Intro: This episode is part of a special Women In Leadership Podcast series.

Sarah Brownell: So really excited to do another podcast session in partnership with SHSMD. And it's another podcast focusing on interviewing female leaders in healthcare. My name is Sarah Brownell. I'm the Strategic Growth Director for HDR. And I have the absolute pleasure of sitting here with Christine Alvero with Moffitt Cancer Center. I'm really excited about our discussion today. I'm really excited to hear your story. But before we get into that, why don't you introduce yourself and maybe share a little bit about your background.

Christine Alvero: Thank you so much. I appreciate you for having me on this and talking and highlighting female leaders in hospital operations and in these different unique roles. So, I really appreciate that. I think it's something that other females need to hear it and need to, you know, see that there's opportunities out here for all of us female leaders. I appreciate that. I am currently in the role of VP of Operations for our Moffitt McKinley Hospital. Currently, this is a surgical hospital, although we are in the process of expanding to medical patients here as well.

Sarah Brownell: Perfect. And so, I've gotten to know you a little bit from the process of the design and construction of this hospital, which we are currently happy to be sitting in, this beautiful new hospital for Moffitt Cancer Center, and learn a little bit about your background, which I think is just so fascinating. So, can you talk a little bit about your background and kind of all the amazing things you've done?

Christine Alvero: Yeah, I had an interesting path to get here, but I think it served me well. I actually started in college as an athletic trainer. That was my initial career and background, is people get hurt on the field, I'm the one that runs out and takes care of them. And then, I moved into physical therapy school, really moved into that thinking that that would make me be an even better athletic trainer. And the reality is, during PT school, I did one of my internships here at Moffitt, and I dreaded it. I thought it would be horrible. I didn't want to be in a hospital setting. I didn't want to be with sick people. I didn't want any part of it. But truly, after being here at Moffitt, within the first two weeks, I fell in love. I loved the place. I loved the staff. I loved the patients. You name it. I wanted to be here.

So, I was fortunate enough, once I graduated from PT school, that there was an opening here at Moffitt and I was able to start here as a PT and then have grown, you know, through the ranks here at Moffitt over the last 21 years. I just had my anniversary back in September, so that was very exciting and went from being a staff therapist to initially taking on a manager role in just physical therapy. Then, that expanded to also including speech and then inherited nutrition, the transport team. And then, over time, I also grew to have the respiratory team, cardiopulmonary team, bronchoscopy, and just another kind of varying group of folks that fell up under me. So, I always lovingly called myself the junk drawer. I had all of the very random things, but all very, very important to making the place run. But all of those junk drawer items fell under me, until then getting to do all of the work here for MMH and the design process and operational readiness and getting this place ready to open.

Sarah Brownell: So, let's talk about that a little bit, because we are recording this in the new hospital, which was quite a journey and you were such an instrumental part of not only the design and construction, but the whole operational readiness and staffing and training. It's such a core part of the team and it was amazing to watch and see you in action and see that leadership transpire and and translate into the design. And it's a beautiful building, right?

But I want to ask you, and don't feel pressure, like I'm not leading you to this answer, but I do want to know, thinking about your background and all of these amazing things that you've done, going from being on the field and now, you know, really running this hospital, what are some of the most standout moments for you, the things that really resonate as you look back on the things you've done so far?

Christine Alvero: I think standout moments here with this facility and with this, you know, transition to this new role here, I think first of all, just being given the opportunity to be in the role that I am, and to have the opportunity to be in design and to be operational readiness and really in charge of everything to get this place ready to open. I think a lot of places and a lot of times you wouldn't think you're going to have this type of opportunity and being able to have that. I'm not a nurse. I don't have that type of background, which a lot of promotional opportunities within a hospital do fall on. You have to have a nursing background. And so, it was nice that Moffitt recognized my skills and what I could bring to the table and gave me this opportunity to be involved. I think that having the junk drawer previously opened my eyes to a bigger perspective. So, that really when we're going through design, I was able to say, "Well, what about this piece?" or "What about this group?" or "What about this department?" And I think a lot of those groups that felt like they're always kind of afterthoughts felt important and felt like they had a voice and they were a part of it. And so, bringing that together is something that I'm very proud of. And I think that's really a standout, is hearing from all those groups of how included they felt and how everybody was really a part of it, which helped in the long term as well, because now people are bought into the facility and the way things are designed and the way things are run, because they were in it from the get-go.

