Leadership and Resilience in Healthcare - Discover the Secrets Behind WellStar Health System Success with President and CEO, Candice L. Saunders

Matt Bush:
Hi everyone and welcome to Better Together. My name is Matt Bush and on behalf of Great Place To Work, I thank you for tuning into today's conversation. Today we'll be speaking with Candice Saunders, president and CEO of Wellstar Health System to learn more about her experience and insights. Wellstar Health System is one of the largest and most integrated health systems in Georgia whose mission is to enhance the health and wellbeing of every person they serve. They're nationally ranked and locally recognized for their high quality of care, inclusive culture, and exceptional physicians and caregivers and have appeared on our Fortune 100 Best Companies To Work For list five times. Candice began her career as a critical care nurse. Joined Wellstar as president of Kennestone Hospital in May of 2007.

And as a result of her experience and strong leadership, she was promoted to executive Vice president and COO in 2013. In 2015, she assumed the role of president and CEO and was responsible for overseeing the health and wellbeing of Wellstar's patients across the state. Candice has built her career around improving community access to vital healthcare needs, implementing new care models and programs to address consumer health issues and integrating health delivery processes to improve operational efficiencies, enhance the patient care experience. From the boardroom to the operating room and across Wellstar Health System, Candice is a champion for delivering world-class healthcare for every person every time.

So Candice, thank you for joining us today, and leading today's conversation will be Michael Bush, CEO of Great Place to Work. Michael joined Great Place to Work as CEO in 2015 and has since been leading our organization in its global mission to help create great workplaces for all. So Michael, thank you very much for being here today and I'll hand it over to you to handle the conversation.

Michael Bush:
Thank you very much, Matt. Appreciate that. Candice, good to see you.

Candice Saunders:
Good to see you.

Michael Bush:
Looking forward to this time. Yeah, really looking forward to it. And what a treat for our audience. If I were you, I'd have my notepad handy because this is going to be a super session and just Candice, minus the introduction, just talked about all the great things that you and your team have done, but a few notables, in 2020 you were number 26 on the Fortune Best Workplaces in Healthcare and Biopharma. In 2021, you were number nine on the Fortune Best Workplaces in Healthcare and Biopharma, number 90 on the 100 Best Companies to Work For List. This is in 2021 people. This is the year when most healthcare organizations left our 100 list, but you were able to stay on in number 50 on the people ... Companies That Care list in 2021 and in 2022, number nine on the Fortune Best Workplaces in Healthcare and number 90 again in the 100 Best Companies To Work For list.

And then in 2023 already number 35 on the Fortune List Best Workplaces in Healthcare. So to do that at any time is amazing but to do those things in 2021, 2022 after the tragedy of the pandemic sitting in the middle of it, just congratulations to you and your team, and how did you do it?

Candice Saunders:
Well, I think that you always are building on a focus on your people. So as we look back at the challenges that we all faced with the Worldwide Pandemic, what you have to do is if you've already been on the journey where your people are at the center of everything you do, and if you're taking care of your people and listening to what they need and want, then they're going to be best positioned to take care of the patients or the consumer and then most importantly, each other. So we were fortunate that we'd already been working with the Great Place to Work. We'd been on this journey since I joined Wellstar, and it was one of the reasons I joined Wellstar.

Because our board has always had a very big focus on employer of choice, putting our people first. And as a service industry, we don't have healthcare without our people. So I think that helped us, but as you would also already appreciate that we had to get out and really be present rounding and listening because what I learned was how dynamic the landscape was both in their personal lives as well as in the healthcare landscape. And so we had to stay very close and help put things in place to help them to deal with their personal lives so they could be at work and be present for the patients. So a lot of listening, a lot of coming up with, and doing it in a very nimble way. What did they need from us?

So when schools closed, when they did not ... when we had shortages of supplies that they needed some time away, even under very intense staffing shortages, we really had to be looking and being very creative, but it was most important that they were driving those priorities. They were helping us determine what would help them the most. With 30,000 team members and the five generations, we had to also be looking at tailoring it to the different needs that we saw in the workplace.

