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Michael Caresse (Host):  Welcome to the ASHRM podcast made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted health care through enterprise risk management, you can visit ashrm.org/membership to learn more and become an ASHRM member. I’m Michael Caresse. It's Healthcare Risk Management Week, June 21st through 25th held every year to give folks an opportunity to show appreciation for Healthcare Risk Management Professionals in their organization and their communities.

The theme this year, prepared for the present, planning for the future, celebrates all the hard work of risk management professionals over the last year, all while laying the foundation for what's to come. You can visit ashram.org/resources/hrm-week to check out activities and resources available.

So, of course we all recognize that risk managers do amazing work yet challenges with doing versus leading can result in being overworked, undervalued, and undefined. To mark HRM week, we're going to devote this episode of the podcast to exploring strategies, to help risk management leaders address these challenges and support development as leaders. Joining us as our guide is Elaine Ziemba, Vice President and Chief Risk Officer at Stanford Healthcare. She has over 30 years of healthcare risk and operational management experience within large academic medical centers, hospital system settings, and at a national professional liability insurance company among other experiences. Along the way, she also earned a master's in Health Administration and a law degree. Elaine, Welcome to the ASHRM podcast.

Elaine Ziemba, MHA, JD (Guest): Thank you very much, Michael. Pleasure to be here.

Host: So how would you start by filling us in on what you're doing day-to-day there at Stanford.

Elaine: Sure. As my fellow risk management colleagues will tell you, that can vary day to day between what we think we do and what we plan to do. And ultimately, how our days shape up. But functionally I'm, as you mentioned, the Vice President and Chief Risk Officer for the Stanford Medicine Enterprise, inclusive of three hospitals, academic medical centers, and a community based hospital, as well as affiliation with the school of medicine, and all of us are part of the greater Stanford University family. We also have a large network of affiliated physicians. So, really my job is to manage the risks and develop the risk management strategies for that enterprise.

Host: Well, you certainly have your hands full that's for sure. And as I mentioned in the introduction, you have just such a long career and experience in this field. So, what does leadership look like in your experience as you look back over your career? How would you define it?

Elaine: So, leadership for me has been a really interesting and evolving arena, so to speak. I've had some amazing leaders and currently have amazing leaders that I work with on a day-to-day basis and through my network and relationships. And what excellent leadership has proven to be for me over the course of my career is really somebody or some element of really having a big picture and being able to integrate that big picture into your day to day functional activities. Along with that, there's really been clearly poignant highlight for me, which is what we do and how we do it is rarely done alone. And in healthcare in particular, our relationships, our networking, our partnering with our amazing colleagues in our day to day work, really is what drives us all and really supports us all and how we better nurture that and coordinate within that, really defines the leadership talent.

Host: So, help us understand how a good leader can do that, can take the big picture and integrate into the day to day activities.

Elaine: Yeah. Well, first of all, I really believe if you're going to be managing the risks of the organization, you need to know that organization inside and out and the business of that organization. I think many times we get sort of tunnel vision into the task at hand. And really understand how to match the strategy and the theory and the law and the risk management principles and weave those into the practical elements of what our colleagues are working with and dealing with every day. How best to serve our patients with that theoretical blending with the practical is really what risk management looks like to me. And so being able to understand, not just the rules and the principles, but really how things work and strategically what the goals and objectives are and weave that into a practical approach to risk management, really I think has been a defining framework for me, leadership wise. And also I think if I could impart some guidance to colleagues, I would say that above all really is the jumping off point for good leadership.

Host: Are there one or two key bits of advice that you received along the way that helped shape your leadership style?

Elaine: Absolutely. As I mentioned, I've had great leaders over the course of my career. I'm so fortunate to have had wonderful mentors and leaders that I both learned from and was prompted by. Two key points really stand out in my head over the course of time. And those two points have really been a framework and foundation for what I do.

And that first bit of advice was always look ahead to the next step. You may have the answer and you may have the solution and you may have the guidance, but there's always something beyond that. Anticipate that and weave that into what you do. And I have found that extra step of not just concluding with an answer or a point or a solution, really does help with educating our colleagues and nurturing the risk management relationship and imparting skills to all of us, that needed, we all are doing this together type approach. And it really is an opportunity to not just stop at what you're doing and concluding it, but always anticipating what the next question or the next step might be.

