What I Learned Leading New York’s Largest Healthcare Provider Through Covid

Chief Executive asked Michael Dowling, president and CEO of Northwell Health and author of Leading Through a Pandemic, about the lessons he’ll take away from this extraordinary time at the helm. Here’s what he told us:

As the largest healthcare provider and private employer in New York state, we were at the epicenter of Covid-19 from the very beginning. By April, we had almost 3,500 Covid patients in our hospitals on a day-to-day basis, which put an awful lot of pressure on the organization. Over the past year, we treated more than 200,000 Covid patients. As horrific as it was—we had days with 100 deaths—we learned some valuable lessons that every organization should be considering in preparation for the next crisis that will call:

Develop a basic emergency management disaster preparedness infrastructure. It’s imperative that you have a plan with all the processes and the people in place so you’re able to turn it on quickly when something bad happens. We created our infrastructure prior to 9/11, and we had to activate it, of course, during 9/11, hurricanes Sandy and Irene, as well as during the H1N1 and SARS epidemics. The tabletop exercises we do on an ongoing basis became unbelievably important to allow us to be as prepared as we were, even though we got lots of surprises along the way. 

Integrated systems are key. If that the idea was ever in doubt, Covid showed that having hospitals, long-term care, primary care, ambulatory care and the academic side of our organization all working together in unison on an ongoing basis in an integrated fashion was absolutely key. 

We did a lot of what we call load balancing, moving patients from one hospital to the next so that none of them got overwhelmed. I cannot imagine how you could have dealt with a lack of connection and coordination in the middle of Covid. You cannot be figuring these kinds of things out during a crisis, particularly one like this that came on so quickly and has lasted so long.

You need a good supply chain infrastructure. We have our own GPO. We had our own warehouses. We were the first to require everybody to put masks on, yet we never ran out of PPE, not even close. We had plenty of equipment, not everybody was in that situation, but that was because we had built up a supply chain infrastructure. 

Take extraordinary care of your people. We provided daycare, hotel rooms, a $2,500 bonus to every staff person who engaged with Covid and seven days paid time off for every employee. That was a big investment at a time when all of our other business was curtailed and we were losing revenue. But during Covid, we had the largest increase in employee engagement in our history. We got to the 91st percentile nationally, and we actually got No. 19 in Fortune 100 places to work recently, which tells you something about the importance of what you do on frontline staff. 

Be visible. The leadership of the organization has to be out on the floor on an ongoing basis. I personally walked the floors of every unit. I was in every Covid unit, in every hospital on a regular basis. If you’re going to ask your frontline staff to go into the trenches, you’ve got to go there with them. It develops this sense of unity and that support that became absolutely invaluable. 

I’m a big believer that it’s not what happens to you that matters. It’s how you react to it. This has been a transformational year. It has definitely changed our individual perspectives and the perspectives of our organizations. I believe firmly that we will, at the end of the day, learn and adapt from it and be better off for that.