Sarah Brownell: So, let me ask a little bit about that, and this is kind of diverting from the questions I prepared, but I think there is something special about Moffitt culturally that, you know, from an outsider looking in, there does seem to be this culture of thinking different and valuing multifaceted perspectives and different perspectives. So, you talked about being given the opportunity, how did that come to be? And can you talk about that a little bit? Was it like a mentor or a...?

Christine Alvero: Well, it's an ironic situation. I have had a mentor here at Moffitt truly since I started. One of the physicians and I just clicked from the get-go, even when I was a student. And so, he really mentored me over the years and helped guide. Sometimes there were hard things that I didn't want to hear when I would think, you know, "What about this position?" And he would be very open and say, "I don't think it's a fit. I don't think that's where you're going to excel." And so, hearing some of those hard feedback of, "Okay," ultimately, you know, that's why you have a mentor, is to listen to that advice and to really take it.

And so,, he's always pushed me. And so, that has helped. And then specifically with this, I was not initially part of the design group that came in. And so, there was a team, and it had a lot of our nurses and APPs and physicians in, and they called a group of us in and said, "We have a general design of the patient floor, and we'd like to get sign off." And so, I was called in and some social work leadership and some of the others were invited in to come sign off. And when I went to the warehouse where we were doing the design, I had a lot of questions and I had a lot of concerns. "Well, what about this? Well, where's the surgical hospital? I assume we're going to have ventilators. Where are we putting vents? Where are we putting a respiratory team?" "Well, we hadn't really thought about that." "Well, we weren't really thinking about that." So, I would not sign off on the plans. And I said, "I need to go talk to my boss. I have some concerns." So at the time, I was reporting to our chief nursing officer. And I went to her and said, "Here's my concerns. I think there's gaps. I think we're missing things. And I truly in my heart of hearts thought that she would say, "You are right. We will fix this." And instead, she said, "You are right. You should do this." Whoopsie. But again, it was great that she had faith in me and she saw those qualities in me. And our chief operating officer at the time was fully supportive and said, "You know, I don't see anyone else better. Let's do this. I think you can absolutely take this on," which again is nice because literally I've never opened a hospital before. I've never had that breadth of responsibility. And so, their confidence in me helped me feel and know that I could do it.

Sarah Brownell: I think that's such a beautiful story because for a couple of reasons, first of all, to have the courage. I'm sure that was uncomfortable, right? You're in a room full of all these professionals that feel like they have it figured out. And then, you go to another professional and say, "Hey, I've got questions." So, I applaud you for that. Because, I think that that is where we grow is when we're in those uncomfortable places and, you know, it's not intuitive. And it's one of the reasons why I really appreciate this opportunity, this podcast, because I think it highlights where growth happens. And it's a lot of times it's taking on new roles. It's doing different things and it's being uncomfortable. So, kudos to you for having the courage to do that, and because look at the reward.

But also, another thing I think that is just so fascinating about that is when you talk about your mentor and the fact that he would tell you, "No," or "Not yet." And I applaud that too, because I think in mentor relationships so often, we only want to hear the good and it's like, "Give me the bad. I want to hear that I'm not ready or what am I not doing right, because I want to grow." And so, I think that it's amazing to hear that you had that experience. I think that that's really important.

Christine Alvero: It was. And I will be the first to tell you, man, it hurt. Yeah, it hurt. And it was way back when I was a PT and thinking of going into a manager role. And he said, "No. You're not ready. This is not the time. It's not for you right now." And I mean, daggers to the heart, it was hard to hear that. But then, you know what? That made it even sweeter when an opportunity came up again for that manager role. And I said, you know, "Well, things have come up again." And he said, "I know exactly what it is, and now is the time. You are ready. You're the one. You can step up and do this now." And it made it mean so much more, because I knew he would be very honest. He would tell me if I still wasn't ready.