The second piece of advice that I have long since held onto and really, again, it frames my approach is don't rely on telling people what you're going to do. It very poignantly has been spelled out that we all have great intentions and we all have the answers that we are providing about how we're going to approach things we're going to do, but what really matters in the end is what have you done and how have you done that?

And again, it goes to many of us thinking that we're the ones who need to fix things or to solve things or the task master for certain approaches to our risk management issues. And if we step back and nurture the relationships and form a collegial partnership with the really smart minds and able colleagues that we have throughout the med centers and the hospitals and outpatient centers and elsewhere; we nurture those relationships so that others work with us and we can lead to get things done. And at the end of the day, we stand tall in saying here's what we did. And I just think that's been a really strong principle to build a foundation of leadership upon.

Host: Right. So, I noted at the beginning, the doing versus leading conundrum and the problems it can create. Tell me more about that and what are some strategies managers can use to avoid the consequences of being overworked, undervalued and undefined.

Elaine: That all is best met strategy wise by again, understanding what is happening within the organization and who's doing what and how it's being done because many of the situations that we're dealing with on a day to day basis are complicated. And we often as risk management professionals take on some role or some fix that, frankly, we may not be most suited for driving that fix, or we may not have the complete picture or again in addressing the task of getting something done, we have may have missed other opportunities in working with our colleagues to formulate a greater whole. So, I very much believe that our task driven selves, where we tend to take on any of the things that flow into our offices or our phone lines, or our emails, really is best suited when it's approached as an understanding that, hey, if there's a device issue that needs to be resolved, I'm not the only one who needs to address this. I have great colleagues in engineering and biomed and supply chain and other resources that are more than capable and eager and can work with us to get things done.

So, a little bit of removing it from I'm the one who got the information and I'm going to fix this problem, to really understanding what everybody else is doing and how they're doing it and nurturing that collegial approach to fixing things.

Host: Right. And getting back to that point, you made earlier about you're not alone.

Elaine: No, definitely not

Host: And the relationships really count. So, as we wrap up here, what are some key bits of advice that you have for new risk managers?

Elaine: For new risk managers, I would really say again, have a good understanding of your organization. You may have been placed in a risk management role and are learning the ins and outs of that particular professional discipline, but it really is incumbent upon you to understand the business at hand. What is your organization striving to do? How are they planning on doing it? Do you have an understanding of the global strategy? Do you understand the finances of the organization, its position in the community, the patients and others that are part of the mission and objectives of the organization. Do you understand the roles and responsibilities functionally that others serve?

And I would say, get to know that. We, at ASHRM have a series of modules and courses that periodically happen throughout the year. And I'm very fortunate to be involved in the advanced forum and we cover a variety of topics that you, as a risk manager may never directly be responsible for, or need to have a broad scope working knowledge of, but you need to know where to go when those types of issues might evolve.

Or know the professionals in your organization who are addressing those and do have a deep knowledge. So, I would say really get to know and understand foundationally the organization within which you're managing the risks. And then secondarily, I would tell a new risk manager, develop your best five-year-old self.

What I mean by that is constantly ask why. Don't settle for, this is what happened and how we did things or how we do things. There's always another step. Again, going to that look beyond the immediate and really nurture your knowledge around that by developing that ever inquisitive approach to everything that you do. Ask why, ask how, ask often and really serve yourself by developing through that inquisitive nature a better understanding that you'll eventually be able to use in spades, around both what you do and understanding what others do.

Host: That is really interesting advice. So, just to be clear folks, she's not giving you permission to act like a five-year-old in all circumstances, but think a little bit like a five-year-old, right?

Elaine: Correct. Correct. Michael.

Host: Well, listen, we're going to have to leave it there, but I want to thank you very much for being with us today and sharing all of that great wisdom with our audience.

Elaine: Thank you. And it's my pleasure. And I would say to all of my colleagues, this is a great opportunity to be your best professional self, evolve the profession along with yourselves in a leadership direction. And by all means, please not only do great work, but have fun and do well while doing it.

Host: You've been listening to Elaine Ziemba, Vice President and Chief Risk Officer at Stanford Healthcare. I want to remind everybody that you can join ASHRM in celebrating healthcare risk management week 2021 by going to ashrm.org/resources/hrm-week. This podcast is made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted health care through enterprise risk management. You can visit ashram.org/membership to learn more and become an ASHRM member. I'm Michael Caresse. Thanks for listening.