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Patrick Anderson's CIO Playbook: Collaboration, Curiosity and Generosity
Episode 2911th March 2022 • This Week Health: Academy • This Week in Health IT
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Today on Insights. We go back to a conversation Host Bill Russell had with Patrick Anderson who is now CIO at City of Hope. The topic of discussion was The CIO Playbook: Collaboration, Curiosity and Generosity by Patrick Anderson. And Bill asks Patrick what are the principles that he goes by? How does he run IT effectively?


Hello and welcome to another episode of Insights. My name is Bill Russell. I'm a former CIO for a 16 hospital system 📍 and creator of This Weekin Health IT. A channel dedicated to keeping health IT staff current and engaged. Our hope is that these episodes serve as a resource for the advancement of your career and the continued success of your team. Now onto the 📍 show.

Today on insights. We go back to a conversation host. The Russell had with Patrick Anderson, who is NASA CIO at city of heart. The topic of discussion was the CIO, playbook, collaboration, curiosity, and generosity by Patrick Anderson. And Bill asks him, what are the principles that he goes by and how does he run it effectively?

You have shared with me your CIO playbook. So you've gone into health systems on several occasions, inherited IT shops, and you have some principles here that you go by. So I'm going to share some of that as we go through and just ask questions around it. So the first principle is you run IT as a leadership team.

The team runs IT. Tell us about that. Tell us what that looks like.

Sure. Years ago, I couldn't keep up Bill. My time was, was just, I was buried. I was working every day, every night, every weekend, and I thought, gosh, am I delegating enough? Do I have enough leadership resources in the organization to handle the demand and to support the organization, all of the institutes and all of the activities appropriately. So I, I really started working on developing the leadership team principle, where all of the leaders know everything that's going on in IT, and we solve our issues together and we'd help each other.

So bringing the leadership team together, huddling multiple times during the week to to make sure that we're staying on track. And then setting the pace of monitoring all of the critical success factors across the IT organization with a rigor was really the key. What was the real benefit of this is everybody's well-informed, everybody's accountable to meet their service levels and their dashboards deliverables. And then it provides bandwidth. It provides bandwidth for me. And it provides a bandwidth for the leadership team. So we have a regiment and a rigor that we go through.

Cool. So let's, let's go through this a little bit. So you run IT as a leadership team, sort of a fellowship of the ring kind of thing. So talk about the qualities of the people that you invite into the leadership team and how you form that leadership team.

Well, first of all, all of my direct reports are on the leadership team and, they all have to be very collaborative.

They have to support each other. I'm looking for cross functional support. I don't want to have to intervene on one of my subordinates and say, I think you really have a lot to offer this project over here. I want to see that occur. So I start mentoring my subordinates to give and to continue to give and support because when you give, you get it back.

So I look for highly collaborative people, but I bring in a multi-disciplinary team. I bring in HR and I bring in finance. And we literally operate as a team. And as we work I want to make sure that we're cohesive and I'm highly sensitive. Matter of fact, I have a high level of awareness of anything dysfunctional.

And again, you have to be very careful not to jump in and change people in front of everybody else. And you literally have to, you have to mold these people and if they don't want to mold into a team, then you really have to help them get there or, or actually help them exit. So basically collaboration, a lot of curiosity and a lot of generosity is the key leadership attributes.

Yeah those are great attributes. Yeah. I mean, we've all seen the silo approach, which leads to destruction where somebody goes, well that problem was not my problem. It's that group over there. And that's just, that's just death. And so you create this shared accountability but you're still the CIO.

So is there a sort of the buck stops here kind of Harry Truman kind of thing that you have ultimate responsibility? I mean, so that when there's a a decision to be made and the group can't come to consensus that you sort of step in and say, okay, this is what we're going to do.

I do that Bill and I, and the buck does stop here, but I provide explanations and I provide the reasoning behind that.

If if I have, let's say I have two direct reports that want to go in two different directions and they can't seem to work it out, which is, which is fine. I will work it out for them but I'll provide the sound reasoning. And I will ask them to to provide feedback to my own reasoning because you have to have no ego in this work.

So it's not about egos. It's really about objectivity and trying to find the least path of resistance to move progress forward effectively. So the buck does stop here.

Your second principle really is data-driven. So, you meet pretty often with your team and you go through dashboards. You go through service delivery metrics, HR dashboard, financial performance, contracts dashboard, which is interesting.

Outages, challenges of the week just audit and compliance things, portfolio and project management. So you're looking at the health of the organization from a lot of different lenses as you as you get together multiple times during the week. What do you think makes that so effective?

Why do you think so many people adopt that kind of model or a lean model or a huddle model where you're looking at those things? What aspects of it make it effective?

Well, you know I developed this from my lean learnings, 5, 10 years ago, as I developed this over, over the last 10 years. The real situation is it's accountability.

If people know that they have to talk about their oldest tickets because all these tickets drive executive escalations. So people know they have to talk about oldest tickets. They want to get their tickets out of their environment completed quickly. They don't want age tickets because they'd have to talk to me.

So when I look at any dashboards and we have Tuesday, Thursday huddles Bill and they're scheduled, right. The first Tuesday of the month is the HR dashboard. Where are we with hiring and recruiting and getting offers and delivering on the resources that we need and back filling with contractors as we struggle in certain areas.

So I maintain a rich resource capability. I don't want to ever hear that we can't do something because we don't have resources. So you have to focus on resources and you have to have your HR partner there. So as we look across all these various dashboards I want accountability. I want accountability from HR.

I want accountability from all the hiring managers. I want accountability from everybody. So every Tuesday and Thursday of week 1, 2, 3, and 4 of every month, we have presentations by those various dashboard owners walking us through the health of those operations. Accountability is the key.

