Tunnel, Meet Light

It’s a cold morning in mid-February, and Mary Wey ’13, M’19 is checking in on nurses and staff who are manning a community vaccine clinic in Austin, Texas. Frost dusts the windshields of the cars in the parking lot; a chill snaps through the lobby every time the front door is propped open.

But let’s stop there. There are no lines of people waiting outside, their breath visible from the sides of their face masks. There is no traffic jam or battle for parking spaces or line of idling vehicles on the street. There’s no confusion, no anxiety, no endless stream of questions or loud demands. The only thing seemingly disruptive today is the weather—“Just in case, we’re all hands on deck,” Wey says—but for now, there’s a smooth transition of scheduled patients in and out of the clinic like clockwork.

“It’s our goal for today to get everybody vaccinated who comes,” Wey says matter-of-factly. Wey, an economics major and graduate of Trinity’s on-campus health care administration program who also logged several years working in a pharmacy, is currently a program manager for Ascension Medical Group Texas. Ascension outpatient clinics dot the landscape from Hillsboro to San Marcos, and all clinics—including the one in Austin that Wey helps lead—are focused on strengthening the network for vaccine distribution under Centers for Disease Control and Prevention (CDC) guidelines and prioritizing patient experience. “A successful patient experience means getting our patients in and out quickly and making sure that we’re still here when a patient needs us. We have a lot of great teamwork and good leadership that values that.”

And that Thursday, when the clinic wrapped for the evening, Wey deemed it successful. No lines, no wait, few no-shows. Yet little did she know, the next week would bring record winter weather, dangerous travel conditions, and statewide power and water outages, and much of the Lone Star State would come to a grinding halt.

Across Texas, vaccine rates plummeted. In the seven days before the storm, almost 1 million Texans had received injections; on Monday, Feb. 15, the first day after the storm, only 10,495 doses were administered, and more than 450,000 doses were halted in transit. Overall, the state saw an 85% drop in average daily doses administered from Monday, Feb. 7 through Sunday, Feb. 20.*

Armed with PPE and disposable gear, Mary Wey ’13, M’19 works with colleagues in a COVID-19 vaccination clinic in Austin.

So how does this community clinic recover and get back on track? Wey suggests the same thing she and her team have been doing, day after day since the beginning of this pandemic: tenacious agility and an unabating willingness to “do whatever it takes.”

“As a health care administrator, being agile is a core competency,” says Piotr Gorecki M’18. Gorecki, a graduate of Trinity’s on-campus health care administration program, is an assistant administrator at Methodist Hospital and Methodist Children’s Hospital in San Antonio. This position has qualified him to lead non-clinical operations for the hospitals’ COVID-19 vaccine clinic.

Development of this on-site clinic required immediate and iterative innovation and creativity: From the moment the U.S. Food and Drug Administration approved the Pfizer vaccine, Gorecki and his team had limited time to size and scale an operation that could provide vaccines to hospital employees, physicians, and affiliated staff within CDC guidelines. “The teamwork involved in establishing the clinic was truly remarkable,” Gorecki says, noting that from software infrastructure to data reporting to care within the clinic itself, the spin-up wouldn’t have been possible without the HCA Healthcare network, of which all seven San Antonio Methodist acute care facilities are a part.

“Being able to serve our hospitals in this way means that we have a safer workforce, and that our caregivers have the ability to provide high quality care in an environment where we see patients every single day,” Gorecki says. “We’re also making sure that our team members’ families are safe; we’re very fortunate in our country and in our health care system to have vaccines accessible to them.”

Gorecki’s eyes soften as he speaks from his heart. A Poland native, Gorecki immigrated to the United States at a young age with his parents, who were “lucky enough to win the visa lottery.” He spent his formative years in Chicago, where he helped his parents who had limited English proficiency and financial resources navigate a complicated set of social systems. “Health is one of the greatest gifts that one has,” says Gorecki, who volunteered in hospitals through grade school and college. “Health care is scarce, even in a developed country like Poland. So from an early age, health care was a calling for me. Both witnessing and having an impact on health care journeys are incredible, and this continues to drive me every single day.”

Channeling Humbition

Across the nation, “drive” is a common word used to describe the grit and determination of caregivers and administrators navigating unknown territory within a health care system on overdrive. After a full year when the only constant has been change, long hours and fatigue have become the norm. Will “drive” continue to be enough to push health care administrators back through the front door of the hospital, day after day?

Ask health care administration professor Amer Kaissi, Ph.D., and he’ll say yes—because that is who the Trinity Department of Health Care Administration (HCAD) has developed these leaders to be.

“When we interview students for our program, we ask them, ‘What is your Why?’ With their answers, we want to know that the students are committed. We want people who are passionate about serving others and helping patients,” Kaissi says. He reflects on a conversation he had with a physician student in the HCAD executive program amid the rise in cases last summer: “He told me he would sit in the parking lot of his hospital every morning when he gets to the hospital and ask himself, ‘Can I do this one more day? Am I able to bring myself to go back in there and see patients, but also plan and manage and lead knowing that each day is getting worse?’”

Health care administration professor Amer Kaissi leads a master’s-level course on coaching and public speaking.

So, how did he bring himself to go back in there? Kaissi notes that the HCAD program teaches students to “put your oxygen mask on first” before assisting others, as administrators’ assistance is vital to the health of the system as a whole. “From the first day of class on, it’s always about how your actions ultimately impact the patient—you’re doing all of this so that you can be there for people,” Kaissi says. “We want you to be the best leader ever.”