Sarah Brownell: Yeah. You had that trust and that's tremendous. So, I think that's phenomenal. So, you've done a lot of different things. You're now leading this hospital, is such an integral part of the design and construction. You've navigated all of these different roles. I'd like to talk about how you manage that, the transition. And so from a couple different things, you know, knowing when you're ready to take that move. I mean, it sounds like you had some great insight. But then also, I think when you do different things, like how you navigate internally communicating, "Hey, I'm not doing that anymore. I'm doing this now." And so, I'd love to hear insight from you on how you managed all of that.

Christine Alvero: Yeah, that is always a challenge. I think knowing when you're ready, I don't know if you ever really know that you're ready. You just have to feel that you can make the jump and that you're going to be able to do it. But I still personally never feel that confident that, "Oh, yes, I'm ready for this next step." I think I can do it. But there's always that hesitation. So, I do think, you know, having your mentors in place that can validate or can give you that support that you need is very important. I think learning and always being willing to jump in and ask questions and get in the weeds to learn about things is crucial. Taking the step from a PT to a manager, I felt like I was ready. And then, I got in the role and realized, "Oh my goodness. I went to school to be a PT. I don't know anything about management. And so, it was at that point that I went back to school to work on an MBA and to take additional classes and get more training on those skills that, in fairness, I didn't have. And so, being willing to do that when I inherited different groups over the year, being willing to step out of that comfort zone and say, "Hey, I am not a speech pathologist. I don't know exactly what you're doing or what skills you have. Show me. I want to shadow you. I want to see what you're doing. I want to understand it, because how am I going to be able to lead you if I really don't understand what you're doing?" And I always made a point to do that with any new group that I took on.

Same thing here with doing this new hospital facility. I came into this, I didn't know anything about imaging or lab or certainly not construction. I was way out of my element, but being willing to ask and say, "I don't know these things. So, teach me, tell me. Let me learn and understand." And now, I joke around, I'm a part-time construction worker, I'm part-time radiology," you know, all the things. Got it all figured out, yeah. But you have to be willing to jump in and learn, and I'm a big believer in I would never ask somebody to do something that I wouldn't do myself. So, moving into this building and getting things ready, I mean, I was the one in there, "Okay, great. Can I push this cart to go install glove boxes or do whatever?" Because I needed the help of everybody else that was going to be working here to do all those same things. And so again, I wouldn't sit in my office and say, "You go do this and you go do that." I want to be right there in it with everybody so that they feel like they have a partner, not a boss. That's not what I want to be.

Sarah Brownell: Yeah. So, how did you manage the communication then, I guess, as you transitioned into new roles?

Christine Alvero: Again, it's a little tricky, and I think I had the hardest time going when I was really in the rehab area to expanding out of that, because I did get continually kind of sucked into, "Well, you're a PT, you're a PT." And so, breaking that barrier of "I'm not a PT anymore," I mean, I am, but that's not what I do anymore. And so, it's tough, and I think delegating to the folks that are in those roles is critical.

Initially, it was much easier for me just to answer the question and then move on. It was faster. But the more I did that, the more people are going to continue to come to me for those kinds of things. So, pushing it to the right people, pushing it to the people that are in the role, even if I knew I could answer the question quickly, it wasn't my place to do that anymore. And so, I think that helped by just not answering those and pushing it out. I think for this facility, being involved in that design and construction and leading the parts and all the operational readiness, that was much easier. It was a natural progression so that when this building opened, I was already the one that was coordinating everything for the last several years. So now, running the building, I think that was very natural. People just already were coming to me with the building issues or concerns or do we need to get your approval on this or can you help us with this? So, that part wasn't nearly as bad as it was earlier in my career.

Sarah Brownell: Yeah, I think that's interesting. And I think it also goes back to your growth mindset a little bit. You know, I think making that move from one role to another, you're leaving what's comfortable and you kind of have to make a conscious decision to, "I'm going to create space for the people that are owning it now and empowering them," and making sure that you are following that because agreement's faster, it's easier, but it's also uncomfortable.

