Award winners stress collaboration, flexibility, asking for help

Emerging from the thick of the pandemic has been tough for OR managers and clinicians, between rampant healthcare industry burnout and other challenges. Yet the winners of this year’s OR Manager leadership awards, presented at the OR Manager Conference, are proving that the right combination of hard work, empathy, and a willingness to learn can still boost patient outcomes and career outlooks.

After this year’s OR Manager Conference, OR Manager sat down with the award recipients to discuss their leadership skills, overcoming obstacles, and the lessons they have learned during their time leading different perioperative areas. They are:

• Tracy Hoeft-Hoffman, MBA, MSN, RN, CASC, administrator at Heartland Surgery Center and Ambulatory Nurse Leader of the Year

• Bryanne Harrington, MSN, BSN, RN, CNOR, nurse director operating room at Mass General Brigham-Newton Wellesley Hospital and OR Manager of the Year

• Gretchen Gannon, BSN, RN, CPAN, SGRN, clinical manager PACU, Endo, and PAT at Newport Hospital and PACU Leader of the Year.

Q: Reflecting on your career, what are some of the most important milestones you have accomplished?

Hoeft-Hoffman: The most important milestone I’ve accomplished was championing a bill in the Nebraska Legislature that changed the ASC length of stay to 23 hours 59 minutes from having to have patients dismissed by 11:59 pm. I worked with our local senator to educate him and have the bill introduced. I educated the board of managers on the need to hire a lobbyist, which we did. I rallied my colleagues and the physicians they work with to write letters to the Health and Human Services Committee and/or present testimony at the legislative hearing. This change in length of stay does not just impact the ambulatory surgery center (ASC) I am at, but all the ASCs in the entire state of Nebraska.

The second milestone was successfully overseeing the construction of an 8,800-square-foot addition that includes two ORs, a sterile processing area, three pre- and postoperative bays, and four overnight stay rooms. While construction took longer than expected, the addition opened in October. The addition was needed after the state regulations were changed to allow for longer stays. This gives our center the opportunity to grow over the next several years as more surgical procedures move from the hospital to ASCs.

Harrington: I would say that some of the most important milestones have to do with my educational process. One of my proudest moments was graduating from the Harvard Business School Consortium on Community Healthcare Leadership. It brought people together, making sure they could care for patients in the community in healthcare. It was a really great program—very specific and very meaningful. I also enjoyed my time working at Boston Children’s Hospital. I worked with talented teams and did incredible work that was both clinically and emotionally very challenging. I learned a lot there, and it’s definitely an accomplishment I’m very proud of in my journey so far.

Gannon: I’d say one of my important milestones was becoming a nurse manager and leading my team at the start of the COVID-19 pandemic amid staffing challenges that have affected us at every level.

Q: What does it take to be a successful clinical leader today?

Hoeft-Hoffman: It takes dedication and commitment, tenacity and perseverance, vision, optimism, a genuine caring attitude, and support from leadership above you, the team you lead, and your family/friends.

Harrington: Leaders have to be fluid. And I say that because healthcare systems right now are very different in a post-COVID world. Some of the challenges we are dealing with are things we never really had to deal with before. Global supply changes and shortages and temporary labor markets have been very challenging to manage.

Also, be reflective. People have really reevaluated what is important to them post-COVID and what they want. I would say it’s a very different workforce. They want flexibility and work-life balance. The next stage of life and in the OR is really going to have to have that built in, which is very different from how it was before.

Gannon: Daily investment in our staff and supporting staff as they continue to pursue their careers and advanced education. Supporting staff as they look to further their careers in nursing and look for additional opportunities for growth.

Q: What are some challenges you faced in your career? How did you overcome them?

Hoeft-Hoffman: One of the biggest challenges I have faced in my career is leading through COVID-19. The goal was to keep our team and patients from exposure. We worked through being able to only perform emergent cases, yet still had the need to keep the ASC solvent. I read CDC [Centers for Disease Control and Prevention] and CMS [Centers for Medicare & Medicaid Services] updates every day.

I applied for and was granted the 1135-Waiver for Hospital Without Walls so we could take the surgical burden off the local hospitals. I applied for and received a PPP [public–private partnership] Loan to ensure our team continued to get paid. I also applied for CMS Stimulus funds and received them. The most important challenge was keeping our team and patients healthy, and secondly keep out center solvent.

Harrington: I think it’s challenging to be the voice of the bedside team, to those who are non-clinical and decision-makers. I really tried in my role to balance the urgency of what the clinical care teams need with the larger vision of the hospital. Knowing what the teams in perioperative want, whether it is a new piece of equipment or new technology, I will try to understand the financial background and strategic vision for the hospital so that I can match those clinical goals with the hospital partners’ goals. Really understanding the strategy of the hospital is imperative so OR leaders can bridge that gap between the two.