According to Kaissi, author of the book Intangibles: The Unexpected Traits of High-Performing Healthcare Leaders, research shows that the best leaders are not necessarily the loud, charismatic ones. “If we look at all the evidence together, high-performing leaders—inside and outside of health care—have traits that build long-term success and long-term performance.” Kaissi’s research and teaching focuses on four of these traits: humility, compassion, kindness, and generosity.

“Leadership starts with understanding your strengths and understanding your areas for improvement,” Kaissi says, “and humility is key. The starting point in our HCAD curriculum is that you must truly know yourself first, lead yourself first, before you can lead others.”

Both Piotr Gorecki and Mary Wey give enthusiastic nods to the concept of servant leadership and a lasting, Kaissi-dubbed component therein: “humbition” (incidentally the title of his upcoming book). Kaissi admits that often, humility and ambition are seemingly polar opposites. However, in great leaders, these two traits intertwine to ensure empathy and accountability through the lens of self-reflection.

“You have to be humble, but at the same time remain ambitious. You have to show care and be understanding, but at the same time hold people accountable to getting things done,” Kaissi says. “Especially in the midst of this COVID crisis, that is one of the biggest challenges our health care leaders face: They know that their staff is stretched, they know that their people are running on empty. They empathize with them, but still need to hold them accountable for getting the job done because people’s lives depend on that.”

Piotr Gorecki M’18 rounds on hospital physicians and staff late on a Friday afternoon.

Being “humbitious” has always been central to Wey’s professional goals, but the pandemic has shed a new light on how she’s applied the concept to her career. “It is my job to make sure that my staff and physicians can do what they do to the best of their abilities, and that has been amplified with COVID,” she says. “Whether it’s making sure we have the correct safety protocols, making sure we have enough protective equipment, driving from clinic to clinic to deliver supplies—my primary job is to make sure our staff have what they need to take care of our patients and keep them safe.”

Keeping people safe, protected, and cared for is a core tenet of the job for Gorecki, too. “People will forget what you said, people will forget what you did, but people will never forget how you made them feel,” Gorecki says, reciting his favorite Maya Angelou quote. Reflecting on the key role humility plays in caring for those around him, he adds, “It’s how I grew up and part of the values my parents instilled in me. Give back, no matter how little you have. It’s the core of what I do.”

Beckoning Change

Further north in Allen, Texas, a week has passed since the winter storm. For the most part, power is back on, tap water is potable, and impassable roadways have thawed. And Katie Fiedler M’19 is doing what Wey and Gorecki ultimately had to do, too: help spin a vaccination clinic back up after being forced to cancel the previous week’s appointments. Like Wey and Gorecki, Fiedler is a graduate of the on-campus health care administration program who credits her team with exceptional agility and innovation in the throes of a historical moment in health care.

“The first day we were giving vaccines, one of the physicians who received it started crying—it was the moment I really realized the moment we were in, and how much he has actually seen and been truly affected by this,” she says.

At this point, Fiedler has been able to take a bit of a step back from the clinic and begin a comprehensive assessment. At its peak, the hospital was administering 75 vaccinations per day to physicians, nurses, staff members, and their families—but with a majority of employees having received the vaccine, the clinic was beginning to wind down. Fiedler and her team could start shifting focus: What worked? What didn’t?

... What’s next?

“People are going to notice how the pandemic has accelerated the change and development of health care,” she says. “More than anything, it’s made us a little bit more flexible in certain areas”—particularly in Fiedler’s areas. As director of operations for Texas Health Allen, a Dallas-area acute care facility, Fiedler oversees respiratory services, environmental services, and inpatient and outpatient rehabilitation. Respiratory services and environmental (cleaning and housekeeping) services were overwhelmingly affected by constant changes to health and safety standards.

Katie Fiedler M’19 and Jared Shelton M’10, FACHE, president of Texas Health Presbyterian Hospital Allen, discuss the hospital’s daily operations dashboard.

And what’s next for Fiedler is illuminated by a light at the end of the pandemic tunnel: the potential for today’s improvements in health care delivery to benefit care in the future. “Pivoting through the pandemic has necessitated more modern ways of delivering medicine,” she says. “The launch into virtual care is much better for a consumer-faced health care system; it also allows us to refocus on the importance of having acute care hospitals and triaging people’s care into appropriate areas.”

Yet, in Fiedler’s eyes, the most important shift may be toward putting prevention and preventive care first. “The biggest change has really been the importance of the infection prevention team,” Fiedler says. In the past, infection control had been seen as a group of experts “working in the background.” Bbut with the onset of the pandemic, “suddenly everyone in the hospital had their cell phone numbers.” Notably, new practices and procedures are run by the infection prevention team prior to implementation.

“These are all good improvements that should stay,” Fiedler says with confidence—and with humbition. “Innovation makes our physicians’ and staff’s lives better. Day after day, even the smallest improvements and gestures help make caregiving as bearable as possible, particularly through something like this—whatever we can do to help them remember why they picked this profession and to continue to want to be here.”

Mary Wey couldn’t agree more as she smiles toward the small slits of light she can see in the tunnel, too. “You learn how to work in a different environment. It’s what you do. It’s what you live. It’s what you find is your purpose in life. You don’t see it as something that keeps you up at night; rather, it’s how you can do your best to serve your community. And that’s why we will be okay.”