Christine Alvero: It devalues them if you continue to jump in and handle things and answer. You put them in a leadership position because you know they can do it. So, you have to give them that leeway and that freedom to do that. And the only way you do that is for you to stop doing it.

Sarah Brownell: Yeah. Even though it takes more time sometimes and even that's uncomfortable, that it's okay. Yeah, I think that's tremendous insight. So, one of the other reasons why I love this podcast is because we're able to talk about conflict and things that are uncomfortable. And so often in life, like I have three kids and, you know, my instinct with my kids is to always smooth things out. I want it to be as easy as possible. I want it to be no bumps in the road. I think as parents, that's what we like to do. It's certainly like what we like to see in business, right? We want it to be easy, but I think that the growth happens when things are difficult. And so, I want to talk about struggles and conflict and ask you about what struggles or challenges as you think about getting to this point, what's really kind of shaped your path and what are the things that you've really learned from.

Christine Alvero: So, I think I had the benefit, I'll call it a benefit very early on. When I was initially going to school to be an athletic trainer, that is a very male-dominant career. And so from the get-go, I always felt that I had to work a little harder. I had to prove myself more to be offered those same opportunities that the men were offered in that type of position.

And again, I was very fortunate. The athletic director here at University of South Florida could not have been more supportive of me during that time. And so, I really had to push the envelope there. And I went to him and said, "What sport will give me the best opportunities and the most knowledge and growth opportunities?" And he said, "Well, I mean, realistically, that's probably soccer." Football, you get all the big injuries and it's high level, but there's a head trainer that really kind of runs everything. Soccer, you'd be on your own, you're in charge of everything, but there's a lot of injuries. And I said, "Great. Then, that's definitely what I want to do." The issue was they'd never had female with a male team. And so, they really almost stopped it there. And so, pushing and saying, "This is insane. If you think I'm the best for the job, but just because I'm a female, we're not going to go there, that does not sit well with me." And so, I had to go have a meeting with the head coach and talk to him about his willingness to have me as part of their team and part of their staff and what that meant logistically. I mean, even stupid things like traveling, what does that mean? Because I can't room with the male on a travel, assignment, but how can we logistically work this? And I will give hats off to that head coach because he said, "If you're the best, I want the best. And we'll figure it out and I'll room with the assistant coach to give you my room, and they really worked it out. But I think from that point, it really showed me you have to speak up for yourself. You have to push the envelope and you can't just take the status quo and you can't take the "We've never done it that way before." Just because you haven't done it that way before doesn't mean that's right or doesn't mean that you can't do it differently.

And so, I think that moment and that situation has laid the groundwork for everything, for being able to say, "I know I'm a PT, but why can't I take nutrition? I know that I have all these things, but why can't I move into operations?" And so, I think you have to be willing to question things.

Sarah Brownell: That's amazing. And it kind of segues really perfectly to my next question about how your background helps you be effective in your current role. Anything else you want to add on that? Because I think it is so parallel.

Christine Alvero: I just think having that knowledge of many different groups, you know, coming into this new hospital build, certainly I didn't know every department coming in here, the ins and outs. But having all of those different groups under me previously, I was already open to looking at things from many different perspectives. So, I do think that helped versus having one department that I was very focused on and very potentially very good at that department, but you have a little bit more of a narrow focus. Having all of these different groups, I was used to thinking about, "Well, what about this? And what about A, B, C, D?" I got to think about the big, big picture and how everybody fits into the puzzle. I think that helped immensely with this project.

Sarah Brownell: Yeah. So, one of my favorite questions, looking back, if you could, knowing everything you know now, give yourself when you were first starting out in your career advice, what would it be?

