushed median operating margins to negative 29% for the year, despite an infusion of $50 billion from the Coronavirus Aid, Relief, and Economic Security (CARES) stimulus act.

All this made April the single worst month in financial history for U.S. hospitals.

Kaufman Hall managing director Jim Blake shared, “Our nation’s hospitals are in a perilous position. They are serving as the frontlines of our battle against this virus, but the pandemic is threatening their fundamental financial viability at a time when we need them most. The road to recovery will be difficult, and our healthcare system will be forever changed.”9

9 COVID-19 Pandemic Continues to Ravage Hospital Finances, Driving April Operating Margins Down 282%, Kaufman Hall / May 21, 2020.



Indeed, the financial ravages of COVID-19 will be devastating to many hospitals. Some will close. Most will experience budget cuts and layoffs. Knowing this, you must take control of your own destiny in three ways:

1 First, make the case for philanthropy as a valuable, high-ROI, alternative, revenue resource that is a solution to help address current financial challenges. You must raise awareness that philanthropy is not only about dollars in the door but also about strengthening the organization’s position with credit rating agencies like Moody’s and Fitch.

However, as you can imagine, numbers talk. So, you must share documented evidence of past performance and future potential. This is not a moment for trying to rally your leaders around a kumbaya-like picture of potential. If you’ve not been successful raising meaningful sums of money before, you will likely not gain anyone’s ear now. However, if you have, bring your numbers, updated business intelligence about your potential and an updated strategic philanthropy plan in hand.

I believe in the considerable power of philanthropy. I know you do, too. I believe it has always been a source of revenue to drive competitive advantage and to enable hospitals to achieve their vision of potential. However, in today’s climate, philanthropy could literally enable survival and will be essential to progress and transformation. That’s why it’s imperative to make the case for your work in the business-oriented language used by your CEO and CFO.



2 Second, you must try to hold the line on keeping your philanthropy team intact. You know layoffs and furloughs have already arrived for many—and there will be more. Anticipate the hospital will likely pursue reductions in force in non-clinical cost centers that are perceived as being overhead. Further, the size of any layoff is often closely related to productivity statistics that are largely driven by patient census; so, when beds are empty and not producing income, more people have to go.

This second issue is really an extension of your earlier conversation. You must make the case that you are a revenue center rather than a cost center. You also must advocate there should be an inverse correlation between productivity statistics and cutbacks in the foundation, since philanthropy is actually needed more when census is low. In making the case for keeping your team intact, it’s also valuable to look back at the recession of 2008. Organizations that cut philanthropy staff were slower to achieve their pre-recession performance, since they had to rehire and then rebuild trust and relationships with donors. So, those were not good cuts.

There is further evidence for the “hold the line” argument within a recent Harvard Business Review assessment of corporate performance across the past three recessions. The study of 4,700 firms found those that cut costs fastest and deepest had the lowest probability of outperforming competitors after the economy recovered. In other words, those that balanced short- and long-term strategies while selectively reducing costs to survive the recession were best-off in the long run.10

10 Ranjay Gulati, Nitin Nohria, and Franz Wohlgezogen,“Roaring out of recession,” Harvard Business Review, March 2010.



3 However, the third piece of this is proactively making the decisions about cuts yourself. This is hard. We don’t want to think that budgets—and especially valued people on our team—could be affected. However, if you know it is coming, it is better to craft a thoughtful plan for how you could reduce your own budget than to be compelled to take regretful actions that fail to be strategic.

To make the right decisions about potential cuts and to position for the future, we must shift from fighting fires to refining strategy. Your strategic philanthropy plan was always intended to be a dynamic document that enabled you to pivot and recalibrate as assumptions shift and as new opportunities become available. However, now, revisiting strategy can be the difference between surviving and thriving. And, there is almost no chance your existing strategic plan for philanthropy has been untouched by recent developments. Pressure-testing your strategy begins with incorporating changes in perspective and in challenging assumptions that shaped the plan in the first place in order to reconsider or rework your plans.

