Becker's Hospital Review

104 104 THOUGHT LEADERSHIP Living Like a Leader: A day in the life of Paul Viviano, CEO of Children's Hospital Los Angeles By Alia Paavola B etween driving growth, meeting clinical objectives and navi- gating complex payer dynamics, there don't seem to be enough hours in the day for healthcare executives. Leaders succeed despite these challenges, each with their own habits, hacks, styles and methods — and Paul Viviano, president and CEO of Children's Hospital Los Angeles, is no exception. Mr. Viviano, who began leading the hospital in late 2015, oversees the oldest freestanding children's hospital in California that employs more than 7,000 team members, cares for 17,576 inpatients per year and sees more than 600,000 patient visits annually. Before joining Children's Hospital Los Angeles, Mr. Viviano led the UC San Diego Health System as president and CEO and also served as asso- ciate vice chancellor of UC San Diego Health Sciences. Mr. Viviano has also held chief executive positions at USC University Hospital and USC/ Norris Cancer Hospital in Los Angeles; St. Joseph Hospital of Orange, St. Jude Medical Center; and Los Alamitos (Calif.) Medical Center. Editor's Note: Responses have been edited for length and clarity. Question: What's the first thing you do when you wake up? Paul Viviano: I'm an early riser. e latest I wake up would be 4 a.m. ree days a week, I just get up, get in the shower and come to work. I literally can't wait to get to the hospital to start my day. About two days a week, I will start my day with a workout. I have a small gym in the garage. e Peloton bike has become a favorite, but I also have an elliptical, weight machine and heavy bag. Each morning, I'm up instantaneously and am either getting ready to come into the office or exercising and then coming into the office. Q: What's the first thing you do when you get to work? PV: I come in through the main hospital entrance and I undergo a COVID-19 health screening like every team member and visitor to the hospital. I go to the front desk and greet the team welcoming ear- ly-arriving patients for surgical and other operative procedures. I'll say hello and offer to buy them a cup of coffee or tea. From there I'll walk to my office, past the surgical admitting area, and say hello to families as well. When I get to my physical office, I will immediately check my emails. Q: How much of your time is spent with your direct reports? PV: No two days are alike, but I would say 20 percent to 25 percent of my time is spent with direct reports. ere are days when it's 100 per- cent, so it varies. e vast majority of the people who report directly to me are within a few steps of where I sit. e frequent interaction with them is important and allows us to get together spontaneously several times a day. Q: How often do you meet with clinical staff or perform rounds? PV: Every day I talk to clinical staff. Pre-pandemic, I'd say I made clinical rounds every other day. It's been a little less frequent since the pandemic started, as I want to be respectful of our protocols concern- ing physical distancing among caregivers, patients and their families. Q: How has your daily routine changed amid the pan- demic? PV: When the pandemic first showed up, I asked our leaders who could do so safely to be present, to be here, be visible and ensure we are leading by example since we are designated as an essential service. ere was a lot of pressure to have team members work remotely, but I asked my direct reports to refrain from working from home routinely. I wanted our presence to be felt by the entire team. We also took im- portant steps to ensure a safe environment for all — team members, patients and patient families. Today we have about 2,000 of our team members working from home out of our roughly 7,000 team mem- bers. But the vast majority of the management team is on site. Additionally, the composition of the day has changed. We created a COVID-19 command center, and at least once a day I connect with the response team, thanking them, getting the updates and helping to make decisions about testing, masking, supplies and new physical dis- tancing measures. In addition, email traffic has gone up significantly for me. I probably get 100 more emails today than I did pre-pandem- ic, as people are trying to communicate in a different way. In addi- tion to my weekly newsletter update, I began recording weekly video messages to our team members. e goal is to be as communicative and transparent as possible at a time when a lot of decisions are being made quickly and in direct response to the ever present need to assure the safety of our team members, our patients and their families. Also, many functions have moved online. Q: How are you, as CEO, working to bring back patients and normalize operations? PV: We've done a lot to offset the adverse impact, including reaching out directly to patient families and launching a campaign urging families to not postpone appointments, emergency care or chronic care while assuring them that CHLA's environment is safe. But demand is down. Because children are home and aren't congregating in daycare centers and schools and because of physical distancing, they're not exposing each other to germs. ey're not going to sports camps and therefore they're not sustaining sports injuries. We are responding in several ways. Our outreach campaign includes television and radio news segments, out-of-home and public service announcements. e goal is to make sure families know that we are a safe environment for every type of care we were providing before the pandemic. All inpatients and any child undergoing a medical pro- cedure is tested. Every employee and all visitors are screened prior to entering the hospital. Wearing a mask is mandatory and physical distancing measures are in place. In addition, we have done a remarkable job boosting our telehealth infrastructure. We had developed a platform that wasn't being used very frequently prior to the pandemic, but now that we revamped the technology and trained our teams, telehealth has provided extensive access to families. About a quarter of our patients now are being seen via telehealth, and our doctors have conducted more than 50,000 vir- tual visits in the first five months of the pandemic. We've also reached out to a number of adult hospitals in Los Angeles County that have small pediatric units and have volunteered to help

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