Christine Alvero: I think being patient and waiting for the right opportunity. Sometimes you get hung up on what's the title or what's the promotion or, you know, what's the next step. And for me, I think that is not a good focus. For me, the focus needs to be on where can I provide the most value? Where can I make the most difference and make the most impact? And I think that's tough, because a lot of times you can make a big impact and it's not through a promotion and you can make a huge difference and it's not a new title. But I think we get very hung up on that. And I would give that advice to myself or to anyone starting out, stop worrying about those pieces. They will come. They will absolutely come. I did a whole lot of things and we used to joke because I would be in meetings when I was a manager and the meetings would run with, you know, "Well, so I need the directors and Christine to do blah, blah, blah. I need the directors and Christine to do..." Until I finally said, "I'm doing all the things that a director's doing. It's clear because you say directors and Christine, why am I not in this same playing field?" But it had been years that this was going on. But at the end of the day, who cares? I was doing the role. I was making a difference. I was making an impact. It'll come. The rewards come eventually.

Sarah Brownell: Yeah, I think that's great advice. It's advice I would also like to have had when I was starting out my career and I can use all the time. I think you're right. I think just the patience and the focusing on the value, I think that's really great. So, can you talk a little bit about what motivates you? I think you've got a really demanding job. How do you feed back into yourself and stay focused and continue managing everything you have on your plate?

Christine Alvero: I think it's twofold. I think my family motivates me immensely. I have two kids, I've got a 16-year-old and an 11-year-old. And so, showing them the importance of what I do and the importance of hard work and putting in the time and what that means and what that payoff is. And so, they support me and they understand. And especially with this building, there was a lot of long hours that went into play. And there was things that I missed for their school and things that I wasn't able to be present for, but being able to explain to them, this is a short-term investment that I have to make with my time. And then once it gets open, then I am back to all of those things.

And I brought them in here. We were getting ready to open the couple of months before, they would come in on the weekends with me and they helped stock glove boxes and they helped do some of those little things that showed them how much work went into it. And I have had them volunteering for Moffitt events since forever. They each have attended Miles for Moffitt since they were infants. They just came with me and then they both volunteer every year at Miles for Moffitt. We have a sarcoma shootout that they volunteer. So, I try to immerse them in our patients as well so that they see the why. And I think that's kind of the second part of my motivation, is the patients. I mean, they are Incredible. And what they're going through is so challenging that if I can be a small part in making that a better experience, that's what I'm here for.

Sarah Brownell: No, that's amazing. Yeah. It definitely helps to be connected to such a clear mission.

Christine Alvero: Absolutely.

Sarah Brownell: Any of them showing any signs of following in your footsteps?

Christine Alvero: I doubt it. I think my son wants to be a veterinarian and my daughter is very undecided, but she is very artistic and more of that creative mindset that I don't have any of those skills. Totally different, but that's okay.

Sarah Brownell: Well, that's good with me too. Well, hopefully, they at least recognize what an amazing leader their mom is and how inspirational.

Christine Alvero: I appreciate that.

Sarah Brownell: Yes. Hopefully. That's amazing. So last question, you've obviously done a ton so far in the short time. You've been in Moffitt, you know, 21 years seems like a long time. That's nothing, right? So, what's next? I mean, I'm just dying to know what else you're looking forward to and other goals you have for yourself.

Christine Alvero: Yeah. I love it here at Moffitt. I just wouldn't trade this place for the world. I'm always very honest. We are not perfect, but we're always striving for that. And so, I'm really happy being at this facility. I kind of I felt like I grew the baby and we had the baby and now I need to raise the child. And so, I am here to raise the child and, you know, there's so much more growth here on this campus that I want to be a part of. We have two shelved floors that we have to build out. We're actually bringing our medical patients in and over the next six months, so that we're working on. We have the potential for a second tower to go in on this campus. So, I want to continue here in this facility to really maximize the potential of what we have here.

Sarah Brownell: Well, that's awesome. And I know Moffitt appreciates it. I know the patients and the team appreciates it, all the work you do. And we certainly as partners for you at HGR really appreciate your leadership. So, thank you so much for taking the time to talk with us and we look forward to seeing what else you accomplish. Thank you.

Christine Alvero: Thank you so much. I appreciate that.

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