Michael Bush:
Well, Candice, from our research, we found that there's only one industry where there was truly a great resignation, that's healthcare. The other industries, people maybe went from one hospitality company to another or maybe one airlines company to another airlines company. Healthcare was a place where people left and said, "I'm not going back to healthcare," which you've been able to not have that experience with your 30,000. So there's something that's going on obviously in terms of the experience that you and your leaders have created, but what is it that you look for when you're looking for someone to join the Wellstar team? What kind of a person at their core, beyond their technical skills, are your values working to attract?

Candice Saunders:
Well, as we look at healthcare and as you said, the great resignation, one of the challenges just that we did have to deal directly within our conversations with our team members was they were right there interfacing daily with members of our community with COVID. So we have always had a very, very intentional approach to safety and quality. So we wanted to make sure that they felt safe and that they had the personal protective equipment they needed that made them feel safe as we were still all learning about this hidden virus and this threat. So I do think Michael, that was different about healthcare in the industry because we were caring with a lot of patients with COVID.

So then their family became a concern, their children, their other neighbors. So some of them had to take some pretty drastic steps to ... because we weren't sure. We didn't know a lot in the beginning to fulfill their professional purpose and duties while they were still doing what they thought was right for their families. So I think that ... I just wanted to add that as something I thought was different for healthcare. I think other industries experienced it too, depending on the interaction they had directly with people with the virus on that. So back to who do we look for? Obviously, we recruit from all sectors.

We have not only the need for physicians and nurses and pharmacists and the health professionals, but we also need team members from the hospitality side for our food and nutrition, environmental services. We have a lot of need then for engineers and our IT and business offices and our professional services. So we do recruit from across the whole community. And what we do is we believe that we can help people develop their applied learning and their technical skills and experience, but it's hard to really have someone learn to be compassionate. So we do look and have some ways of really ... especially if they're going to be very close to patients or consumer facing.

We feel that our values of serving with compassion, honoring every voice and always knowing that we can get better, require that there is more of a purpose-driven draw to healthcare because you're really working with fellow human beings. So we do think that's important. Now, we do have roles that are not close to the patient facing or consumer facing that is not as high a priority. So we want to make sure that we're looking at their values or integrity and that compassion side because it still shows up in their compassion for each other and how they serve each other to serve the patient. So I would say those are the biggest things.

Obviously, we have to have licensed nurses and all those credentials, but really one of the most important common ingredients is that kindness and compassion component.

Michael Bush:
And did you find from your long experience in healthcare ... I guess two things I'm wondering about. One is just the unthinkable amount of pressure on you and your team during the crisis, what did you learn about yourself during that time?

Candice Saunders:
Yeah, I remember obviously, we've always had a health system where people need us 24 hours a day, 365 days of a year. So whether it's acute services or doctor's offices, we're here to take care of people 24 hours a day. And all of a sudden, as you know, early in the pandemic people, where they were asked to stay home, shelter in place, go home. And that became a challenge for some members of our community because they didn't have the proper home or the IT services and all that. So we had to start working and be creative and helping them still be able to get access to the online learning for their children and different things of that nature.

What I learned was that everyone looked to me or to my team for answers. So it was very important and we didn't have it. We didn't have all the answers. Especially the first month of the pandemic, there was so much conflicting information both on the worldwide side as well as on the national and state and local that all of a sudden we had to just really get out there and stay on top of all the information, sort through it, to really become that trusted voice or source of information. I remember thinking, and I sometimes just had to say to the team, because we went to doing state of the systems where we would just broadcast and I'd have 5,000 people on and just say, I'm going to give you the updates as we have them.

I've heard your questions, we're listening. We're working on finding answers, but we don't know right now. All I know is that right now these are things we're going to continue to do. Know that we are all working on continuing to make sure that we bring you the most up-to-date information so that you can focus on taking care of patients. At that ... we kind of pride ourselves in having the answers and being the one that can provide that hope and calmness, and we still had to do that, but do it without having all the answers. So I remember many late nights sitting there going, we're going to get through this. And you know that we're going to just, by working together, staying close together.

And as I mentioned earlier, I do think the work that the journey that we've been on, with our ... putting our people first really in action, not just words. We have a no layoff policy. They know that we continue to invest and the benefits for them and in supporting them in different ways and more importantly that we were being very transparent and honest, and also ... so that built trust even and during times where we didn't have the answers.