One factor you will have to reconsider is around resources. The likelihood of budget reductions in most health care organizations is a near certainty. You need to ensure your strategy does not rely on resources that could be reduced, so you would outstrip your capacity or set yourself up for failure. You also need to ensure the resources you have are focused on the highest and best use to achieve efficiency and effectiveness in raising money. Finally, this is the place and time to consider where you could self-identify opportunities for budget reductions.

A few weeks ago, when discussing this issue, I compared it to tending to a bonsai tree. There are times a bonsai tree just needs a little bit of maintenance pruning to shape it up or to make subtle refinements. However, there are also times when a bonsai requires rigorous structural pruning. When you do this, you may remove entire branches or make fundamental changes that impact the shape of the tree. Right now, I would imagine your strategic philanthropy plan could benefit from a solid structural pruning.



First, review your strategic plan and be really honest with yourself about things you should have already quit doing before.

• What is not optimally contributing to mission fulfillment?

• What is truly not strategic or high value?

• What would any rational person outside the politics and social norms of your organization see is obvious to cut?

Next, what no longer make sense due to the COVID-19 crisis?

• What is no longer as important or relevant?

• What would seem tone deaf or out of touch now?

• What do you simply no longer have the ability to advance?

Hopefully, this allows you to gain focus and helps identify where resources could be reduced or realigned if needed. Once you get down to refinement, consider that some shifts in the environment may seem subtle but could significantly affect

how we engage donors now. Simply, what seemed relevant and right before might now feel risky, insensitive or tone deaf. For example, consider donor visits or donor communications based on a recent article from Deloitte. It noted, “Designing for the customer’s heart starts with understanding how that heart may have changed dramatically from what you perceived before…In crisis, customers often revert down Maslow’s Hierarchy of Needs to basic desires such as safety, security, and health. How does the nature and tone of your customer communications and the sensitivity of your customer experience need to shift?”11

With that in mind, how can you recalibrate plans to include more empathy, to respond to fears, to provide assurance of our commitments or to be more kind? How do you, in turn, adjust organizational metrics to reflect the new reality of more time with donors on Zoom and less time in their living rooms?

Revisiting strategy also offers an opportunity to reimagine based on potential for innovation or on new opportunities. For example, how do you connect the dots between the boom of telemedicine visits and your patient acquisition strategy or grateful engagement strategy? How do you reconcile the world’s elevated embrace of digital platforms with your plans for donor engagement or donor communications?

11 Deloitte, The Heart of Resilient Leadership: Responding to COVID-19 A guide for Senior Executives, 16 March 2020.

How can you recalibrate plans to

include more empathy, to respond

to fears, to provide assurance of our

commitments or to be more kind?



There are also places we can now significantly reposition our efforts within our organizations. For example, one issue many organizations should likely revisit is their grateful engagement strategy. Many organizations define this effort too narrowly by focusing exclusively on engaging clinicians and grateful patients to nurture giving—but the current environment lends itself to a much bigger and highly relevant play. For example, about 50% of physicians and 30% of nurses went into the COVID-19 crisis saying they were emotionally exhausted and burned out. So, imagine how they must feel today. While physicians and nurses have been lifted up as heroes during this time, many will also tell you they felt like sacrificial lambs that were sent into untenable and terrifying situations

While physicians and nurses have been lifted up

as heroes during this time, many will also tell

you they felt like sacrificial lambs that were sent

into untenable and terrifying situations without

the physical supplies or emotional support

they needed.

without the physical supplies or emotional support they needed. Across the crisis, there were also headline-grabbing stories of clinicians who died of coronavirus or who committed suicide.

Let’s take this chance to broaden our perspective about our ability to positively impact the clinicians within our organizations. It is this simple. We’ve been talking about the implications of gratitude for charitable giving for years. However, gratitude also offers tremendous insulating and elevating effects for clinicians. Multiple scientific studies show expressions of gratitude from patients and families to clinicians decrease emotional exhaustion, decrease burnout, increase a sense of personal accomplishment and increase joy in work.



Rather than confining your discussion of gratitude to giving, take this opening to expand your efforts to embrace gratitude as a clinician wellness strategy, as a lift to patient experience initiatives and more. This could be your moment to weave gratitude into the whole hospital culture rather than having it siloed as a foundation initiative. This would not only be a valuable resource to help care for our caregivers right now but also could exponentially expand your impact. And, your clinical leadership may be more open to this conversation than ever before.