Yeah. And I can't tell you the number of times sitting in the CIO chair that people came up and said, well, this is happening.

And we hear so many anecdotal stories of, Hey, this is happening or this is happening. And the numbers, the charts, the metrics sort of blow that away. You know we're the best in the industry in this. Well show me the numbers. You should look at the members. You're like really the rest of the industry is this bad.

And they just go, well, I don't know if the numbers are right. Well, let's get the numbers right. And let's get our story right. Cause we're going to take action and taking action on concrete numbers metrics is always better than the stories.

Give us an idea of how you handle competing priorities within your team staff organization. So I get this question a lot from CIOs. You have competing priorities, you have limited resources. How do you determine which one's going to get funded, which one's going to get the resources those kinds of things?

You know I think that the key is first of all, you build budgets based on a plan and you build that plan with the business.

We do this every winter for the next year and we build that plan. Anytime there is any changes to that plan. The business is going to have to partner with me to go find contingency dollars. If they're not budgeted So working with competing priorities is really more about competing resources.

If you have a pool of resources and some professional services partners that you can trust to bring in A plus resources on a short-term immediate basis, that's the way for you to be able to scale resources up and down and meet those ad hoc demands. So I'm not really that worried about it because these demands are typically born in the business and the business has to bear some of that financial responsibility So when you, when you put that responsibility back on the business, they take much more consideration in their adhoc demands.

Right. Yeah. And that's really true. That's where a lot of the constraint comes on IT, is these things that pop up throughout the year of, Hey, can we do this? Can we do this?

And making it a business decision rather than an IT decision. So your third principle is culture of collaboration and support. So my next question on that is just, I think most people are striving for that culture of collaboration and support. What do you do when it breaks down? How do you reestablish trust and collaboration?

Because it will break down from time to time. There will be stress on the organization. You'll have a massive project, you'll have something go wrong. So it breaks down. How do you re-establish it? How do you get it back to where it needs to be.

They break down often. We have over a hundred projects in flight at any time. They're critical. They're very complex. They're multidisciplinary and people have to leave for weeks on end sometimes for family emergencies, these critical resources, other other things happen or there's surprises especially when you're doing pioneering type projects And things break People also sometimes they don't understand requirements and sometimes that may lead to some designs that are not appropriate for the project. So things break down Hardware breaks down. Software breaks because of volumes were unexpected or whatever it is.

You have to be able to have a cohesive leadership team that that can draw upon the entire organization for health That's why one of my principles is the monthly project and we bring in all the managers and above and all the project managers and we go through the health of all the projects and we look for anything that is trending.

And then I look around the room to see who's going to offer up health And when you build that culture of collaboration, you help each other when, when things are going left and right. I get to the point Bill where we borrow budget dollars from each other. If one group has a positive variance and another group has a negative variance We'll share dollars We'll share resources we'll share managers we'll share leaders We'll pull together and create a small sub management team. Whatever it takes to get that project back on track on time, on budget within the overall it budget. So the culture of no ego, the culture of collaboration and the culture of generosity is a big deal.

a budget mechanism is key. When I came in to be the CIO, one of the first things I did is every department within IT had their own budget. And as I walked around the department, I found these closets full of Cisco switches. And I'm like, why are these closets full of uninstalled Cisco switches?

And they said, well, it was end of budget year We wanted to make sure we kept our money So we you know you had those kinds of just poor behaviors And one of the first things I did is I said all right no more department budgets all the budgets It's one budget We will meet as a group and we'll determine how we're going to spend that money.

And one of the things that did was gave us that ability which is, as a group, we sat there and said, Hey, you know what? This is critical. We need to move money in this direction. And it wasn't like, Hey, we're going to take money from you and take money from you. It was essentially we had this budget to get a certain amount of things done as IT. And because we had a big picture of that, it really ended up working. And so that's, that's a great model. Your fourth principle is to foster a great work environment. I love what you say here. You have a great place to work committee Tell us a little bit about that. You're not just chasing an accolade, like, we're a great place to work. You're actually trying to create something here So tell us about it.

The results of our work is double digit increases in employee satisfaction year over year. That's the goal and we've hit that year over year. So how do you do it? You ask each manager to provide a high performance person from each manager's group into this committee. I meet with them once a month and there's no managers, directors, vice-presidents, none of them are, it's me and an admin person and this great places to work committee.

They become ombudsman. What did I ask them to do Bill, as I asked them to round within their team and then round with any of their friends and colleagues across the IT organization. And let's find opportunities, let's find ridiculous processes. Let's find other items where, where people are just not happy or they need this mechanism to work with these ombudsman and find out what are the issues. We also use this group to look at the employee satisfaction survey results, and let's look at some areas that are still good, but are sliding and let's reinforce them. And then let's look at the areas where we are struggling and maybe not hitting the baseline. And then let's take the ombudsman group or the great places to work committee.

Let's go out and round and let's talk to everybody. And let's validate what are the root causes for those issues? Let's not just take it at face value. So we'll go out and we'll validate what the issues are. And then we will solution them together. And I bring my leadership abilities. I bring budget.

I bring whatever it takes to solve those problems. We've created new training programs. We've cleaned stairwells. We've fixed up PTO policies in the organization. Overtime policies. We've solved so many things that have just made this a great place to work. And the the survey results really show the value of that work.

I have to tell you, a happy, progressive workforce is an effective workforce.

Wow, thanks for tuning in another great episode. If you have feedback for us regarding this content and materials, or if you would like to help us to amplify great thinking to propel healthcare forward, which is our 📍 mission, please send us a note at Thanks for listening. That's all for now. 📍