Mary Jane Kornacki, MS, interviews Kimberlydawn Wisdom, MD, MS, Senior Vice President of Community Health and Equity and Chief Wellness and Diversity Officer for Henry Ford Health System, during the 2017 IHI National Forum.
Mary Jane Kornacki: I’m at the IHI’s National Forum on Quality Improvement in Health Care, and I’m with Dr. Kimberlydawn Wisdom from Henry Ford [Health System]. Dr. Wisdom is the Senior Vice President for Community Health and Equity and the Chief Wellness and Diversity Officer. Welcome, Dr. Wisdom.
Kimberlydawn Wisdom: I’m delighted to be here.
Kornacki: You’ve been a leader for many years and taken on many different leadership roles. Can you tell us a little bit about that journey and any particular lesson you’d like to share?
Wisdom: Sure. A key part of leadership is connecting to your purpose, what you’re here on this earth to do. We are here to serve. I feel very fortunate, because at the age of 14, I was able to clearly identify what my purpose was and is, and I’m doing the same thing now that I was doing when I was 14 years old. I feel blessed in that respect. What I’d like to share with you is at the age of 14, I wanted to learn how to swim and went to my local YWCA.
Now, I’m from Mystic, Connecticut, and I was in New London, not a very diverse community.
Kornacki: But near the water.
Wisdom: Near the water, exactly. The need to swim was relevant. I joined the YWCA, and one of the first things I did was attend a summer camp because I was going to go learn how to swim. After a couple of days at that camp I went to my room, and my clothes were thrown on the floor, out of the drawers. I couldn’t understand what was going on. I investigated. I went to a few more colleagues’ rooms and found out their clothes were on the floor as well.
I was outraged. I wondered what was going on. Well, lo and behold, it became clear that they were looking in [on] the students of color, they were looking for drugs. I was incensed. I had not been exposed to drugs. I had no interest in using any substances of any sort. So I figured, okay. I’m going to take that real concern, real outrage and I’m going to package it in a way to do something productive.
I went back to my Y in New London and I talked with my counselor. I shared with her what happened and said that we need to do something about this. She said, “I will help you work through a strategy, a plan.” Our plan was to go to the National YWCA during the time that they were having a board meeting and picket the YWCA.
Kornacki: Oh my, at 14.
Wisdom: A protest. I organized my friends, my seniors. Some were 15, 16. Some were younger. We organized and we took this 2-hour trip to 600 Lexington Avenue to visit the National YWCA.
Kornacki: New York City?
Wisdom: New York City. Big for us, you know, 14 years old, it was a big city. We made our picket signs and went and demonstrated in front of the Y. Interestingly, Dorothy Height, a major civil rights leader, was the chair of the board at the time. She invited the rabble-rouser, the spokesperson for this group, up to speak to the board. That was me. I had the privilege of addressing the board that had Mary Rockefeller, Ruth Bunch, and a few other notable luminaries. I didn’t know who they were at the time, but I shared the story and said how outraged I was, and I was prepared to do something about it in a constructive way.
They asked me to serve ex officio on the board and attend meetings. Within probably 6 months or maybe 8 months I was able to be elected to a national post as one of the Y youth team leaders, representing one of the four regions across the United States. It became clear to me then that my role, my purpose, was to be a voice, be an advocate, be a bridge, and help address inequities — I didn’t know that word at the time — but to address inequities and injustices.
That’s just one example, which was racial and ethnic, but also in school and my elementary school, [for] the students who were maybe not as fast as the other students, I was always trying to advocate for them, tutor them in the back of the room. [This was] upsetting to the teachers and my mother got called up to the school quite often, but it was that I needed to be that bridge. I needed to reconcile as much as I could those injustices.
Even now, when I think about leadership, I think about identifying a gap, identifying a problem that really disturbs you, developing some sort of strategy, some sort of vision as I did with my counselor at the Y, and then moving forward to see what role you could play in solving the problem. To me, that’s my probably most life-defining leadership moment. And it wasn’t like I said, “I think I want to be a leader.” It was [that] I found something that I could not live with myself without addressing, and that’s what brought out that leadership ability.
Kornacki: At this conference, there’s been a lot of talk about purpose, and it sounds like at a young age you found your purpose and you have been living it for the years since then. What you shared spoke a good deal to courage. I can imagine a 14-year-old girl of color having the chutzpah, as we would say in Yiddish, but the courage of your convictions and to stand up for yourself and for others.