I love a story told by Dr. Leif Hass from Sutter Health in California. He says every time he is washing his hands or using hand sanitizer, he takes that time to think about why he is grateful for the patient in the room. That gave him the ability to say, “Thank you for the privilege of caring for you. I’ve really enjoyed seeing your family rally around you.” Or, “Thank you for letting me care for you, I have loved hearing about the book that you are reading.” He admits it started out as a

“public relations move.” However, what he found is that he ended up feeling happier and more fulfilled.

Revisiting strategy is also a great excuse to talk about innovation. Interestingly enough, crisis is often an incubator for creative new

gratitude ideas or improvements upon old ones. It goes back in part to a proverb you have heard many times: “necessity is the mother of invention.” You can see how this would be true even within COVID-19. Think about how many health care organizations launched vast telemedicine networks overnight. Think about how many local restaurants swiftly figured out a way to convert their operations to enable online ordering and touch-free delivery when they had never considered it before. Within our field, think about how many foundations held donor visits on FaceTime, board meetings on Microsoft Teams or virtual special events for the first time? Simply, when we had to get something done, we were forced to find workarounds or driven to see new possibilities.



There are also some of those things we should not be willing to give up going forward. There are other areas where we have to challenge ourselves to consider what might have seemed ridiculous before could have potential to elevate engagement, save money, streamline processes or more. Sometimes, we’re too frightened to pursue innovation because we are worried about the risk of failure, squandering resources or more. However, a lack of courage can’t be what stops you. As Tom Kelley, the general manager of the progressive design firm IDEO once said, “Some skeptics insist innovation is expensive. In the long run, innovation is cheap. Mediocrity is expensive.”

If you’ve got the guts and gumption to pursue innovation, consider the approach used by large for-profit firms that rate and rank a deep list of potential product expansions, process improvements or

Some skeptics insist innovation is expensive. In the long run, innovation is cheap. Mediocrity is expensive.

TOM KELLEY General Manager, IDEO

other innovation opportunities every year. Rather than considering each opportunity as a single, standalone effort, think about your overall philanthropy program as a portfolio of opportunities. Knowing you can balance and mitigate overall risk within a diversified portfolio, where could you focus on innovation? If you did not fear failure and had the resources you needed, what would you try?

This could be an opportunity to transform our organizations based upon new opportunities that did not exist before. Harvard Business Review recently noted that,

“Visionary leaders like Abraham Lincoln, FDR, Winston Churchill, and Nelson Mandela didn’t simply react to the most imminent threats confronting them; they also looked beyond the dark horizon. They were guided—and guided their people in turn—by their vision for a better future.”12

12 Harvard Business Review, Leaders, Do You Have a Clear Vision for the Post-Crisis Future? by Mark W. Johnson and Josh Suskewicz, April 17, 2020.



Considering our own opportunity beyond the dark horizon, I am drawn back to a question posed by Jim Collins in his monograph Good to Great and the Social Sectors. He asks, “How can we develop a sustainable resource engine to deliver superior performance relative to our mission?”13

In other words, how can we elevate our philanthropy program to raise more money more efficiently and more consistently in order to increase our impact on the health care mission? His question continues to offer a clear yardstick against which to measure all our goals, strategies and objectives to ensure they are right and relevant for a brave, new world.

As you consider the direction of your organization and your role as a leader, I don’t believe you can discount the power of purpose. While “mission“ is about your organization, “purpose” is more personal. Purpose provides meaning and context to what we do. It is the invisible force that holds us all together and urges us forward. It fuels meaning, internal resolve and urgency to act.

While talking with a health care system CEO a few weeks ago, I was moved by hearing him discuss his personal convictions and passion for the mission. He was telling me about the health system’s response to COVID-19 and their fast-track innovations to expand capacity. It was exciting stuff. However, what moved me was hearing him talk about role of the system and its leaders. He said, “In times like this, we have an even greater opportunity to serve. It is in exceptional times like these that we can offer the most value. It is such a privilege to be able to respond when our community needs us most. Times like these amplify our WHY.”