Michael Bush:
Yeah. Well, the numbers tell a really important story where just in normal business, this work of creating a high trusts workplace, which is what you're describing, one where people trust the leaders even when the leaders don't really know how to predict the future, this is trust at the highest level. And through the survey experience where you have over 20,000 employees, I think at one of our survey windows I took look at, it's almost 21,000 and you surveyed them all. Okay, we have some customers who survey 5,000.

Candice Saunders:
We do it all.

Michael Bush:
Which is just the ultimate show of respect to every employee. I mean, that's what you do when you're doing that. And then, looking at the results where 86% of the people said that my direct manager cares about my wellbeing. That's 86% during these really difficult times, that my direct manager takes the time to have meaningful conversations with me throughout the year about my performance and development, 84%. And then, I value the programs that this company offers to me to help maintain or improve my physical health and wellbeing. 84%, so this is during the toughest of times in history, 84, 80, 86%. What were you doing ... I want the magic wand first of all.

What were you doing to continue to assure that your vice presidents, mid-level managers and where the rubber meets the road for these numbers, frontline supervisors were able to handle the pressure and yet stay focused and open and caring and compassionate about the people who were on their teams.

Candice Saunders:
Yeah, and I think you ... as you said on that, caring and compassion, the leaders, that frontline leader as you know in our work together becomes so important. So what we have is we would be looking at multiple means of communication that we needed to get out. And in the five generations, they all have different needs for the type of communication and the way they receive it, but I will tell you the one that's ... from my days at the bedside and now in the boardroom, it still comes down to that trusted leader. So to make sure that they have the leadership toolkits, they have a chance to talk about where we're at and what needs to happen, and be done. When we were redeploying people all to the front line that took leadership.

That took those managers to say, I know that this is going to change your life up, but we need everyone at the front line taking care of patients right now. So we still made sure that they were very informed and had the information while we were providing other communication. The other thing that helped us is through our great place to work, we do ... it's a very action-oriented approach to us. When we get the results from the survey, we are very transparent and open with our people to share those work group results. So we share the overall results of the company, we share the care site or the business unit and then the local work groups.

So the action plan, they talk about the results. What do they want to continue to strengthen? What do they want to ... maybe something that needs to get stronger, but it's driven by their work together. So that too ... again, my voice matters. This is not just giving you a survey result. I'm actually ... you're going to do something with it. Then, what we do at the system level is we look at common areas. So one of the things that kept coming back on the survey was people wanted to have an individual development plan. They didn't want to just come and take a job with us in IT. They wanted us to sit down with them and talk about what their ambitions were, what they were looking to do, and start developing that individual plan.

And then, what we also were very intentional about is cross-functional teamwork because you just really can't do what we do today without that. So I share that because that already is part of our culture. That was something that we were already doing and we know the direct relationship to the survey feedback between action planning and having intentional approach to it and really improving the engagement and the trust. So that was already going on and I think it helped us significantly as we had to navigate together the ups and downs of the pandemic. The other thing that we had just completed was we had gone through a lot of merger and acquisitions during that 2016, 2017 timeframe.

So you brought together all this rich history of these different hospitals and physicians and different markets. So we went from a five market to an 11 market company in Atlanta. So, we had just completed listening tours, probably about a year before the pandemic because we wanted to come up with a unified brand and also, revisit the mission, vision and values because we had different markets with different historical approaches to that. We had just gotten together all that, pulled it all together and worked on what did we think represented us, what was our purpose and what really was ... what people thought about us, our team members, our community, our patients.

That's when we came up with more than healthcare people care. It was all about the people. We had just completed all that and gone on out of our socializing, gotten out in January of 2020. If I look back, I would never know, that helped us too because do that work and talking and cross market and people were proud of coming up with our values of serving with compassion, honoring and revoice and continuous commitment to excellence, and that helped. Then, that mission of improving the health and wellbeing of every person, every time. A safe quality experience, not only for our patients and our consumers, but for our physicians, nurses and team members.

So some things happened for a reason, but that really was an important part of these ... I think these results. So it wasn't something we just did during the pandemic. It was our journey and then, we've also renewed during the pandemic, we'd already been on the journey of our diversity, our equity, inclusion and belonging. Obviously, that also brought to bear some opportunities for whereby listening we could strengthen our work together. And that just to me just is kind of another add on the importance of that honoring every voice.