Kornacki: Are there recent examples of that thread being pulled through your life?
Wisdom: Oh, I would say most definitely. I can give many, many examples, but I would say one that’s probably most recent and relevant today. And mind you, at the time when I was 14, I didn’t think it was courageous, I didn’t think it was remarkable. It was just [that] this is what had to be done, and I remember clearly. I’m a scrapbooker, and I’ve saved all the newspaper clippings and everything in my scrapbook. I actually went to the University of Pennsylvania for my interview with five scrapbooks and almost was accepted on the spot.
But at the time, I didn’t feel it was courageous or bold. It wasn’t until reporters started wanting to talk with me and understand what happened that I realized, wow, this is unusual, this is a little aberrant from typical behavior. But for me, it was how I felt and I was driven.
Something more recent in our health system at Henry Ford is the [data] collection of race, ethnicity, and primary language. Mind you, we’re in the city of Detroit, where there have been significant racial tensions over the last 50 years. And they still exist, although I’d say improved, but still exist.
Asking frontline team members to collect race, ethnicity, and primary language data was a bit disturbing. People felt, why should we have to do that? We’re all part of the human race. It’s disruptive, too, when you’re collecting information about what the patient is coming in for, to start asking personal information about their race and ethnicity. [But] I felt this was something that needed to be done for many, many reasons, because how are we going to care for a population when we truly don’t know who’s represented in the population that we care for?
There came a moment in time — and this is where mentorship and leadership of others around you is so important — when it came to the collection of that data within our health system, of course there were a lot of priorities and front-desk redesign. Many important things, all very, very important, so it was considered that this is kind of disruptive and there’s going to be a lot of pushback among the thousands of registration clerks who would have to collect this. Why do we want to be so disturbing and so disruptive? You felt that it may be somewhat necessary, but we’re working on more important things now like redesigning our front desk, which is important, and collecting financial information, which is important.
I’m not minimizing any of those, but I felt like this was important, too. Going before our leadership, I had to make the plea with data, statistics, the importance of it. And that was one of those moments where Nancy Schlichting, my CEO at the time, heard the arguments on how we had many other priorities and maybe we should put this on the back burner — not that we weren’t going to do it, but just put it on the back burner. And Schlichting came forward and said no, this is a priority. We must move forward on this now. So we did.
That was another one of those times when it wasn’t the popular thing to do, it wasn’t something that was an easy lift. We had a lot of data, a lot of research, so there was all the support yet understanding that we’re in a complex organization with a lot of complex challenges and this might be too disruptive. However, it took courage on my senior leader’s part, Schlichting, to stand behind what she knew was scientifically sound. It wasn’t like I didn’t feel that it was a courageous move from my standpoint. I felt like it was a necessary move, but I had others around me who were courageous in terms of supporting the effort.
Kornacki: What I hear in that story is your persistence.
Wisdom: Absolutely. You know, Nancy Schlichting, my former CEO, described me in two words over the 10 years that we worked closely together, and one word she said was relentless.
Kornacki: Yeah, persistent.
Wisdom: And I was like, “I hope this is a compliment.” And the other word was disruptive.
It’s interesting. I would say that has probably been a pattern in my life, being respectfully disruptive, but that’s what the YWCA situation was. That was very disruptive. The collection of race, ethnicity, primary language, all throughout my career — there are many, many examples I can state that were disruptive, but yet doors seemed to open, goals seemed to be achieved. That gave me more energy to continue the journey.
Kornacki: Sure. You’re going forward. Let me ask you about joy. Again, at this conference, we’re talking about joy in work. How are you promoting at Henry Ford this construct when people seem — in my own experience of frontline doctors, they are so besieged, whether it’s from EMR, quality measures that are inconsistent and complex, and many of them — how do you maintain a focus on joy, especially for primary care doctors?
Wisdom: That’s so key. My role now is primarily administrative, but I practiced emergency medicine for 20 years. That question is key and so important, and I’m delighted that joy and happiness are coming to the forefront — relationships, trust, all those things that we considered as health care professionals soft things. The data and the quality scores and the star ratings, those are the hard things, but the soft things like kindness and joy and happiness and relationships, those were always considered the soft things.
Even in my community role, many of my colleagues would say, “There’s W over there, shaking hands, singing ‘Kumbaya.’” And I said, “No, we are taking the scientific approach to a lot of this.”