It was clear his eyes remained steadfast on the “why.” It’s powerful, and it’s the kind of thing that makes our work so special and unique. We truly have a calling instead of a job. The last two months have surely demonstrated the purpose and tenacity and selflessness of those who serve in health care. Over and over, your hospitals and your caregivers rose to incomprehensible challenges.

purpose

13 GOOD TO GREAT AND THE SOCIAL SECTORS: Why Business Thinking Is Not the Answer, by Jim Collins, November 2005.



There was a story in the media about a chief surgeon at one New York Hospital—Columbia University Irving Medical Center, who closed an all-staff memo by reminding people that patients survive “because we don’t give up.”14

Right now, our role and our purpose within something much bigger is more evident than ever before. Yet, I have talked to so many people recently who are discouraged, emotionally exhausted and weary. And, while pep talks or deadlines may prop up our resolve to go forward in the short term, it’s essential to feel intrinsically motivated and fulfilled in our work over the long term. Purpose can provide that.

There is a 2007 Gallup study that revealed a universal desire to matter. When people were asked, “How important to you is the belief that your life is meaningful or has purpose?” an astounding 98% said it is a priority. The research says most of us want to feel part of something larger and more important than ourselves. We want our life to matter. We want to make a dent in the universe.15

A similar sentiment is shared in Dan Pink’s book Drive. There, he calls upon the work of Dr. Edward Deci, a professor of psychology at the University of Rochester. He says the secret to both performance and satisfaction is tied to our ability to meet deeply human

needs. Further, he describes the importance of three forms of intrinsic motivation:

• The ability to direct our own lives

• The ability to learn and create new things

• The opportunity to do better by ourselves and our world

Purpose.

That ability to do better by ourselves and the world spurs us to be other-centered. It helps us get past ourselves to find ways we can contribute and add value to the greater good. Here the other amazing thing…when we focus outward on others, it makes us stronger and more resilient. It makes us better able to survive the challenges that life throws as us.

How important to

you is the belief that

your life is meaningful

or has purpose?

98% said it is a priority

15

14 “COVID-19 Update from Dr. Smith,” Columbia University Irving Medical Center, Craig Smith, March 27, 2020.

15 Gallup Business Journal, “The Eighth Element of Great Managing”, Rodd Wagner and Jim Harter, December 13, 2007.



Ironically, challenging times are the perfect opportunity to crystalize our purpose. Research shows times of change and crisis actually give us greater clarity, focus and perspective about what our purpose may be. That’s because in times of crisis, we tend to be still, quiet and introspective…to think. It often gives us the space and perspective to push our values clearly into focus.

These last months have likely given all of us moments to pause and to reconsider what we care about, what we prioritize and what we are called to do. Gallup research also shows that, in times of crisis, there are two directions human nature can take us:

Î Path one is fear, helplessness and victimization.

Î Path two is self-actualization and engagement.

When leaders can provide a clear way forward, people are much more likely to be gravitate toward the second path of self-actualization and engagement. They are also much more likely to be resilient. In fact, there is a documented “rally effect.”16 That, once again, makes it so important for you as a leader to step up right now. It goes back to the Gallup study we discussed earlier of what people need and want from leaders in a crisis. They need:

Trust

Stability

Compassion

Hope

16 Gallup, COVID-19: What Employees Need From Leadership Right Now, Jim Harter, March 23, 2020.



Hope is not false

optimism. It is not

sugar-coating things or

putting a happy face on

a crummy situation. The

research is pretty clear

“hope” is about defining

the path toward future

possibilities. It is a vision

grounded in reality and

facts that lets people

know where we can go if

we can pull together.

When you are able to provide that clear path forward, you help meet their needs for stability and hope. Now, let’s take a quick sidebar here and unpack “hope” a little bit.

Hope is not false optimism. It is not sugar-coating things or putting a happy face on a crummy situation. The research is pretty clear “hope” is about defining the path toward future possibilities. It is a vision grounded in reality and facts that lets people know where we can go if we can pull together.