Michael Bush:
Yeah. Well, a couple of things that you said that really stood out to me. One of them is the mentioning of diversity, equity, inclusion and belonging, which became really important during the pandemic for many, many reasons, but without trust, you can't have any of those things. It will not grow. Then, the other is in 2020, CEOs would call me and say, "We have a really low trust culture, and what can I do to build trust now?" And I'm like, incense and prayer maybe. Okay, that was the wrong time to try and build trust in an organization. So you had the advantage of already doing what was best for people and being able to carry that through the pandemic.

And I know in terms of leadership development, which you can't have the scores you have without your leaders working to get better every day, it's just not possible. We know this, our research tells us this, and I know you like role plays. So can you talk a little bit about why and what do you feel that that's done and why you feel like that's such an important part in leadership development?

Candice Saunders:
As we look at our leadership development, just as I spend a lot of time, a lot of my time is on development of our people, and our leadership side. What I've learned is that you can read about it, you can actually go to a class about it, and we have all that. We have it during our orientation. We have new manager, orientation, we have middle manager development and leadership classes. We have a physician leadership academy. So we do put a lot of investment in what I call more of the classwork and the teamwork and all those assignments when you had to work on something as a team. And then, we also offer support for people to go back to school and get advanced degrees or even to move from one part of our service area to another.

What I learned was that, to really develop the courage in the committee room and in the boardroom, it takes some practice. It takes time where they ... so were they actually in a safe environment and watching someone else do it and learning, seeing that and say, "Oh, they didn't do a good job at that at all," or I could have done that better. And many times they're play-acting how not to do it and how to do it. We just got back from a leadership retreat, so we actually invest in our team retreats and we go offsite. What I say to all these type A leaders, which I can relate to, I'll say, this is not time for solving a problem or attacking what you think is most important in the workplace.

This is your time to now practice these different skills, and the last one was about conflict. How do you handle a high conflict conversation? And I think I would've loved to have you in the room because I so enjoyed, because they first did the how you wouldn't do it and then how you would do it. At first, these were some physician leaders. At first I thought, I'm always ... when I first go into these retreats and we're kind of choosing the topic and they always tell me, "Role playing makes this hard, Candice. It makes me a little feel self-conscious." After about an hour, they got into it. Let me tell you, there was no self-conscious, but the role playing helps them feel safe that they're practicing it.

I was just amazed where they felt that breaking out in groups and small groups and really practicing it, they were all thinking about a high conflict conversation, they'd been avoiding they were going to go back and do. Our whole thing is practice here, get safe here and then, go back and use some of these new skills in the workplace or applying it, but it's my standpoint. Now, it's when they really see that these tools can help them be more effective leaders, but do it in a way with kindness, because we do ... in healthcare, we take care of fellow human beings, but performance matters. People want safe quality experience. They have a need for their time to matter in more consumer exchanges that we have in our offices and that.
I do think the role modeling and where they can see it done well and where they can see it, but then talk about it in a constructive way helps bring it back into the applied, and I do think that helps them feel more ... have more mastery with it is what I learned on it.

Michael Bush:
I like how the practice, the role play, the hypothetical, the fictional, surfaces some real need to go and do this tomorrow. There's something the subconscious brings forward, kind of the reward for the humility and the practice and doing something uncomfortable is something coming up that's really important that you actually didn't realize you were getting trained to do and the benefit from that. So all, again, back to compassion and people who not only want to learn what other people might be experiencing, but they want to do something that's going to be difficult yet better for that other person

Candice Saunders:
Yeah, when they share their successes and their failures, they do. They share both, but I do think they also see the importance of body language and other dimensions that sometimes you don't get if you're not looking at yourself. Okay? So it's on ... we're on a journey with it. I tell my fellow colleagues, it has to be part of your overall culture that you believe that this is something that we will continue to work on, be intentional. It's not a one and done and then, as you mentioned, when the team members drive what they need to help with their wellbeing and to support them in their lives and in their work. We call it our MyCare, and we say, you can either choose some days off for your getaway or you can choose a bonus payment.

You might have some life needs that would require you to have some more cash during that period, but you let them have choice. It's just that it has to be something that you make part of who you are.