Let me give you a couple of examples of how joy is so important in bringing your whole self to work, which I talk about a lot. I lead our community benefit effort with our legal team and lawyers or auditors, that sort of thing. Community benefit is one way that we have to show that we’re giving back to the community in order to retain and maintain our 501(c)(3) tax exempt status. So it’s important from an IRS standpoint. But at Henry Ford, we don’t want to do it just because the IRS is requiring us to do it. We want to do it because those are our values. It gives us lift. It gives us more justification for the naysayers, but it’s something that we’re already wired to do.
It became clear to me that a lot of our team members, particularly our physicians, were doing fabulous work out in the community, speaking at churches, speaking at Kiwanis clubs, doing all kinds of wonderful things with volunteering, with their spare time, and this could count as a community benefit, but they didn’t realize that. If I asked my typical frontline doc, “What’s community benefit?”, they were like, “I don’t know. I really don’t know.” I said, “Do you realize that when you’re out there giving these speeches we can actually count your time toward that IRS requirement?”
They didn’t realize that, so I got a little frustrated. I remember writing in one of my team member’s performance [reviews], we have to do something about this. We have to do “your work counts.” We have to help people understand their work counts when they do it in the community and it counts twice because it counts for the IRS. Lo and behold, that brainchild evolved into a whole campaign around community benefit: Your Work Counts, YWC, and my husband came up with the A. I was frustrated in the kitchen, we’re cooking, and he said, “You know, you need something for the A, and then it would be YWCA.” I’m like, “YWCA, oh, my gosh.” So it was “Your Work Counts Again.” Then we took the soundtrack to “Y.M.C.A.,” the Village People from ’78.
Kornacki: I remember.
Wisdom: We took that soundtrack, we repurposed it. We got permission, of course, legal permission to do this. We modified all the words but we used the same soundtrack.
Wisdom: We gathered about 40 people from across the system and we had them choreographed, singing, doing cards, and we developed a whole video around “Your Work Counts Again,” which we call YWCA. We had a blast. The video is available on YouTube if you “Henry Ford Health System Your Work Counts Again.” You’ll see the whole video and so many people. We had 40 people who were part of that, all volunteer, and they would work probably 6 to 8 hours after hours per week for weeks on end until we finished this video.
We finished that probably 4 years ago, and people are still coming up to me now [asking], “What’s the next project?” We’re ready. We want to sing. These are VPs, these are our valet drivers, able to bring this cross section of different people at different levels of the organization. They loved it. It brought them joy.
Kornacki: You tapped into something big time.
Wisdom: You know what? After hearing some of the lectures here today, the presentations, key notes, I am going to operationalize this other idea that I’ve had for a while in terms of how to bring more joy to the workplace, how to bring more happiness to the workplace. And I don’t think it’s rocket science. I don’t think it’s that heavy a lift, because people want to bring themselves to work fully. So I envision more around music, more around music therapy but for the employees, and engaging them in a way that they’ll enjoy coming to work. The spillover, the halo effect of all of this is the patients will benefit.
Kornacki: Of course.
Wisdom: The patients will be joyful.
Kornacki: And now we have data that shows that.
Wisdom: Exactly. I’m excited, but we sort of tripped onto that. It wasn’t anything that we knew about, data we knew. It was just that I was frustrated that my doctors, who were probably putting thousands of hours — we have 1200 doctors as part of the medical group and others in private practice — 1200 doctors are probably putting, I don’t know, 20,000 hours of their time easily into the community, and none of that was documented.
It was out of frustration. That’s why I encourage people [to ask themselves]: What disturbs you? What makes you mad? What upsets you? Oftentimes, that’s where you’re going to discover your purpose, and that gives you the energy. So, guess what, I was motivated to get this thing going because it was going to help our community benefit effort, it will help the community, it will help the docs. I mean it was a win-win.
Kornacki: Great. Well, thank you for sharing, Dr. Wisdom. I really enjoyed this.
Wisdom: You’re welcome. Thank you for having me.
This story was recorded at the Institute for Healthcare Improvement’s 29th Annual National Forum in Orlando, Florida, on December 10–13, 2017, by Mary Jane Kornacki on behalf of NEJM Catalyst. We wish to thank IHI for support of this project, especially Madge Kaplan for her technical advice and guidance. Click here for more Lessons in Leadership stories.