I believe our path toward future possibilities is clear. Being a health philanthropy executive is not just what we do, it is who we are. We have all chosen to be of service to others through advancing health care. Right now, COVID-19 has simultaneously thrust our hospitals into the national consciousness like never before and has also gutted our financial reserves and capacity. We must harness the new understanding our communities have on the importance and relevance of our hospitals to strengthen, sustain and transform our work. We must share our organization’s vision of potential. We must serve as conduits and catalysts to connect donors with the ability to make an impact through our organizations to elevate the health status and well-being of our communities.

COVID-19 has been a bitter reminder of the fragility of life and of the central importance of our health. Together, our shared purpose to engage donors in advancing work that enables our hospitals to rise, means our

hope



hospitals are ready for the next moment that will bring people to their knees.

While purpose and mission remain, COVID-19 has certainly changed all our lives. As Holocaust survivor and psychiatrist Viktor Frankl said in his memoir Man’s Search for Meaning, “When we are no longer able to change a situation, we are challenged to change ourselves.”17

Let’s take this time of change as a chance to reaffirm our commitments or to hit the reset button. Let’s see this as an opportunity to reflect on who we are both as people and as leaders. Let’s consider how we must change ourselves to lead now.

Changing and growing and rising as a leader can be hard. You know this. It requires risk and vulnerability and humility—all of which can be awkward when people are looking to you for solutions. It requires getting comfortable with being uncomfortable.

Great leaders create great organizations

in part because they are never content

with where they are. They always see

the finish line in the distance. They

always want to do more or to do it

better. They see a journey of constant

improvement and pervasive possibility.

However, if there were ever a moment our organizations need for us to push beyond what we thought was possible, this is it.

Let this be your time in the crucible that makes you stronger. Let this be the moment that redefines the trajectory of your organization. Let this be the impetus to hold yourself to higher standards. If you are not asking for better out of yourself, nobody will step in and do it for you—and your organization and team deserve breakthrough leadership.

I hope this time will also give you a new sense of restlessness about the possibilities. Great leaders create great organizations in part because they are never content with where they are. They always see the finish line in the distance. They always want to do more or to do it better. They see a journey of constant improvement and pervasive possibility.

17 Viktor Frankl, “Man’s Search for Meaning”, New York, Pocket Books, 1959.



If you are going to navigate this path of restless refinement, you are also going to do what the airlines say and “put the oxygen on yourself first.” I am frankly an abject failure at self-care, and I bet many of you are the same way. I take on too much because I am excited about and passionate about the work. Right now, however, we all must at least try to take moments to pause and rest and enjoy all that is around us. Otherwise, as one day melds into another, we could find ourselves on a treadmill that just will not stop. And, we just can’t do that.

Finally, I wish for you to have joy. Even in the darkest days of this crisis, I continued to be overwhelmed with gratitude for the joy of simple things like the love of my family, a beautiful sunset or a deepened sense of shared humanity. Therefore, I hope you will make gratitude and joy an everyday occasion. As Sheryl Sandburg said in her book Option B, “Whether you see joy as a discipline, an act of defiance, a luxury or a necessity, it is something everyone deserves.

joyJoy allows us to go on living and loving and being there for others. Even when we’re in great distress, joy can still be found in moments we seize and moments we create…And when these moments add up, we find they give us more than happiness; they also give us strength.”18

I am inspired by our collective opportunity now to rise as breakthrough leaders. Thank you for all you are doing to push yourself, to lead your organization, to care for your team and to serve your stakeholders. Your leadership is a steady source of strength for all you serve.

Betsy Chapin Taylor, FAHP serves as CEO of the health care consulting firm Accordant. Accordant advances philanthropy and purpose-driven partnership to support health organizations in achieving their vibrant missions. Our experts deliver value in four key areas: elevating charitable giving, forging partnerships to promote healthy communities, strengthening health care governance and building values-based organizational cultures. Client partners include health systems, hospitals, long term care, hospice and similar.

18 Option B, Sheryl Sandburg & Adam Grant, Alfred A. Knopf, 2017.

Documents

Breakthrough Leadership · Betsy Chapin Taylor, FAHP serves as CEO of the health care consulting firm Accordant. Accordant advances philanthropy and purpose-driven partnership to