Michael Bush:
So say a little bit more about that MyCare Rewards program. Just let our audience know.

Candice Saunders:
Yeah, it was something that did come out of the pandemic when we were moving fast, we had to help them get access to teachers. We were doing pods for teachers, because we were helping our team members. Those children's schools were closed. Some of them had access to wifi, others didn't. Some of them had multiple children. So what we did is we went ... and we started to put together, we called it, it's MyCare. It's because we were saying to them, take care of yourself, take care of your wellbeing, as we're helping take care of the wellbeing of each other as well as those we serve. We found initially that a lot of the nurses and doctors were reticent to go visit with a counselor or someone in the mental health field because they were like, we're doctors, we're nurses.

We can do this. So we didn't get as much usage of it until we started using some of the online apps and where they could access it privately. Also, we put these wellbeing rooms right where frontline and where the action was, where they could go to a room, have a time, listen to music, relaxation chairs and then, they were more prone to use that counselor if they just needed to talk through as someone the fears or some of their anxieties of losing patients or continuing every day to face large volumes of patients during the pandemic. So we said ... we called it the MyCare Program because it had menus and choices, so that people could select things based on their role or what they needed.

Our biggest thing was we want you to take time away and we're going to work together to make that happen. They were working overtime, long hours to support each other. There's a big support that comes from nurses and doctors and the other health professionals on not wanting to leave their colleague there without their support. So the MyCare program continues to evolve today. We're going to continue to build on it, but it really comes from the voice of our people on ... we did a pass to all the state parks in Georgia, a very favored one by the way, where we were encouraging people to get out in nature, because they couldn't go to some of the traditional social things.

So a nice hike in the park and be able to get into the park gave them again, another ... just take them away from the day to day. Those were some of the smaller things, but probably, I think some of the feedback, some of the most impactful for some of them that we were thinking about how they could have still some time away and that would also be supporting their health and wellbeing on it. So again, something that was very tailored to what we were dealing with, because we did ... I could write a book on the waves of the pandemic, as I'm sure you could through your work with all of us. Some parts of the pandemic affected the team members more because they all got sick from the community spread to then all of a sudden people wanting the vaccine.
And there wasn't enough to ... then the vaccine was plentiful, but then there was controversy about requiring the vaccine. So there was a lot of ups and downs, but I think the common denominator is when you're focused on a culture of trust and a culture where I'm going to come out and I'm just going to let you know I don't have the answer today, but we've heard your questions and we're going to continue to try to get the answers you need. Then, honoring that, most of them said, that's all we're asking. We just want to know that someone is out there because while we're busy taking care of the patient, we just want to know that our leaders are working hard to ensure ... looking ahead to ensure that we have the best thinking and their best efforts.

Michael Bush:
And in healthcare, you've got an industry where when you have subpar performance, the results are terrible, a high level of performance, sometimes people think that a great place to work is everybody is just happy all day every day. So one of the things that I'd like you to talk about, because I've heard you talk about it, is about accountability and 200% accountability.

Candice Saunders:
Yes, and so in healthcare as I always say, it's compassion, but we all look for capabilities. We want to have individuals that are capable and confident, and that's our part of our role, our responsibility is to continue to develop that. And then obviously, the compassion and caring. What we work a lot on is this 200% accountability that we've talked about, Michael. It started in the safety and quality area, and that as we really want to make sure we have a safe environment as well as the quality work, it's both our team member's safety as well as the patient safety. So in that 200% accounting means that when you and I go in and you're doing some of the areas of our work that do require precision, they require 100% following of the guideline, then I'm with you.

And if you decide to take a shortcut that day, the 200% accountability comes in that I say, "Michael, remember that we know that if we follow this process first time every time, we'll get the outcome, the best outcome for the patient." So it's me feeling comfortable or also accountable to you to say, I know you probably were tired, you want to take a shortcut, but I'm here for you and we need to ... what can I do to help us do this in the manner that we know, is going to get the best outcome for the patient? So we've moved that now to all parts of our work, because it's like how we look out for each other. Even, it's not okay for me to say, well, that's Michael's responsibility. My part of the work is fine over here.