Gannon: One of our biggest challenges was the unexpected loss of staff to lucrative travel assignments. I continued to work and support all levels of staff to optimize the work environment and make our unit a rewarding place to work.

Q: What is the best lesson you learned about working in the OR that still holds true?

Hoeft-Hoffman: “WAIT,” which stands for, “Why Am I Talking?” The surgeon needs to take the lead in the OR on talking or not talking. The acronym WAIT holds true just as much in leadership!

Harrington: Give people the benefit of the doubt. Everybody came to work today to take care of patients, and they really came to do a good job. So if there are challenges, usually they are based on frustration or miscommunication. I think the thing that everybody can agree on is that we all want to give excellent care. We have to figure out how to bring people back together.

Gannon: The best lesson for me is that you can’t know everything, and you need to reach out to all areas of the hospital and staff to develop a cohesive problem-solving plan for unexpected challenges that may arise.

Q: How has your career changed since you began?

Hoeft-Hoffman: Once I started in leadership, I quickly realized I needed some business knowledge, so I pursued an MBA. I never would have seen myself doing that. As far as patient-care changes: open cases to now being done by robotics; inpatient stays of several days for total joint replacements now going home on the same day…the list goes on. It’s a different world.

Harrington: I would say that hospital systems have changed and become much more integrated. It takes a village to do surgery. Everybody has a voice and people need to speak up and that is definitely different because it was much more hierarchical when I began and now I see that the playing field has changed dramatically. It’s more inclusive.

Gannon: I rely on my staff and have the confidence that they will overcome whatever obstacles and /or patient care issues that may arise.

Q: What is your advice to younger managers? Is there anything you would do differently?

Hoeft-Hoffman: My advice to younger managers is to find a mentor, even if it is outside of your organization. It can be lonely in these positions unless you have a great mentor and peers in like positions to network with. I am sure there are things I would have done differently, but honestly every challenge has been an opportunity.

Harrington: I would say, you know, don’t be afraid to say that you want more or just say that you want to be in leadership or that you see an opportunity. Also don’t be afraid to say that ‘this is too much.’ You should never worry alone. If you’re worried about something as a young leader, talk to the people around you and find out, ‘should they also be worried?’ Because they might want to be! I’d also say, find mentors that can give you honest feedback and take that feedback as an opportunity for yourself for growth.

Gannon: Get to know your staff and support their career initiatives as they progress along their own careers. Support your people during times of adversities and challenges.

Q: What is your secret to finding balance and avoiding burnout?

Hoeft-Hoffman: I have a very supportive spouse, which helps immensely. I have a strong faith and am not afraid to engage my prayer warriors when needed. An occasional massage never hurts. Take time off because the work will be there when you return, and you need that break to rejuvenate and refresh—it is healthy to take time off.

Harrington: I would say trying to build a supportive team that can check in on each other to say, ‘You look like you’re stressed,’ when the workload is heavy or difficult. It’s usually that way for everybody. It’s not just one person. See how the whole team is doing, then you can kind of normalize that this is just too much. We all need a break, and strong teams can build each other up in those difficult times.

Gannon: I have a wonderful director, Perry Wein, and equally supportive OR manager, Vikki Franco, who support me during those times when things are difficult and give me unbiased support to achieve my goals.

Q: What do you hope to accomplish in the next 5 to 10 years?

Hoeft-Hoffman: My next work goal is to grow the ASC case volume now that we have added on—this is the 3-year plan. My professional goal is to continue to grow every day in my administrator role. If I decide to semi-retire sometime in the next 5 to 10 years, I would like to do consulting or interim ASC administrator roles.

Harrington: I hope to continue in my leadership position and help the team at the bedside as well as by the OR table in my role. I’m really energized by helping to develop staff and guide them to reach their ultimate potential. Whatever the job is, I hope to help talented and supporting staff join the perioperative workforce.

Newton Wellesley Hospital partnered with a local university to help train surgical technologists. The hospital provides financial support to great employees so they can join this career path, and it really knocks down those barriers that exist for people to join. Many of these barriers prevent excellent employees from progressing.

Helping them get to that place is two-fold. We’ve developed those paths that help people get there and support them, but we’re also creating our own workforce. Because we have been challenged in that area, we’re taking the best and brightest from other areas in the hospital and really giving them a great opportunity and supporting them. It’s been life changing, so I think if I had to do a job where I have to use that sort of passion and get that benefit, that would be the dream job.

Gannon: I hope to grow the next team of nurses who will be the next leaders of our department.

—Marisa Torrieri is a freelance writer who lives in Connecticut.