Improving Healthcare During the Post-COVID Era

By Melanie Blackman

Editor’s note: This conversation is a transcript from an episode of the HealthLeaders Women in Healthcare Leadership Podcast. Audio of the full interview can be found here.

Amy Compton-Phillips, MD, has only ever wanted to serve in healthcare. Thirty years ago, she started a practice on the East Coast. In 1993, she joined Kaiser Permanente as a front-line internist. Over her 22-year tenure, she worked as a physician and moved through a variety of administration roles, eventually serving as the physician director of population care, then finally as chief quality officer for the Oakland, California-based health organization.

In 2015, Compton-Phillips joined Providence as the president of clinical care. Among leading healthcare and value outcomes at the Seattle, Washington-based health system, she also led the treatment for the first confirmed COVID-19 patient in the country.

In the newest Women in Healthcare Leadership podcast episode, Compton-Phillips shares the organization’s COVID-19 learnings, how to improve patient safety and quality, and offers leadership advice.

This transcript has been edited for clarity and brevity.

HealthLeaders: What are the major learnings that the health system has hung on to since the first COVID-19 patient was admitted to Providence Regional Medical Center Everett in Washington State in January 2020?

Amy Compton-Phillips: The key lesson was that planning is the antidote to panic. When that first patient hit us, fortunately we had been working with our infection prevention team and our infectious disease clinical decision team monitoring the breakthrough infection in Wuhan, China.

We learned that we had to have a sensing system around the globe after Ebola. We knew we would need to be ready. In fact, because of the breakout infection in Wuhan, we’d even been doing drills at some of our facilities, including at our Everett hospital, to be ready for, when and if, the infection came to the U.S.

When the first patient came in, the nurse practitioner who this patient originally came to, was prepared when he said that he had been in Wuhan, China, and had a fever and a cough. She called the CDC and said, ‘What do I do?’ That person who saw the patient in the clinic knew to be prepared.

The patient had gone home and then came back to the hospital when the test came up positive, and the entire hospital infrastructure, from the EMTs, to the people in the emergency room, to the people in the clinic, were ready. They calmly were able to handle this person with the breakthrough infection. Back in those early days, we treated every person like they had Ebola, with incredibly high-level infection prevention processes in place. Not very long after that, we had patients on cruise ships that were needing places to go get care, and we also provided facilities for those patients.

We started designing a very patient-centric, person-centric way for people to access care if they had COVID. That kind of human-centered design thinking is what has absolutely stuck with us since then, that if we think about it from our consumers’, our patients’, and our neighbors’ perspective, how do we make sure that we make intentional decisions in the healthcare system to be ready for how people want to use our system.

The third key learning is that teams matter. We had quickly, like the rest of the planet, shut things down. We went on to video capability, but because we realized that we were all working alone, we had to be intentional about staying connected. We set up a series of huddles. Initially they were every day, then we’d have workgroups during the day, then we’d have our Emergency Operations Center connecting back in the evening again.

HL: What can hospitals and health systems do right now to improve their patient safety and quality and expand it in the post-COVID world?

Compton-Phillips: COVID has given us time to think, and pause, and imagine differently than we would have without it. Very often, if you look back in history, pandemics have been threshold events. There’s the before and after.

There’s the before and after the Black Death. It truly changed the way the society of the Middle Ages moved through the world. The 1918 flu and World War I was happening at the same time, too, but between World War I and the 1918 flu, we went from this era when the world was at war and fighting amongst itself to the roaring 20s, where the future seemed bright.

As we think about the capacity for the pandemic to serve as a threshold event, now is the time for us to be doing the small tests of change to make a healthcare system that’s much more distributed, much more equitable, much more focused on getting care to where people live, work, and play. That’s exactly what we need to be focused on for the next five years, because my suspicion is in 2030, healthcare is going to look very different than the way it does today.

Look at what happened with the regulations on telehealth. The regulator’s realized that if we didn’t enable telehealth, and we didn’t have some kind of way to reimburse for telehealth and simplify the regulations on where providers sit compared to where patients sit, that we wouldn’t have had any healthcare at all during the pandemic.

When they realized that and they took away the hurdles that regulatory environments can create, it helped innovation blossom. I hope that now as we move forward, that the regulatory environment and healthcare providers together agree on a few simple rules, but allow for some experimentation, and innovation, and new models of care so that we can take advantage of the incredible digital and technological innovations that are out there. We have to enable innovation, otherwise we’re going to keep getting stuck doing the same things over and over again.

HL: What originally drew you into working in the healthcare sector as a physician?

Compton-Phillips: I never wanted to do anything else. I think there’s a lot of doctors and nurses who were born to be in the profession that they’re in, and I’m one of those. From the time I was in kindergarten, I never had an answer that was different than ‘I want to be a doctor,’ when people asked me what I wanted to do when I grew up.

HL: What has been your experience working as a woman in clinical care leadership?

Compton-Phillips: My suspicion is it’s not all that far off of any human being who is working as a clinical care leader. Although I do think that it has evolved over the past 30 years.

One thing that is different is that if you look at the healthcare workforce, it’s about 75% women, the healthcare leadership is not approaching that. It is, fortunately, getting closer and closer to 50% women.

For women as well as people of color, who have different styles and different backgrounds, we must create room for opportunities, training, and mentorships to help get them in the C-suite. We need to recognize and create the capacity and the ability for people who look different than those that came before to lead into the future. We will get more innovation and a more vibrant community when we do that.

HL: What advice do you have for women and others who want to serve in leadership roles in the healthcare sector?

Compton-Phillips: Something that I think is different between women of my generation and men of my generation, is there is a different approach to leadership, that at least it seems to be in my observation, that when there is a big job to be done, I often see men raising their hand, and I often see women waiting to be asked. Even in my career, I’ve taken jobs because people reached out to me, I can’t think of any job that I’ve taken because I reached out and asked for a different job or asked for help.

If we’re a leader looking for women to lead something, or looking for a person of color, or somebody who’s not used to taking point on a project, we need to be looking around for leadership and asking folks to step up, inviting them in to lead, and not just waiting for people who raise their hands. It’s an important way for us to continue to develop leaders that do look outside of what we might have traditionally seen as a leader in the past.

Melanie Blackman is the strategy editor at HealthLeaders, an HCPro brand.