If Michael is not meeting deadlines and Candice is over here, it doesn't help to complain about Michael, whatever, I need to have the courage to go sit with Michael and talk about, the fact that he didn't meet the deadline and how that affected my work or the rest of the teamwork, and that's that accountability, but doing it in a way that it's back to the purpose of the company and it's about going to Michael in a respectful, supportive way or Candice or any member of the team and then, if we're not successful in getting Candice to change or whatever, then having the courage in the meeting room to say, not again. Not in a accusatory way, but in a respectful way, we're behind on this project because we've not been able to get this component done.
To me, that's accountability that's affecting the results of the company or what we need to do for patients. That takes a lot of training and time off in our teamwork that we do, but it's getting people to see it because sometimes they'll say to me ... kind people will say, "Well, that's like throwing Michael or Candice under the bus." I'm like, no, that's being accountable to those we serve and the overall performance and purpose of the company, and you're doing it for that reason. That's your intent. Not because you're mad at Candice or Julie or Joanie. It does take ... I'm amazed that it takes a lot of work to get people to not feel like that is ... they're basically playing along to get along.

And I believe that's a very dangerous thing for companies. So I say to the team, this is something that many of us will be a little clumsy, may not be as refined, but we need to help each other to get better at it, whether it's in the boardroom, in the committee room, but more importantly on the front line, that we should all be open to someone saying that we might've missed something or didn't get it, did not get our part done in order to make sure our mission is accomplished. So, it's a very ... it's a more maturing part of the culture, but I do think that it resonates with people when they start to see that it's about moving the work of the team.

And also, it is really more kind if you talk about somebody that's not in the room. I said, how's that helping them or helping the overall team. So you can tell I've had a lot of one-on-one time on this one.

Michael Bush:
Yeah, I think Candice, you're describing this is the highest level of trust and you got to work your way there.

Candice Saunders:
Yes.

Michael Bush:
And there's always work to do, but that's what you're describing that somebody nudging me is because they care that I succeed.

Candice Saunders:
That's right.

Michael Bush:
It takes work. You don't still start that, but it's what the hard work will enable you to do. And then, you create this culture where people are ... 20,000 people are caring if the other 19,999 succeed.

Candice Saunders:
Exactly. I love it. I love how you ... It is, it gets down to, feedback is a gift. Once you start to get comfortable with it and not avoid it, it's really a gift. And I mentioned to you how we do 360s, not from a punishing, but from an improvement. From a feedback, performance improvement. Everyone does a 360 and I'll never forget I told you about when I had these physicians walk into me and say, we want to have 360s too. I looked down, I'm like ... because I thought now, I have made it to another milestone here.

Michael Bush:
Yeah. Yeah.

Candice Saunders:
People walking in and asking me they need to have their 360, and guess what, every one of my physicians leaders completed them. They got with their feedback on it and working on their development, but you're changing the culture from one of feat of the 360 is punitive or when you're, "Candice must be having problems," to everybody wants to know how they're doing and where they can get better and how they can be a better contributor, but also a better teammate. And so it takes away that thinking that it's more about punitive versus development, and it really does build stronger teams because they start to now, crosspollinate with that.

I will have to say that'll go in any of my summaries of this work, because people tell me, no, you'll never change that connotation. People are still always going to be nervous about it. I said they will be ... they are nervous about it and they want to select who does it, and I try to encourage them to have a diverse panel, but once they start to experience it and then, give feedback, they start to see it is a gift. You're really helping someone and as you said so well, it's really looking out for them.

Michael Bush:
Yeah.

Candice Saunders:
Because you didn't care about them. You could just say, "Oh, you're doing great, Michael. Yeah, you're wonderful. You're wonderful, Michael." Even though you have some specific areas, you could offer him to be better.

Michael Bush:
Yeah. Well, you've gone to healthcare administrator heaven. I was in healthcare for 13 years and I won't say where, but the idea of physicians asking-

Candice Saunders:
I know.

Michael Bush:
Yeah, so-

Candice Saunders:
And then they have coaches. I mean, so this is my executive team, I had to kind of coach some ... kind of get them to go in there. So I share that because ... I share with my fellow leaders, never be afraid to try. I mean, there are days when you're up there, as you know, and I'm thinking, "Oh, I wonder if they're going to find the focus of this team building to be one that they can get into." And I always share that with them. I'm very vulnerable. I said, I put this together, but it's just high level. It's all going to be in your hands how it comes together. I encourage my colleagues to invest in it. I do think as CEOs we need to be there and visible and really reinforcing that this is important work.

Because it's constantly changing, as you and I talked about before. Yeah, we'll look at where we are today and we'll celebrate as you encourage us to do, but then, we know that I have new people coming in. The demands of the market are changing. We're self-inflicting strategic destinations, that we're purposely moving our business into this digital operating world, which alone is a mind shift change for the company. So that strong culture helps you, but then you still have to change management and you still have to be intentional and you still have to be changing it up.

Michael Bush:
Yeah. Candice, I just got a couple more questions for you. One of them, everybody knows healthcare has been under attacked financially for 25 years in terms of the landscape constantly changing and people having to do tremendous work with less year in, year out and then, coming through the pandemic and then, you've decided to invest $2.7 million annually in education and career development. I mean, it sounds like a wonderful thing to do, but that's a really hard thing to do, to make that investment and to find the money to do that. So how do you make a decision like that and then, implement a decision like that, as a leader getting the support for it and so on?

I think that would be very inspiring for everybody listening who's trying to find more during these uncertain times.

Candice Saunders:
Yeah, and to your point, sometimes it catches people a little off guard when they look at the order of magnitude of some of these investments. And just to give you an idea with the MyCare to give another day off or two days off or bonus. You're looking at million investments because when you have 20,000 people, 30,000 people, all different levels of work and members of the team, so they're big investments. So again, that really again, is another indicator of the intentionality of the board and the leadership team. So on the educational side, we just see that it's kind of one of those must haves as we continue to have people learn and grow with us.

As a learning organization, we're constantly needing to learn more about the latest developments, not only in the healthcare and the care people technology, but also how learning and the diversity and the health equity aspects of our care. So we see it as a must have and so, it's similar to our safety and quality efforts. So as a not-for-profit health system, we do operate in less scarce resources. The only dollars we have come from running our operations because we get the revenues for patient care services, doctor services, outpatient. So it really is, are those surpluses that we have to invest back into merit increases for our people based on recognizing their hard work.

If we need to do market adjustments based on changes, supply increases, and it's gotten harder through the pandemic and then, as we were coming out of the largest throes of the pandemic into ... we got into this double-digit inflation that was hitting all the industries. I'd meet with some of my other cross industries at the chambers and all that, and they would say, "Well, we're going to have to increase prices." Well, healthcare is not a ... it's a flat reimbursement environment. Once you do the governmental payers, which are one of our largest percent of payers, it's flat fixed rate of reimbursement. And then our contracts with the other payers are also fixed.

So you have to really continue to work on being effective and efficient and eliminating waste, but you still have to prioritize your people because to me that's educating ... we do so much with our elementary schools, our middle schools, our high schools, our universities, because again, that's our future workforce. We also have a program that we do with our pediatricians and with our communities on reading to newborns from the point of ... well really now when they're still in utero, they're actually having moms and dads read to, at that point. Then, in our pediatrician's office, we introduced the parents and the grandparents to reading.

We know that the largest portion of their ability to learn and will help them throughout the rest of their life occurs before they even go to kindergarten. So we see it as just essential must have and we have that same opinion about supporting our team throughout their ... we want them to come and stay with us and continue to learn and grow. So we want to make sure they have that investment in their education, and we've had team members start with us in our food and nutrition services, right out of high school and go right on and get support, go back to school and get a nursing degree. They had one go to become a physician assistant, then went on to be a doctor.

So we want to make sure that we're supporting them. So I agree with you. When we're in those meetings and we're prioritizing, and I know you've been in those meetings, you have to sit there and say, "Okay, yes, this is new investment and we're going to have to figure out how we do it, but it's consistent with our mission and our purpose and it's putting action with the words."

Michael Bush:
So Candice, this is my last question. With all the success, and just on behalf of the people of Georgia, I thank you for what you're doing, especially with the environment within which you've done it, which is truly remarkable. What are you working on as a leader? When you're designing the role play or maybe participating, what comes up for you now at this point in 2023 in terms of something that you're working on, to improve on?

Candice Saunders:
One of the areas ... I'm a strategic big thinker, okay? I realize that about myself, but I'm also very clear about where we need to go and what that ... I can see the destination many times before, some of my team members or others might. So I'm learning to be more intentional of what I call situational leadership, where I'm more ... we know about some style. I laugh, I have several that are very detailed oriented. So I'm a big picture 30 on the Myers-Briggs, and they're 30 on the S side. So I really have had to be more intentional on meeting them where they're at for that need for detail, because I'm more broad stroke, here's the concept, here's some framework, kind of go struggle and figure it out.

Some of my leaders love that. Some are like, "Oh, thank you. That's the best thing I heard all day." She knows there's a place we want to go. She probably knows how she would get there the fastest, but she's saying to me, "You go, let me know," because They come back with some ... I'm like, "Wow, that's a way of ... I would've never figured that out," but then, there's some that need me to give them a little more specific. So I have to be intentional about it because it's not my nature. I think we all have our styles. So I am working on that. Then, it comes down to still saying to that leader, you need struggle some though. It's important, the struggle is important as you're learning.

I have two sons, but I also now have two granddaughters. I watched this two year old and five-year-old now, and there is a struggle as they start to learn ... and even though you could get those shoes on fast and let's go, you got to sit there with the two-year-old and I watch my son and I'm just so proud of him because he's like, "She'll get them on mom, eventually." An hour later, she's still struggling with her shoes. So I bring that back to the workplace because I'm like, "Yeah, I could do it. I could be the one presenting it at the board meeting. I could be the one," because I do ... it's not so much, it's just the experience level, you have learning over time and after you do it so many times.

I say, no, you need to do it. You need to present and tell me how you want to do it. So tell me how to do it. No, no. Tell me how you want to do it and we'll shape it. So you need to allow a bit of that struggle and starting as a nurse at the bedside, you want to help people. I've gotten better at saying, "No, it'll end up being ... you'll have more accomplishment if you struggle a bit on it. And you'll also come up with some of the different way to do it." And that's another kind of confidence building that I see is really our job is to lift others and get them stretching, to keep moving into the next role as we succession plan.

And we're building this pipeline of having internal talent ready to take on the roles in the company. We're still going to probably have to do a mix of some external recruitment just because I think you get some ... as you're moving to new places, but that is part of an intentional way. So yeah, you'd have to ask the team how I'm doing with that.

Michael Bush:
Okay, we will. We will. Thank you very much, Candice. Thank you for sharing that too. That's not easy to do, but it's very inspiring and just the idea ... like the need for the struggle, the benefit of the struggle and the belief that you can struggle and you're going to be stronger as a result, which is an ultimate show of respect and care for another person. So before we invite our friend Matthew back in, I just want to share this quote with you that I'm going to read. It came right from your survey. This is from one of your employees. "Starting at Wellstar, it gave me my work life balance back. This is starting at Wellstar, a healthcare organization gave me my work-life balance back."

"I was offered a competitive salary, good benefits and receive recognition when I do good work, my manager and his direct bosses are very open and receptive to hearing the team's ideas and needs. I have never had more approachable managers. I plan on staying at Wellstar a long time due to the great leadership on my team." So congratulations for getting that comment and best to you and your team, and thank you for your time today. Spreading this good information to those who are also trying to work to create a high trusts workplace. Matthew, can you come back in and join us?

Matt Bush:
Thank you so much, Michael for leading us to the conversation, and thank you Candice, especially for just sharing your wisdom so openly and vulnerably. I hope that all leaders, both current and aspiring, were taking really careful notes there. If you're watching today and you would like more information or have questions, please email us at This email address is being protected from spambots. You need JavaScript enabled to view it.. And today's session, will be posted in our website within an hour. So if you're one of those leaders who realize that you probably should have been taking really good notes along the way but didn't get a chance to, feel free to go ahead and watch it back to make sure that you capture all of Candice's wisdom and make sure to forward the video as well, to anyone else you think may benefit from what's been shared today.
So Candice, thank you again so much for your time. Thank you for your leadership, Michael, and thank you, the viewer for watching today.

Candice Saunders:
Thank you, Matt.

Matt Bush:
Take care.

Candice Saunders:
Bye-Bye now.